High risk blood pressure and obesity increase the risk for left ventricular hypertrophy in African-American adolescents.

PubMed

Falkner, Bonita; DeLoach, Stephanie; Keith, Scott W; Gidding, Samuel S

2013-01-01

To examine the relative effects of high blood pressure (HBP) and obesity on left ventricular mass (LVM) among African-American adolescents; and if metabolic or inflammatory factors contribute to LVM. Using a 2 × 2 design, African-American adolescents were stratified by body mass index percentile (body mass index <95th percentile = non-obese; ≥ 95th percentile = obese) and average blood pressure (BP) (normal BP <120/80 mm Hg; HBP ≥ 120/80). Glucose, insulin, insulin resistance, lipids, and inflammatory cytokines were measured. From echocardiography measures of LVM, calculated LVM index (LVMI) ≥ 95th percentile defined left ventricular hypertrophy (LVH). Data included 301 adolescents (48% female), mean age 16.2 years, 51% obese, and 29% HBP. LVMI was highest among adolescents with both obesity and HBP. The multiplicative interaction of obesity and HBP on LVH was not significant (OR = 2.35, P = .20) but the independent additive associations of obesity and HBP with log-odds of LVH were significant; obesity OR = 3.26, P < .001; HBP OR = 2.92, P < .001. Metabolic and inflammatory risk factors were associated with obesity, but had no independent association with LVMI. Compared with those with average systolic BP (SBP) <75th percentile, adolescents with SBP from the 75th percentile to 90th percentile had higher LVMI (33.2 vs 38.7 g/m(2.7), P < .001) and greater LVH (18% vs 43%, P < .001), independent of obesity. Prevalence of LVH is highest among African-American adolescents with average BP ≥ 120/80 mm Hg and obesity. There also is an independent association of LVMI with BP, beginning at the 75th SBP percentile. Copyright © 2013 Mosby, Inc. All rights reserved.

Menstruation disorders in adolescents with eating disorders-target body mass index percentiles for their resolution.

PubMed

Vale, Beatriz; Brito, Sara; Paulos, Lígia; Moleiro, Pascoal

2014-04-01

To analyse the progression of body mass index in eating disorders and to determine the percentile for establishment and resolution of the disease. A retrospective descriptive cross-sectional study. Review of clinical files of adolescents with eating disorders. Of the 62 female adolescents studied with eating disorders, 51 presented with eating disorder not otherwise specified, 10 anorexia nervosa, and 1 bulimia nervosa. Twenty-one of these adolescents had menstrual disorders; in that, 14 secondary amenorrhea and 7 menstrual irregularities (6 eating disorder not otherwise specified, and 1 bulimia nervosa). In average, in anorectic adolescents, the initial body mass index was in 75th percentile; secondary amenorrhea was established 1 month after onset of the disease; minimum weight was 76.6% of ideal body mass index (at 4th percentile) at 10.2 months of disease; and resolution of amenorrhea occurred at 24 months, with average weight recovery of 93.4% of the ideal. In eating disorder not otherwise specified with menstrual disorder (n=10), the mean initial body mass index was at 85th percentile; minimal weight was in average 97.7% of the ideal value (minimum body mass index was in 52nd percentile) at 14.9 months of disease; body mass index stabilization occurred at 1.6 year of disease; and mean body mass index was in 73rd percentile. Considering eating disorder not otherwise specified with secondary amenorrhea (n=4); secondary amenorrhea occurred at 4 months, with resolution at 12 months of disease (mean 65th percentile body mass index). One-third of the eating disorder group had menstrual disorder - two-thirds presented with amenorrhea. This study indicated that for the resolution of their menstrual disturbance the body mass index percentiles to be achieved by female adolescents with eating disorders was 25-50 in anorexia nervosa, and 50-75, in eating disorder not otherwise specified.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

PubMed

Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

2015-03-01

A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

Reference centile curves for wrist circumference for Indian children aged 3-18 years.

PubMed

Khadilkar, Vaman; Chiplonkar, Shashi; Ekbote, Veena; Kajale, Neha; Mandlik, Rubina; Khadilkar, Anuradha

2018-01-26

Childhood obesity and its consequences have reached alarming proportions worldwide and in India. Wrist circumference is emerging as an easily measurable reproducible parameter for screening children at risk of obesity-related morbidities such as hypertension and insulin resistance. The objectives of this study were: (1) to compute age and gender-specific wrist circumference percentiles for 3-18-year-old apparently healthy Indian children and adolescents; (2) to assess the relationship of wrist circumference with measures of obesity and adiposity such as body mass index (BMI), fat percentage and blood pressure (BP) and (3) to suggest age and gender-specific cut-offs for wrist circumference percentile for the risk of hypertension in Indian children and adolescents. This was a cross-sectional study on samples of 10,199 3-18-year-old children (5703 boys) from randomly selected schools from five major cities in India. Height, weight, waist and wrist circumference and BP were recorded. Body composition was measured using bioelectrical impedance analysis (BIA). Wrist circumference percentiles were computed using the LMS method. The average wrist circumference of boys and girls was 10.4 cm and 10.0 cm at 3 years and increased to 15.1 cm and 13.9 cm, respectively, at 18 years. Compared to their Caucasian counterparts, Indian children's wrists were smaller. Receiver operating characteristic (ROC) curve analysis derived the 70th percentile of wrist circumference as the cut-off for identifying the risk of hypertension. Contemporary cross-sectional reference percentile curves for wrist circumference for 3-18-year-old Indian children are presented. The 70th percentile of the current study is proposed as the cut-off to screen children for cardiometabolic risk factors such as hypertension.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination

PubMed Central

Sisson, Stephen D.; Bertram, Amanda; Yeh, Hsin-Chieh

2015-01-01

Background A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. Objective We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). Methods A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. Results The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Conclusions Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE. PMID:26217421

Estimated monthly percentile discharges at ungaged sites in the Upper Yellowstone River Basin in Montana

USGS Publications Warehouse

Parrett, Charles; Hull, J.A.

1986-01-01

Once-monthly streamflow measurements were used to estimate selected percentile discharges on flow-duration curves of monthly mean discharge for 40 ungaged stream sites in the upper Yellowstone River basin in Montana. The estimation technique was a modification of the concurrent-discharge method previously described and used by H.C. Riggs to estimate annual mean discharge. The modified technique is based on the relationship of various mean seasonal discharges to the required discharges on the flow-duration curves. The mean seasonal discharges are estimated from the monthly streamflow measurements, and the percentile discharges are calculated from regression equations. The regression equations, developed from streamflow record at nine gaging stations, indicated a significant log-linear relationship between mean seasonal discharge and various percentile discharges. The technique was tested at two discontinued streamflow-gaging stations; the differences between estimated monthly discharges and those determined from the discharge record ranged from -31 to +27 percent at one site and from -14 to +85 percent at the other. The estimates at one site were unbiased, and the estimates at the other site were consistently larger than the recorded values. Based on the test results, the probable average error of the technique was + or - 30 percent for the 21 sites measured during the first year of the program and + or - 50 percent for the 19 sites measured during the second year. (USGS)

The Status at Two Years of Low-Birth-Weight Infants Born in 1974 with Birth Weights of Less Than 1,001 gm

ERIC Educational Resources Information Center

Pape, K. E.; And Others

1978-01-01

For availibility see EC 103 548 Among findings of a 2-year followup study of 43 infants of birth weight less than 1000 grams were the following: average height at age 2 years was between the tenth and twenty-fifth percentiles; average weight was between the third and tenth percentiles; 15 Ss developed lower respiratory tract infections during the…

A time-efficient web-based teaching tool to improve medical knowledge and decrease ABIM failure rate in select residents.

PubMed

Drake, Sean M; Qureshi, Waqas; Morse, William; Baker-Genaw, Kimberly

2015-01-01

The American Board of Internal Medicine (ABIM) exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate. Internal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤ 35 th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤ 35 percentile pre- (2002-2006) and post-intervention (2007-2013). A time commitment survey was also given to physicians and DR residents at the end of the study. Residents who never scored ≤ 35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤ 35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p < 0.001). This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response. Although residents who ever scored ≤ 35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty.

A time-efficient web-based teaching tool to improve medical knowledge and decrease ABIM failure rate in select residents

PubMed Central

Drake, Sean M.; Qureshi, Waqas; Morse, William; Baker-Genaw, Kimberly

2015-01-01

Aim The American Board of Internal Medicine (ABIM) exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate. Methods Internal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤35th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤35 percentile pre- (2002–2006) and post-intervention (2007–2013). A time commitment survey was also given to physicians and DR residents at the end of the study. Results Residents who never scored ≤35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p<0.001). This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response. Conclusions Although residents who ever scored ≤35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty. PMID:26521767

A time-efficient web-based teaching tool to improve medical knowledge and decrease ABIM failure rate in select residents.

PubMed

Drake, Sean M; Qureshi, Waqas; Morse, William; Baker-Genaw, Kimberly

2015-01-01

Aim The American Board of Internal Medicine (ABIM) exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate. Methods Internal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤35th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤35 percentile pre- (2002-2006) and post-intervention (2007-2013). A time commitment survey was also given to physicians and DR residents at the end of the study. Results Residents who never scored ≤35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p<0.001). This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response. Conclusions Although residents who ever scored ≤35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty.

Regression Equations for Monthly and Annual Mean and Selected Percentile Streamflows for Ungaged Rivers in Maine

USGS Publications Warehouse

Dudley, Robert W.

2015-12-03

The largest average errors of prediction are associated with regression equations for the lowest streamflows derived for months during which the lowest streamflows of the year occur (such as the 5 and 1 monthly percentiles for August and September). The regression equations have been derived on the basis of streamflow and basin characteristics data for unregulated, rural drainage basins without substantial streamflow or drainage modifications (for example, diversions and (or) regulation by dams or reservoirs, tile drainage, irrigation, channelization, and impervious paved surfaces), therefore using the equations for regulated or urbanized basins with substantial streamflow or drainage modifications will yield results of unknown error. Input basin characteristics derived using techniques or datasets other than those documented in this report or using values outside the ranges used to develop these regression equations also will yield results of unknown error.

Determining shapes and dimensions of dental arches for the use of straight-wire arches in lingual technique.

PubMed

Kairalla, Silvana Allegrini; Scuzzo, Giuseppe; Triviño, Tarcila; Velasco, Leandro; Lombardo, Luca; Paranhos, Luiz Renato

2014-01-01

This study aims to determine the shape and dimension of dental arches from a lingual perspective, and determine shape and size of a straight archwire used for lingual Orthodontics. The study sample comprised 70 Caucasian Brazilian individuals with normal occlusion and at least four of Andrew's six keys. Maxillary and mandibular dental casts were digitized (3D) and the images were analyzed by Delcam Power SHAPET 2010 software. Landmarks on the lingual surface of teeth were selected and 14 measurements were calculated to determine the shape and size of dental arches. Shapiro-Wilk test determined small arch shape by means of 25th percentile (P25%)--an average percentile for the medium arch; and a large one determined by means of 75th percentile (P75%). T-test revealed differences between males and females in the size of 12 dental arches. The straight-wire arch shape used in the lingual straight wire technique is a parabolic-shaped arch, slightly flattened on its anterior portion. Due to similarity among dental arch sizes shown by males and females, a more simplified diagram chart was designed.

Use of probability analysis to establish routine bioassay screening levels

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

Carbaugh, E.H.; Sula, M.J.; McFadden, K.M.

1990-09-01

Probability analysis was used by the Hanford Internal Dosimetry Program to establish bioassay screening levels for tritium and uranium in urine. Background environmental levels of these two radionuclides are generally detectable by the highly sensitive urine analysis procedures routinely used at Hanford. Establishing screening levels requires balancing the impact of false detection with the consequence of potentially undetectable occupation dose. To establish the screening levels, tritium and uranium analyses were performed on urine samples collected from workers exposed only to environmental sources. All samples were collected at home using a simulated 12-hour protocol for tritium and a simulated 24-hour collectionmore » protocol for uranium. Results of the analyses of these samples were ranked according to tritium concentration or total sample uranium. The cumulative percentile was calculated and plotted using log-probability coordinates. Geometric means and screening levels corresponding to various percentiles were estimated by graphical interpolation and standard calculations. The potentially annual internal dose associated with a screening level was calculated. Screening levels were selected corresponding to the 99.9 percentile, implying that, on the average, 1 out of 1000 samples collected from an unexposed worker population would be expected to exceed the screening level. 4 refs., 2 figs.« less

Visual vs Fully Automatic Histogram-Based Assessment of Idiopathic Pulmonary Fibrosis (IPF) Progression Using Sequential Multidetector Computed Tomography (MDCT)

PubMed Central

Colombi, Davide; Dinkel, Julien; Weinheimer, Oliver; Obermayer, Berenike; Buzan, Teodora; Nabers, Diana; Bauer, Claudia; Oltmanns, Ute; Palmowski, Karin; Herth, Felix; Kauczor, Hans Ulrich; Sverzellati, Nicola

2015-01-01

Objectives To describe changes over time in extent of idiopathic pulmonary fibrosis (IPF) at multidetector computed tomography (MDCT) assessed by semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative evaluation and to test the relationship between these two methods of quantification. Methods Forty IPF patients (median age: 70 y, interquartile: 62-75 years; M:F, 33:7) that underwent 2 MDCT at different time points with a median interval of 13 months (interquartile: 10-17 months) were retrospectively evaluated. In-house software YACTA quantified automatically lung density histogram (10th-90th percentile in 5th percentile steps). Longitudinal changes in VSs and in the percentiles of attenuation histogram were obtained in 20 untreated patients and 20 patients treated with pirfenidone. Pearson correlation analysis was used to test the relationship between VSs and selected percentiles. Results In follow-up MDCT, visual overall extent of parenchymal abnormalities (OE) increased in median by 5 %/year (interquartile: 0 %/y; +11 %/y). Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram. Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; p<0.001) as compared to Δ 80th percentile (r=0.58; p<0.001); closer correlation was found between Δ ground-glass extent and Δ 40th percentile (r=0.66, p<0.001) as compared to Δ 80th percentile (r=0.47, p=0.002), while the Δ reticulations correlated better with the Δ 80th percentile (r=0.56, p<0.001) in comparison to Δ 40th percentile (r=0.43, p=0.003). Conclusions There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities. PMID:26110421

Predicting Success for Actuarial Students in Undergraduate Mathematics Courses

ERIC Educational Resources Information Center

Smith, Richard Manning; Schumacher, Phyllis A.

2005-01-01

A study of undergraduate actuarial graduates found that math SAT scores, verbal SAT scores, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam had some relevance to forecasting the students' grade point averages in their major. For both males and females, percentile rank in high school…

Assessing the impact of local meteorological variables on surface ozone in Hong Kong during 2000-2015 using quantile and multiple line regression models

NASA Astrophysics Data System (ADS)

Zhao, Wei; Fan, Shaojia; Guo, Hai; Gao, Bo; Sun, Jiaren; Chen, Laiguo

2016-11-01

The quantile regression (QR) method has been increasingly introduced to atmospheric environmental studies to explore the non-linear relationship between local meteorological conditions and ozone mixing ratios. In this study, we applied QR for the first time, together with multiple linear regression (MLR), to analyze the dominant meteorological parameters influencing the mean, 10th percentile, 90th percentile and 99th percentile of maximum daily 8-h average (MDA8) ozone concentrations in 2000-2015 in Hong Kong. The dominance analysis (DA) was used to assess the relative importance of meteorological variables in the regression models. Results showed that the MLR models worked better at suburban and rural sites than at urban sites, and worked better in winter than in summer. QR models performed better in summer for 99th and 90th percentiles and performed better in autumn and winter for 10th percentile. And QR models also performed better in suburban and rural areas for 10th percentile. The top 3 dominant variables associated with MDA8 ozone concentrations, changing with seasons and regions, were frequently associated with the six meteorological parameters: boundary layer height, humidity, wind direction, surface solar radiation, total cloud cover and sea level pressure. Temperature rarely became a significant variable in any season, which could partly explain the peak of monthly average ozone concentrations in October in Hong Kong. And we found the effect of solar radiation would be enhanced during extremely ozone pollution episodes (i.e., the 99th percentile). Finally, meteorological effects on MDA8 ozone had no significant changes before and after the 2010 Asian Games.

[Nutritional evaluation of adolescent students from Extremadura based on anthropometric measurements].

PubMed

Fernández Cabrera, Jacinta; Aranda Medina, Emilio; Córdoba Ramos, María de Guía; Hernández León, Alejandro; Rodríguez Bernabé, José Antonio; Pérez-Nevado, Francisco

2014-03-01

Nutrition is one of the pillars for proper body development and optimal nutritional status. Anthropometric methods are most commonly used for body composition analysis and are an essential part in the assessment of the nutritional status of individuals and population groups. This study aims to assess the nutritional status of adolescents from Extremadura (Spain); to determine variations in body composition according to the percentiles obtained; and to propose these values as a reference to the nutritional status of the adolescent population in Extremadura. A cross sectional study in the community of Extremadura was performed, including a total of 816 students of Secondary School Education of both sexes; and of all ages in the adolescence stage. The selected secondary schools belonged to populations of different sizes (less than 5,000 to more than 60,000 inhabitants). From the measurements taken, different anthropometric indices were determined and the percentiles 3, 10, 25, 50, 75, 90, 95 and 97 for weight, height and complexion were found. There were significant gender differences for height, weight, triceps skinfold, arm muscle area and arm fat area. Boys showed greater figures for height, weight and arm muscle area; however, the triceps skinfold and arm fat area was higher in girls. When compared to other national studies, the average height of our population was lower by about 3 cm in both sexes; the average weight was similar, but our adolescents had a higher proportion of fat in the arm. Extremadura girls seem to have a faster growth, reaching final height at an earlier age than the national average, although this height is below average. The boys had a continuous growth in all ages, maintaining national averages. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

A study of T2-weighted MR image texture features and diffusion-weighted MR image features for computer-aided diagnosis of prostate cancer

NASA Astrophysics Data System (ADS)

Peng, Yahui; Jiang, Yulei; Antic, Tatjana; Giger, Maryellen L.; Eggener, Scott; Oto, Aytekin

2013-02-01

The purpose of this study was to study T2-weighted magnetic resonance (MR) image texture features and diffusionweighted (DW) MR image features in distinguishing prostate cancer (PCa) from normal tissue. We collected two image datasets: 23 PCa patients (25 PCa and 23 normal tissue regions of interest [ROIs]) imaged with Philips MR scanners, and 30 PCa patients (41 PCa and 26 normal tissue ROIs) imaged with GE MR scanners. A radiologist drew ROIs manually via consensus histology-MR correlation conference with a pathologist. A number of T2-weighted texture features and apparent diffusion coefficient (ADC) features were investigated, and linear discriminant analysis (LDA) was used to combine select strong image features. Area under the receiver operating characteristic (ROC) curve (AUC) was used to characterize feature effectiveness in distinguishing PCa from normal tissue ROIs. Of the features studied, ADC 10th percentile, ADC average, and T2-weighted sum average yielded AUC values (+/-standard error) of 0.95+/-0.03, 0.94+/-0.03, and 0.85+/-0.05 on the Phillips images, and 0.91+/-0.04, 0.89+/-0.04, and 0.70+/-0.06 on the GE images, respectively. The three-feature combination yielded AUC values of 0.94+/-0.03 and 0.89+/-0.04 on the Phillips and GE images, respectively. ADC 10th percentile, ADC average, and T2-weighted sum average, are effective in distinguishing PCa from normal tissue, and appear robust in images acquired from Phillips and GE MR scanners.

The Accuracy of Aggregate Student Growth Percentiles as Indicators of Educator Performance

ERIC Educational Resources Information Center

Castellano, Katherine E.; McCaffrey, Daniel F.

2017-01-01

Mean or median student growth percentiles (MGPs) are a popular measure of educator performance, but they lack rigorous evaluation. This study investigates the error in MGP due to test score measurement error (ME). Using analytic derivations, we find that errors in the commonly used MGP are correlated with average prior latent achievement: Teachers…

A cross-sectional examination of the physical fitness and selected health attributes of recreational all-terrain vehicle riders and off-road motorcyclists.

PubMed

Burr, Jamie F; Jamnik, Veronica; Gledhill, Norman

2010-11-01

The aims of this study were: (1) to characterize selected fitness and health attributes of two types of habitual recreational off-road vehicle riders - off-road motorcyclists and all-terrain vehicle riders; (2) to explore differences among riders in terms of vehicle type, age, and gender; and (3) to compare the fitness and health of riders to population norms and clinical health standards. Canadian off-road riders (n = 141) of both sexes aged 16 years and over were recruited through local and national off-road riding organizations. Anthropometry, fitness, and health measures of off-road motorcycle and all-terrain vehicle riders were compared with population norms, health standards, and physical activity guidelines. Off-road motorcycle riders had above average aerobic fitness (79th percentile), while all-terrain vehicle riders were lower than average (40th percentile). All riders had a healthy blood lipid profile and a low incidence of the metabolic syndrome (12.9%) compared with members of the general population. Off-road motorcycle riders had healthier body composition and fitness than all-terrain vehicle riders; however, the body composition of off-road motorcycle riders was no healthier than that of the general population and all-terrain vehicle riders were worse than the general population. Off-road motorcycle riders had healthier anthropometry and fitness than all-terrain vehicle riders and thus fewer health risk factors for future disease, demonstrating that the physiological profiles of off-road riders are dependent on vehicle type.

Variability of runoff-based drought conditions in the conterminous United States

USGS Publications Warehouse

McCabe, Gregory J.; Wolock, David M.; Austin, Samuel H.

2017-01-01

In this study, a monthly water-balance model is used to simulate monthly runoff for 2109 hydrologic units (HUs) in the conterminous United States (CONUS) for water-years 1901 through 2014. The monthly runoff time series for each HU were smoothed with a 3-month moving average, and then the 3-month moving-average runoff values were converted to percentiles. For each HU, a drought was considered to occur when the HU runoff percentile dropped to the 20th percentile or lower. A drought was considered to end when the HU runoff percentile exceeded the 20th percentile. After identifying drought events for each HU, the frequency and length of drought events were examined. Results indicated that (1) the longest mean drought lengths occur in the eastern CONUS and parts of the Rocky Mountain region and the northwestern CONUS, (2) the frequency of drought is highest in the southwestern and central CONUS, and lowest in the eastern CONUS, the Rocky Mountain region, and the northwestern CONUS, (3) droughts have occurred during all months of the year and there does not appear to be a seasonal pattern to drought occurrence, (4) the variability of precipitation appears to have been the principal climatic factor determining drought, and (5) for most of the CONUS, drought frequency appears to have decreased during the 1901 through 2014 period.

Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study.

PubMed

Størvold, Gunfrid V; Jahnsen, Reidun B; Evensen, Kari Anne I; Romild, Ulla K; Bratberg, Grete H

2018-05-01

To examine associations between interventions and child characteristics; and enhanced gross motor progress in children with cerebral palsy (CP). Prospective cohort study based on 2048 assessments of 442 children (256 boys, 186 girls) aged 2-12 years registered in the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Gross motor progress estimates were based on repeated measures of reference percentiles for the Gross Motor Function Measure (GMFM-66) in a linear mixed model. Mean follow-up time: 2.9 years. Intensive training was the only intervention factor associated with enhanced gross motor progress (mean 3.3 percentiles, 95% CI: 1.0, 5.5 per period of ≥3 sessions per week and/or participation in an intensive program). Gross motor function was on average 24.2 percentiles (95% CI: 15.2, 33.2) lower in children with intellectual disability compared with others. Except for eating problems (-10.5 percentiles 95% CI: -18.5, -2.4) and ankle contractures by age (-1.9 percentiles 95% CI: -3.6, -0.2) no other factors examined were associated with long-term gross motor progress. Intensive training was associated with enhanced gross motor progress over an average of 2.9 years in children with CP. Intellectual disability was a strong negative prognostic factor. Preventing ankle contractures appears important for gross motor progress.

Using lean Six Sigma to improve hospital based outpatient imaging satisfaction.

PubMed

McDonald, Angelic P; Kirk, Randy

2013-01-01

Within the hospital based imaging department at Methodist Willowbrook, outpatient, inpatient, and emergency patients are all performed on the same equipment with the same staff. The critical nature of the patient is the deciding factor as to who gets done first and in what order procedures are performed. After an aggressive adoption of Intentional Tools, the imaging department was finally able to move from a two year mean Press Ganey, outpatient satisfaction average score of 91.2 and UHC percentile ranking of 37th to a mean average of 92.1 and corresponding UHC ranking of 60th percentile. It was at the 60th percentile ranking that the department flat lined. Using the Six Sigma DMAIC process, opportunity for further improvement was identified. A two week focus pilot was conducted specifically on areas identified through the Six Sigma process. The department was able to jump to 88th percentile ranking and a mean of 93.7. With pay for performance focusing on outpatient satisfaction and a financial incentive to improving and maintaining the highest scores, it was important to know where the imaging department should apply its financial resources to obtain the greatest impact.

Genotype by environment interaction effects in genetic evaluation of preweaning gain for Line 1 Hereford cattle from Miles City, Montana.

PubMed

MacNeil, M D; Cardoso, F F; Hay, E

2017-09-01

It has long been recognized that genotype × environment interaction potentially influences genetic evaluation of beef cattle. However, this recognition has largely been ignored in systems for national cattle evaluation. The objective of this investigation was to determine if direct and maternal genetic effects on preweaning gain would be reranked depending on an environmental gradient as determined by year effects. Data used were from the 76-yr selection experiment with the Line 1 Hereford cattle raised at Miles City, MT. The data comprised recorded phenotypes from 7,566 animals and an additional 1,862 ancestral records included in the pedigree. The presence of genotype × environment interaction was examined using reaction norms wherein year effects on preweaning gain were hypothesized to linearly influence the EBV. Estimates of heritability for direct and maternal effects, given the average environment, were 10 ± 2 and 26 ± 3%, respectively. In an environment that is characterized by the 5th (95th) percentile of the distribution of year effects, the corresponding estimates of heritability were 18 ± 3 (22 ± 3%) and 30 ± 3% (30 ± 3%), respectively. Rank correlations of direct and maternal EBV appropriate to the 5th and 95th percentiles of the year effects were 0.67 and 0.92, respectively. In the average environment, the genetic trends were 255 ± 1 g/yr for direct effects and 557 ± 3 g/yr for maternal effects. In the fifth percentile environment, the corresponding estimates of genetic trend were 271 ± 1 and 540 ± 3 g/yr, respectively, and in the 95th percentile environment, they were 236 ± 1 and 578 ± 3 g/yr, respectively. Linear genetic trends in environmental sensitivity were observed for both the direct (-8.06 × 10 ± 0.49 × 10) and maternal (8.72 × 10 ± 0.43 × 10) effects. Therefore, changing systems of national cattle evaluation to more fully account for potential genotype × environment interaction would improve the assessment of breeding stock, particularly for direct effects. Estimates of environmental sensitivity parameters could also facilitate identification of genetic limitations to production.

[Evaluation of the nutritional status and feeding patterns of 3-7 year old children --results of a questionnaire].

PubMed

Weker, H

2000-01-01

Questionnaire studies on feeding patterns and nutritional status of 822 pre-school children (age 3-7) in different regions of Poland were performed between June 1999 and January 2000. Nutritional status was evaluated on the basis of anthropometric indices - height, body weight, body mass index (BMI) and BMI z-score. The mode of feeding was evaluated on the basis of recall of 24-hours menus. Average daily food rations and their nutritional value were calculated from the questionnaires data. Quantity and number of meals were also evaluated. In a group of 402 boys the average height was between 75-90 percentiles and body mass (50-75 percentiles). In 420 girls the average height was about the 90 percentile (age 3-4) and between 75-90 percentiles (age 5-7). The study showed that normal BMI z-score was found in 75% of children, underweight in 16.5% overweight and obesity in 8.5%. Feeding patterns showed great than differences. It was found that meat, fat, sweets and sugar content in daily food rations exceeded the recommended for pre-school children, but the vegetables intake was lower than recommended. Vitamins A and C deficiency in average daily rations didn't occur. The fat intake provided 36% of total energy, whereas carbohydrates (without lactose and starch) - about 20%. This can have inhibitory effect on microelements (Fe, Zn) absorption. Attention must be paid to the choice of products and the wrong distribution of total energy intake in daily rations. The habits of snack eating between the meals were reported in 91% of children. These snacks consisted of fruits, chips, french fries, sweets and sandwiches. These products provides 232 kcal +/- 171 kcal/day.

Methods for estimating selected low-flow statistics and development of annual flow-duration statistics for Ohio

USGS Publications Warehouse

Koltun, G.F.; Kula, Stephanie P.

2013-01-01

This report presents the results of a study to develop methods for estimating selected low-flow statistics and for determining annual flow-duration statistics for Ohio streams. Regression techniques were used to develop equations for estimating 10-year recurrence-interval (10-percent annual-nonexceedance probability) low-flow yields, in cubic feet per second per square mile, with averaging periods of 1, 7, 30, and 90-day(s), and for estimating the yield corresponding to the long-term 80-percent duration flow. These equations, which estimate low-flow yields as a function of a streamflow-variability index, are based on previously published low-flow statistics for 79 long-term continuous-record streamgages with at least 10 years of data collected through water year 1997. When applied to the calibration dataset, average absolute percent errors for the regression equations ranged from 15.8 to 42.0 percent. The regression results have been incorporated into the U.S. Geological Survey (USGS) StreamStats application for Ohio (http://water.usgs.gov/osw/streamstats/ohio.html) in the form of a yield grid to facilitate estimation of the corresponding streamflow statistics in cubic feet per second. Logistic-regression equations also were developed and incorporated into the USGS StreamStats application for Ohio for selected low-flow statistics to help identify occurrences of zero-valued statistics. Quantiles of daily and 7-day mean streamflows were determined for annual and annual-seasonal (September–November) periods for each complete climatic year of streamflow-gaging station record for 110 selected streamflow-gaging stations with 20 or more years of record. The quantiles determined for each climatic year were the 99-, 98-, 95-, 90-, 80-, 75-, 70-, 60-, 50-, 40-, 30-, 25-, 20-, 10-, 5-, 2-, and 1-percent exceedance streamflows. Selected exceedance percentiles of the annual-exceedance percentiles were subsequently computed and tabulated to help facilitate consideration of the annual risk of exceedance or nonexceedance of annual and annual-seasonal-period flow-duration values. The quantiles are based on streamflow data collected through climatic year 2008.

Reproductive performance in a select sample of dairy herds.

PubMed

Ferguson, James D; Skidmore, Andrew

2013-02-01

Sixteen herds were selected from a pool of 64 herds nominated by consultants for participation in a national survey to demonstrate excellence in reproductive performance. For inclusion in the survey, herds had to have comprehensive records in a farm computer database or participate in a Dairy Herd Improvement Association record system and have superior reproductive performance as judged by the herd advisor. Herd managers were asked to fill out a questionnaire to describe their reproductive management practices and provide herd records for data analysis. Reproductive analysis was based on individual cow records for active and cull dairy cows that calved during the calendar year 2010. Breeding records by cow were used to calculate indices for insemination rate (IR), conception rate (CR), pregnancy rate (PR), and culling. Herds ranged in size from 262 to 6,126 lactating and dry cows, with a mean of 1,654 [standard deviation (SD) 1,494] cows. Mean days to first insemination (DFS) was 71.2d (SD 4.7d), and IR for first insemination was 86.9%. Mean days between inseminations were 33.4d (SD 3.1d), and 15.4% of insemination intervals were greater than 48 d (range: 7.2 to 21.5%). First-service conception rate was 44.4% (SD 4.8%) across all herds and ranged from 37.5 to 51.8%. Mean PR was 32.0% (SD 3.9%) with a range of 26.5 to 39.4%. Lactation cull rate was 32.2% (SD 12.4%) with a range from 13.6 to 58.1%. Compared with mean data and SD for herds in the Raleigh Dairy Herd Improvement Association system, mean indices for these herds ranked them in the 99 th percentile for IR (using heat detection rate as comparison), 99 th percentile for PR, the bottom 18.6 percentile for DFS, and around the 50th percentile for CR. This suggests that excellent herd reproductive performance was associated with reproductive management that resulted in high insemination rates combined with average CR. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Thermal IR satellite data application for earthquake research in Pakistan

NASA Astrophysics Data System (ADS)

Barkat, Adnan; Ali, Aamir; Rehman, Khaista; Awais, Muhammad; Riaz, Muhammad Shahid; Iqbal, Talat

2018-05-01

The scientific progress in space research indicates earthquake-related processes of surface temperature growth, gas/aerosol exhalation and electromagnetic disturbances in the ionosphere prior to seismic activity. Among them surface temperature growth calculated using the satellite thermal infrared images carries valuable earthquake precursory information for near/distant earthquakes. Previous studies have concluded that such information can appear few days before the occurrence of an earthquake. The objective of this study is to use MODIS thermal imagery data for precursory analysis of Kashmir (Oct 8, 2005; Mw 7.6; 26 km), Ziarat (Oct 28, 2008; Mw 6.4; 13 km) and Dalbandin (Jan 18, 2011; Mw 7.2; 69 km) earthquakes. Our results suggest that there exists an evident correlation of Land Surface Temperature (thermal; LST) anomalies with seismic activity. In particular, a rise of 3-10 °C in LST is observed 6, 4 and 14 days prior to Kashmir, Ziarat and Dalbandin earthquakes. In order to further elaborate our findings, we have presented a comparative and percentile analysis of daily and five years averaged LST for a selected time window with respect to the month of earthquake occurrence. Our comparative analyses of daily and five years averaged LST show a significant change of 6.5-7.9 °C for Kashmir, 8.0-8.1 °C for Ziarat and 2.7-5.4 °C for Dalbandin earthquakes. This significant change has high percentile values for the selected events i.e. 70-100% for Kashmir, 87-100% for Ziarat and 84-100% for Dalbandin earthquakes. We expect that such consistent results may help in devising an optimal earthquake forecasting strategy and to mitigate the effect of associated seismic hazards.

Assessment of RF exposures from emerging wireless communication technologies in different environments.

PubMed

Joseph, Wout; Verloock, Leen; Goeminne, Francis; Vermeeren, Gönter; Martens, Luc

2012-02-01

In situ electromagnetic (EM) radio frequency (RF) exposure to base stations of emerging wireless technologies is assessed at 311 locations, 68 indoor and 243 outdoor, spread over 35 areas in three European countries (Belgium, The Netherlands, and Sweden) by performing narrowband spectrum analyzer measurements. The locations are selected to characterize six different environmental categories (rural, residential, urban, suburban, office, and industrial). The maximal total field value was measured in a residential environment and equal to 3.9 V m(-1), mainly due to GSM900 signals. Exposure ratios for maximal electric field values, with respect to ICNIRP reference levels, range from 0.5% (WiMAX) to 9.3% (GSM900) for the 311 measurement locations. Exposure ratios for total field values vary from 3.1% for rural environments to 9.4% for residential environments. Exposures are lognormally distributed and are the lowest in rural environments and the highest in urban environments. Highest median exposures were obtained in urban environments (0.74 V m(-1)), followed by office (0.51 V m(-1)), industrial (0.49 V m(-1)), suburban (0.46 V m(-1)), residential (0.40 V m(-1)), and rural (0.09 V m(-1)) environments. The average contribution to the total electric field is more than 60% for GSM. Except for the rural environment, average contributions of UMTS-HSPA are more than 3%. Contributions of the emerging technologies LTE and WiMAX are on average less than 1%. The dominating outdoor source is GSM900 (95 percentile of 1.9 V m(-1)), indoor DECT dominates (95 percentile of 1.5 V m(-1)).

Alarm Limits for Intraoperative Drug Infusions: A Report From the Multicenter Perioperative Outcomes Group.

PubMed

Berman, Mitchell F; Iyer, Nikhil; Freudzon, Leon; Wang, Shuang; Freundlich, Robert E; Housey, Michelle; Kheterpal, Sachin

2017-10-01

Continuous medication infusions are commonly used during surgical procedures. Alarm settings for infusion pumps are considered important for patient safety, but limits are not created in a standardized manner from actual usage data. We estimated 90th and 95th percentile infusion rates from a national database for potential use as upper limit alarm settings. We extracted infusion rate data from 17 major hospitals using intraoperative records provided by Multicenter Perioperative Outcomes Group for adult surgery between 2008 and 2014. Seven infusions were selected for study: propofol, remifentanil, dexmedetomidine, norepinephrine, phenylephrine, nitroglycerin, and esmolol. Each dosage entry for an infusion during a procedure was included. We estimated the 50th, 90th, and 95th percentile levels for each infusion across institutions, and performed quantile regression to examine factors that might affect the percentiles rates, such as use in general anesthesia versus sedation. The median 90th and 95th percentile infusion rates (with interquartile range) for propofol were 150 (140-150) and 170 (150-200) μg/kg/min. Quantile regression demonstrated higher 90th and 95th percentile rates during sedation for gastrointestinal endoscopy than for all surgical procedures performed under general anesthesia. For selected vasoactive medications, the corresponding median 90th and 95th percentile rates (with interquartile range) were norepinephrine 14.0 (9.8-18.1) and 18.3 (12.6-23.9) μg/min, and phenylephrine 60 (55-80) and 80 (75-100) μg/min. Alarm settings based on infusion rate percentile limits would be triggered at predictable rates; ie, the 95th percentile would be exceeded and an alarm sounded during 1 in 20 infusion rate entries. As a result, institutions could establish pump alarm settings consistent with desired alarm frequency using their own or externally validated usage data. Further study will be needed to determine the optimal percentile for infusion alarm settings.

Using base rates of low scores to interpret the ANAM4 TBI-MIL battery following mild traumatic brain injury.

PubMed

Ivins, Brian J; Lange, Rael T; Cole, Wesley R; Kane, Robert; Schwab, Karen A; Iverson, Grant L

2015-02-01

Base rates of low ANAM4 TBI-MIL scores were calculated in a convenience sample of 733 healthy male active duty soldiers using available military reference values for the following cutoffs: ≤2nd percentile (2 SDs), ≤5th percentile, <10th percentile, and <16th percentile (1 SD). Rates of low scores were also calculated in 56 active duty male soldiers who sustained an mTBI an average of 23 days (SD = 36.1) prior. 22.0% of the healthy sample and 51.8% of the mTBI sample had two or more scores below 1 SD (i.e., 16th percentile). 18.8% of the healthy sample and 44.6% of the mTBI sample had one or more scores ≤5th percentile. Rates of low scores in the healthy sample were influenced by cutoffs and race/ethnicity. Importantly, some healthy soldiers obtain at least one low score on ANAM4. These base rate analyses can improve the methodology for interpreting ANAM4 performance in clinical practice and research. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Enhancement of anesthesiology in-training exam performance with institution of an academic improvement policy.

PubMed

Joseph, Julie A; Terry, Chris M; Waller, Eva J; Bortsov, Andrey V; Zvara, David A; Mayer, David C; Martinelli, Susan M

2014-01-01

Anesthesiology resident physicians across the United States complete an annual in-training examination (ITE). The ITE evaluates resident knowledge and provides personalized feedback to guide future study in low scoring sections(1). Performance on the ITE correlates with outcomes on the American Board of Anesthesiology (ABA) written board examination(2). Over the last several years, declining ITE scores were observed at the University of North Carolina (UNC). In response to this decline, our department reprioritized the ITE by instituting an academic improvement policy (AIP). The AIP employed both reward for satisfactory achievement and consequence for under-performance to elevate the ITE as a "high stakes" examination. Our hypothesis was that implementation of this AIP would improve ITE scores. ITE scores were compiled from 150 residents in the Department of Anesthesiology at UNC for graduating classes from 2004-2015. Data is presented as the number of residents scoring below the 20th percentile when compared to the national distribution before and after the AIP. In addition, average USMLE Step 1 three-digit scores for each graduating class were compared to average ITE percentile scores of the corresponding graduating class (USMLE does not provide percentile scores). Between 2009 and 2013, the number of residents who scored below the 20th percentile on the ITE increased steadily to a peak of 10 in 2011. After implementation of the AIP in July 2011, there was an 80% decrease in those scoring below the 20th percentile, from 10 to 2 residents (p<0.05). Anesthesiology resident ITE scores improved after implementation of an academic improvement policy.

Use of Pearson's Chi-Square for Testing Equality of Percentile Profiles across Multiple Populations.

PubMed

Johnson, William D; Beyl, Robbie A; Burton, Jeffrey H; Johnson, Callie M; Romer, Jacob E; Zhang, Lei

2015-08-01

In large sample studies where distributions may be skewed and not readily transformed to symmetry, it may be of greater interest to compare different distributions in terms of percentiles rather than means. For example, it may be more informative to compare two or more populations with respect to their within population distributions by testing the hypothesis that their corresponding respective 10 th , 50 th , and 90 th percentiles are equal. As a generalization of the median test, the proposed test statistic is asymptotically distributed as Chi-square with degrees of freedom dependent upon the number of percentiles tested and constraints of the null hypothesis. Results from simulation studies are used to validate the nominal 0.05 significance level under the null hypothesis, and asymptotic power properties that are suitable for testing equality of percentile profiles against selected profile discrepancies for a variety of underlying distributions. A pragmatic example is provided to illustrate the comparison of the percentile profiles for four body mass index distributions.

Using Static Percentiles of AE9/AP9 to Approximate Dynamic Monte Carlo Runs for Radiation Analysis of Spiral Transfer Orbits

NASA Astrophysics Data System (ADS)

Kwan, Betty P.; O'Brien, T. Paul

2015-06-01

The Aerospace Corporation performed a study to determine whether static percentiles of AE9/AP9 can be used to approximate dynamic Monte Carlo runs for radiation analysis of spiral transfer orbits. Solar panel degradation is a major concern for solar-electric propulsion because solar-electric propulsion depends on the power output of the solar panel. Different spiral trajectories have different radiation environments that could lead to solar panel degradation. Because the spiral transfer orbits only last weeks to months, an average environment does not adequately address the possible transient enhancements of the radiation environment that must be accounted for in optimizing the transfer orbit trajectory. Therefore, to optimize the trajectory, an ensemble of Monte Carlo simulations of AE9/AP9 would normally be run for every spiral trajectory to determine the 95th percentile radiation environment. To avoid performing lengthy Monte Carlo dynamic simulations for every candidate spiral trajectory in the optimization, we found a static percentile that would be an accurate representation of the full Monte Carlo simulation for a representative set of spiral trajectories. For 3 LEO to GEO and 1 LEO to MEO trajectories, a static 90th percentile AP9 is a good approximation of the 95th percentile fluence with dynamics for 4-10 MeV protons, and a static 80th percentile AE9 is a good approximation of the 95th percentile fluence with dynamics for 0.5-2 MeV electrons. While the specific percentiles chosen cannot necessarily be used in general for other orbit trade studies, the concept of determining a static percentile as a quick approximation to a full Monte Carlo ensemble of simulations can likely be applied to other orbit trade studies. We expect the static percentile to depend on the region of space traversed, the mission duration, and the radiation effect considered.

Variable Selection for Regression Models of Percentile Flows

NASA Astrophysics Data System (ADS)

Fouad, G.

2017-12-01

Percentile flows describe the flow magnitude equaled or exceeded for a given percent of time, and are widely used in water resource management. However, these statistics are normally unavailable since most basins are ungauged. Percentile flows of ungauged basins are often predicted using regression models based on readily observable basin characteristics, such as mean elevation. The number of these independent variables is too large to evaluate all possible models. A subset of models is typically evaluated using automatic procedures, like stepwise regression. This ignores a large variety of methods from the field of feature (variable) selection and physical understanding of percentile flows. A study of 918 basins in the United States was conducted to compare an automatic regression procedure to the following variable selection methods: (1) principal component analysis, (2) correlation analysis, (3) random forests, (4) genetic programming, (5) Bayesian networks, and (6) physical understanding. The automatic regression procedure only performed better than principal component analysis. Poor performance of the regression procedure was due to a commonly used filter for multicollinearity, which rejected the strongest models because they had cross-correlated independent variables. Multicollinearity did not decrease model performance in validation because of a representative set of calibration basins. Variable selection methods based strictly on predictive power (numbers 2-5 from above) performed similarly, likely indicating a limit to the predictive power of the variables. Similar performance was also reached using variables selected based on physical understanding, a finding that substantiates recent calls to emphasize physical understanding in modeling for predictions in ungauged basins. The strongest variables highlighted the importance of geology and land cover, whereas widely used topographic variables were the weakest predictors. Variables suffered from a high degree of multicollinearity, possibly illustrating the co-evolution of climatic and physiographic conditions. Given the ineffectiveness of many variables used here, future work should develop new variables that target specific processes associated with percentile flows.

Wealth inhomogeneity applied to crash rate theory.

PubMed

Shuler, Robert L

2015-11-01

A crash rate theory based on corporate economic utility maximization is applied to individual behavior in U.S. and German motorway death rates, by using wealth inhomogeneity data in ten-percentile bins to account for variations of utility maximization in the population. Germany and the U.S. have similar median wealth figures, a well-known indicator of accident risk, but different motorway death rates. It is found that inhomogeneity in roughly the 10(th) to 30(th) percentile, not revealed by popular measures such as the Gini index which focus on differences at the higher percentiles, provides a satisfactory explanation of the data. The inhomogeneity analysis reduces data disparity from a factor of 2.88 to 1.75 as compared with median wealth assumed homogeneity, and further to 1.09 with average wealth assumed homogeneity. The first reduction from 2.88 to 1.75 is attributable to inequality at lower percentiles and suggests it may be as important in indicating socioeconomic risk as extremes in the upper percentile ranges, and that therefore the U.S. socioeconomic risk may be higher than generally realized.

THE AVERAGE ABILITY STUDENT IN CALIFORNIA'S UNIVERSITY BRANCHES AND STATE COLLEGES.

ERIC Educational Resources Information Center

HALL, LINCOLN

FOR THE PURPOSES OF THIS STUDY, "AVERAGE" STUDENTS WERE DEFINED AS THOSE WHOSE COLLEGE APTITUDE TEST PERCENTILE RANKINGS WERE BETWEEN 40 AND 60 AND WHOSE INTELLIGENCE QUOTIENTS WERE BETWEEN 90 AND 110. OF THE ENTRANTS AT THE COLLEGE ON THE SEQUOIAS BETWEEN 1953 AND 1962, STUDENTS OF AVERAGE ABILITY HAD THE SAME OPPORTUNITY AS THE ABOVE…

Changes of the time-varying percentiles of daily extreme temperature in China

NASA Astrophysics Data System (ADS)

Li, Bin; Chen, Fang; Xu, Feng; Wang, Xinrui

2017-11-01

Identifying the air temperature frequency distributions and evaluating the trends in time-varying percentiles are very important for climate change studies. In order to get a better understanding of the recent temporal and spatial pattern of the temperature changes in China, we have calculated the trends in temporal-varying percentiles of the daily extreme air temperature firstly. Then we divide all the stations to get the spatial patterns for the percentile trends using the average linkage cluster analysis method. To make a comparison, the shifts of trends percentile frequency distribution from 1961-1985 to 1986-2010 are also examined. Important results in three aspects have been achieved: (1) In terms of the trends in temporal-varying percentiles of the daily extreme air temperature, the most intense warming for daily maximum air temperature (Tmax) was detected in the upper percentiles with a significant increasing tendency magnitude (>2.5 °C/50year), and the greatest warming for daily minimum air temperature (Tmin) occurred with very strong trends exceeding 4 °C/50year. (2) The relative coherent spatial patterns for the percentile trends were found, and stations for the whole country had been divided into three clusters. The three primary clusters were distributed regularly to some extent from north to south, indicating the possible large influence of the latitude. (3) The most significant shifts of trends percentile frequency distribution from 1961-1985 to 1986-2010 was found in Tmax. More than half part of the frequency distribution show negative trends less than -0.5 °C/50year in 1961-1985, while showing trends less than 2.5 °C/50year in 1986-2010.

Influence of population selection on the 99th percentile reference value for cardiac troponin assays.

PubMed

Collinson, Paul O; Heung, Yen Ming; Gaze, David; Boa, Frances; Senior, Roxy; Christenson, Robert; Apple, Fred S

2012-01-01

We sought to determine the effect of patient selection on the 99th reference percentile of 2 sensitive and 1 high-sensitivity (hs) cardiac troponin assays in a well-defined reference population. Individuals>45 years old were randomly selected from 7 representative local community practices. Detailed information regarding the participants was collected via questionnaires. The healthy reference population was defined as individuals who had no history of vascular disease, hypertension, or heavy alcohol intake; were not receiving cardiac medication; and had blood pressure<140/90 mmHg, fasting blood glucose<110 mg/dL (approximately 6 mmol/L), estimated creatinine clearance>60 mL·min(-1)·(1.73 m2)(-1), and normal cardiac function according to results of echocardiography. Samples were stored at -70 °C until analysis for cardiac troponin I (cTnI) and cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide. Application of progressively more stringent population selection strategies to the initial baseline population of 545 participants until the only individuals who remained were completely healthy according to the study criteria reduced the number of outliers seen and led to a progressive decrease in the 99th-percentile value obtained for the Roche hs-cTnT assay and the sensitive Beckman cTnI assay but not for the sensitive Siemens Ultra cTnI assay. Furthermore, a sex difference found in the baseline population for the hs-cTnT (P=0.0018) and Beckman cTnI assays (P<0.0001) progressively decreased with more stringent population selection criteria. The reference population selection strategy significantly influenced the 99th percentile reference values determined for troponin assays and the observed sex differences in troponin concentrations.

Esthetics and smile-related characteristics assessed by laypersons.

PubMed

Wang, Cui; Hu, Wen-Jie; Liang, Ling-Zhi; Zhang, Yan-Ling; Chung, Kwok-Hung

2018-03-01

This study aimed to identify the characteristics of full-smile images assessed by laypersons using visual analog scale measurement. A total of 176 young Chinese subjects (88 males and 88 females; 20-35 years of age) with healthy dentogingival tissue were recruited to have their dynamic smiles captured using digital technology. A full-smile frame image of each subject was selected and evaluated by 22 laypersons (11 males and 11 females; 20-35 years of age) using visual analog scale measurement. Unattractive and attractive groups were designated according to the 25th percentile and 75th percentile of average visual analog scale score for the subjects, respectively. Eight smile variables were used to measure the characteristics of the full-smile images. Pearson's Chi-square test and unpaired t tests were used to analyze the data with significance level α = 0.05. The visual analog scale measurement scores of unattractive and attractive subgroups, respectively, were 37.89 ± 2.12 and 50.67 ± 2.75 (male subjects), and 37.14 ± 2.80 and 51.92 ± 1.99 (female subjects). VAS scores were significantly different between subgroups for both male and female subjects (P < .001). No significant differences were observed between male and female subjects (P > .05). Attractive full-smiles in young Chinese subjects demonstrated higher frequencies of average or low anterior smile line, average or low posterior smile line, upward upper lip curvature, and "broad and short" smile with high smile index. The smile variables of anterior smile line, posterior smile line, upper lip curvature, and smile index are predominant factors of smile attractiveness, which should be given priority to consider and manage in the anterior esthetic treatment plan. © 2017 Wiley Periodicals, Inc.

[The applicable study of two models used in the assessment of long-term exposure to food lead].

PubMed

Jin, Ying-liang; Zhang, Ya-fei; Liu, Pei

2013-07-01

To compare the results of observed individual means (OIM) model with beta binomial-normal (BBN) model and to apply the two models to assessment of long-term dietary lead exposure. Food consumption data were obtained from the National Nutrition and Health Survey conducted in 2002 by 24-hour recall method. Contamination data were derived from the national food contamination monitoring program from 2000 to 2006 and from monitoring data of Customs exports for agricultural products between 2005 and 2006. By multiplying the average consumption of food with the average concentration of contaminant, the OIM model calculated dietary intake per day. By correcting the within-person variation and keeping the between-person variation, the BBN model built dietary intake in the long-term.Using the example of food lead data, the results of two models were compared. The high-end percentile of OIM model was higher than the BBN model in various age groups.In the general population, the dietary intake of OIM model from 25th percentile to 99.9th percentile was between 1.167 and 7.313 µg×kg(-1)×d(-1), and the dietary intake of BBN model with the same percentile range was between 1.193 and 5.729 µg×kg(-1)×d(-1). The median of various groups was similar between the two models. The dietary intakes in the general population of two models were 1.543 and 1.579 µg×kg(-1)×d(-1). The high-end percentile of OIM model is more conservative than BBN model in the long-term dietary exposure assessment.

Concentrations and elemental composition of particulate matter in the Buenos Aires underground system

NASA Astrophysics Data System (ADS)

Murruni, L. G.; Solanes, V.; Debray, M.; Kreiner, A. J.; Davidson, J.; Davidson, M.; Vázquez, M.; Ozafrán, M.

Total suspended particulate (TSP) samples have been collected at six stations in the C and B lines of the Buenos Aires underground system and, almost simultaneously, at six ground level sites outside and nearby the corresponding underground stations, in the Oct 2005/Oct 2006 period. All these samples were analyzed for mass and elemental Fe, Cu, and Zn concentrations by using the Particle Induced X-ray Emission (PIXE) technique. Mostly, TSP concentrations were found to be between 152 μg m -3 (25% percentile) and 270 μg m -3 (75% percentile) in the platform of the stations, while those in outside ambient air oscillated from 55 μg m -3 (25% percentile) to 137 μg m -3 (75% percentile). Moreover, experimental results indicate that TSP levels are comparable to those measured for other underground systems worldwide. Statistical results demonstrate that subway TSP levels are about 3 times larger on average than those for urban ambient air. The TSP levels inside stations and outdoors are poorly correlated, indicating that TSP levels in the metro system are mainly influenced by internal sources. Regarding metal concentrations, the most enriched element in TSP samples was Fe, the levels of which ranged from 36 (25% percentile) to 86 μg m -3 (75% percentile) in Line C stations, while in Line B ones they varied between 8 μg m -3 (25% percentile) and 46 μg m -3 (75% percentile). As a comparison, Fe concentrations in ambient air oscillated between 0.7 μg m -3 (25% percentile) and 1.2 μg m -3 (75% percentile). Other enriched elements include Cu and Zn. With regard to their sources, Fe and Cu have been related to processes taking place inside the subway system, while Zn has been associated with outdoor vehicular traffic. Additionally, concerns about possible health implications based on comparisons to various indoor air quality limits and available toxicological information are discussed.

Watershed Regressions for Pesticides (WARP) for Predicting Annual Maximum and Annual Maximum Moving-Average Concentrations of Atrazine in Streams

USGS Publications Warehouse

Stone, Wesley W.; Gilliom, Robert J.; Crawford, Charles G.

2008-01-01

Regression models were developed for predicting annual maximum and selected annual maximum moving-average concentrations of atrazine in streams using the Watershed Regressions for Pesticides (WARP) methodology developed by the National Water-Quality Assessment Program (NAWQA) of the U.S. Geological Survey (USGS). The current effort builds on the original WARP models, which were based on the annual mean and selected percentiles of the annual frequency distribution of atrazine concentrations. Estimates of annual maximum and annual maximum moving-average concentrations for selected durations are needed to characterize the levels of atrazine and other pesticides for comparison to specific water-quality benchmarks for evaluation of potential concerns regarding human health or aquatic life. Separate regression models were derived for the annual maximum and annual maximum 21-day, 60-day, and 90-day moving-average concentrations. Development of the regression models used the same explanatory variables, transformations, model development data, model validation data, and regression methods as those used in the original development of WARP. The models accounted for 72 to 75 percent of the variability in the concentration statistics among the 112 sampling sites used for model development. Predicted concentration statistics from the four models were within a factor of 10 of the observed concentration statistics for most of the model development and validation sites. Overall, performance of the models for the development and validation sites supports the application of the WARP models for predicting annual maximum and selected annual maximum moving-average atrazine concentration in streams and provides a framework to interpret the predictions in terms of uncertainty. For streams with inadequate direct measurements of atrazine concentrations, the WARP model predictions for the annual maximum and the annual maximum moving-average atrazine concentrations can be used to characterize the probable levels of atrazine for comparison to specific water-quality benchmarks. Sites with a high probability of exceeding a benchmark for human health or aquatic life can be prioritized for monitoring.

40 CFR 133.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... arithmetic mean of pollutant parameter values for samples collected in a period of 7 consecutive days. (b) 30-day average. The arithmetic mean of pollutant parameter values of samples collected in a period of 30... percentile value for the 30-day average effluent quality achieved by a treatment works in a period of at...

Temporal Variability of Daily Personal Magnetic Field Exposure Metrics in Pregnant Women

PubMed Central

Lewis, Ryan C.; Evenson, Kelly R.; Savitz, David A.; Meeker, John D.

2015-01-01

Recent epidemiology studies of power-frequency magnetic fields and reproductive health have characterized exposures using data collected from personal exposure monitors over a single day, possibly resulting in exposure misclassification due to temporal variability in daily personal magnetic field exposure metrics, but relevant data in adults are limited. We assessed the temporal variability of daily central tendency (time-weighted average, median) and peak (upper percentiles, maximum) personal magnetic field exposure metrics over seven consecutive days in 100 pregnant women. When exposure was modeled as a continuous variable, central tendency metrics had substantial reliability, whereas peak metrics had fair (maximum) to moderate (upper percentiles) reliability. The predictive ability of a single day metric to accurately classify participants into exposure categories based on a weeklong metric depended on the selected exposure threshold, with sensitivity decreasing with increasing exposure threshold. Consistent with the continuous measures analysis, sensitivity was higher for central tendency metrics than for peak metrics. If there is interest in peak metrics, more than one day of measurement is needed over the window of disease susceptibility to minimize measurement error, but one day may be sufficient for central tendency metrics. PMID:24691007

Can Professional Environments in Schools Promote Teacher Development? Explaining Heterogeneity in Returns to Teaching Experience

PubMed Central

Kraft, Matthew A.; Papay, John P.

2014-01-01

Although wide variation in teacher effectiveness is well established, much less is known about differences in teacher improvement over time. We document that average returns to teaching experience mask large variation across individual teachers and across groups of teachers working in different schools. We examine the role of school context in explaining these differences using a measure of the professional environment constructed from teachers responses to state-wide surveys. Our analyses show that teachers working in more supportive professional environments improve their effectiveness more over time than teachers working in less supportive contexts. On average, teachers working in schools at the 75th percentile of professional environment ratings improved 38% more than teachers in schools at the 25th percentile after 10 years. PMID:25866426

Heart Rates in Hospitalized Children by Age and Body Temperature

PubMed Central

Bonafide, Christopher P.; Brady, Patrick W.

2015-01-01

BACKGROUND AND OBJECTIVES: Heart rate (HR) is frequently used by clinicians in the hospital to assess a patient’s severity of illness and make treatment decisions. We sought to develop percentiles that characterize the relationship of expected HR by age and body temperature in hospitalized children and to compare these percentiles with published references in both primary care and emergency department (ED) settings. METHODS: Vital sign data were extracted from electronic health records of inpatients <18 years of age at 2 large freestanding children’s hospitals from July 2011 to June 2012. We selected up to 10 HR-temperature measurement pairs from each admission. Measurements from 60% of patients were used to derive the percentile curves, with the remainder used for validation. We compared our upper percentiles with published references in primary care and ED settings. RESULTS: We used 60 863 observations to derive the percentiles. Overall, an increase in body temperature of 1°C was associated with an increase of ∼10 beats per minute in HR, although there were variations across age and temperature ranges. For infants and young children, our upper percentiles were lower than in primary care and ED settings. For school-age children, our upper percentiles were higher. CONCLUSIONS: We characterized expected HR by age and body temperature in hospitalized children. These percentiles differed from references in primary care and ED settings. Additional research is needed to evaluate the performance of these percentiles for the identification of children who would benefit from further evaluation or intervention for tachycardia. PMID:25917984

Heart rates in hospitalized children by age and body temperature.

PubMed

Daymont, Carrie; Bonafide, Christopher P; Brady, Patrick W

2015-05-01

Heart rate (HR) is frequently used by clinicians in the hospital to assess a patient's severity of illness and make treatment decisions. We sought to develop percentiles that characterize the relationship of expected HR by age and body temperature in hospitalized children and to compare these percentiles with published references in both primary care and emergency department (ED) settings. Vital sign data were extracted from electronic health records of inpatients <18 years of age at 2 large freestanding children's hospitals from July 2011 to June 2012. We selected up to 10 HR-temperature measurement pairs from each admission. Measurements from 60% of patients were used to derive the percentile curves, with the remainder used for validation. We compared our upper percentiles with published references in primary care and ED settings. We used 60,863 observations to derive the percentiles. Overall, an increase in body temperature of 1°C was associated with an increase of ∼ 10 beats per minute in HR, although there were variations across age and temperature ranges. For infants and young children, our upper percentiles were lower than in primary care and ED settings. For school-age children, our upper percentiles were higher. We characterized expected HR by age and body temperature in hospitalized children. These percentiles differed from references in primary care and ED settings. Additional research is needed to evaluate the performance of these percentiles for the identification of children who would benefit from further evaluation or intervention for tachycardia. Copyright © 2015 by the American Academy of Pediatrics.

The development of phonological skills in late and early talkers

PubMed Central

KEHOE, Margaret; CHAPLIN, Elisa; MUDRY, Pauline; FRIEND, Margaret

2016-01-01

This study examined the relationship between phonological and lexical development in a group of French-speaking children (n=30), aged 29 months. The participants were divided into three sub-groups based on the number of words in their expressive vocabulary : low vocabulary (below the 15th percentile) (<< late-talkers >>) ; average-sized vocabulary (40-60th percentile) (<< middle group >>) and advanced vocabulary (above the 90th percentile) (<< precocious >> or “early talkers”). The phonological abilities (e.g., phonemic inventory, percentage of correct consonants, and phonological processes) of the three groups were compared. The comparison was based on analyses of spontaneous language samples. Most findings were consistent with previous results found in English-speaking children, indicating that the phonological abilities of late talkers are less well developed than those of children with average-sized vocabularies which in turn are less well-developed than those of children with advanced vocabularies. Nevertheless, several phonological measures were not related to vocabulary size, in particular those concerning syllable-final position. These findings differ from those obtained in English. The article finally discusses the clinical implications of the findings for children with delayed language development. PMID:26924855

Percentiles of the run-length distribution of the Exponentially Weighted Moving Average (EWMA) median chart

NASA Astrophysics Data System (ADS)

Tan, K. L.; Chong, Z. L.; Khoo, M. B. C.; Teoh, W. L.; Teh, S. Y.

2017-09-01

Quality control is crucial in a wide variety of fields, as it can help to satisfy customers’ needs and requirements by enhancing and improving the products and services to a superior quality level. The EWMA median chart was proposed as a useful alternative to the EWMA \\bar{X} chart because the median-type chart is robust against contamination, outliers or small deviation from the normality assumption compared to the traditional \\bar{X}-type chart. To provide a complete understanding of the run-length distribution, the percentiles of the run-length distribution should be investigated rather than depending solely on the average run length (ARL) performance measure. This is because interpretation depending on the ARL alone can be misleading, as the process mean shifts change according to the skewness and shape of the run-length distribution, varying from almost symmetric when the magnitude of the mean shift is large, to highly right-skewed when the process is in-control (IC) or slightly out-of-control (OOC). Before computing the percentiles of the run-length distribution, optimal parameters of the EWMA median chart will be obtained by minimizing the OOC ARL, while retaining the IC ARL at a desired value.

Assessment of Lower Missouri River physical aquatic habitat and its use by adult sturgeon (Genus Scaphirhynchus), 2005-07

USGS Publications Warehouse

Reuter, Joanna M.; Jacobson, Robert B.; Elliott, Caroline M.; DeLonay, Aaron J.

2009-01-01

This report presents an exploratory analysis of habitat availability and use by adult Scaphirhynchus sturgeon on the Lower Missouri River from Gavins Point Dam, South Dakota, to the junction with the Mississippi River. The analysis is based on two main data sources collected from 2005 to 2007: (1) a compilation of 153 reach-scale habitat maps (mean reach length, 2.4 kilometers) derived from boat-collected hydroacoustic data and (2) a sturgeon location dataset from which 378 sturgeon telemetry locations are associated with the maps (within 7 days of the mapping and within 10 percent of the discharge). The report focuses on: (1) longitudinal patterns of geomorphic and hydraulic characteristics revealed by the collection of reach maps; (2) assessment of environmental characteristics at sturgeon locations in the context of the mapped reaches; and (3) consideration of spatial distribution of habitat conditions that sturgeon appear to select. Longitudinal patterns of geomorphology, hydraulics, and associated habitats relate strongly to the engineered state of the river. Reaches within each of the following river sections tended to share similar geomorphic, hydrologic, and hydraulic characteristics: the Minimally Engineered section (Gavins Point Dam to Sioux City, Iowa), the Upstream Channelized section (Sioux City, Iowa, to the junction with the Kansas River), and the Downstream Channelized section (Kansas River to the junction with the Mississippi River). Adult sturgeon occupy nearly the full range of available values for each continuous variable assessed: depth, depth slope, depth-averaged velocity, velocity gradient, and Froude number (a dimensionless number relating velocity to depth). However, in the context of habitat available in a reach, sturgeon tend to select some areas over others. Reproductive female shovelnose sturgeon (Scaphirhynchus platorynchus), in particular, were often found in parts of the reach with one or more of the following characteristics: high velocity gradient, high depth slope, low Froude number, and low (though not necessarily the lowest) depth-averaged velocity. Depths used by sturgeon varied considerably. We explored spatial patterns representing the variable ranges that reproductive female shovelnose sturgeon most strongly and consistently selected by mapping areas within reaches meeting the following criteria: greater than the 80th percentile of depth slope, greater than the 80th percentile of velocity gradient, and less than the 20th percentile of Froude number. Our data exploration indicates that areas meeting these criteria have some predictive value regarding sturgeon habitat selection. Of all sturgeon locations that fall on maps from the same year (sample size = 2,013), about 63 percent fall within about 35 percent of the area where at least one variable meets the above criteria and 18 percent of locations fall within 4 percent of the area where all three variables meet the above criteria. The spatial patterns of these mapped areas show distinct differences among the sections of the Lower Missouri River. For example, the areas of predicted selection exhibit a relatively complex mosaic with multiple interconnected pathways in reaches of the Minimally Engineered section. In contrast, areas of predicted selection are concentrated along the channel margins in reaches of the Upstream Channelized section. Because the patterns described in this report represent habitat use in the context of the available habitat in a highly altered river system, selection may not necessarily indicate preferred habitats or habitats sufficient for reproduction and survival of sturgeon species.

Climate and its change over the Tibetan Plateau and its Surroundings in 1963-2015

NASA Astrophysics Data System (ADS)

Ding, J.; Cuo, L.

2017-12-01

Tibetan Plateau and its surroundings (TPS, 23°-43°N, 73°-106°E) lies in the southwest of China and includes Tibet Autonomous Region, Qinghai Province, southern Xinjiang Uygur Autonomous Region, part of Gansu Province, western Sichuan Province, and northern Yunnan Province. The region is of strategic importance in water resources because it is the headwater of ten large rivers that support more than 16 billion population. In this study, we use daily temperature maximum and minimum, precipitation and wind speed in 1963-2015 obtained from Climate Data Center of China Meteorological Administration and Qinghai Meteorological Bureau to investigate extreme climate conditions and their changes over the TPS. The extreme events are selected based on annual extreme values and percentiles. Annual extreme value approach produces one value each year for all variables, which enables us to examine the magnitude of extreme events; whereas percentile approach selects extreme values by setting 95th percentile as thresholds for maximum temperature, precipitation and wind speed, and 5th percentile for minimum temperature. Percentile approach not only enables us to investigate the magnitude but also frequency of the extreme events. Also, Mann-Kendall trend and mutation analysis were applied to analyze the changes in mean and extreme conditions. The results will help us understand more about the extreme events during the past five decades on the TPS and will provide valuable information for the upcoming IPCC reports on climate change.

Dosimetric factors for diagnostic nuclear medicine procedures in a non-reference pregnant phantom.

PubMed

Rafat-Motavalli, Laleh; Miri Hakimabad, Hashem; Hoseinian Azghadi, Elie

2018-05-01

This study was evaluated the impact of using non-reference fetal models on the fetal radiation dose from diagnostic radionuclide administration. The 6 month pregnant phantoms including fetal models at 10th and 90th growth percentiles were constructed at either end of the normal range around the 50th percentile and implemented in the Monte Carlo N-Particle code version MCNPX 2.6. The code have been used then to evaluate the 99mTc S factors of interested target organs as the most common used radionuclide in nuclear medicine procedures. Substantial variations were observed in the S factors between the 10th/90th percentile phantoms from the 50th percentile phantom, with the greatest difference being 38.6 %. When the source organs were in close proximity to, or inside the fetal body, the 99mTc S factors presented strong statistical correlations with fetal body habitus. The trends observed in the S factors and the differences between various percentiles were justified by the source organs' masses, and chord length distributions (CLDs). The results of this study showed that fetal body habitus had a considerable effect on fetal dose (on average up to 8.4%) if constant fetal biokinetic data was considered for all fetal weight percentiles. However, an almost smaller variation on fetal dose (up to 5.3%) was obtained if the available biokinetic data for the reference fetus was scaled by fetal mass. © 2018 IOP Publishing Ltd.

Birth Weight Ratio as an Alternative to Birth Weight Percentile to Express Infant Weight in Research and Clinical Practice: A Nationwide Cohort Study

PubMed Central

Kazemier, Brenda M.; Schuit, Ewoud; Mol, Ben Willem J.; Pajkrt, Eva; Ganzevoort, Wessel

2014-01-01

Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome. Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age. The discriminative ability of birth weight ratio and birth weight percentile to identify infants at risk of perinatal death (fetal death and neonatal death) or adverse pregnancy outcome (perinatal death + severe neonatal morbidity) was compared using the area under the curve. Outcomes were expressed stratified by gestational age at delivery separate for birth weight ratio and birth weight percentile. Results. We studied 1,299,244 pregnant women, with an overall perinatal death rate of 0.62%. Birth weight ratio and birth weight percentile have equivalent overall discriminative performance for perinatal death and adverse perinatal outcome. In late preterm infants (33+0–36+6 weeks), birth weight ratio has better discriminative ability than birth weight percentile for perinatal death (0.68 versus 0.63, P  0.01) or adverse pregnancy outcome (0.67 versus 0.60, P < 0.001). Conclusion. Birth weight ratio is a potentially valuable instrument to identify infants at risk of perinatal death and adverse pregnancy outcome and provides several advantages for use in research and clinical practice. Moreover, it allows comparison of groups with different average birth weights. PMID:25197283

Impaired reading comprehension and mathematical abilities in male adolescents with average or above general intellectual abilities are associated with comorbid and future psychopathology.

PubMed

Weiser, Mark; Reichenberg, Abraham; Rabinowitz, Jonathan; Nahon, Daniella; Kravitz, Efrat; Lubin, Gad; Knobler, Haim Y; Davidson, Michael; Noy, Shlomo

2007-11-01

Research indicates that persons with learning disorders often suffer from psychopathology. We assessed current and future psychopathology in male adolescents with discrete impairments in reading comprehension (IRC) or arithmetic abilities (IAA) but with average or above-average general intellectual abilities. Subjects were a population-based cohort of 174,994 male adolescents screened by the Israeli Draft Board with average or above-average intellectual abilities but with low scores (8.6th and 10th lowest percentile respectively) on reading or arithmetic tests. They were compared with adolescents who scored in the 10th percentile and above on these tests (comparison group). Relative to the comparison group, male adolescents with IRC, IAA, or IRC and IAA (0.69%), had poorer scores on most behavioral assessments and higher prevalence of current psychopathology: 4.2% (comparison group), 8.0% (IRC), 7.0% (IAA), and 9.8% (IRC and IAA). Adolescents with IRC were also at increased risk for later hospitalization for schizophrenia (hazard ratios = 1.8, 95% confidence interval: 1.3-2.6). Male adolescents with average and above-average general intellectual abilities but with IRC or IAA are more likely to have current and future psychopathology. Impairments in intellectual functioning and abnormal behaviors leading to mental illnesses may share common neurobiological substrates. The results support screening male adolescents with learning disorders for psychopathology.

Variation in urinary spot sample, 24 h samples, and longer-term average urinary concentrations of short-lived environmental chemicals: implications for exposure assessment and reverse dosimetry

PubMed Central

Aylward, Lesa L; Hays, Sean M; Zidek, Angelika

2017-01-01

Population biomonitoring data sets such as the Canadian Health Measures Survey (CHMS) and the United States National Health and Nutrition Examination Survey (NHANES) collect and analyze spot urine samples for analysis for biomarkers of exposure to non-persistent chemicals. Estimation of population intakes using such data sets in a risk-assessment context requires consideration of intra- and inter-individual variability to understand the relationship between variation in the biomarker concentrations and variation in the underlying daily and longer-term intakes. Two intensive data sets with a total of 16 individuals with collection and measurement of serial urine voids over multiple days were used to examine these relationships using methyl paraben, triclosan, bisphenol A (BPA), monoethyl phthalate (MEP), and mono-2-ethylhexyl hydroxyl phthalate (MEHHP) as example compounds. Composited 24 h voids were constructed mathematically from the individual collected voids, and concentrations for each 24 h period and average multiday concentrations were calculated for each individual in the data sets. Geometric mean and 95th percentiles were compared to assess the relationship between distributions in spot sample concentrations and the 24 h and multiday collection averages. In these data sets, spot sample concentrations at the 95th percentile were similar to or slightly higher than the 95th percentile of the distribution of all 24 h composite void concentrations, but tended to overestimate the maximum of the multiday concentration averages for most analytes (usually by less than a factor of 2). These observations can assist in the interpretation of population distributions of spot samples for frequently detected analytes with relatively short elimination half-lives. PMID:27703149

Developing empirical lightning cessation forecast guidance for the Kennedy Space Center

NASA Astrophysics Data System (ADS)

Stano, Geoffrey T.

The Kennedy Space Center in east Central Florida is one of the few locations in the country that issues lightning advisories. These forecasts are vital to the daily operations of the Space Center and take on even greater significance during launch operations. The U.S. Air Force's 45th Weather Squadron (45WS), who provides forecasts for the Space Center, has a good record of forecasting the initiation of lightning near their locations of special concern. However, the remaining problem is knowing when to cancel a lightning advisory. Without specific scientific guidelines detailing cessation activity, the Weather Squadron must keep advisories in place longer than necessary to ensure the safety of personnel and equipment. This unnecessary advisory time costs the Space Center millions of dollars in lost manpower each year. This research presents storm and environmental characteristics associated with lightning cessation that then are utilized to create lightning cessation guidelines for isolated thunderstorms for use by the 45WS during the warm season months of May through September. The research uses data from the Lightning Detection and Ranging (LDAR) network at the Kennedy Space Center, which can observe intra-cloud and portions of cloud-to-ground lightning strikes. Supporting data from the Cloud-to-Ground Lightning Surveillance System (CGLSS), radar observations from the Melbourne WSR-88D, and Cape Canaveral morning radiosonde launches also are included. Characteristics of 116 thunderstorms comprising our dataset are presented. Most of these characteristics are based on LDAR-derived spark and flash data and have not been described previously. In particular, the first lightning activity is quantified as either cloud-to-ground (CG) or intra-cloud (IC). Only 10% of the storms in this research are found to initiate with a CG strike. Conversely, only 16% of the storms end with a CG strike. Another characteristic is the average horizontal extent of all the flashes comprising a storm. Our average is 12-14 km, while the greatest flash extends 26 km. Comparisons between the starting altitude of the median and last flashes of a storm are analyzed, with only 37% of the storms having a higher last flash initiating altitude. Additional observations are made of the total lightning flash rate, percentage of CG to IC lightning, trends of individual flash initiation altitudes versus the average initiation altitude, the average inter-flash time distribution, and time series of inter-flash times. Five schemes to forecast lightning cessation are developed and evaluated. 100 of the 116 storms were randomly selected as the dependent sample, while the remaining 16 storms were used for verification. The schemes included a correlation and regression tree analysis, multiple linear regression, trends of storm duration, trend of the altitude of the greatest reflectivity to the time of the final flash, and a percentile scheme. Surprisingly, the percentile method was found to be the most effective technique and the simplest. The inclusion of real time storm parameters is found to have little effect on the results, suggesting that different forecast predictors, such as microphysical data from polarimetric radar, will be necessary to produce improved skill. When the percentile method used a confidence level of 99.5%, it successfully maintained lightning advisories for all 16 independent storms on which the schemes were tested. Since the computed wait time was 25 min, compared to the 45WS' most conservative and accurate wait time of 30 min, the percentile method saves 5 min for each advisory. This 5 min of savings safely shortens the Weather Squadron's advisories and saves money. Additionally, these results are the first to evaluate the 30/30 rule that is used commonly. The success of the percentile method is surprising since it out performs more complex procedures involving correlation and regression tree analysis and regression schemes. These more sophisticated statistical analyses were expected to perform better since they include more predictors in the forecasts. However, with the predictors available to us, this was not the case. While not the expected result, the percentile method succeeds in creating a safe and expedited forecast.

Estimated water use and availability in the East Narragansett Bay study area, Rhode Island, 1995-99

USGS Publications Warehouse

Wild, Emily C.

2007-01-01

Water availability became a concern in Rhode Island during a drought in 1999, and further investigation was needed to assess the current demands on the hydrologic system from withdrawals during periods of little to no precipitation. The low ground-water levels and streamflows measured in Rhode Island prompted initiation of a series of studies on water use and availability in each major drainage area in Rhode Island for the period 1995–99. The investigation of the East Narragansett Bay area is the last of these studies. The East Narragansett Bay study area (130.9 square miles) includes small sections of the Ten Mile and Westport River Basins in Rhode Island. The area was divided into three regions (islands and contiguous land areas separated by the bay) within each of which the freshwater water use and availability were assessed. During the study period from 1995 through 1999, three major public water suppliers in the study area withdrew 7.601 million gallons per day (Mgal/d) from ground-water and surface-water reservoirs. The estimated water withdrawals by minor public water suppliers during the study period were 0.063 Mgal/d. Total self-supply domestic, industrial, commercial, and agricultural withdrawals from the study area averaged 1.891 Mgal/d. Total water use in the study area averaged 16.48 Mgal/d, of which about 8.750 Mgal/d was imported from other basins. The average return flow to freshwater within the basin was 2.591 Mgal/d, which included effluent from permitted facilities and septic systems. The average return flow to saltwater (Narragansett Bay) outside of the basin was about 45.21 Mgal/d and included discharges by permitted facilities (wastewater-treatment plants and Rhode Island Pollutant Discharge Elimination Systems). The PART program, a computerized hydrographseparation application, was used for the data collected at two selected index stream-gaging stations in the East Narragansett Bay study area to determine water availability on the basis of the 75th, 50th, and 25th percentiles of the total base flow; the base flow for the 7-day, 10-year low-flow scenario; and the base flow for the Aquatic Base Flow scenario for both stations. Base flows in the study area were lowest in September for the 75th, 50th, and 25th percentiles. The safe yields determined for the surface-water reservoirs (14.10 Mgal/d) were added to the estimated available ground water (gross yield) in the Southeastern Narragansett and East Narragansett Islands regions to give the total available water. The water availability in the study area at the 50th percentile ranged from 33.18 Mgal/d in September to 94.62 Mgal/d in June, water availability for the 7-day, 10-year low-flow scenario at the 50th percentile ranged from 21.87 Mgal/d in September to 83.03 Mgal/d in June, and water availability for the Aquatic Base Flow scenario at the 50th percentile ranged from 14.10 Mgal/d in August and September to 65.48 Mgal/d in June. Because water withdrawals and use are greater during the summer than at other times of the year, water availability in June, July, August, and September was compared to water withdrawals in the three regions. For the study period, the withdrawals in July were higher than in the other summer months. For the 50th percentile, the ratios of water withdrawn to water available were close to one in August for the estimated basic and Aquatic Base Flow scenarios and in September for the estimated 7-day, 10-year low-flow scenario. For the 25th percentile, the ratios were close to one in August for the estimated basic and for the 7-day, 10-year low-flow scenario, and were close to one in July for the estimated Aquatic Base Flow scenario. A long-term water budget was calculated for the East Narragansett Bay study area to identify and assess inflows and outflows by region. The water withdrawals and return flows used in the budget were from 1995 through 1999. Total inflow and outflow were calculated separately for each region. Inflow was assumed to equal outflow; the total water budget was 292.1 Mgal/d for the study area. Precipitation and return flow were 99 and less than 1 percent of the total estimated inflow to the study area, respectively. Evapotranspiration, streamflow, and water withdrawals were 47, 49, and 3 percent of the total outflow from the study area, respectively.

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

Viner, Brian J.; Jannik, Tim; Stone, Daniel

Firefighters responding to wildland fires where surface litter and vegetation contain radiological contamination will receive a radiological dose by inhaling resuspended radioactive material in the smoke. This may increase their lifetime risk of contracting certain types of cancer. Using published data, we modelled hypothetical radionuclide emissions, dispersion and dose for 70th and 97th percentile environmental conditions and for average and high fuel loads at the Savannah River Site. We predicted downwind concentration and potential dose to firefighters for radionuclides of interest ( 137Cs, 238Pu, 90Sr and 210Po). Predicted concentrations exceeded dose guidelines in the base case scenario emissions of 1.0more » × 10 7 Bq ha –1 for 238Pu at 70th percentile environmental conditions and average fuel load levels for both 4- and 14-h shifts. Under 97th percentile environmental conditions and high fuel loads, dose guidelines were exceeded for several reported cases for 90Sr, 238Pu and 210Po. Potential for exceeding dose guidelines was mitigated by including plume rise (>2 m s –1) or moving a small distance from the fire owing to large concentration gradients near the edge of the fire. As a result, our approach can quickly estimate potential dose from airborne radionuclides in wildland fire and assist decision-making to reduce firefighter exposure.« less

Traffic-related air pollution increased the risk of Parkinson's disease in Taiwan: A nationwide study.

PubMed

Lee, Pei-Chen; Liu, Li-Ling; Sun, Yu; Chen, Yu-An; Liu, Chih-Ching; Li, Chung-Yi; Yu, Hwa-Lung; Ritz, Beate

2016-11-01

Ambient air pollution has been associated with many health conditions, but little is known about its effects on neurodegenerative diseases, such as Parkinson's disease (PD). In this study, we investigated the influence of ambient air pollution on PD in a nationwide population-based case-control study in Taiwan. We identified 11,117 incident PD patients between 2007 and 2009 from the Taiwanese National Health Insurance Research Database and selected 44,468 age- and gender-matched population controls from the longitudinal health insurance database. The average ambient pollutant exposure concentrations from 1998 through the onset of PD were estimated using quantile-based Bayesian Maximum Entropy models. Basing from logistic regression models, we estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of ambient pollutant exposures and PD risk. We observed positive associations between NO x , CO exposures, and PD. In multi-pollutant models, for NO x and CO above the 75th percentile exposure compared with the lowest percentile, the ORs of PD were 1.37 (95% CI=1.23-1.52) and 1.17 (95% CI=1.07-1.27), respectively. This study suggests that ambient air pollution exposure, especially from traffic-related pollutants such as NO x and CO, increases PD risk in the Taiwanese population. Copyright © 2016 Elsevier Ltd. All rights reserved.

An investigation into the probabilistic combination of quasi-static and random accelerations

NASA Technical Reports Server (NTRS)

Schock, R. W.; Tuell, L. P.

1984-01-01

The development of design load factors for aerospace and aircraft components and experiment support structures, which are subject to a simultaneous vehicle dynamic vibration (quasi-static) and acoustically generated random vibration, require the selection of a combination methodology. Typically, the procedure is to define the quasi-static and the random generated response separately, and arithmetically add or root sum square to get combined accelerations. Since the combination of a probabilistic and a deterministic function yield a probabilistic function, a viable alternate approach would be to determine the characteristics of the combined acceleration probability density function and select an appropriate percentile level for the combined acceleration. The following paper develops this mechanism and provides graphical data to select combined accelerations for most popular percentile levels.

Mortality risk attributable to high and low ambient temperature: a multicountry observational study

PubMed Central

Gasparrini, Antonio; Guo, Yuming; Hashizume, Masahiro; Lavigne, Eric; Zanobetti, Antonella; Schwartz, Joel; Tobias, Aurelio; Tong, Shilu; Rocklöv, Joacim; Forsberg, Bertil; Leone, Michela; De Sario, Manuela; Bell, Michelle L; Guo, Yue-Liang Leon; Wu, Chang-fu; Kan, Haidong; Yi, Seung-Muk; de Sousa Zanotti Stagliorio Coelho, Micheline; Saldiva, Paulo Hilario Nascimento; Honda, Yasushi; Kim, Ho; Armstrong, Ben

2015-01-01

Summary Background Although studies have provided estimates of premature deaths attributable to either heat or cold in selected countries, none has so far offered a systematic assessment across the whole temperature range in populations exposed to different climates. We aimed to quantify the total mortality burden attributable to non-optimum ambient temperature, and the relative contributions from heat and cold and from moderate and extreme temperatures. Methods We collected data for 384 locations in Australia, Brazil, Canada, China, Italy, Japan, South Korea, Spain, Sweden, Taiwan, Thailand, UK, and USA. We fitted a standard time-series Poisson model for each location, controlling for trends and day of the week. We estimated temperature–mortality associations with a distributed lag non-linear model with 21 days of lag, and then pooled them in a multivariate metaregression that included country indicators and temperature average and range. We calculated attributable deaths for heat and cold, defined as temperatures above and below the optimum temperature, which corresponded to the point of minimum mortality, and for moderate and extreme temperatures, defined using cutoffs at the 2·5th and 97·5th temperature percentiles. Findings We analysed 74 225 200 deaths in various periods between 1985 and 2012. In total, 7·71% (95% empirical CI 7·43–7·91) of mortality was attributable to non-optimum temperature in the selected countries within the study period, with substantial differences between countries, ranging from 3·37% (3·06 to 3·63) in Thailand to 11·00% (9·29 to 12·47) in China. The temperature percentile of minimum mortality varied from roughly the 60th percentile in tropical areas to about the 80–90th percentile in temperate regions. More temperature-attributable deaths were caused by cold (7·29%, 7·02–7·49) than by heat (0·42%, 0·39–0·44). Extreme cold and hot temperatures were responsible for 0·86% (0·84–0·87) of total mortality. Interpretation Most of the temperature-related mortality burden was attributable to the contribution of cold. The effect of days of extreme temperature was substantially less than that attributable to milder but non-optimum weather. This evidence has important implications for the planning of public-health interventions to minimise the health consequences of adverse temperatures, and for predictions of future effect in climate-change scenarios. Funding UK Medical Research Council. PMID:26003380

Orthopedic surgery postgraduate year 1 intern curriculum improves initial orthopedic in-training examination performance.

PubMed

Roberts, Craig S; Nyland, John; Broome, Brandon

2012-04-01

To determine the efficacy of an educational curriculum designed for orthopedic surgery postgraduate year 1 (PGY-1) interns to improve initial Orthopedic In-Training Examination (OITE) performance. A retrospective cohort study was performed that evaluated the PGY-1 intern OITE performance of one residency training program (n = 55) during 7-year periods before (1996-2002) and after structured curriculum implementation (2003-2009). Linear regression analysis revealed insignificant changes in median PGY-1 intern OITE percentile rank during the precurriculum period (R = 0.08, P = 0.53). Postcurriculum period comparisons revealed significantly improving PGY-1 intern OITE percentile rank (R = 0.46, P = 0.048). Pre- and postcurriculum median US Medical Licensing Examination (USMLE) Step I scores did not display statistically significant differences (218.2 ± 6.6 vs 229.1 ± 13.8, Mann-Whitney U test, z = -1.5, P = 0.10). Spearman rho correlations revealed a moderate relation (r = 0.61) between postcurriculum PGY-1 intern OITE percentile rank and USMLE Step I score, but not during the precurriculum period. A moderate relation (r = 0.50) also was observed between postcurriculum USMLE Step I score and average OITE percentile rank during the 5-year residency program, but not during the precurriculum period. PGY-1 intern OITE percentile rank improved significantly with the addition of a specially designed educational curriculum. The stronger USMLE Step I score and PGY-1 intern OITE percentile rank relation observed during the postcurriculum period suggests that interns who participated in the educational curriculum were better prepared to translate general medical and patient care knowledge into orthopedic surgery knowledge.

Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach

PubMed Central

Cho, Kang Su; Jung, Hae Do; Ham, Won Sik; Chung, Doo Yong; Kang, Yong Jin; Jang, Won Sik; Kwon, Jong Kyou; Choi, Young Deuk; Lee, Joo Yong

2015-01-01

Objectives To investigate whether skin-to-stone distance (SSD), which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL) in patients with upper ureter stones. Patients and Methods We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4–20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU), and SSD were determined on pretreatment non-contrast computed tomography (NCCT). For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile. Results In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032). The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL. Conclusions Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL. PMID:26659086

Short stature

MedlinePlus

... SD) or more below the average height for children of the same sex and age Below the 2.3rd percentile on ... Compare your child's height and weight to other children of the same age and sex. Talk with you if you are worried that ...

Association between blood lead and blood pressure: a population-based study in Brazilian adults.

PubMed

Almeida Lopes, Ana Carolina Bertin de; Silbergeld, Ellen Kovner; Navas-Acien, Ana; Zamoiski, Rachel; Martins, Airton da Cunha; Camargo, Alissana Ester Iakmiu; Urbano, Mariana Ragassi; Mesas, Arthur Eumann; Paoliello, Monica Maria Bastos

2017-03-14

Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension. The availability of data on blood lead levels (BLL) in adult Brazilian population is scarce and population-based studies are important for screening the population exposure and also to evaluate associations with adverse health effects. The goal of this study was to examine the association of BLL with blood pressure and hypertension in a population-based study in a city in Southern Brazil. A total of 948 adults, aged 40 years or older, were randomly selected. Information on socioeconomic, dietary, lifestyle and occupational background was obtained by orally administered household interviews. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to the guidelines VI Brazilian Guidelines on Hypertension. BLL were measured by inductively coupled plasma mass spectrometry technique. Multiple linear and logistic regression models were performed to evaluate associations of BLL with SBP and DBP, and with the chance of hypertension and of elevated SBP and DBP. The geometric mean of BLL was 1.97 μg/dL (95%CI:1.90-2.04 μg/dL). After multivariable adjustment, participants in the quartile 4 of blood lead presented 0.06 mm/Hg (95%CI, 0.04-0.09) average difference in DBP comparing with those in quartile 1. Participants in the 90th percentile of blood lead distribution had 0.07 mmHg (95% CI, 0.03 to 0.11) higher DBP compared with those participants in the 10th percentile of blood lead. The adjusted OR for hypertension was 2.54 (95% CI, 1.17-5.53), comparing the highest to the lowest blood lead quartiles. Compared with participants in the 10th percentile of blood lead, participants in the 90th percentile presented higher OR for hypertension (OR: 2.77; 95% CI, 1.41 to 5.46). At low concentrations, BLL were positively associated with DBP and with the odds for hypertension in adults aged 40 or older. It is important to enforce lead exposure monitoring and the enactment of regulatory laws to prevent lead contamination in urban settings.

77 FR 64737 - Partial Approval and Partial Disapproval of Air Quality State Implementation Plans; Nevada...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... standard was set at 15 micrograms per cubic meter ([mu]g/m\\3\\), based on the 3-year average of annual... 2.5 standard was set at 65 [mu]g/m\\3\\, based on the 3- year average of the 98th percentile of 24... partially approve the submittal based on EPA's independent evaluation of Nevada's impact on receptor states...

Estimated Daily Average Per Capita Water Ingestion by Child and Adult Age Categories Based on USDA's 1994-96 and 1998 Continuing Survey of Food Intakes by Individuals (Journal Article)

EPA Science Inventory

Current water ingestion estimates are important for the assessment of risk to human populations of exposure to water-borne pollutants. This paper reports mean and percentile estimates of the distributions of daily average per capita water ingestion for 12 age range groups. The a...

Speeds of coronal mass ejections: SMM observations from 1980 and 1984-1989

NASA Technical Reports Server (NTRS)

Hundhausen, A. J.; Burkepile, J. T.; St. Cyr, O. C.

1994-01-01

The speeds of 936 features in 673 coronal mass ejections have been determined from trajectories observed with the Solar Maximum Mission (SMM) coronagraph in 1980 and 1984 to 1989. The distribution of observed speeds has a range (from 5th to 95th percentile) of 35 to 911 km/s; the average and median speeds are 349 and 285 km/s. The speed distributions of some selected classes of mass ejections are significantly different. For example, the speeds of 331 'outer loops' range from 80 to 1042 km/s; the average and median speeds for this class of ejections are 445 and 372 km/s. The speed distributions from each year of SMM observations show significant changes, with the annual average speeds varying from 157 (1984) to 458 km/s (1985). These variations are not simply related to the solar activity cycle; the annual averages from years near the sunspot maxima and minimum are not significantly different. The widths, latitudes, and speeds of mass ejections determined from the SMM observations are only weakly correlated. In particular, mass ejection speeds vary only slightly with the heliographic latitudes of the ejection. High-latitude ejections, which occur well poleward of the active latitudes, have speeds similar to active latitude ejections.

Physical Activity, Sleep, and BMI Percentile in Rural and Urban Ugandan Youth.

PubMed

Christoph, Mary J; Grigsby-Toussaint, Diana S; Baingana, Rhona; Ntambi, James M

Uganda is experiencing a dual burden of over- and undernutrition, with overweight prevalence increasing while underweight remains common. Potential weight-related factors, particularly physical activity, sleep, and rural/urban status, are not currently well understood or commonly assessed in Ugandan youth. The purpose of this study was to pilot test a survey measuring weight-related factors in rural and urban Ugandan schoolchildren. A cross-sectional survey measured sociodemographics, physical activity, sleep patterns, and dietary factors in 148 rural and urban schoolchildren aged 11-16 in central Uganda. Height and weight were objectively measured. Rural and urban youth were compared on these factors using χ 2 and t tests. Regression was used to identify correlates of higher body mass index (BMI) percentile in the full sample and nonstunted youth. Youth were on average 12.1 ± 1.1 years old; underweight (10%) was more common than overweight (1.4%). Self-reported sleep duration and subjective sleep quality did not differ by rural/urban residence. Rural children overall had higher BMI percentile and marginally higher stunting prevalence. In adjusted analyses in both the full and nonstunted samples, higher BMI percentile was related to living in a rural area, higher frequency of physical activity, and higher subjective sleep quality; it was negatively related to being active on weekends. In the full sample, higher BMI percentile was also related to female gender, whereas in nonstunted youth, higher BMI was related to age. BMI percentile was unrelated to sedentary time, performance of active chores and sports, and dietary factors. This study is one of the first to pilot test a survey assessing weight-related factors, particularly physical activity and sleep, in Ugandan schoolchildren. BMI percentile was related to several sociodemographic, sleep, and physical activity factors among primarily normal-weight school children in Uganda, providing a basis for understanding weight status in the context of the nutrition transition. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Nutrient, suspended-sediment, and total suspended-solids data for surface water in the Great Salt Lake basins study unit, Utah, Idaho, and Wyoming, 1980-95

USGS Publications Warehouse

Hadley, Heidi K.

2000-01-01

Selected nitrogen and phosphorus (nutrient), suspended-sediment and total suspended-solids surface-water data were compiled from January 1980 through December 1995 within the Great Salt Lake Basins National Water-Quality Assessment study unit, which extends from southeastern Idaho to west-central Utah and from Great Salt Lake to the Wasatch and western Uinta Mountains. The data were retrieved from the U.S. Geological Survey National Water Information System and the State of Utah, Department of Environmental Quality, Division of Water Quality database. The Division of Water Quality database includes data that are submitted to the U.S. Environmental Protection Agency STOrage and RETrieval system. Water-quality data included in this report were selected for surface-water sites (rivers, streams, and canals) that had three or more nutrient, suspended-sediment, or total suspended-solids analyses. Also, 33 percent or more of the measurements at a site had to include discharge, and, for non-U.S. Geological Survey sites, there had to be 2 or more years of data. Ancillary data for parameters such as water temperature, pH, specific conductance, streamflow (discharge), dissolved oxygen, biochemical oxygen demand, alkalinity, and turbidity also were compiled, as available. The compiled nutrient database contains 13,511 samples from 191 selected sites. The compiled suspended-sediment and total suspended-solids database contains 11,642 samples from 142 selected sites. For the nutrient database, the median (50th percentile) sample period for individual sites is 6 years, and the 75th percentile is 14 years. The median number of samples per site is 52 and the 75th percentile is 110 samples. For the suspended-sediment and total suspended-solids database, the median sample period for individual sites is 9 years, and the 75th percentile is 14 years. The median number of samples per site is 76 and the 75th percentile is 120 samples. The compiled historical data are being used in the basinwide sampling strategy to characterize the broad-scale geographic and seasonal water-quality conditions in relation to major contaminant sources and background conditions. Data for this report are stored on a compact disc.

Delineation of gravel-bed clusters via factorial kriging

NASA Astrophysics Data System (ADS)

Wu, Fu-Chun; Wang, Chi-Kuei; Huang, Guo-Hao

2018-05-01

Gravel-bed clusters are the most prevalent microforms that affect local flows and sediment transport. A growing consensus is that the practice of cluster delineation should be based primarily on bed topography rather than grain sizes. Here we present a novel approach for cluster delineation using patch-scale high-resolution digital elevation models (DEMs). We use a geostatistical interpolation method, i.e., factorial kriging, to decompose the short- and long-range (grain- and microform-scale) DEMs. The required parameters are determined directly from the scales of the nested variograms. The short-range DEM exhibits a flat bed topography, yet individual grains are sharply outlined, making the short-range DEM a useful aid for grain segmentation. The long-range DEM exhibits a smoother topography than the original full DEM, yet groupings of particles emerge as small-scale bedforms, making the contour percentile levels of the long-range DEM a useful tool for cluster identification. Individual clusters are delineated using the segmented grains and identified clusters via a range of contour percentile levels. Our results reveal that the density and total area of delineated clusters decrease with increasing contour percentile level, while the mean grain size of clusters and average size of anchor clast (i.e., the largest particle in a cluster) increase with the contour percentile level. These results support the interpretation that larger particles group as clusters and protrude higher above the bed than other smaller grains. A striking feature of the delineated clusters is that anchor clasts are invariably greater than the D90 of the grain sizes even though a threshold anchor size was not adopted herein. The average areal fractal dimensions (Hausdorff-Besicovich dimensions of the projected areas) of individual clusters, however, demonstrate that clusters delineated with different contour percentile levels exhibit similar planform morphologies. Comparisons with a compilation of existing field data show consistency with the cluster properties documented in a wide variety of settings. This study thus points toward a promising, alternative DEM-based approach to characterizing sediment structures in gravel-bed rivers.

Modelling and mitigating dose to firefighters from inhalation of radionuclides in wildland fire smoke

DOE PAGES

Viner, Brian J.; Jannik, Tim; Stone, Daniel; ...

2015-06-12

Firefighters responding to wildland fires where surface litter and vegetation contain radiological contamination will receive a radiological dose by inhaling resuspended radioactive material in the smoke. This may increase their lifetime risk of contracting certain types of cancer. Using published data, we modelled hypothetical radionuclide emissions, dispersion and dose for 70th and 97th percentile environmental conditions and for average and high fuel loads at the Savannah River Site. We predicted downwind concentration and potential dose to firefighters for radionuclides of interest ( 137Cs, 238Pu, 90Sr and 210Po). Predicted concentrations exceeded dose guidelines in the base case scenario emissions of 1.0more » × 10 7 Bq ha –1 for 238Pu at 70th percentile environmental conditions and average fuel load levels for both 4- and 14-h shifts. Under 97th percentile environmental conditions and high fuel loads, dose guidelines were exceeded for several reported cases for 90Sr, 238Pu and 210Po. Potential for exceeding dose guidelines was mitigated by including plume rise (>2 m s –1) or moving a small distance from the fire owing to large concentration gradients near the edge of the fire. As a result, our approach can quickly estimate potential dose from airborne radionuclides in wildland fire and assist decision-making to reduce firefighter exposure.« less

Influence of anthropometry on meat-packing plant workers: an approach to the shoulder joint.

PubMed

Reis, Pedro Ferreira; Peres, Luis Sérgio; Tirloni, Adriana Seára; dos Reis, Diogo Cunha; Estrázulas, Jansen Atier; Rossato, Mateus; Moro, Antônio Renato Pereira

2012-01-01

This study was conducted with 90 poultry slaughterhouse workers, which perform the function of removing chicken parts from the conveyor belt, and sample was composed of 66 women (33.5 ± 6.5 years) and 24 men (35.7 ± 7.2 years), aiming to analyze the influence of anthropometry in the shoulder joint of these workers. Body discomfort was evaluated by a human body diagram, being applied at the end of the work shift. The anthropometric measurement of shoulder was performed by measuring the height of the acromion process, being compared with the height of the conveyor belt. Analysis of the results was performed by descriptive statistics, mean, standard deviation, percentage and percentiles 5%, 50% and 95%. It was found that the height of the conveyor belt was 1.74 meters, while the average shoulder height of workers was 1.38 meters for percentile 5%, 1.41 meters for percentile 50% and 1.65 meters for percentile 95%. The discomfort regions were shoulder 45%, neck 29%, column 26%, arms 23%, and wrists and hand 20%. The upper limb assessment was performed with percentile 5% through the Rapid Upper Limb Assessment method, resulting in a final score > 7, indicating the need for adjustments of the work organization. It was concluded that the workplace does not meet the workers' anthropometric characteristics, mainly affecting the shoulder joint, and correction ergonomics becomes necessary so that the workers involved in this study can perform their functions with health, comfort and safety.

ESTIMATING RISK TO CALIFORNIA ENERGY INFRASTRUCTURE FROM PROJECTED CLIMATE CHANGE

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

Sathaye, Jayant; Dale, Larry; Larsen, Peter

2011-06-22

This report outlines the results of a study of the impact of climate change on the energy infrastructure of California and the San Francisco Bay region, including impacts on power plant generation; transmission line and substation capacity during heat spells; wildfires near transmission lines; sea level encroachment upon power plants, substations, and natural gas facilities; and peak electrical demand. Some end-of-century impacts were projected:Expected warming will decrease gas-fired generator efficiency. The maximum statewide coincident loss is projected at 10.3 gigawatts (with current power plant infrastructure and population), an increase of 6.2 percent over current temperature-induced losses. By the end ofmore » the century, electricity demand for almost all summer days is expected to exceed the current ninetieth percentile per-capita peak load. As much as 21 percent growth is expected in ninetieth percentile peak demand (per-capita, exclusive of population growth). When generator losses are included in the demand, the ninetieth percentile peaks may increase up to 25 percent. As the climate warms, California's peak supply capacity will need to grow faster than the population.Substation capacity is projected to decrease an average of 2.7 percent. A 5C (9F) air temperature increase (the average increase predicted for hot days in August) will diminish the capacity of a fully-loaded transmission line by an average of 7.5 percent.The potential exposure of transmission lines to wildfire is expected to increase with time. We have identified some lines whose probability of exposure to fire are expected to increase by as much as 40 percent. Up to 25 coastal power plants and 86 substations are at risk of flooding (or partial flooding) due to sea level rise.« less

Histogram analysis of diffusion kurtosis imaging estimates for in vivo assessment of 2016 WHO glioma grades: A cross-sectional observational study.

PubMed

Hempel, Johann-Martin; Schittenhelm, Jens; Brendle, Cornelia; Bender, Benjamin; Bier, Georg; Skardelly, Marco; Tabatabai, Ghazaleh; Castaneda Vega, Salvador; Ernemann, Ulrike; Klose, Uwe

2017-10-01

To assess the diagnostic performance of histogram analysis of diffusion kurtosis imaging (DKI) maps for in vivo assessment of the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 CNS WHO) integrated glioma grades. Seventy-seven patients with histopathologically-confirmed glioma who provided written informed consent were retrospectively assessed between 01/2014 and 03/2017 from a prospective trial approved by the local institutional review board. Ten histogram parameters of mean kurtosis (MK) and mean diffusivity (MD) metrics from DKI were independently assessed by two blinded physicians from a volume of interest around the entire solid tumor. One-way ANOVA was used to compare MK and MD histogram parameter values between 2016 CNS WHO-based tumor grades. Receiver operating characteristic analysis was performed on MK and MD histogram parameters for significant results. The 25th, 50th, 75th, and 90th percentiles of MK and average MK showed significant differences between IDH1/2 wild-type gliomas, IDH1/2 mutated gliomas, and oligodendrogliomas with chromosome 1p/19q loss of heterozygosity and IDH1/2 mutation (p<0.001). The 50th, 75th, and 90th percentiles showed a slightly higher diagnostic performance (area under the curve (AUC) range; 0.868-0.991) than average MK (AUC range; 0.855-0.988) in classifying glioma according to the integrated approach of 2016 CNS WHO. Histogram analysis of DKI can stratify gliomas according to the integrated approach of 2016 CNS WHO. The 50th (median), 75th , and the 90th percentiles showed the highest diagnostic performance. However, the average MK is also robust and feasible in routine clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk of selected structural abnormalities in infants after increased nuchal translucency measurement.

PubMed

Baer, Rebecca J; Norton, Mary E; Shaw, Gary M; Flessel, Monica C; Goldman, Sara; Currier, Robert J; Jelliffe-Pawlowski, Laura L

2014-12-01

We sought to examine the association between increased first-trimester fetal nuchal translucency (NT) measurement and major noncardiac structural birth defects in euploid infants. Included were 75,899 singleton infants without aneuploidy or critical congenital heart defects born in California in 2009 through 2010 with NT measured between 11-14 weeks of gestation. Logistic binomial regression was employed to estimate relative risks (RRs) and 95% confidence intervals (CIs) for occurrence of birth defects in infants with an increased NT measurement (by percentile at crown-rump length [CRL] and by ≥3.5 mm compared to those with measurements <90th percentile for CRL). When considered by CRL adjusted percentile and by measurement ≥3.5 mm, infants with a NT ≥95th percentile were at risk of having ≥1 major structural birth defects (any defect, RR, 1.6; 95% CI, 1.3-1.9; multiple defects, RR, 2.1; 95% CI, 1.3-3.4). Infants with a NT measurement ≥95th percentile were at particularly high risk for pulmonary, gastrointestinal, genitourinary, and musculoskeletal anomalies (RR, 1.6-2.7; 95% CI, 1.1-5.4). Our findings demonstrate that risks of major pulmonary, gastrointestinal, genitourinary, and musculoskeletal structural birth defects exist for NT measurements ≥95th percentile. The ≥3-fold risks were observed for congenital hydrocephalus; agenesis, hypoplasia, and dysplasia of the lung; atresia and stenosis of the small intestine; osteodystrophies; and diaphragm anomalies. Copyright © 2014 Elsevier Inc. All rights reserved.

Deployments, Stress, and Soldiers' Academic Performance

ERIC Educational Resources Information Center

Perot, Mindy

2012-01-01

This study focused on identifying whether certain factors affected the academic performance of Soldiers attending an Army educational institution. Academic performance was measured by the grade percentile average of the participant upon the completion of their course of enrollment. Factors that were considered within the study through…

Process-based modelling to evaluate simulated groundwater levels and frequencies in a Chalk catchment in south-western England

NASA Astrophysics Data System (ADS)

Brenner, Simon; Coxon, Gemma; Howden, Nicholas J. K.; Freer, Jim; Hartmann, Andreas

2018-02-01

Chalk aquifers are an important source of drinking water in the UK. Due to their properties, they are particularly vulnerable to groundwater-related hazards like floods and droughts. Understanding and predicting groundwater levels is therefore important for effective and safe water management. Chalk is known for its high porosity and, due to its dissolvability, exposed to karstification and strong subsurface heterogeneity. To cope with the karstic heterogeneity and limited data availability, specialised modelling approaches are required that balance model complexity and data availability. In this study, we present a novel approach to evaluate simulated groundwater level frequencies derived from a semi-distributed karst model that represents subsurface heterogeneity by distribution functions. Simulated groundwater storages are transferred into groundwater levels using evidence from different observations wells. Using a percentile approach we can assess the number of days exceeding or falling below selected groundwater level percentiles. Firstly, we evaluate the performance of the model when simulating groundwater level time series using a spilt sample test and parameter identifiability analysis. Secondly, we apply a split sample test to the simulated groundwater level percentiles to explore the performance in predicting groundwater level exceedances. We show that the model provides robust simulations of discharge and groundwater levels at three observation wells at a test site in a chalk-dominated catchment in south-western England. The second split sample test also indicates that the percentile approach is able to reliably predict groundwater level exceedances across all considered timescales up to their 75th percentile. However, when looking at the 90th percentile, it only provides acceptable predictions for long time periods and it fails when the 95th percentile of groundwater exceedance levels is considered. By modifying the historic forcings of our model according to expected future climate changes, we create simple climate scenarios and we show that the projected climate changes may lead to generally lower groundwater levels and a reduction of exceedances of high groundwater level percentiles.

The Use of a “Hybrid” Trainer in an Established Laparoscopic Skills Program

PubMed Central

Colsant, Brian J.; Lynch, Paul J.; Herman, Björn; Klonsky, Jonathan; Young, Steven M.

2006-01-01

Objectives: Tabletop inanimate trainers have proven to be a safe, inexpensive, and convenient platform for developing laparoscopic skills. Historically, programs that utilize these trainers rely on subjective evaluation of errors and time as the only measures of performance. Virtual reality simulators offer more extensive data collection capability, but they are expensive and lack realism. This study reviews a new electronic proctor (EP), and its performance within the Rosser Top Gun Laparoscopic Skills and Suturing Program. This “hybrid” training device seeks to capture the strengths of both platforms by providing an affordable, reliable, realistic training arena with metrics to objectively evaluate performance. Methods: An electronic proctor was designed for use in conjunction with drills from the Top Gun Program. The tabletop trainers used were outfitted with an automated electromechanically monitored task arena. Subjects performed 10 repetitions of each of 3 drills: “Cup Drop,” “Triangle Transfer,” and “Intracorporeal Suturing.” In real time, this device evaluates for instrument targeting accuracy, economy of motion, and adherence to the rules of the exercises. A buzzer and flashing light serve to alert the student to inaccuracies and breaches of the defined skill transference parameters. Results: Between July 2001 and June 2003, 117 subjects participated in courses. Seventy-three who met data evaluation criteria were assessed and compared with 744 surgeons who had previously taken the course. The total time to complete each task was significantly longer with the EP in place. The Cup Drop drill with the EP had a mean total time of 1661 seconds (average, 166.10) with 54.49 errors (average, 5.45) vs. 1252 seconds (average, 125.2) without the EP (P=0.000, t=6.735, df=814). The Triangle Transfer drill mean total time was 556 seconds (average, 55.63) and 167.57 errors (average. 16.75) (EP) vs. 454 seconds (non-EP) (average. 45.4) (P=0.000, t=4.447, df=814). The mean total times of the suturing task was 1777 seconds (average, 177.73) and 90.46 errors (average. 9.04) (EP) vs. 1682 seconds (non-EP) (average, 168.2) (P=0.040, t=1.150, df=814). When compared with surgeons who had participated in the Top Gun course prior to EP, the participants in the study collectively scored in the 18.3th percentile with the Cup Drop drill, 22.6th percentile with the Triangle Transfer drill, and 36.7th percentile with the Intracorporeal Suturing exercise. When penalizing for errors recorded by the EP, participants scored collectively in the 9.9th, 0.1th, and 17.7th percentile, respectively. No equipment failures occurred, and the agenda of the course did not have to be modified to accommodate the new platform. Conclusions: The EP utilized during the Top Gun Course was introduced without modification of the core curriculum and experienced no device failures. This hybrid trainer offers a cost-effective inanimate simulator that brings quality performance monitoring to traditional inanimate trainers. It appears that the EP influenced student performance by alerting them to errors made, thus causing an increased awareness of and focus on precision and accuracy. This suggests that the EP could have internal guidance capabilities. However, validation studies must be done in the future. PMID:16709348

[Spatial heterogeneity in body condition of small yellow croaker in Yellow Sea and East China Sea based on mixed-effects model and quantile regression analysis].

PubMed

Liu, Zun-Lei; Yuan, Xing-Wei; Yan, Li-Ping; Yang, Lin-Lin; Cheng, Jia-Hua

2013-09-01

By using the 2008-2010 investigation data about the body condition of small yellow croaker in the offshore waters of southern Yellow Sea (SYS), open waters of northern East China Sea (NECS), and offshore waters of middle East China Sea (MECS), this paper analyzed the spatial heterogeneity of body length-body mass of juvenile and adult small yellow croakers by the statistical approaches of mean regression model and quantile regression model. The results showed that the residual standard errors from the analysis of covariance (ANCOVA) and the linear mixed-effects model were similar, and those from the simple linear regression were the highest. For the juvenile small yellow croakers, their mean body mass in SYS and NECS estimated by the mixed-effects mean regression model was higher than the overall average mass across the three regions, while the mean body mass in MECS was below the overall average. For the adult small yellow croakers, their mean body mass in NECS was higher than the overall average, while the mean body mass in SYS and MECS was below the overall average. The results from quantile regression indicated the substantial differences in the allometric relationships of juvenile small yellow croakers between SYS, NECS, and MECS, with the estimated mean exponent of the allometric relationship in SYS being 2.85, and the interquartile range being from 2.63 to 2.96, which indicated the heterogeneity of body form. The results from ANCOVA showed that the allometric body length-body mass relationships were significantly different between the 25th and 75th percentile exponent values (F=6.38, df=1737, P<0.01) and the 25th percentile and median exponent values (F=2.35, df=1737, P=0.039). The relationship was marginally different between the median and 75th percentile exponent values (F=2.21, df=1737, P=0.051). The estimated body length-body mass exponent of adult small yellow croakers in SYS was 3.01 (10th and 95th percentiles = 2.77 and 3.1, respectively). The estimated body length-body mass relationships were significantly different from the lower and upper quantiles of the exponent (F=3.31, df=2793, P=0.01) and the median and upper quantiles (F=3.56, df=2793, P<0.01), while no significant difference was observed between the lower and median quantiles (F=0.98, df=2793, P=0.43).

Coherent motion threshold measurements for M-cell deficit differ for above- and below-average readers.

PubMed

Solan, Harold A; Hansen, Peter C; Shelley-Tremblay, John; Ficarra, Anthony

2003-11-01

Research during the past 20 years has influenced the management of diagnosis and treatment of children identified as having learning-related vision problems. The intent of this study is to determine whether coherent motion threshold testing can distinguish better-than-average non-disabled (ND) readers from those who are moderately reading disabled (RD) among sixth-grade students. A sample of 23 better-than-average non-disabled readers (> or = 80th percentile) and 27 moderately disabled readers (< or = 32nd percentile) were identified using a standardized reading comprehension test. Each participant was tested for coherent motion threshold. Previous psychophysical and fMRI research with adults suggests that coherent motion threshold is a valid measure of magnocellular (M-cell) integrity. The average of two coherent motion threshold trials was significantly greater for moderately reading disabled subjects than for above-average readers (p < 0.01). The mean threshold percentage of dots required to observe lateral motion was 9.2% for moderately reading disabled readers and 4.6% for superior readers (p = 0.001). The outcome of this preliminary study provides an efficient procedure to identify sixth-grade students whose reading disability may be associated with an M-cell deficit. Our previous investigations involving visual processing, visual attention, and oculomotor therapy have resulted in significant improvements in reading comprehension, visual attention, and eye movements. It remains to be demonstrated whether vision therapy has an impact on the M-cell deficit, as measured with coherent motion threshold testing for moderately disabled readers.

Assessment of operative times of multiple surgical specialties in a public university hospital

PubMed Central

Costa, Altair da Silva

2017-01-01

ABSTRACT Objective To evaluate the indicators duration of anesthesia, operative time and time patients stay in the operating rooms of different surgical specialties at a public university hospital. Methods It was done by a descriptive cross-sectional study based on the operating room database. The following stages were measured: duration of anesthesia, procedure time and patient length of stay in the room of the various specialties. We included surgeries carried out in sequence in the same room, between 7:00 a.m. and 5 p.m., either elective or emergency. We calculated the 80th percentile of the stages, where 80% of procedures were below this value. Results The study measured 8,337 operations of 12 surgical specialties performed within one year. The overall mean duration of anesthesia of all specialties was 178.12±110.46 minutes, and the 80th percentile was 252 minutes. The mean operative time was 130.45±97.23 minutes, and the 80th percentile was 195 minutes. The mean total time of the patient in the operating room was 197.30±113.71 minutes, and the 80th percentile was 285 minutes. Thus, the variation of the overall mean compared to the 80th percentile was 41% for anesthesia, 49% for surgeries and 44% for operating room time. In average, anesthesia took up 88% of the operating room period, and surgery, 61%. Conclusion This study identified patterns in the duration of surgery stages. The mean values of the specialties can assist with operating room planning and reduce delays. PMID:28767919

Crystallized verbal skills in schizophrenia: relationship to neurocognition, symptoms, and functional status.

PubMed

Kurtz, Matthew M; Donato, Jad; Rose, Jennifer

2011-11-01

To study the relationship of superior (i.e., ≥ 90th percentile), average (11th-89th percentile) or extremely low (i.e., ≤ 10th percentile) crystallized verbal skills to neurocognitive profiles, symptoms and everyday life function in schizophrenia. Crystallized verbal skill was derived from Vocabulary subtest scores from the Wechsler Adult Intelligence Scale (WAIS). Out of a sample of 165 stable outpatients with schizophrenia we identified 25 participants with superior crystallized verbal skill, 104 participants with average verbal skill, and 36 participants with extremely low crystallized verbal skill. Each participant was administered measures of attention, working memory, verbal learning and memory, problem-solving and processing speed, as well as symptom and performance-based adaptive life skill assessments. The magnitude of neuropsychological impairment across the three groups was different, after adjusting for group differences in education and duration of illness. Working memory, and verbal learning and memory skills were different across all three groups, while processing speed differentiated the extremely low verbal skill group from the other two groups and problem-solving differentiated the very low verbal skill group from the superior verbal skill group. There were no group differences in sustained attention. Capacity measures of everyday life skills were different across each of the three groups. Crystallized verbal skill in schizophrenia is related to the magnitude of impairment in neurocognitive function and performance-based skills in everyday life function. Patterns of neuropsychological impairment were similar across different levels of crystallized verbal skill.

Dynamic cervicomedullary cord compression and alterations in cerebrospinal fluid dynamics in children with achondroplasia: review of an 11-year surgical case series.

PubMed

Mukherjee, Debraj; Pressman, Barry D; Krakow, Deborah; Rimoin, David L; Danielpour, Moise

2014-09-01

Achondroplasia may be associated with compression at the cervicomedullary junction. Determining which patients are at greatest risk for neurological complications of cervicomedullary compression can be difficult. In the current study the authors reviewed their records to determine the incidence and clinical significance of dynamic cervicomedullary stenosis and obstruction of CSF flow along with surgical outcomes following posterior fossa decompression. The authors reviewed 34 consecutive cases involving symptomatic children with achondroplasia undergoing cervicomedullary decompression performed by a single surgeon over 11 years. Of these patients, 29 had undergone preoperative dynamic MRI of the cervicomedullary junction with cine (cinema) CSF flow studies; 13 of these patients underwent postoperative dynamic MRI studies. Clinical outcomes included changes in polysomnography, head circumference percentile, and fontanel characteristics. Radiographic outcomes included changes in dynamic spinal cord diameter, improvement in CSF flow at the foramen magnum, and change in the Evans ratio. Patients were predominantly female, with a mean age at presentation of 6.6 years and mean follow-up of 3.7 years (range 1-10 years). All patients had moderate to excellent improvement in postoperative polysomnography, slight decrease in average head circumference percentile (from 46.9th percentile to 45.7th percentile), and no subjective worsening of fontanel characteristics. The Evans ratio decreased by 2%, spinal cord diameter increased an average of 3.1 mm, 5.2 mm, and 0.2 mm in the neutral, flexed, and extended positions, respectively, and CSF flow improved qualitatively in all 3 positions. There were no postoperative infections, CSF leaks, or other major complications. None of the patients undergoing initial foramen magnum decompression performed at our medical center required reoperation. Patients with achondroplasia and symptomatic cervicomedullary compression have increased risk of dynamic stenosis at the foramen magnum evident upon dynamic cine MRI. Operative decompression may be offered with low risk of complications or need for reoperation.

Effects of an education program on the health and illness profile of rural breast-fed babies.

PubMed

Nakao, R M

1988-01-01

In the Philippines, researchers followed 135 babies born between August 1985-January 1986 to determine the effects of health education on infant health. Mothers in the experimental group learned about infant care, frequent nursing, personal hygiene, waiting until 4-6 months to begin supplementary foods, and the importance of the colostrum. Those in the control group received no such education. Both groups of mothers breast fed. 65% of the babies in the control group were healthy after 1 month, 48% after 4 months, 64% after 6 months, and 25% at 1 year while 57% of those from the experimental group were healthy after 1 month, 52% after 2 months, 3% after 5 months, and non at 1 year. There was a statistical difference in mean weights between the experimental and control groups at birth, 8 and 11 months. The average weights for babies in the experimental group were in the Class II category (weight for age 25th percentile and or = 50% percentile) while the average weight for those in the control group were in the Class I category (weight for age or = 25% percentile). Babies of multigravida mothers were more likely to be in Class III and IV (both classes 50th percentile) categories than those of primigravida mothers. No experimental group 5-7 month old babies had gastroenteritis while 6.1% 5 month olds, 16.1% 6 month olds, and 17.1% 7 months old in the control group had gastroenteritis. The incidence of respiratory infections was higher among control babies than experimental babies, except at 9 months. The incidence of fever was basically the same in both groups, except 9 and 12 month old experimental babies did not have any fever. Results of this study indicate that health education on infant health contributes to a lower incidence of gastroenteritis and respiratory infections and to higher weight gains.

Gamified Twitter Microblogging to Support Resident Preparation for the American Board of Surgery In-Service Training Examination.

PubMed

Lamb, Laura C; DiFiori, Monica M; Jayaraman, Vijay; Shames, Brian D; Feeney, James M

We sought to determine if a daily gamified microblogging project improves American Board of Surgery In-Service Training Examination (ABSITE) scores for participants. In July 2016, we instituted a gamified microblogging project using Twitter as the platform and modified questions from one of several available question banks. A question of the day was posted at 7-o׳clock each morning, Monday through Friday. Respondents were awarded points for speed, accuracy, and contribution to discussion topics. The moderator challenged respondents by asking additional questions and prompted them to find evidence for their claims to fuel further discussion. Since 4 months into the microblogging program, a survey was administered to all residents. Responses were collected and analyzed. After 6 months of tweeting, residents took the ABSITE examination. We compared participating residents׳ ABSITE percentile rank to those of their nonparticipating peers. We also compared residents׳ percentile rank from 2016 to those in 2017 after their participation in the microblogging project. The University of Connecticut general surgery residency is an integrated program that is decentralized across 5 hospitals in the central Connecticut region, including Saint Francis Hospital and Medical Center, located in Hartford. We advertised our account to the University of Connecticut general surgery residents. Out of 45 residents, 11 participated in Twitter microblogging (24.4%) and 17 responded to the questionnaire (37.8%). In all, 100% of the residents who were participating in Twitter reported that daily microblogging prompted them to engage in academic reading. Twitter participants significantly increased their ABSITE percentile rank from 2016 to 2017 by an average of 13.7% (±14.1%) while nonparticipants on average decreased their ABSITE percentile rank by 10.0% (±16.6) (p = 0.003). Microblogging via Twitter with gamification is a feasible strategy to facilitate improving performance on the ABSITE, especially in a geographically distributed residency. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

ERIC Educational Resources Information Center

Jones, Roger; Panda, Mukta; Desbiens, Norman

2008-01-01

Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

[Penis growth and development in children and adolescents: a study based on GAMLSS].

PubMed

Yi, Qing-Jie; Zeng, Yan; Zeng, Qing; Wang, Yi-Nan; Xiong, Feng

2017-08-01

To investigate penis development in children and adolescents aged 0-16 years, and to plot the percentile curve for penis development in different age groups. A total of 3 024 normal male neonates, children, and adolescents aged 0-16 years in Chongqing, China were selected by simple random sampling and stratified cluster sampling. The length and diameter of the penis were measured for all subjects. A descriptive statistical analysis was used to investigate the data characteristics of the penis, and the GAMLSS fitting model was used to plot the percentile curves of P 3 , P 10 , P 25 , P 50 , P 75 , P 90 , and P97 and obtain percentile reference values. The length and diameter of the penis grew rapidly before the age of 1 year, grew relatively slowly from 1 to 11 years old, and entered a rapid growth period from 11 years old. The length of the penis was positively correlated with its diameter (r=0.961, P<0.01). The percentile reference values of penis length and diameter were obtained and the percentile curve was plotted. The growth and development of penis length is consistent with that of penis diameter in male children and adolescents in Chongqing, and 0-1 year and 11-16 years are rapid growth periods of penis length and diameter. The percentile curve of penis length and diameter in children and adolescents aged 0-16 years in Chongqing which has been established will provide a reference for further studies on sexual development in children and adolescents.

Consensus Based Definition of Growth Restriction in the Newborn.

PubMed

Beune, Irene M; Bloomfield, Frank H; Ganzevoort, Wessel; Embleton, Nicholas D; Rozance, Paul J; van Wassenaer-Leemhuis, Aleid G; Wynia, Klaske; Gordijn, Sanne J

2018-05-01

To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight <10th percentile; head circumference <10th percentile; length <10th percentile; prenatal diagnosis of fetal growth restriction; and maternal pregnancy information. Consensus was reached on a definition for growth restriction in the newborn. This definition recognizes that infants with birth weights <10th percentile may not be growth restricted and that infants with birth weights >10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction. Copyright © 2017 Elsevier Inc. All rights reserved.

Variability of Arthroscopy Case Volume in Orthopaedic Surgery Residency.

PubMed

Gil, Joseph A; Waryasz, Gregory R; Owens, Brett D; Daniels, Alan H

2016-05-01

To examine orthopaedic surgery case logs for arthroscopy case volume during residency training and to evaluate trends in case volume and variability over time. Publicly available Accreditation Council for Graduate Medical Education surgical case logs from 2007 to 2013 for orthopaedic surgery residency were assessed for variability and case volume trends in shoulder, elbow, wrist, hip, knee, and ankle arthroscopy. The national average number of procedures performed in each arthroscopy category reported was directly compared from 2009 to 2013. The 10th and 90th percentile arthroscopy case volume was compared between 2007 and 2013 for shoulder and knee arthroscopy procedures. Subsequently, the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2007 was compared with the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2013. From 2007 to 2013, shoulder arthroscopy procedures performed per resident increased by 43.1% (P = .0001); elbow arthroscopy procedures increased by 28.0% (P = .00612); wrist arthroscopy procedures increased by 8.6% (P = .05); hip arthroscopy procedures, which were first reported in 2012, increased by 588.9%; knee arthroscopy procedures increased by 8.5% (P = .0435); ankle arthroscopy increased by 27.6% (P = .00149). The difference in knee and shoulder arthroscopy volume between residents in the 10th and 90th percentile in 2007 and residents in the 10th and 90th percentile in 2013 was not significant (P > .05). There was a 3.66-fold difference in knee arthroscopy volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 3.36-fold in 2013 (P = .70). There was a 5.86-fold difference in shoulder arthroscopy case volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 4.96-fold in 2013 (P = .29). The volume of arthroscopy cases performed by graduating orthopaedic surgery residents has significantly increased over time. There continues to be substantial variability in knee and shoulder arthroscopy case volume between residents in the 10th and 90th percentile. Variability in residency training is notable and may affect knowledge, skill, and practice patterns of surgeons. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The impact of a medication record sharing program among diabetes patients under a single-payer system: The role of inquiry rate.

PubMed

Lin, Jin-Hung; Cheng, Shou-Hsia

2018-08-01

Taiwan's single health insurer introduced a medication record exchange platform, the PharmaCloud program, in 2013. This study aimed to evaluate the effects of the medication record inquiry rate on medication duplication among patients with diabetes. A retrospective pre-post design with a comparison group was conducted using nationwide health insurance claim data of diabetic patients from 2013 to 2014. Patients whose medication record inquiry rate fell within the upper 25th percentile were classified as the high-inquiry group, and the others as the low-inquiry group. The dependent variables were the likelihood of receiving duplicated medication and the overlapped medication days of the study subjects. Generalized estimation equations with difference-in-difference analysis were calculated to examine the net effect of the PharmaCloud inquiry rate for a matched sub-sample. In total, 106,508 patients with diabetes were randomly selected. From 2013 to 2014, the medication duplication rate was reduced 7.76 percentile (54.12%-46.36%) for the high-inquiry group and 9.58 percentile (63.72%-54.14%) for the low-inquiry group; the average medication overlap periods were shortened 4.36 days (8.49-4.13) and 6.29 days (11.28-4.99), respectively. The regression models showed patients in the high-inquiry group were more likely to receive duplicated medication (OR = 1.11, 95% C.I. = 1.07-1.16) and with longer overlapped days (7.53%, P = 0.0081) after the program. The medication record sharing program has reduced medication duplication among diabetes patients. However, higher inquiry rate did not lead to greater reduction in medication duplication; the overall effect might be due to enhanced internal control via prescription alert system in hospitals rather physician's review of the records. Copyright © 2018 Elsevier B.V. All rights reserved.

Contrast sensitivity measured by two different test methods in healthy, young adults with normal visual acuity.

PubMed

Koefoed, Vilhelm F; Baste, Valborg; Roumes, Corinne; Høvding, Gunnar

2015-03-01

This study reports contrast sensitivity (CS) reference values obtained by two different test methods in a strictly selected population of healthy, young adults with normal uncorrected visual acuity. Based on these results, the index of contrast sensitivity (ICS) is calculated, aiming to establish ICS reference values for this population and to evaluate the possible usefulness of ICS as a tool to compare the degree of agreement between different CS test methods. Military recruits with best eye uncorrected visual acuity 0.00 LogMAR or better, normal colour vision and age 18-25 years were included in a study to record contrast sensitivity using Optec 6500 (FACT) at spatial frequencies of 1.5, 3, 6, 12 and 18 cpd in photopic and mesopic light and CSV-1000E at spatial frequencies of 3, 6, 12 and 18 cpd in photopic light. Index of contrast sensitivity was calculated based on data from the three tests, and the Bland-Altman technique was used to analyse the agreement between ICS obtained by the different test methods. A total of 180 recruits were included. Contrast sensitivity frequency data for all tests were highly skewed with a marked ceiling effect for the photopic tests. The median ICS for Optec 6500 at 85 cd/m2 was -0.15 (95% percentile 0.45), compared with -0.00 (95% percentile 1.62) for Optec at 3 cd/m2 and 0.30 (95% percentile 1.20) FOR CSV-1000E. The mean difference between ICSFACT 85 and ICSCSV was -0.43 (95% CI -0.56 to -0.30, p<0.00) with limits of agreement (LoA) within -2.10 and 1.22. The regression line on the difference of average was near to zero (R2=0.03). The results provide reference CS and ICS values in a young, adult population with normal visual acuity. The agreement between the photopic tests indicated that they may be used interchangeably. There was little agreement between the mesopic and photopic tests. The mesopic test seemed best suited to differentiate between candidates and may therefore possibly be useful for medical selection purposes. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Ambient temperature and air quality in relation to small for gestational age and term low birthweight

PubMed Central

Ha, Sandie; Zhu, Yeyi; Liu, Danping; Sherman, Seth; Mendola, Pauline

2017-01-01

Background Exposures to extreme ambient temperature and air pollution are linked to adverse birth outcomes, but the associations with small for gestational age (SGA) and term low birthweight (tLBW) are unclear. We aimed to investigate exposures to site-specific temperature extremes and selected criteria air pollutants in relation to SGA and tLBW. Methods We linked medical records of 220,572 singleton births (2002–2008) from 12 US sites to local temperature estimated by the Weather Research and Forecasting model, and air pollution estimated by modified Community Multiscale Air Quality models. Exposures to hot (>95th percentile) and cold (<5th percentile) were defined using site-specific distributions of daily temperature over three-month preconception, each trimester, and whole-pregnancy. Average concentrations of five criteria air pollutants and six fine particulate matter constituents were also calculated for these pregnancy windows. Poisson regression with generalized estimating equations calculated the relative risks (RR) and 95% confidence intervals for SGA (weight <10th percentile conditional on gestational age and sex) and tLBW (≥37 weeks and <2,500 grams) associated with an interquartile range increment of air pollutants, and cold or hot compared to mild (5–95th percentile) temperature. Models were adjusted for maternal demographics, lifestyle, and clinical factors, season, and site. Results Compared to mild temperature, cold exposure during trimester 2 [RR: 1.21 (1.05–1.38)], trimester 3 [RR: 1.18 (1.03–1.36)], and whole-pregnancy [RR: 2.57 (2.27–2.91)]; and hot exposure during trimester 3 [RR: 1.31 (1.15–1.50)] and whole-pregnancy [RR: 2.49 (2.20–2.83)] increased tLBW risk. No consistent association was observed between temperature and SGA. Air pollutant analyses were generally null but preconception elemental carbon was associated with a 4% increase in SGA while dust particles increased tLBW by 10%. Particulate matter ≤10 microns in the second trimester and whole pregnancy also appeared related to tLBW. Conclusions: Our findings suggest prenatal exposures to extreme ambient temperature relative to usual environment may increase tLBW risk. Given concerns related to climate change, these findings merit further investigation. PMID:28258738

Metabolic effects of antipsychotics in prepubertal children: a retrospective chart review.

PubMed

Ebert, Tanya; Midbari, Yael; Shmilovitz, Ronen; Kosov, Ira; Kotler, Moshe; Weizman, Abraham; Ram, Anca

2014-05-01

Antipsychotics, especially atypical ones, are in common use in children and adolescents with psychotic or affective spectrum disorders, as well as in various other psychopathologies. The adverse effects of atypical antipsychotics in children and adolescents are similar to those seen in adults, and include weight gain, elevated blood glucose levels, and hyperlipidemia. In this retrospective chart review, we compared these adverse events in children who were treated with typical, atypical, or no antipsychotic treatment. The medical charts of 72 children, 65 boys and 7 girls, were reviewed. All children were 6-13 years old (mean age 9.5±1.7 years). In total, 48 children received antipsychotic treatment, and 24 children were in the control group. Data were extracted from the medical charts, including weight, height, body mass index (BMI), blood pressure, aspartate transaminase (AST), alanine transaminase (ALT), triglycerides, total cholesterol, and glucose blood levels. We examined the values in the beginning of the antipsychotic treatment and at release from the hospital in the study group, and at admission and in the end of the drug-free period or at release from the hospital (a duration of at least 4 weeks) in the control group. The average weight gain was 3.9±3.8 kg in the atypical antipsychotic treatment (AAT) group, 1.1±4.4 kg in the typical antipsychotic treatment (TAT) group, and 0.23±2.9 kg in the control group. The average increase in BMI was 15.1±22.0 percentiles in the AAT group, 6.4±14.2 percentiles in the TAT group, and 1.6±12.5 percentiles in the control group. No statistically significant difference was found in the increase in height percentile. There were no significant differences in the rates of elevated values of serum triglycerides, cholesterol, AST, ALT, or fasting blood glucose. We found a significant increase in both absolute weight gain and BMI percentile following atypical antipsychotic treatment. In contrast, typical antipsychotic treatment did not affect weight gain significantly, and the same was true for the control group. In addition, the rates of elevated values of biochemical parameters (AST, ALT, total cholesterol, triglycerides, and fasting blood glucose levels) were very low at the beginning of the study, and were not significantly altered by the various treatments.

A Two-Step Method to Identify Positive Deviant Physician Organizations of Accountable Care Organizations with Robust Performance Management Systems.

PubMed

Pimperl, Alexander F; Rodriguez, Hector P; Schmittdiel, Julie A; Shortell, Stephen M

2018-06-01

To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). Third National Survey of Physician Organizations (NSPO3, n = 1,398). Organizational and external factors from NSPO3 were analyzed. Linear regression estimated the association of internal and contextual factors on PMSYS. Two cutpoints (75th/90th percentiles) identified PDs with the largest residuals and highest PMSYS scores. A total of 65 and 41 PDs were identified using 75th and 90th percentiles cutpoints, respectively. The 90th percentile more strongly differentiated PDs from non-PDs. Having a high proportion of vulnerable patients appears to constrain PMSYS development. Our PD identification method increases the likelihood that PD organizations selected for in-depth inquiry are high-performing organizations that exceed expectations. © Health Research and Educational Trust.

Extent of areal inundation of riverine wetlands along five river systems in the upper Hillsborough river watershed, west-central Florida

USGS Publications Warehouse

Lewelling, B.R.

2004-01-01

Riverine and palustrine wetlands are a major ecological component of river basins in west-central Florida. Healthy wetlands are dependent, in part, upon the frequency and duration of periodic flooding or inundation. This report assesses the extent, area, depth, frequency, and duration of periodic flooding and the effects of potential surface-water withdrawals on wetlands along five river systems in the upper Hillsborough River watershed: Hillsborough and New Rivers, Blackwater and Itchepackesassa Creeks, and East Canal. Results of the study were derived from step-backwater analyses performed for each of the river systems using the U.S. Army Corps of Engineers Hydrologic Engineering Center-River Analysis System (HEC-RAS) one-dimensional model. Step-backwater analyses were performed based on daily mean discharges at the 10th, 50th, 70th, 80th, 90th, 95th, 99.5th, and 99.97th percentiles for selected periods. The step-backwater analyses computed extent of inundation, area of inundation, and hydraulic depth. An assessment of the net reduction of areal inundation for each of the selected percentile discharges was computed if 10 percent of the total river flow were diverted for potential withdrawals. The extent of areal inundation at a cross section is controlled by discharge volume, topography, and the degree to which the channel is incised. Areal inundation can occur in reaches characterized by low topographic relief in the upper Hillsborough watershed during most, if not all, selected discharge percentiles. Most river systems in the watershed, however, have well defined and moderately incised channels that generally confine discharges within the banks at the 90th percentile. The greatest increase in inundated area along the five river systems generally occurred between the 95th to 99.5th percentile discharges. The decrease in inundated area that would result from a potential 10-percent discharge withdrawal at the five river systems ranged as follows: Hillsborough River, 7 to 940 acres (2.0 to 6.0 percent); and New River, 0.2 to 58.9 acres (0 to 11.9 percent); Blackwater Creek, 3.3 to 148 acres (2.2 to 9.4 percent); Itchepackesassa Creek, 1.0 to 104 acres (0.9 to 10.8 percent); and East Canal 0.7 to 34.6 acres (0.5 to 7.6 percent).

Defect Detection of Steel Surfaces with Global Adaptive Percentile Thresholding of Gradient Image

NASA Astrophysics Data System (ADS)

Neogi, Nirbhar; Mohanta, Dusmanta K.; Dutta, Pranab K.

2017-12-01

Steel strips are used extensively for white goods, auto bodies and other purposes where surface defects are not acceptable. On-line surface inspection systems can effectively detect and classify defects and help in taking corrective actions. For detection of defects use of gradients is very popular in highlighting and subsequently segmenting areas of interest in a surface inspection system. Most of the time, segmentation by a fixed value threshold leads to unsatisfactory results. As defects can be both very small and large in size, segmentation of a gradient image based on percentile thresholding can lead to inadequate or excessive segmentation of defective regions. A global adaptive percentile thresholding of gradient image has been formulated for blister defect and water-deposit (a pseudo defect) in steel strips. The developed method adaptively changes the percentile value used for thresholding depending on the number of pixels above some specific values of gray level of the gradient image. The method is able to segment defective regions selectively preserving the characteristics of defects irrespective of the size of the defects. The developed method performs better than Otsu method of thresholding and an adaptive thresholding method based on local properties.

Prediction and Stability of Reading Problems in Middle Childhood

ERIC Educational Resources Information Center

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

2015-01-01

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

Baseline Serum Testosterone in Men Treated With Androgen Deprivation Therapy and Radiotherapy for Localized Prostate Cancer

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

Roach, Mack, E-mail: mroach@radonc.ucsf.ed; Bae, Kyounghwa; Lawton, Colleen

Introduction: It is believed that men diagnosed with prostate cancer and a low baseline serum testosterone (BST) may have more aggressive disease, and it is frequently recommended they forgo testosterone replacement therapy. We used two large Phase III trials involving androgen deprivation therapy and external beam radiation therapy to assess the significance of a BST. Methods and Materials: All patients with a BST and complete data (n = 2,478) were included in this analysis and divided into four categories: 'Very Low BST' (VLBST) {<=}16.5th percentile of BST ({<=}248 ng/dL; n = 408); 'Low BST' (LBST) >16.5th percentile and {<=}33rd percentilemore » (>248 ng/dL but {<=}314 ng/dL; n = 415); 'Average BST' (ABST) >33rd percentile and {<=}67th percentile (314-437 ng/dL; n = 845); and 'High BST' (HBST) >67th percentile (>437 ng/dL; n = 810). Outcomes included overall survival, distant metastasis, biochemical failure, and cause-specific survival. All outcomes were adjusted for the following covariates: treatment arm, BST, age (<70 vs. {>=}70), prostate-specific antigen (PSA; <10 vs. 10 {<=} PSA <20 vs. 20 {<=}), Gleason score (2-6 vs. 7 vs. 8-10); T stage (T1-T2 vs. T3-T4), and Karnofsky Performance Status (60-90 vs. 100). Results: On multivariable analysis age, Gleason score, and PSA were independently associated with an increased risk of biochemical failure, distant metastasis and a reduced cause-specific and overall survival (p < 0.05), but BST was not. Conclusions: BST does not affect outcomes in men treated with external beam radiation therapy and androgen deprivation therapy for prostate cancer.« less

Greater screen time is associated with adolescent obesity: a longitudinal study of the BMI distribution from Ages 14 to 18.

PubMed

Mitchell, Jonathan A; Rodriguez, Daniel; Schmitz, Kathryn H; Audrain-McGovern, Janet

2013-03-01

Previous research has examined the association between screen time and average changes in adolescent body mass index (BMI). Until now, no study has evaluated the longitudinal relationship between screen time and changes in the BMI distribution across mid to late adolescence. Participants (n = 1,336) were adolescents who were followed from age 14 to age 18 and surveyed every 6 months. Time spent watching television/videos and playing video games was self-reported (<1 h day(-1) , 1 h day(-1) , 2 h day(-1) , 3 h day(-1) , 4 h day(-1) , or 5+ h day(-1) ). BMI (kg m(-2) ) was calculated from self-reported height and weight. Longitudinal quantile regression was used to model the 10th, 25th, 50th, 75th, and 90th BMI percentiles as dependent variables. Study wave and screen time were the main predictors, and adjustment was made for gender, race, maternal education, hours of sleep, and physical activity. Increases at all the BMI percentiles over time were observed, with the greatest increase observed at the 90th BMI percentile. Screen time was positively associated with changes in BMI at the 50th (0.17, 95% CI: 0.06, 0.27), 75th (0.31, 95% CI: 0.10, 0.52), and 90th BMI percentiles (0.56, 95% CI: 0.27, 0.82). No associations were observed between screen time and changes at the 10th and 25th BMI percentiles. Positive associations between screen time and changes in the BMI at the upper tail of the BMI distribution were observed. Therefore, lowering screen time, especially among overweight and obese adolescents, could contribute to reducing the prevalence of adolescent obesity. Copyright © 2013 The Obesity Society.

A child with chronic manganese exposure from drinking water.

PubMed Central

Woolf, Alan; Wright, Robert; Amarasiriwardena, Chitra; Bellinger, David

2002-01-01

The patient's family bought a home in a suburb, but the proximity of the house to wetlands and its distance from the town water main prohibited connecting the house to town water. The family had a well drilled and they drank the well water for 5 years, despite the fact that the water was turbid, had a metallic taste, and left an orange-brown residue on clothes, dishes, and appliances. When the water was tested after 5 years of residential use, the manganese concentration was elevated (1.21 ppm; U.S. Environmental Protection Agency reference, < 0.05 ppm). The family's 10-year-old son had elevated manganese concentrations in whole blood, urine, and hair. The blood manganese level of his brother was normal, but his hair manganese level was elevated. The patient, the 10-year-old, was in the fifth grade and had no history of learning problems; however, teachers had noticed his inattentiveness and lack of focus in the classroom. Our results of cognitive testing were normal, but tests of memory revealed a markedly below-average performance: the patient's general memory index was at the 13th percentile, his verbal memory at the 19th percentile, his visual memory at the 14th percentile, and his learning index at the 19th percentile. The patient's free recall and cued recall tests were all 0.5-1.5 standard deviations (1 SD = 16th percentile) below normal. Psychometric testing scores showed normal IQ but unexpectedly poor verbal and visual memory. These findings are consistent with the known toxic effects of manganese, although a causal relationship cannot necessarily be inferred. PMID:12055054

Output power distributions of mobile radio base stations based on network measurements

NASA Astrophysics Data System (ADS)

Colombi, D.; Thors, B.; Persson, T.; Wirén, N.; Larsson, L.-E.; Törnevik, C.

2013-04-01

In this work output power distributions of mobile radio base stations have been analyzed for 2G and 3G telecommunication systems. The approach is based on measurements in selected networks using performance surveillance tools part of the network Operational Support System (OSS). For the 3G network considered, direct measurements of output power levels were possible, while for the 2G networks, output power levels were estimated from measurements of traffic volumes. Both voice and data services were included in the investigation. Measurements were conducted for large geographical areas, to ensure good overall statistics, as well as for smaller areas to investigate the impact of different environments. For high traffic hours, the 90th percentile of the averaged output power was found to be below 65% and 45% of the available output power for the 2G and 3G systems, respectively.

[Kaup index in 16 887 singleton neonates with a gestational age of 27-42 weeks in Shenzhen, China].

PubMed

Huang, Xiao-Yun; Liu, Hui-Long; Lei, Min; Lian, Zhao-Hui; Mai, Hui-Fen

2018-05-01

To study the Kaup index (KI), an index used to evaluate body burliness and nutritional status, of neonates with a gestational age (GA) of 27-42 weeks at birth, and to establish the percentile curves of KI. Cross-sectional cluster sampling was performed from April 2013 to September 2015 to select 16 887 singleton neonates with a GA of 27-42 weeks in two hospitals in Shenzhen, China. Body weight and body length were measured to calculate KI. The percentile curves of KI were plotted in these neonates. Mean KIs and corresponding standard deviations were obtained for singleton neonates with a gestational age of 27-42 weeks (in male, female, and mixed groups), and the 3rd-97th percentile curves of KI were plotted. The singleton neonates with a GA of 27 weeks had the lowest 50th percentile value of KI, and KI gradually increased with GA. Boys had a higher 50th percentile value of KI than girls in each GA group. In all groups except the 33-week GA group, boys had a higher mean KI than girls, and there was a significant difference in the mean KI between boys and girls in the GA groups of 34 and 36-40 weeks (P<0.05). KI of neonates at birth increases with GA, suggesting that body density and body burliness increase with GA. Boys have better body burliness than girls at birth. The percentile curves of KI plotted for singleton neonates with a GA of 27-42 weeks (in male, female, and mixed groups) can provide a reference for evaluating the body burliness and nutritional status of neonates at birth in Shenzhen.

[Percentile Values for the Anthropometric Dimensions of Triplet Neonates - Analysis of German Perinatal Survey Data of 2007-2011 from all States of Germany].

PubMed

Voigt, M; Olbertz, D; Hentschel, R; Kunze, M; Hagenah, H-P; Scholz, R; Wittwer-Backofen, U; Hesse, V; Straube, S

2016-04-01

We aimed to develop national reference values for birth weight, length, head circumference, and weight for length for newborn triplets based on data from the German perinatal survey of 2007-2011. Perinatal survey data of 3,690 newborn triplets from all the states of Germany were kindly provided to us by the AQUA Institute in Göttingen, Germany. Data of 3,567 newborn triplets were included in the analyses. Sex-specific percentile values were calculated using cumulative frequencies. Percentile values at birth were computed for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles for 21-36 completed weeks of gestation. We present the first German reference values (tables and curves) for the anthropometric dimensions of triplet neonates and compare selected birth weight and length percentiles of triplets (after 32 and 34 completed weeks of gestation) to those of singletons and twins. The differences in the 50th birth weight percentiles between singletons and triplets after 32 completed weeks of gestation were 180 g for girls and 210 g for boys; after 34 weeks of gestation the differences were 320 and 325 g, respectively. The differences between twins and triplets after 32 weeks of gestation were 100 g for girls and 120 g for boys; after 34 weeks of gestation they were 130 and 135 g, respectively. The data presented here enable the classification of newborn triplets according to somatic parameters making reference to German perinatal data. © Georg Thieme Verlag KG Stuttgart · New York.

The effects of publishing emergency department wait time on patient utilization patterns in a community with two emergency department sites: a retrospective, quasi-experiment design.

PubMed

Xie, Bin; Youash, Sabrina

2011-06-14

Providing emergency department (ED) wait time information to the public has been suggested as a mechanism to reduce lengthy ED wait times (by enabling patients to select the ED site with shorter wait time), but the effects of such a program have not been evaluated. We evaluated the effects of such a program in a community with two ED sites. Descriptive statistics for wait times of the two sites before and after the publication of wait time information were used to evaluate the effects of the publication of wait time information on wait times. Multivariate logistical regression was used to test whether or not individual patients used published wait time to decide which site to visit. We found that the rates of wait times exceeding 4 h, and the 95th percentile of wait times in the two sites decreased after the publication of wait time information, even though the average wait times experienced a slight increase. We also found that after controlling for other factors, the site with shorter wait time had a higher likelihood of being selected after the publication of wait time information, but there was no such relationship before the publication. These findings were consistent with the hypothesis that the publication of wait time information leads to patients selecting the site with shorter wait time. While publishing ED wait time information did not improve average wait time, it reduced the rates of lengthy wait times.

Effect of pesticide fate parameters and their uncertainty on the selection of 'worst-case' scenarios of pesticide leaching to groundwater.

PubMed

Vanderborght, Jan; Tiktak, Aaldrik; Boesten, Jos J T I; Vereecken, Harry

2011-03-01

For the registration of pesticides in the European Union, model simulations for worst-case scenarios are used to demonstrate that leaching concentrations to groundwater do not exceed a critical threshold. A worst-case scenario is a combination of soil and climate properties for which predicted leaching concentrations are higher than a certain percentile of the spatial concentration distribution within a region. The derivation of scenarios is complicated by uncertainty about soil and pesticide fate parameters. As the ranking of climate and soil property combinations according to predicted leaching concentrations is different for different pesticides, the worst-case scenario for one pesticide may misrepresent the worst case for another pesticide, which leads to 'scenario uncertainty'. Pesticide fate parameter uncertainty led to higher concentrations in the higher percentiles of spatial concentration distributions, especially for distributions in smaller and more homogeneous regions. The effect of pesticide fate parameter uncertainty on the spatial concentration distribution was small when compared with the uncertainty of local concentration predictions and with the scenario uncertainty. Uncertainty in pesticide fate parameters and scenario uncertainty can be accounted for using higher percentiles of spatial concentration distributions and considering a range of pesticides for the scenario selection. Copyright © 2010 Society of Chemical Industry.

Designing for multiple global user populations: increasing resource allocation efficiency for greater sustainability.

PubMed

Nadadur, G; Parkinson, M B

2012-01-01

This paper proposes a method to identify opportunities for increasing the efficiency of raw material allocation decisions for products that are simultaneously targeted at multiple user populations around the world. The values of 24 body measures at certain key percentiles were used to estimate the best-fitting anthropometric distributions for female and male adults in nine national populations, which were selected to represent the diverse target markets multinational companies must design for. These distributions were then used to synthesize body measure data for combined populations with a 1:1 female:male ratio. An anthropometric range metric (ARM) was proposed for assessing the variation of these body measures across the populations. At any percentile, ARM values were calculated as the percentage difference between the highest and lowest anthropometric values across the considered user populations. Based on their magnitudes, plots of ARM values computed between the 1st and 99 th percentiles for each body measure were grouped into low, medium, and high categories. This classification of body measures was proposed as a means of selecting the most suitable strategies for designing raw material-efficient products. The findings in this study and the contributions of subsequent work along these lines are expected to help achieve greater efficiencies in resource allocation in global product development.

A weight-gain-for-gestational-age z score chart for the assessment of maternal weight gain in pregnancy.

PubMed

Hutcheon, Jennifer A; Platt, Robert W; Abrams, Barbara; Himes, Katherine P; Simhan, Hyagriv N; Bodnar, Lisa M

2013-05-01

To establish the unbiased relation between maternal weight gain in pregnancy and perinatal health, a classification for maternal weight gain is needed that is uncorrelated with gestational age. The goal of this study was to create a weight-gain-for-gestational-age percentile and z score chart to describe the mean, SD, and selected percentiles of maternal weight gain throughout pregnancy in a contemporary cohort of US women. The study population was drawn from normal-weight women with uncomplicated, singleton pregnancies who delivered at the Magee-Womens Hospital in Pittsburgh, PA, 1998-2008. Analyses were based on a randomly selected subset of 648 women for whom serial prenatal weight measurements were available through medical chart record abstraction (6727 weight measurements). The pattern of maternal weight gain throughout gestation was estimated by using a random-effects regression model. The estimates were used to create a chart with the smoothed means, percentiles, and SDs of gestational weight gain for each week of pregnancy. This chart allows researchers to express total weight gain as an age-standardized z score, which can be used in epidemiologic analyses to study the association between pregnancy weight gain and adverse or physiologic pregnancy outcomes independent of gestational age.

A slice of π: An exploratory neuroimaging study of digit encoding and retrieval in a superior memorist

PubMed Central

Raz, Amir; Packard, Mark G.; Alexander, Gerianne M.; Buhle, Jason T.; Zhu, Hongtu; Yu, Shan; Peterson, Bradley S.

2015-01-01

Subject PI demonstrated superior memory using a variant of a Method of Loci (MOL) technique to recite the first digits of the mathematical constant π to more than 216 decimal places. We report preliminary behavioral, functional magnetic resonance imaging (fMRI), and brain volumetric data from PI. fMRI data collected while PI recited the first 540 digits of π (i.e., during retrieval) revealed increased activity in medial frontal gyrus and dorsolateral prefrontal cortex. Encoding of a novel string of 100 random digits activated motor association areas, midline frontal regions, and visual association areas. Volumetric analyses indicated an increased volume of the right subgenual cingulate, a brain region implicated in emotion, mentalizing, and autonomic arousal. Wechsler Abbreviated Scale of Intelligence (WASI) testing indicated that PI is of average intelligence, and performance on mirror tracing, rotor pursuit, and the Silverman and Eals Location Memory Task revealed normal procedural and implicit memory. PI’s performance on the Wechsler Memory Scale (WMS-III) revealed average general memory abilities (50th percentile), but superior working memory abilities (99th percentile). Surprisingly, PI’s visual memory (WMS-III) for neutral faces and common events was remarkably poor (3rd percentile). PI’s self-report indicates that imagining affective situations and high emotional content is critical for successful recall. We speculate that PI’s reduced memory for neutral/non-emotional faces and common events, and the observed increase in volume of the right subgenual cingulate, may be related to extensive practice with memorizing highly emotional material. PMID:19585350

A slice of pi : an exploratory neuroimaging study of digit encoding and retrieval in a superior memorist.

PubMed

Raz, Amir; Packard, Mark G; Alexander, Gerianne M; Buhle, Jason T; Zhu, Hongtu; Yu, Shan; Peterson, Bradley S

2009-10-01

Subject PI demonstrated superior memory using a variant of a Method of Loci (MOL) technique to recite the first digits of the mathematical constant pi to more than 2(16) decimal places. We report preliminary behavioral, functional magnetic resonance imaging (fMRI), and brain volumetric data from PI. fMRI data collected while PI recited the first 540 digits of pi (i.e., during retrieval) revealed increased activity in medial frontal gyrus and dorsolateral prefrontal cortex. Encoding of a novel string of 100 random digits activated motor association areas, midline frontal regions, and visual association areas. Volumetric analyses indicated an increased volume of the right subgenual cingulate, a brain region implicated in emotion, mentalizing, and autonomic arousal. Wechsler Abbreviated Scale of Intelligence (WASI) testing indicated that PI is of average intelligence, and performance on mirror tracing, rotor pursuit, and the Silverman and Eals Location Memory Task revealed normal procedural and implicit memory. PI's performance on the Wechsler Memory Scale (WMS-III) revealed average general memory abilities (50th percentile), but superior working memory abilities (99th percentile). Surprisingly, PI's visual memory (WMS-III) for neutral faces and common events was remarkably poor (3rd percentile). PI's self-report indicates that imagining affective situations and high emotional content is critical for successful recall. We speculate that PI's reduced memory for neutral/non-emotional faces and common events, and the observed increase in volume of the right subgenual cingulate, may be related to extensive practice with memorizing highly emotional material.

The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants.

PubMed

Song, You Hong; Chang, Hyun Jung; Shin, Yong Beom; Park, Young Sook; Park, Yun Hee; Cho, Eun Sol

2018-04-01

To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.

Relationships between walking and percentiles of adiposity inolder and younger men

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

Williams, Paul T.

2005-06-01

To assess the relationship of weekly walking distance to percentiles of adiposity in elders (age {ge} 75 years), seniors (55 {le} age <75 years), middle-age men (35 {le} age <55 years), and younger men (18 {le} age <35 years old). Cross-sectional analyses of baseline questionnaires from 7,082 male participants of the National Walkers Health Study. The walkers BMIs were inversely and significantly associated with walking distance (kg/m{sup 2} per km/wk) in elders (slope {+-} SE: -0.032 {+-} 0.008), seniors (-0.045 {+-} 0.005), and middle-aged men (-0.037 {+-} 0.007), as were their waist circumferences (-0.091 {+-} 0.025, -0.045 {+-} 0.005, andmore » -0.091 {+-} 0.015 cm per km/wk, respectively), and these slopes remained significant when adjusted statistically for reported weekly servings of meat, fish, fruit, and alcohol. The declines in BMI associated with walking distance were greater at the higher than lower percentiles of the BMI distribution. Specifically, compared to the decline at the 10th BMI percentile, the decline in BMI at the 90th percentile was 5.1-fold greater in elders, 5.9-fold greater in seniors, and 6.7-fold greater in middle-age men. The declines in waist circumference associated with walking distance were also greater among men with broader waistlines. Exercise-induced weight loss (or self-selection) causes an inverse relationship between adiposity and walking distance in men 35 and older that is substantially greater among fatter men.« less

Microclimatic temperatures at Danish cattle farms, 2000-2016: quantifying the temporal and spatial variation in the transmission potential of Schmallenberg virus.

PubMed

Haider, Najmul; Cuellar, Ana Carolina; Kjær, Lene Jung; Sørensen, Jens Havskov; Bødker, Rene

2018-03-05

Microclimatic temperatures provide better estimates of vector-borne disease transmission parameters than standard meteorological temperatures, as the microclimate represent the actual temperatures to which the vectors are exposed. The objectives of this study were to quantify farm-level geographic variations and temporal patterns in the extrinsic incubation period (EIP) of Schmallenberg virus transmitted by Culicoides in Denmark through generation of microclimatic temperatures surrounding all Danish cattle farms. We calculated the hourly microclimatic temperatures at potential vector-resting sites within a 500 m radius of 22,004 Danish cattle farms for the months April to November from 2000 to 2016. We then modeled the daily EIP of Schmallenberg virus at each farm, assuming vectors choose resting sites either randomly or based on temperatures (warmest or coolest available) every hour. The results of the model output are presented as 17-year averages. The difference between the warmest and coolest microhabitats at the same farm was on average 3.7 °C (5th and 95th percentiles: 1.0 °C to 7.8 °C). The mean EIP of Schmallenberg virus (5th and 95th percentiles) for all cattle farms during spring, summer, and autumn was: 23 (18-33), 14 (12-18) and 51 (48-55) days, respectively, assuming Culicoides select resting sites randomly. These estimated EIP values were considerably shorter than those estimated using standard meteorological temperatures obtained from a numerical weather prediction model for the same periods: 43 (39-52), 21 (17-24) and 57 (55-58) days, respectively. When assuming that vectors actively select the coolest resting sites at a farm, the EIP was 2.3 (range: 1.1 to 4.1) times longer compared to that of the warmest sites at the same farm. We estimated a wide range of EIP in different microclimatic habitats surrounding Danish cattle farms, stressing the importance of identifying the specific resting sites of vectors when modeling vector-borne disease transmission. We found a large variation in the EIP among different farms, suggesting disease transmission may vary substantially between regions, even within a small country. Our findings could be useful for designing risk-based surveillance, and in the control and prevention of emerging and re-emerging vector-borne diseases.

Math on the Fast Track

ERIC Educational Resources Information Center

Howe, Quincy

2006-01-01

In this article, the author relates how a math-assessment software has allowed his school to track the academic progress of its students. The author relates that in the first year that the software was deployed, schoolwide averages in terms of national standing on the math ITBS rose from the 42nd to 59th percentile. In addition, a significant…

Epicardial adipose tissue and signs of metabolic syndrome in children.

PubMed

Barbaro, Giuseppe; Piedimonte, Alessandra; Podagrosi, Maria; Mercurio, Roberta; Mosca, Antonella; D'Avanzo, Miriam; Vania, Andrea

2016-06-01

The aim of this study was to investigate the possible correlation between epicardial adipose tissue (EAT) thickness and predictive parameters for metabolic syndrome (MS) in overweight/obese prepubertal children. 73 prepubertal children, average age of 8.22 years, with no endocrine or syndromic causes of obesity or under drug therapy for chronic disease were enrolled. Weight, height, body circumferences and skinfolds' thickness were measured. BMI, BMI z score (z-BMI) and waist-to-height ratio (WtHR) were calculated. Standard MS-related laboratory parameters were assessed. Finally, all children underwent echocardiographic measurement of EAT. A positive correlation between EAT and z-BMI was found only among overweight/obese children (r = 0.43, p = 0.001). In particular, data showed that 89 % of our sample had a waist (W) >90th percentile. Statistical differences in diastolic blood pressure (DBP; p < 0.01) and EAT (p = 0.02) were observed on comparing W <90th percentile vs W >90th percentile patients. Besides, in patients with W >90th percentile and family history of risk factors for MS, the value of EAT correlated positively with z-BMI, W, WtHR, triglycerides (Tg), insulin and homeostatic model assessment of insulin resistance and negatively with HDL. The EAT and the markers of MS probably share the same pathogenetic factors. Further studies might elucidate whether EAT deserves to be included among the diagnostic factors of MS.

Percentiles of the product of uncertainty factors for establishing probabilistic reference doses.

PubMed

Gaylor, D W; Kodell, R L

2000-04-01

Exposure guidelines for potentially toxic substances are often based on a reference dose (RfD) that is determined by dividing a no-observed-adverse-effect-level (NOAEL), lowest-observed-adverse-effect-level (LOAEL), or benchmark dose (BD) corresponding to a low level of risk, by a product of uncertainty factors. The uncertainty factors for animal to human extrapolation, variable sensitivities among humans, extrapolation from measured subchronic effects to unknown results for chronic exposures, and extrapolation from a LOAEL to a NOAEL can be thought of as random variables that vary from chemical to chemical. Selected databases are examined that provide distributions across chemicals of inter- and intraspecies effects, ratios of LOAELs to NOAELs, and differences in acute and chronic effects, to illustrate the determination of percentiles for uncertainty factors. The distributions of uncertainty factors tend to be approximately lognormally distributed. The logarithm of the product of independent uncertainty factors is approximately distributed as the sum of normally distributed variables, making it possible to estimate percentiles for the product. Hence, the size of the products of uncertainty factors can be selected to provide adequate safety for a large percentage (e.g., approximately 95%) of RfDs. For the databases used to describe the distributions of uncertainty factors, using values of 10 appear to be reasonable and conservative. For the databases examined the following simple "Rule of 3s" is suggested that exceeds the estimated 95th percentile of the product of uncertainty factors: If only a single uncertainty factor is required use 33, for any two uncertainty factors use 3 x 33 approximately 100, for any three uncertainty factors use a combined factor of 3 x 100 = 300, and if all four uncertainty factors are needed use a total factor of 3 x 300 = 900. If near the 99th percentile is desired use another factor of 3. An additional factor may be needed for inadequate data or a modifying factor for other uncertainties (e.g., different routes of exposure) not covered above.

Prevalence of and factors associated with obesity among Pakistani schoolchildren: a school-based, cross-sectional study.

PubMed

Ahmed, J; Laghari, A; Naseer, M; Mehraj, V

2013-03-01

Childhood obesity is nowadays a concern in the developing world. This cros-sectional study was conducted on 501 randomly selected students from 10 high schools in an urban setting in Hyderabad, Pakistan. Children who were underweight were excluded. Interviews were conducted to determine demographic data, dietary intake, physical activity and other variables that may be associated with obesity. Overall 58 students (12%) had body mass index (BMI)>or=95th percentile, 40 (8%) BMI>or=85th percentile and 403 (80%) had BMI<85th percentile (WHO age- and sex-specific cut-offs). The prevalence of obesity was higher in boys than girls (15% than 8% respectively). In multivariate regression analysis significant risk factors for obesity/overweight were male sex, middle socioeconomic status, poor self-rated athletic ability, trying to lose weight and eating fruit<4 times per week. Childhood obesity is determined by factors in the home, school and society and a multidisciplinary approach is needed to prevention.

Evaluation of a residency program's experience with a one-week emergency medicine resident rotation at a medical liability insurance company.

PubMed

Houry, D; Shockley, L W

2001-07-01

The authors' residency program implemented a one-week rotation at the office of a medical liability insurance company. Residents examined 30 closed malpractice claims cases and sat in on settlement discussions. To review the residents' evaluations of their experiences and to determine whether this was a worthwhile addition to the emergency medicine (EM) residency curriculum. This was a five-year retrospective study that reviewed residents' annual evaluations from 1994 to 1999 regarding the medical liability rotation. A five-point scale was used to score specific categories in the rotation and an open-ended section was used to collect general comments. A total of 179 resident evaluations were reviewed. The quality of teaching ranked in the 80th percentile, the clinical caseload ranked in the 85th percentile, and level of responsibility ranked in the 79th percentile for all EM rotations. Specific comments included "All MDs should do this in their training"; "Quite an eye opener"; and "Good exposure to legal aspects of EM." Overall, EM residents found the one-week rotation to be invaluable and a good learning experience. This rotation ranked above average when compared with all of our other EM residency rotations.

The Recognition Memory Test Examination of ethnic differences and norm validity.

PubMed

O'Bryant, Sid E; Hilsabeck, Robin C; McCaffrey, Robert J; Drew Gouvier, Wm

2003-03-01

The possibility of racial bias in neuropsychological test materials has received increasing attention in recent years. The purpose of the present study was to investigate whether an own-race recognition bias would provide an advantage for Caucasian participants over African American participants on the Faces subtest of the Recognition Memory Test (RMT). Thirty Caucasian and 30 African American undergraduates completed the RMT, Shipley Institute of Living Scale (SILS), and Symbol Digit Modalities Test (SDMT). No significant group difference was found on RMT Faces. However, mean RMT Faces scores for both groups were below the 10th percentile in spite of average scores on the SDMT and SILS. A second study was conducted to further examine the validity of the RMT norms for this age range (i.e., 18-24) and to provide 2-week test-retest reliabilities. The mean RMT Faces subtest score was 39.78 (10th percentile), and 28% of the sample scored at or below the fifth percentile. Test-retest reliabilities were.63 and.64 for RMT Words and Faces, respectively. Results of these studies suggest that re-examination of the current norms for RMT Faces is warranted for adults aged.

[Anthropometric measures in urban child population from 6 to 12 years from the northwest of México].

PubMed

Brito-Zurita, Olga Rosa; López-Leal, Josefa; Exiga-González, Emma Beatriz; Armenta-Llanes, Oscar; Jorge-Plascencia, Blanca; Domínguez-Banda, Alberto; López-Morales, Mónica; Ornelas-Aguirre, José Manuel; Sabag-Ruiz, Enrique

2014-01-01

The degree of overweight-obesity varies according to the conditions of each population and depending on geographical area, race or ethnicity, socioeconomic status, and susceptibility of each individual. The aim of this study was to determine anthropometric measures in urban child population from 6 to 12 years of Ciudad Obregón, Sonora. We studied 684 schoolchildren from 6 to 12 years of age, of both genders in the urban area of Ciudad Obregón, Sonora. We measured weight, height, arm circumference (AC), waist, and body mass index (BMI). We used descriptive statistics (frequencies, percentages), and to compare the growth charts of this study vs. the reference standards (CDC and Ramos-Galván), we employed statistical inference (Student t test). On average, weight, height, AC, BMI for age by gender were higher than the reference standards at all ages. Seventy-four boys (22 %) and 51 girls (14.5 %) were above 95th percentile. With regards to size, 42 children (12.6 %) were below the 5th percentile and 37 (10.5 %) above the 95th percentile. Schoolchildren in the southern zone of Sonora showed a higher anthropometric pattern than the reference standards.

Using type IV Pearson distribution to calculate the probabilities of underrun and overrun of lists of multiple cases.

PubMed

Wang, Jihan; Yang, Kai

2014-07-01

An efficient operating room needs both little underutilised and overutilised time to achieve optimal cost efficiency. The probabilities of underrun and overrun of lists of cases can be estimated by a well defined duration distribution of the lists. To propose a method of predicting the probabilities of underrun and overrun of lists of cases using Type IV Pearson distribution to support case scheduling. Six years of data were collected. The first 5 years of data were used to fit distributions and estimate parameters. The data from the last year were used as testing data to validate the proposed methods. The percentiles of the duration distribution of lists of cases were calculated by Type IV Pearson distribution and t-distribution. Monte Carlo simulation was conducted to verify the accuracy of percentiles defined by the proposed methods. Operating rooms in John D. Dingell VA Medical Center, United States, from January 2005 to December 2011. Differences between the proportion of lists of cases that were completed within the percentiles of the proposed duration distribution of the lists and the corresponding percentiles. Compared with the t-distribution, the proposed new distribution is 8.31% (0.38) more accurate on average and 14.16% (0.19) more accurate in calculating the probabilities at the 10th and 90th percentiles of the distribution, which is a major concern of operating room schedulers. The absolute deviations between the percentiles defined by Type IV Pearson distribution and those from Monte Carlo simulation varied from 0.20  min (0.01) to 0.43  min (0.03). Operating room schedulers can rely on the most recent 10 cases with the same combination of surgeon and procedure(s) for distribution parameter estimation to plan lists of cases. Values are mean (SEM). The proposed Type IV Pearson distribution is more accurate than t-distribution to estimate the probabilities of underrun and overrun of lists of cases. However, as not all the individual case durations followed log-normal distributions, there was some deviation from the true duration distribution of the lists.

More controlling child-feeding practices are found among parents of boys with an average body mass index compared with parents of boys with a high body mass index.

PubMed

Brann, Lynn S; Skinner, Jean D

2005-09-01

To determine if differences existed in mothers' and fathers' perceptions of their sons' weight, controlling child-feeding practices (ie, restriction, monitoring, and pressure to eat), and parenting styles (ie, authoritarian, authoritative, and permissive) by their sons' body mass index (BMI). One person (L.S.B.) interviewed mothers and boys using validated questionnaires and measured boys' weight and height; fathers completed questionnaires independently. Subjects were white, preadolescent boys and their parents. Boys were grouped by their BMI into an average BMI group (n=25; BMI percentile between 33rd and 68th) and a high BMI group (n=24; BMI percentile > or = 85th). Multivariate analyses of variance and analyses of variance. Mothers and fathers of boys with a high BMI saw their sons as more overweight (mothers P=.03, fathers P=.01), were more concerned about their sons' weight (P<.0001, P=.004), and used pressure to eat with their sons less often than mothers and fathers of boys with an average BMI (P<.0001, P<.0001). In addition, fathers of boys with a high BMI monitored their sons' eating less often than fathers of boys with an average BMI (P=.006). No differences were found in parenting by boys' BMI groups for either mothers or fathers. More controlling child-feeding practices were found among mothers (pressure to eat) and fathers (pressure to eat and monitoring) of boys with an average BMI compared with parents of boys with a high BMI. A better understanding of the relationships between feeding practices and boys' weight is necessary. However, longitudinal research is needed to provide evidence of causal association.

Uncertainty in determining extreme precipitation thresholds

NASA Astrophysics Data System (ADS)

Liu, Bingjun; Chen, Junfan; Chen, Xiaohong; Lian, Yanqing; Wu, Lili

2013-10-01

Extreme precipitation events are rare and occur mostly on a relatively small and local scale, which makes it difficult to set the thresholds for extreme precipitations in a large basin. Based on the long term daily precipitation data from 62 observation stations in the Pearl River Basin, this study has assessed the applicability of the non-parametric, parametric, and the detrended fluctuation analysis (DFA) methods in determining extreme precipitation threshold (EPT) and the certainty to EPTs from each method. Analyses from this study show the non-parametric absolute critical value method is easy to use, but unable to reflect the difference of spatial rainfall distribution. The non-parametric percentile method can account for the spatial distribution feature of precipitation, but the problem with this method is that the threshold value is sensitive to the size of rainfall data series and is subjected to the selection of a percentile thus make it difficult to determine reasonable threshold values for a large basin. The parametric method can provide the most apt description of extreme precipitations by fitting extreme precipitation distributions with probability distribution functions; however, selections of probability distribution functions, the goodness-of-fit tests, and the size of the rainfall data series can greatly affect the fitting accuracy. In contrast to the non-parametric and the parametric methods which are unable to provide information for EPTs with certainty, the DFA method although involving complicated computational processes has proven to be the most appropriate method that is able to provide a unique set of EPTs for a large basin with uneven spatio-temporal precipitation distribution. The consistency between the spatial distribution of DFA-based thresholds with the annual average precipitation, the coefficient of variation (CV), and the coefficient of skewness (CS) for the daily precipitation further proves that EPTs determined by the DFA method are more reasonable and applicable for the Pearl River Basin.

Laboratory Measurement Implications of Decreasing Childhood Blood Lead Levels

PubMed Central

Caldwell, Kathleen L.; Cheng, Po-Yung; Jarrett, Jeffery M.; Makhmudov, Amir; Vance, Kathryn; Ward, Cynthia D.; Jones, Robert L.; Mortensen, Mary E.

2017-01-01

In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLL) in children one to five years old from 2007–2010 National Health and Nutrition Examination Survey (NHANES) data. We calculated and updated selected percentiles, including the 97.5th percentile, using NHANES 2011–2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5% percentile BLL of 3.48 μg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤ 5 μg/dL. Review of five years of results for target blood lead values < 11 μg/dL for U.S. clinical laboratories participating in CDC’s voluntary Lead and Multi-Element Proficiency (LAMP) quality assurance program showed 40% unable to quantify and reported a non-detectable result at a target blood lead value of 1.48 μg/dL compared 5.5 % at a target blood lead of 4.60 μg/dL. We describe actions taken at CDC’s Environmental Health Laboratory in the Division of Laboratory Sciences, which measures blood lead for NHANES, to improve analytical accuracy and precision and to reduce external lead contamination during blood collection and analysis. PMID:28771411

Measurement Challenges at Low Blood Lead Levels.

PubMed

Caldwell, Kathleen L; Cheng, Po-Yung; Jarrett, Jeffery M; Makhmudov, Amir; Vance, Kathryn; Ward, Cynthia D; Jones, Robert L; Mortensen, Mary E

2017-08-01

In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLLs) in children 1 to 5 years old from 2007 to 2010 NHANES data. We calculated and updated selected percentiles, including the 97.5th percentile, by using NHANES 2011 to 2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5th percentile BLL of 3.48 µg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤5 μg/dL. Review of 5 years of results for target blood lead values <11 µg/dL for US clinical laboratories participating in the CDC's voluntary Lead and Multi-Element Proficiency quality assurance program showed 40% unable to quantify and reported a nondetectable result at a target blood lead value of 1.48 µg/dL, compared with 5.5% at a target BLL of 4.60 µg/dL. We describe actions taken at the CDC's Environmental Health Laboratory in the National Center for Environmental Health, which measures blood lead for NHANES, to improve analytical accuracy and precision and to reduce external lead contamination during blood collection and analysis. Copyright © 2017 by the American Academy of Pediatrics.

Estimating the population distribution of usual 24-hour sodium excretion from timed urine void specimens using a statistical approach accounting for correlated measurement errors.

PubMed

Wang, Chia-Yih; Carriquiry, Alicia L; Chen, Te-Ching; Loria, Catherine M; Pfeiffer, Christine M; Liu, Kiang; Sempos, Christopher T; Perrine, Cria G; Cogswell, Mary E

2015-05-01

High US sodium intake and national reduction efforts necessitate developing a feasible and valid monitoring method across the distribution of low-to-high sodium intake. We examined a statistical approach using timed urine voids to estimate the population distribution of usual 24-h sodium excretion. A sample of 407 adults, aged 18-39 y (54% female, 48% black), collected each void in a separate container for 24 h; 133 repeated the procedure 4-11 d later. Four timed voids (morning, afternoon, evening, overnight) were selected from each 24-h collection. We developed gender-specific equations to calibrate total sodium excreted in each of the one-void (e.g., morning) and combined two-void (e.g., morning + afternoon) urines to 24-h sodium excretion. The calibrated sodium excretions were used to estimate the population distribution of usual 24-h sodium excretion. Participants were then randomly assigned to modeling (n = 160) or validation (n = 247) groups to examine the bias in estimated population percentiles. Median bias in predicting selected percentiles (5th, 25th, 50th, 75th, 95th) of usual 24-h sodium excretion with one-void urines ranged from -367 to 284 mg (-7.7 to 12.2% of the observed usual excretions) for men and -604 to 486 mg (-14.6 to 23.7%) for women, and with two-void urines from -338 to 263 mg (-6.9 to 10.4%) and -166 to 153 mg (-4.1 to 8.1%), respectively. Four of the 6 two-void urine combinations produced no significant bias in predicting selected percentiles. Our approach to estimate the population usual 24-h sodium excretion, which uses calibrated timed-void sodium to account for day-to-day variation and covariance between measurement errors, produced percentile estimates with relatively low biases across low-to-high sodium excretions. This may provide a low-burden, low-cost alternative to 24-h collections in monitoring population sodium intake among healthy young adults and merits further investigation in other population subgroups. © 2015 American Society for Nutrition.

Pubertal Height Velocity and Associations with Pre-pubertal and Adult Heights in Cystic Fibrosis

PubMed Central

Zhang, Zhumin; Lindstrom, Mary J.; Lai, HuiChuan J.

2013-01-01

Objectives To test the hypothesis that pubertal peak height velocity (PHV) in cystic fibrosis (CF) has improved and is influenced by pre-pubertal growth and genetic potential. Study design PHV from 1862 children born in 1984–87 and documented in the 1986–2008 US CF Foundation Registry was determined by statistical modeling and classified into normal, delayed (2-SD > average age), attenuated (magnitude < 5th percentile), or both (D&A). Genetic potential for height was estimated by parental stature. Results PHV averaged 8.4 cm/y at age 14.0 y in boys and 7.0 cm/y at age 12.1 y in girls, ~6 mo delay and ~15% reduction compared with healthy children. PHV was normal in 60%, delayed in 9%, attenuated in 21% and D&A in 5%. Patients with delayed PHV reached similar adult height percentile (boys: 34th, girls: 46th) to those with normal PHV (boys: 33rd, girls: 34th); both were significantly taller than the attenuated (boys: 11th, girls: 19th) and D&A PHV subgroups (boys: 8th, girls: 14th). Pancreatic sufficient patients had taller pre-pubertal and adult heights but similar PHV compared with pancreatic insufficient or meconium ileus patients. Adjusting for genetic potential reduced adult height percentiles more in boys (25th to 16th) than girls (28th to 24th). Height at age 7 y, PHV age and magnitude, and parental stature significantly predicted adult height. Conclusions Pubertal PHV has improved in children with CF born after mid 1980s compared with older cohorts but remains below normal. Suboptimal pre-pubertal and pubertal growth led to adult height below genetic potential in CF. PMID:23535012

Variations in the persistence of health expenditures and the implications for the design of capitation payments in Taiwan.

PubMed

Ku, Li-Jung Elizabeth; Chiou, Meng-Jiun; Liu, Li-Fan

2015-07-01

The National Health Insurance (NHI) system in Taiwan launched a trial capitation provider payment programme in 2011, with the capitation formula based on patients' average NHI expenditure in the previous year. This study seeks to examine the concentration and persistence of health care expenditure among the elderly, and to assess the performance of the current capitation formula in predicting future high-cost users. This study analysed NHI expenditures for a nationally representative sample of people aged 65 years and over who took part in Taiwan's National Health Interview Survey, 2005. Expenditure concentration was assessed by the proportion of NHI expenditures attributable to four groups by expenditure percentile. Four transition probability matrixes examined changes in a person's position in the expenditure percentiles and generalized estimation equation models were estimated to identify significant predictors of a patient being in the top 10% of users. Between 2005 and 2009, the top 10% of users on average accounted for 55% of total NHI expenditures. Of the top 10% in 2005, 39% retained this position in 2006. However, expenditure persistence was the highest (77%) among the bottom 50% of users. NHI expenditure percentiles in both the baseline year and the prior year, and chronic conditions all significantly predicted future high expenditures. The model including chronic conditions performed better in predicting the top 10% of users (c-statistics increased from 0.772 to 0.904) than the model without. Given the increase in predictive ability, adding chronic conditions and baseline health care use data to Taiwan's capitation payment formula would correctly identify more high users. © The Author(s) 2015.

Fluoride in the diet of 2-years-old children.

PubMed

Martinez-Mier, E A; Spencer, Kathryn L; Sanders, Brian J; Jones, James E; Soto-Rojas, Armando E; Tomlin, Angela M; Vinson, LaQuia A; Weddell, James A; Eckert, George J

2017-06-01

This study aimed to calculate the fluoride concentrations of commonly consumed foods and beverages for 2-years-old children utilizing market basket information for the US Midwest region. Total Diet Study food lists were cross-referenced with National Health and Nutrition Examination Survey-What We Eat in America data to determine the foods and beverages to be included. Fluoride concentrations were determined using a modification of the hexamethyldisiloxane microdiffusion technique. Fluoride concentrations were summarized for each of the food categories. Daily dietary fluoride intake was estimated using a simulation analysis. Food and beverage fluoride concentrations varied widely, ranging from nondetectable for some oils and dairy products to more than 3.0 μgF/g food for some processed meats, fish and fruits. The estimated mean (±SD) daily dietary fluoride intake, excluding dentifrice and supplements, was 412±114 μgF/d. The estimated average ingestion for a 2-years-old weighing 12.24 kg was 0.034±0.009 mg/kg/d. A diet based on foods and beverages in the fifth percentile of fluoride intake distribution for an average child would result in 247 μgF/d or 0.020 mg/kg/d, while a diet with foods and beverages in the 95th percentile would result in a total intake of 622 μgF/d or 0.051 mg/kg/d. The fluoride concentrations of foods and beverages vary widely, and, if items in the 95th percentile of fluoride intake distribution are ingested, children could consume more fluoride than the recommended 0.05 mg/kg/d. Fluoride intake calculated in this study was higher than historically reported dietary levels. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

ENSO and hydrologic extremes in the western United States

USGS Publications Warehouse

Cayan, D.R.; Redmond, K.T.; Riddle, L.G.

1999-01-01

Frequency distributions of daily precipitation in winter and daily stream flow from late winter to early summer, at several hundred sites in the western United States, exhibit strong and systematic responses to the two phases of ENSO. Most of the stream flows considered are driven by snowmelt. The Southern Oscillation index (SOI) is used as the ENSO phase indicator. Both modest (median) and larger (90th percentile) events were considered. In years with negative SOI values (El Nino), days with high daily precipitation and stream flow are more frequent than average over the Southwest and less frequent over the Northwest. During years with positive SOI values (La Nina), a nearly opposite pattern is seen. A more pronounced increase is seen in the number of days exceeding climatological 90th percentile values than in the number exceeding climatological 50th percentile values, for both precipitation and stream flow. Stream flow responses to ENSO extremes are accentuated over precipitation responses. Evidence suggests that the mechanism for this amplification involves ENSO-phase differences in the persistence and duration of wet episodes, affecting the efficiency of the process by which precipitation is converted to runoff. The SOI leads the precipitation events by several months, and hydrologic lags (mostly through snowmelt) dealy the stream flow response by several more months. The combined 6-12 month predictive aspect of this relationship should be of significant benefit in responding to flood (or drought) risk and in improving overall water management in the western states.Frequency distributions of daily precipitation in winter and daily stream flow from late winter to early summer, at several hundred sites in the western United States, exhibit strong and systematic responses to the two phases of ENSO. Most of the stream flows considered are driven by snowmelt. The Southern Oscillation index (SOI) is used as the ENSO phase indicator. Both modest (median) and larger (90th percentile) events were considered. In years with negative SOI values (El Nino), days with high daily precipitation and stream flow are more frequent than average over the Southwest and less frequent over the Northwest. During years with positive SOI values (La Nina), a nearly opposite pattern is seen. A more pronounced increase is seen in the number of days exceeding climatological 90th percentile values than in the number exceeding climatological 50th percentile values, for both precipitation and stream flow. Stream flow responses to ENSO extremes are accentuated over precipitation responses. Evidence suggests that the mechanism for this amplification involves ENSO-phase differences in the persistence and duration of wet episodes, affecting the efficiency of the process by which precipitation is converted to runoff. The SOI leads the precipitation events by several months, and hydrologic lags (mostly through snowmelt) delay the stream flow response by several more months. The combined 6-12-month predictive aspect of this relationship should be of significant benefit in responding to flood (or drought) risk and in improving overall water management in the western states.

76 FR 22122 - Section 8 Housing Choice Voucher Program-Demonstration Project of Small Area Fair Market Rents in...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-20

... rent and the core-based statistical area (CBSA) rent as applied to the 40th percentile FMR for that..., calculated on the basis of the core-based statistical area (CBSA) or the metropolitan Statistical Area (MSA... will be ranked according to each of the statistics specified above, and then a weighted average ranking...

Comparison of the clinical outcomes between unattended home APAP and polysomnography manual titration in obstructive sleep apnea patients.

PubMed

Wongsritrang, Krongthong; Fueangkamloon, Sumet

2013-09-01

To compare the clinical outcomes and determine the difference in therapeutic pressure between Automatic positive airway pressure (APAP) and polysomnography manual titration. Fifty patients of obstructive sleep apnea (OSA), moderate to severe cases, were randomized into two groups of intervention: 95-percentile pressure derived from APAP titration and an optimal pressure derived from manual titration. Clinical outcomes were assessed before and after four weeks. The average 95-percentile pressure derived from APAP titration was 11.7 +/- 0.3 cmH2O with median mask leak 1.3 L/min. The average optimal pressure derived from manual titration was 8.2 +/- 0.3 cmH2O. Pearson correlation analysis showed weak positive correlation (r = 0.336, p = 0.017). The Epworth Sleepiness Score (ESS), Quality of life tests: PSQI (Pittsburg Sleep Quality Index), and SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey) were improved significantly in both groups, but there were no statistical significant differences between groups. An APAP titration is an effective method of pressure determination for conventional CPAP therapy and shows no difference in clinical outcomes comparing the standard titration.

The Level and Nature of Autistic Intelligence

PubMed Central

Dawson, Michelle; Soulières, Isabelle; Ann Gernsbacher, Morton; Mottron, Laurent

2015-01-01

Autistics are presumed to be characterized by cognitive impairment, and their cognitive strengths (e.g., in Block Design performance) are frequently interpreted as low-level by-products of high-level deficits, not as direct manifestations of intelligence. Recent attempts to identify the neuroanatomical and neurofunctional signature of autism have been positioned on this universal, but untested, assumption. We therefore assessed a broad sample of 38 autistic children on the preeminent test of fluid intelligence, Raven’s Progressive Matrices. Their scores were, on average, 30 percentile points, and in some cases more than 70 percentile points, higher than their scores on the Wechsler scales of intelligence. Typically developing control children showed no such discrepancy, and a similar contrast was observed when a sample of autistic adults was compared with a sample of nonautistic adults. We conclude that intelligence has been underestimated in autistics. PMID:17680932

Tutorial: Calculating Percentile Rank and Percentile Norms Using SPSS

ERIC Educational Resources Information Center

Baumgartner, Ted A.

2009-01-01

Practitioners can benefit from using norms, but they often have to develop their own percentile rank and percentile norms. This article is a tutorial on how to quickly and easily calculate percentile rank and percentile norms using SPSS, and this information is presented for a data set. Some issues in calculating percentile rank and percentile…

Concurrent and construct validation of the short form of the Bruininks-Oseretsky Test of Motor Proficiency and the Movement-ABC when administered under field conditions: implications for screening.

PubMed

Spironello, C; Hay, J; Missiuna, C; Faught, B E; Cairney, J

2010-07-01

Among the most widely used instruments to assess developmental co-ordination disorder (DCD) in children are the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and the Movement Assessment Battery for Children (M-ABC). However, there is little research on agreement between these tests, when administered to children in field-based settings by trained non-clinicians. Ten of 75 schools participating in a larger study were randomly selected. All children in grade 4 (n= 340) in each of these schools were assessed at the same time using both the BOTMP-SF and the M-ABC in May of 2005. The order of tests was balanced, with an average gap in time between tests of 10-15 min. All tests were administered by trained research assistants. The correlation between tests was moderate (r= 0.50, P < 0.01). Kappas were low at the fifth (k= 0.19) and 15th (k= 0.29) percentile cut-points, which are generally used to identify cases of DCD. Re-analysis using the relative improvement over chance (RIOC) statistic, however, revealed slightly better agreement at both cut-points (fifth percentile, RIOC = 0.29; 15th percentile, RIOC = 0.47). Children who scored as probable for DCD on both motor tests, as well as on only the BOTMP-SF, had higher body mass index, poorer physical fitness and lower levels of teacher-reported physical ability than those positive for DCD on the M-ABC only or those who scored negatively on both tests. In general, the agreement between tests, even after adjustment for RIOC, was poor. Children identified with poor motor competence by both tests or by the BOTMP-SF only are at particular risk for poor physical fitness, overweight/obesity and physical inactivity. It appears that each assessment measures different dimensions of motor ability but that under field-based conditions the M-ABC may be less useful when applied by non-clinicians.

A Comparison of Three Conditional Growth Percentile Methods: Student Growth Percentiles, Percentile Rank Residuals, and a Matching Method

ERIC Educational Resources Information Center

Wyse, Adam E.; Seo, Dong Gi

2014-01-01

This article provides a brief overview and comparison of three conditional growth percentile methods; student growth percentiles, percentile rank residuals, and a nonparametric matching method. These approaches seek to describe student growth in terms of the relative percentile ranking of a student in relationship to students that had the same…

Anthropometric survey of the astronaut applicants and astronauts from 1985 to 1991

NASA Technical Reports Server (NTRS)

Rajulu, Sudhakar L.; Klute, Glenn K.

1993-01-01

The Anthropometry and Biomechanics Laboratory at the Johnson Space Center has been collecting anthropometric data from astronaut applicants since 1977. These anthropometric measurements had been taken from 473 applicants. Based on the position they applied for, these applicants were classified as either mission specialists, payload specialists, pilots, or observers. The main objective was to document the variations among these applicants and tabulate the percentile data for each anthropometric dimension. The percentile and the descriptive statistics data were tabulated and graphed for the whole astronaut candidate population; for the male and female groups; for each subject classification such as pilot, mission specialist, and payload specialist; and finally, for those who were selected as astronauts.

Relationship between Small Animal Intern Rank and Performance at a University Teaching Hospital.

PubMed

Hofmeister, Erik H; Saba, Corey; Kent, Marc; Creevy, Kate E

2015-01-01

The purpose of this study was to determine if there is a relationship between selection committee rankings of internship applicants and the performance of small animal interns. The hypothesis was that there would be a relationship between selection committee rank order and intern performance; the more highly an application was ranked, the better the intern's performance scores would be. In 2007, the Department of Small Animal Medicine and Surgery instituted a standardized approach to its intern selection process both to streamline the process and to track its effectiveness. At the end of intern years 2010-2014, every faculty member in the department was provided an intern assessment form for that year's class. There was no relationship between an individual intern's final rank by the selection committee and his/her performance either as a percentile score or a Likert-type score (p=.25, R2=0.04; p=0.31, R2=0.03, respectively). Likewise, when interns were divided into the top and bottom quartile based on their final rank by the selection committee, there was no relationship between their rank and their performance as a percentile score (median rank 15 vs. 20; p=.14) or Likert-type score (median rank 14 vs. 19; p=.27). Institutions that use a similar intern selection method may need to reconsider the time and effort being expended for an outcome that does not predict performance. Alternatively, specific criteria more predictive of performance outcomes should be identified and employed in the internship selection process.

Measurements of Criteria Pollutants in Suburban Locations in the Mexico City Metropolitan Area

NASA Astrophysics Data System (ADS)

Fentanes, O.; Sanchez, A.; Garcia, A.; Martinez, A.

2004-12-01

In the town of Santa Ana in the southern part of the Mexico City Metropolitan Area (MCMA) at an approximate height of 370 meters above the Valley of Mexico, a series of criteria pollutants (nitrogen dioxide, ozone, sulfur dioxide, and carbon monoxide) and meteorological parameters (wind speed and direction, temperature and relative humidity) were measured during the MCMA-2003 field campaign during April 2003. Santa Ana is considered a border site, agriculture being the predominant activity. The generated data in Santa Ana was compared with those from two representative atmospheric monitoring stations from the southeast zone (CENICA Supersite) and southwest (Revolucion Station) of Mexico City. The carbon monoxide and ozone concentrations measured in Santa Ana are atypical for a rural area. The sulfur dioxide and nitrogen dioxide concentrations are characteristic of the local activity. The average obtained during the measurement time for carbon monoxide was 0.86 ppm, the presence of the contaminant was within a 0.3 to 1.5 ppm range, 5 to 95 percentile, and does not follow the observed behavior of the monitoring stations that are located inside the urban area, although during the night (10 pm to 6 am) the carbon monoxide in Santa Ana was preset in levels from 0.4 to 1.5 ppm, 5 to 95 percentiles, average 0.92 ppm, above the reported concentrations at Revolucion Station, levels from 0.1 to 1.7 ppm, 5 to 95 percentiles; average 0.72 ppm. The presence of this contaminant can be attributed to transportation and accumulation phenomena. The ozone daytime behavior is similar to the one observed in the CENICA and Revolucion stations, but with a lower magnitude, the daily maximum generally occuring 2 or 3 hours after the urban stations. The one-hour average maximum values were 133 ppb in Santa Ana area and 188 ppb in the city. During the night the average concentrations were 37 ppb in Santa Ana and 17 ppb in the urban area. Nevertheless, the ozone average value in Santa Ana during the study was 49 ppb, slightly higher than the one obtained in the urban area, which was 44 ppb. The presence of this contaminant can be possibly attributed to the transportation and accumulation factors as well as to the low reactivity due to the absence of NOx, as explained in Dommen Josef and Prévôt, S.H. André, 2002, Characterization of the photooxidant formation in the metropolitan area of Milan from aircraft measurements, Journal of Geophysical Research, 107 (D22): 8197, doi: 10.1029/2000JD000283.

[Growth references for weight and height for Argentinian girls and boys from birth to maturity: incorporation of data from the World Health Organisation from birth to 2 years and calculation of new percentiles and LMS values].

PubMed

Lejarraga, Horacio; del Pino, Mariana; Fano, Virginia; Caino, Silvia; Cole, Timothy J

2009-04-01

Argentine growth references have been widely used by paediatricians in the country for the last 20 years. Two main difficulties were detected during this period: the lack of data on breast-fed children in the first months of age, and problems in the calculation of "z" scores. On these basis, local data on weight and height during the first two years of life were replaced by data from the longitudinal international study recently carried out by WHO. L, M and S values were obtained from the original percentile data for ages 2 to maturity, and smoothed with cubic splines. Selected percentiles for weight and height from birth to maturity were then re-calculated using LMS values. Charts were designed in two formats: birth to maturity and birth to 6.0 years. Now, users can calculate "z" scores automatically at the new site provided by the Department of Growth and Development, Hospital Garrahan, which enables the use of the LMS growth programme. We have also incorporated into the new charts, percentiles of the age of attaining menarche and Tanner s stage II of breast, genitalia and pubic hair for Argentine children. We think the new references represent an improvement in the assessment of growth in our country.

Trend estimates of AERONET-observed and model-simulated AOT percentiles between 1993 and 2013

NASA Astrophysics Data System (ADS)

Yoon, Jongmin; Pozzer, Andrea; Chang, Dong Yeong; Lelieveld, Jos

2016-04-01

Recent Aerosol Optical thickness (AOT) trend studies used monthly or annual arithmetic means that discard details of the generally right-skewed AOT distributions. Potentially, such results can be biased by extreme values (including outliers). This study additionally uses percentiles (i.e., the lowest 5%, 25%, 50%, 75% and 95% of the monthly cumulative distributions fitted to Aerosol Robotic Network (AERONET)-observed and ECHAM/MESSy Atmospheric Chemistry (EMAC)-model simulated AOTs) that are less affected by outliers caused by measurement error, cloud contamination and occasional extreme aerosol events. Since the limited statistical representativeness of monthly percentiles and means can lead to bias, this study adopts the number of observations as a weighting factor, which improves the statistical robustness of trend estimates. By analyzing the aerosol composition of AERONET-observed and EMAC-simulated AOTs in selected regions of interest, we distinguish the dominant aerosol types and investigate the causes of regional AOT trends. The simulated and observed trends are generally consistent with a high correlation coefficient (R = 0.89) and small bias (slope±2σ = 0.75 ± 0.19). A significant decrease in EMAC-decomposed AOTs by water-soluble compounds and black carbon is found over the USA and the EU due to environmental regulation. In particular, a clear reversal in the AERONET AOT trend percentiles is found over the USA, probably related to the AOT diurnal cycle and the frequency of wildfires.

Household fear of deportation in Mexican-origin families: Relation to body mass index percentiles and salivary uric acid.

PubMed

Martínez, Airín D; Ruelas, Lillian; Granger, Douglas A

2017-11-01

Fear of deportation (FOD) is a prevalent concern among mixed-status families. Yet, our understanding of how FOD shapes human health and development is in its infancy. To begin to address this knowledge gap, we examined the relationship between household FOD, body mass index (BMI) percentiles and salivary uric acid (sUA), a biomarker related to oxidative stress/hypertension/metabolic syndrome, among 111 individuals living in Mexican-origin families. Participants were 65 children (2 months-17 years, 49% female) and 46 adults (20-58 years, 71% female) living in 30 Mexican-origin families with at least one immigrant parent in Phoenix, AZ. We recruited families using cluster probability sampling of 30 randomly selected census tracts with a high proportion of Hispanic/Latino immigrants. The head of household completed a survey containing demographic, FOD, and psychosocial measures. All family members provided saliva (later assayed for sUA) and anthropometric measures. Relationships between household FOD, BMI percentile, and sUA levels were estimated using multilevel models. Higher levels of household FOD were associated with lower BMI percentiles and lower sUA levels between families, after controlling for social support and socioeconomic proxies. Key features of the social ecology in which mixed-status families are embedded are associated with individual differences in biological processes linked to increased risk for chronic disease. © 2017 Wiley Periodicals, Inc.

PROPOSALS FOR THE ESTABLISHMENT OF NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR RADIOGRAPHY FOR ADULT PATIENTS BASED ON REGIONAL DOSE SURVEYS IN RUSSIAN FEDERATION.

PubMed

Vodovatov, A V; Balonov, M I; Golikov, V Yu; Shatsky, I G; Chipiga, L A; Bernhardsson, C

2017-04-01

In 2009-2014, dose surveys aimed to collect adult patient data and parameters of most common radiographic examinations were performed in six Russian regions. Typical patient doses were estimated for the selected examinations both in entrance surface dose and in effective dose. 75%-percentiles of typical patient effective dose distributions were proposed as preliminary regional diagnostic reference levels (DRLs) for radiography. Differences between the 75%-percentiles of regional typical patient dose distributions did not exceed 30-50% for the examinations with standardized clinical protocols (skull, chest and thoracic spine) and a factor of 1.5 for other examinations. Two different approaches for establishing national DRLs were evaluated: as a 75%-percentile of a pooled regional sample of patient typical doses (pooled method) and as a median of 75%-percentiles of regional typical patient dose distributions (median method). Differences between pooled and median methods for effective dose did not exceed 20%. It was proposed to establish Russian national DRLs in effective dose using a pooled method. In addition, the local authorities were granted an opportunity to establish regional DRLs if the local radiological practice and typical patient dose distributions are significantly different. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

40 CFR Appendix N to Part 50 - Interpretation of the National Ambient Air Quality Standards for PM2.5

Code of Federal Regulations, 2014 CFR

2014-07-01

... series of daily values represents the 98th percentile for that year. Creditable samples include daily... measured (or averaged from hourly measurements in AQS) from midnight to midnight (local standard time) from... design value (DV) or a 24-hour PM2.5 NAAQS DV to determine if those metrics, which are judged to be based...

78 FR 54828 - Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for the 1997 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

...- oriented monitors, and 65 [mu]g/m\\3\\, based on the three-year average of the 98th percentile of 24-hour PM 2.5 concentrations at each population-oriented monitor within an area (62 FR 38652). On October 17...)(2)(G): Emergency powers. 110(a)(2)(H): Future SIP revisions. 110(a)(2)(J): Consultation with...

Examining the Average and Local Effects of a Standardized Treatment for Fourth Graders with Reading Difficulties

ERIC Educational Resources Information Center

Wanzek, Jeanne; Petscher, Yaacov; Al Otaiba, Stephanie; Kent, Shawn C.; Schatschneider, Christopher; Haynes, Martha; Rivas, Brenna K.; Jones, Francesca G.

2016-01-01

The present study used a randomized control trial to examine the effects of a widely used multicomponent Tier 2-type intervention, Passport to Literacy, on the reading ability of 221 fourth graders who initially scored at or below the 30th percentile in reading comprehension. Intervention was provided by research staff to groups of 4-7 students…

Examining the Average and Local Effects of a Standardized Treatment for Fourth Graders with Reading Difficulties

ERIC Educational Resources Information Center

Wanzek, Jeanne; Petscher, Yaacov; Al Otaiba, Stephanie; Kent, Shawn; Christopher, Schatschneider; Haynes, Martha; Rivas, Brenna K.; Jones, Francesca G.

2016-01-01

The present study used a randomized control trial to examine the effects of a widely-used multi-component Tier 2 type intervention, Passport to Literacy, on the reading ability of 221 fourth graders who initially scored at or below the 30th percentile in reading comprehension. Intervention was provided by research staff to groups of 4-7 students…

A Study of the 1968 Graduates of Manatee Junior College.

ERIC Educational Resources Information Center

Stivers, Earl R.

This study of the 1968 graduates of Manatee Junior College, Florida, showed that: (1) it is not necessary to be in the top 40% of grade 12 to succeed in junior college, (2) students in the lowest percentiles at entrance can earn a degree, (3) the average candidate for a degree should expect to spend more than four terms at the junior college, (4)…

Assessment of long-term monthly and seasonal trends of warm (cold), wet (dry) spells in Kansas, USA

NASA Astrophysics Data System (ADS)

Dokoohaki, H.; Anandhi, A.

2013-12-01

A few recent studies have focused on trends in rainfall, temperature, and frost indicators at different temporal scales using centennial weather station data in Kansas; our study supplements this work by assessing the changes in spell indicators in Kansas. These indicators provide the duration between temperature-based (warm and cold) and precipitation-based (wet and dry) spells. For wet (dry) spell calculations, a wet day is defined as a day with precipitation ≥1 mm, and a dry day is defined as one with precipitation ≤1 mm. For warm (cold) spell calculations, a warm day is defined as a day with maximum temperature >90th percentile of daily maximum temperature, and a cold day is defined as a day with minimum temperature <10th percentile of daily minimum temperature. The percentiles are calculated for 1971-2000, and four spell indicators are calculated: Average Wet Spell Length (AWSL), Dry Spell Length (ADSL), Average Warm Spell Days (AWSD) and Average Cold Spell Days (ACSD) are calculated. Data were provided from 23 centennial weather stations across Kansas, and all calculations were done for four time periods (through 1919, 1920-1949, 1950-1979, and 1980-2009). The definitions and software provided by Expert Team on Climate Change Detection and Indices (ETCCDI) were adapted for application to Kansas. The long- and short-term trends in these indices were analyzed at monthly and seasonal timescales. Monthly results indicate that ADSL is decreasing and AWSL is increasing throughout the state. AWSD and ACSD both showed an overall decreasing trend, but AWSD trends were variable during the beginning of the Industrial Revolution. Results of seasonal analysis revealed that the fall season recorded the greatest increasing trend for ACSD and the greatest decreasing trend for AWSD across the whole state and during all time periods. Similarly, the greatest increasing and decreasing trends occurred in winter for AWSL and ADSL, respectively. These variations can be important indicators of climatic change that may not be represented in mean conditions. Detailed geographical and temporal variations of the spell indices also can be beneficial for updating management decisions and providing adaptation recommendations for local and regional agricultural production.

High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood.

PubMed

Smego, Allison; Woo, Jessica G; Klein, Jillian; Suh, Christina; Bansal, Danesh; Bliss, Sherri; Daniels, Stephen R; Bolling, Christopher; Crimmins, Nancy A

2017-04-01

To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months (P < .001), at 1 year before the median age at onset of obesity. A cutoff of the World Health Organization (WHO) 85th percentile for BMI at 6, 12, and 18 months was a strong predictor of severe obesity by age 6 years (sensitivity, 51%-95%; specificity, 95%). This BMI threshold was validated in a second independent cohort (n = 2649), with a sensitivity of 33%-77% and a specificity of 74%-87%. A BMI ≥85th percentile in infancy increases the risk of severe obesity by age 6 years by 2.5-fold and the risk of clinical obesity by age 6 years by 3-fold. BMI trajectories in children who develop severe obesity by age 6 years differ from those in children who remain at normal weight by age 4-6 months, before the onset of obesity. Infants with a WHO BMI ≥85th percentile are at increased risk for developing severe obesity by age 6 years. Copyright © 2016 Elsevier Inc. All rights reserved.

Hydrologic data for the Larimer-Weld regional water-monitoring program, Colorado, 1975-82

USGS Publications Warehouse

Blakely, S.R.; Steinheimer, J.T.

1984-01-01

The Larimer-Weld, Colorado, regional Monitoring Program was begun in 1976 to provide information on the quality and quantity of the surface-water resources in the area. Three stations on the big Thompson River and five stations on the Cache La Poudre River were selected for a data-collection network. Four previously established stations were added to complete the data-collection network: Horsetooth Reservoir, Joe Wright Creek above and below Joe Wright Reservoir, and Michigan River near Cameron Pass. Station description, location, and period of record are given for each station. A statistical summary of the water-quality data for each station is tabulated. Frequency of occurrence is given at the 95th, 75th, 50th, and 25th percentiles. Monthly water-quality data and daily average streamflow data are tabulated for each streamflow station for which this data was collected; Monthly contents data are presented for Horsetooth Reservoir. All data tabulated and summarized are from the period October 1, 1975, through September 30, 1982. (USGS)

Evaluation of exposure to electromagnetic radiofrequency radiation in the indoor workplace accessible to the public by the use of frequency-selective exposimeters.

PubMed

Gryz, Krzysztof; Karpowicz, Jolanta; Leszko, Wiesław; Zradziński, Patryk

2014-12-01

The aim of the study was to identify and assess electromagnetic radiofrequency radiation (EMRR) exposure in a workplace located in a publicly accessible environment, and represented by offices (where exposure is caused by various transmitters of local fixed indoor and outdoor wireless communication systems). The investigations were performed in 45 buildings (in urban and rural areas in various regions of Poland), using frequency-selective electric field strength (E-field) exposimeters sensitive to the EMRR with a frequency range of 88-2500 MHz, split into 12 sub-bands corresponding to the operating frequencies of typical EMRR sources. The variability of the E-field was analyzed for each frequency range and the total level of exposure by statistical parameters of recorded exposimetric profiles: minimum, maximum, median values and 25-75th - percentiles. The main sources of exposure to EMRR are mobile phone base transceiver stations (BTS) and radio-television transmitters (RTV). The frequency composition in a particular office depends on the building's location. The E-field recorded in buildings in urban and rural areas from the outdoor BTS did not exceed respectively: medians - 0.19 and 0.05 V/m, 75th percentiles -0.25 and 0.09 V/m. In buildings equipped with the indoor BTS antennas the E-field did not exceed: medians - 1 V/m, 75th percentiles - 1.8 V/m. Whereas in urban and rural areas, the median and 75th percentile values of the E-field recorded in buildings located near the RTV (within 1 km) did not exceed: 1.5 and 3.8 V/m or 0.4 and 0.8 V/m, for radio FM band or for TV bands, respectively. Investigations confirmed the practical applicability of the exposimetric measurements technique for evaluating parameters of worker's exposure in both frequency- and time-domain. The presented results show EMRR exposure of workers or general public in locations comparable to offices to be well below international limits.

Impact of socioeconomic adjustment on physicians' relative cost of care.

PubMed

Timbie, Justin W; Hussey, Peter S; Adams, John L; Ruder, Teague W; Mehrotra, Ateev

2013-05-01

Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES). The importance of SES adjustment has not been explored in cost-profiling applications that measure costs using an episode of care framework. We assessed the relationship between SES and episode costs and the impact of adjusting for SES on physicians' relative cost rankings. We analyzed claims submitted to 3 Massachusetts commercial health plans during calendar years 2004 and 2005. We grouped patients' care into episodes, attributed episodes to individual physicians, and standardized costs for price differences across plans. We accounted for differences in physicians' case mix using indicators for episode type and a patient's severity of illness. A patient's SES was measured using an index of 6 indicators based on the zip code in which the patient lived. We estimated each physician's case mix-adjusted average episode cost and percentile rankings with and without adjustment for SES. Patients in the lowest SES quintile had $80 higher unadjusted episode costs, on average, than patients in the highest quintile. Nearly 70% of the variation in a physician's average episode cost was explained by case mix of their patients, whereas the contribution of SES was negligible. After adjustment for SES, only 1.1% of physicians changed relative cost rankings >2 percentiles. Accounting for patients' SES has little impact on physicians' relative cost rankings within an episode cost framework.

Assessment of operative times of multiple surgical specialties in a public university hospital.

PubMed

Costa, Altair da Silva

2017-01-01

To evaluate the indicators duration of anesthesia, operative time and time patients stay in the operating rooms of different surgical specialties at a public university hospital. It was done by a descriptive cross-sectional study based on the operating room database. The following stages were measured: duration of anesthesia, procedure time and patient length of stay in the room of the various specialties. We included surgeries carried out in sequence in the same room, between 7:00 a.m. and 5 p.m., either elective or emergency. We calculated the 80th percentile of the stages, where 80% of procedures were below this value. The study measured 8,337 operations of 12 surgical specialties performed within one year. The overall mean duration of anesthesia of all specialties was 178.12±110.46 minutes, and the 80th percentile was 252 minutes. The mean operative time was 130.45±97.23 minutes, and the 80th percentile was 195 minutes. The mean total time of the patient in the operating room was 197.30±113.71 minutes, and the 80th percentile was 285 minutes. Thus, the variation of the overall mean compared to the 80th percentile was 41% for anesthesia, 49% for surgeries and 44% for operating room time. In average, anesthesia took up 88% of the operating room period, and surgery, 61%. This study identified patterns in the duration of surgery stages. The mean values of the specialties can assist with operating room planning and reduce delays. Avaliar os indicadores de tempo da anestesia, da operação e da permanência do paciente em sala de diversas especialidades do centro cirúrgico de um hospital universitário. Foi realizado em estudo descritivo transversal a partir da base de dados do centro cirúrgico e mensuradas as seguintes etapas: duração de anestesia, tempo do procedimento e tempo de permanência do paciente em sala das diversas especialidades. Foram incluídas as operações realizadas em sequência na mesma sala, das 7h às 17h, eletivas ou de urgências. Realizamos o calculo do percentil 80 da duração das etapas, onde 80% dos procedimentos ficaram abaixo deste valor obtido. O estudo incluiu 8.337 operações realizadas no período de 1 ano de 12 especialidades cirúrgicas. A média geral da duração da anestesia de todas as especialidades foi de 178,12±110,46 minutos, e o percentil 80 foi de 252 minutos. A média do tempo operatório foi 130,45±97,23 minutos, e o percentil 80 foi de 195 minutos. A média do tempo total do paciente em sala operatória foi de 197,30±113,71 minutos, e o percentil 80 foi de 285 minutos. A variação da média geral em relação ao percentil 80 foi de 41% na anestesia, 49% nas operações e 44% no tempo de sala. Na média geral, a anestesia ocupou 88% do tempo de sala e a operação, 61%. Este estudo identificou padrões nas durações das etapas das operações. A informação das médias históricas das especialidades pode auxiliar no planejamento do centro cirúrgico e diminuir os atrasos.

Regional regression equations for the estimation of selected monthly low-flow duration and frequency statistics at ungaged sites on streams in New Jersey

USGS Publications Warehouse

Watson, Kara M.; McHugh, Amy R.

2014-01-01

Regional regression equations were developed for estimating monthly flow-duration and monthly low-flow frequency statistics for ungaged streams in Coastal Plain and non-coastal regions of New Jersey for baseline and current land- and water-use conditions. The equations were developed to estimate 87 different streamflow statistics, which include the monthly 99-, 90-, 85-, 75-, 50-, and 25-percentile flow-durations of the minimum 1-day daily flow; the August–September 99-, 90-, and 75-percentile minimum 1-day daily flow; and the monthly 7-day, 10-year (M7D10Y) low-flow frequency. These 87 streamflow statistics were computed for 41 continuous-record streamflow-gaging stations (streamgages) with 20 or more years of record and 167 low-flow partial-record stations in New Jersey with 10 or more streamflow measurements. The regression analyses used to develop equations to estimate selected streamflow statistics were performed by testing the relation between flow-duration statistics and low-flow frequency statistics for 32 basin characteristics (physical characteristics, land use, surficial geology, and climate) at the 41 streamgages and 167 low-flow partial-record stations. The regression analyses determined drainage area, soil permeability, average April precipitation, average June precipitation, and percent storage (water bodies and wetlands) were the significant explanatory variables for estimating the selected flow-duration and low-flow frequency statistics. Streamflow estimates were computed for two land- and water-use conditions in New Jersey—land- and water-use during the baseline period of record (defined as the years a streamgage had little to no change in development and water use) and current land- and water-use conditions (1989–2008)—for each selected station using data collected through water year 2008. The baseline period of record is representative of a period when the basin was unaffected by change in development. The current period is representative of the increased development of the last 20 years (1989–2008). The two different land- and water-use conditions were used as surrogates for development to determine whether there have been changes in low-flow statistics as a result of changes in development over time. The State was divided into two low-flow regression regions, the Coastal Plain and the non-coastal region, in order to improve the accuracy of the regression equations. The left-censored parametric survival regression method was used for the analyses to account for streamgages and partial-record stations that had zero flow values for some of the statistics. The average standard error of estimate for the 348 regression equations ranged from 16 to 340 percent. These regression equations and basin characteristics are presented in the U.S. Geological Survey (USGS) StreamStats Web-based geographic information system application. This tool allows users to click on an ungaged site on a stream in New Jersey and get the estimated flow-duration and low-flow frequency statistics. Additionally, the user can click on a streamgage or partial-record station and get the “at-site” streamflow statistics. The low-flow characteristics of a stream ultimately affect the use of the stream by humans. Specific information on the low-flow characteristics of streams is essential to water managers who deal with problems related to municipal and industrial water supply, fish and wildlife conservation, and dilution of wastewater.

Role of the standard deviation in the estimation of benchmark doses with continuous data.

PubMed

Gaylor, David W; Slikker, William

2004-12-01

For continuous data, risk is defined here as the proportion of animals with values above a large percentile, e.g., the 99th percentile or below the 1st percentile, for the distribution of values among control animals. It is known that reducing the standard deviation of measurements through improved experimental techniques will result in less stringent (higher) doses for the lower confidence limit on the benchmark dose that is estimated to produce a specified risk of animals with abnormal levels for a biological effect. Thus, a somewhat larger (less stringent) lower confidence limit is obtained that may be used as a point of departure for low-dose risk assessment. It is shown in this article that it is important for the benchmark dose to be based primarily on the standard deviation among animals, s(a), apart from the standard deviation of measurement errors, s(m), within animals. If the benchmark dose is incorrectly based on the overall standard deviation among average values for animals, which includes measurement error variation, the benchmark dose will be overestimated and the risk will be underestimated. The bias increases as s(m) increases relative to s(a). The bias is relatively small if s(m) is less than one-third of s(a), a condition achieved in most experimental designs.

Food security and the nutritional status of children in foster care: new horizons in the protection of a fragile population.

PubMed

Ferrara, Pietro; Scancarello, Marta; Khazrai, Yeganeh M; Romani, Lorenza; Cutrona, Costanza; DE Gara, Laura; Bona, Gianni

2016-10-12

The nutritional status of foster children, the quality of daily menus in group homes and the Food Security inside these organizations have been poorly studied and this study means to investigate them. A sample of 125 children, ranging in age from 0-17 years, among seven group homes (group A) was compared with 121 children of the general population we (group B). To evaluate nutritional status, BMI percentiles were used. Mean percentiles of both groups were compared through statistical analysis. Both nutritional and caloric daily distributions in each organization were obtained using the 24-hour recall method. A specific questionnaire was administered to evaluate Food Security. From the analysis of mean BMI-for-age (or height-for-length) percentiles, did not observe statistically significant differences between group A and group B. The average daily nutrient and calorie distribution in group homes proves to be nearly optimal with the exception of a slight excess in proteins and a slight deficiency in PUFAs. Moreover, a low intake of iron and calcium was revealed. All organizations obtained a "High Food Security" profile. Nutritional conditions of foster children are no worse than that of children of the general population. Foster care provides the necessary conditions to support their growth.

Assessing signatures of selection through variation in linkage disequilibrium between taurine and indicine cattle

PubMed Central

2014-01-01

Background Signatures of selection are regions in the genome that have been preferentially increased in frequency and fixed in a population because of their functional importance in specific processes. These regions can be detected because of their lower genetic variability and specific regional linkage disequilibrium (LD) patterns. Methods By comparing the differences in regional LD variation between dairy and beef cattle types, and between indicine and taurine subspecies, we aim at finding signatures of selection for production and adaptation in cattle breeds. The VarLD method was applied to compare the LD variation in the autosomal genome between breeds, including Angus and Brown Swiss, representing taurine breeds, and Nelore and Gir, representing indicine breeds. Genomic regions containing the top 0.01 and 0.1 percentile of signals were characterized using the UMD3.1 Bos taurus genome assembly to identify genes in those regions and compared with previously reported selection signatures and regions with copy number variation. Results For all comparisons, the top 0.01 and 0.1 percentile included 26 and 165 signals and 17 and 125 genes, respectively, including TECRL, BT.23182 or FPPS, CAST, MYOM1, UVRAG and DNAJA1. Conclusions The VarLD method is a powerful tool to identify differences in linkage disequilibrium between cattle populations and putative signatures of selection with potential adaptive and productive importance. PMID:24592996

Intensity changes in future extreme precipitation: A statistical event-based approach.

NASA Astrophysics Data System (ADS)

Manola, Iris; van den Hurk, Bart; de Moel, Hans; Aerts, Jeroen

2017-04-01

Short-lived precipitation extremes are often responsible for hazards in urban and rural environments with economic and environmental consequences. The precipitation intensity is expected to increase about 7% per degree of warming, according to the Clausius-Clapeyron (CC) relation. However, the observations often show a much stronger increase in the sub-daily values. In particular, the behavior of the hourly summer precipitation from radar observations with the dew point temperature (the Pi-Td relation) for the Netherlands suggests that for moderate to warm days the intensification of the precipitation can be even higher than 21% per degree of warming, that is 3 times higher than the expected CC relation. The rate of change depends on the initial precipitation intensity, as low percentiles increase with a rate below CC, the medium percentiles with 2CC and the moderate-high and high percentiles with 3CC. This non-linear statistical Pi-Td relation is suggested to be used as a delta-transformation to project how a historic extreme precipitation event would intensify under future, warmer conditions. Here, the Pi-Td relation is applied over a selected historic extreme precipitation event to 'up-scale' its intensity to warmer conditions. Additionally, the selected historic event is simulated in the high-resolution, convective-permitting weather model Harmonie. The initial and boundary conditions are alternated to represent future conditions. The comparison between the statistical and the numerical method of projecting the historic event to future conditions showed comparable intensity changes, which depending on the initial percentile intensity, range from below CC to a 3CC rate of change per degree of warming. The model tends to overestimate the future intensities for the low- and the very high percentiles and the clouds are somewhat displaced, due to small wind and convection changes. The total spatial cloud coverage in the model remains, as also in the statistical method, unchanged. The advantages of the suggested Pi-Td method of projecting future precipitation events from historic events is that it is simple to use, is less expensive time, computational and resource wise compared to a numerical model. The outcome can be used directly for hydrological and climatological studies and for impact analysis such as for flood risk assessments.

Associations of daily pediatric asthma emergency department visits with air pollution in Newark, NJ: utilizing time-series and case-crossover study designs.

PubMed

Gleason, Jessie A; Fagliano, Jerald A

2015-10-01

Asthma is one of the most common chronic diseases affecting children. This study assesses the associations of ozone and fine particulate matter (PM2.5) with pediatric emergency department visits in the urban environment of Newark, NJ. Two study designs were utilized and evaluated for usability. We obtained daily emergency department visits among children aged 3-17 years with a primary diagnosis of asthma during April to September for 2004-2007. Both a time-stratified case-crossover study design with bi-directional control sampling and a time-series study design were utilized. Lagged effects (1-d through 5-d lag, 3-d average, and 5-d average) of ozone and PM2.5 were explored and a dose-response analysis comparing the bottom 5th percentile of 3-d average lag ozone with each 5 percentile increase was performed. Associations of interquartile range increase in same-day ozone were similar between the time-series and case-crossover study designs (RR = 1.08, 95% CI 1.04-1.12) and (OR = 1.10, 95% CI 1.06-1.14), respectively. Similar associations were seen for 1-day lag and 3-day average lag ozone levels. PM2.5 was not associated with the outcome in either study design. Dose-response assessment indicated a statistically significant and increasing association around 50-55 ppb consistent for both study designs. Ozone was statistically positively associated with pediatric asthma ED visits in Newark, NJ. Our results were generally comparable across the time-series and case-crossover study designs, indicating both are useful to assess local air pollution impacts.

Performance of High School Students in a Laparoscopic Training Program.

PubMed

Furer, Scott; Alam, Sarah; Rosser, James

2017-01-01

We hypothesized that high school students can be subjected to the same laparoscopic surgical training curriculum used by surgeons and successfully complete it. The goal of this study was to evaluate the appropriateness of early training in minimally invasive surgical techniques. Thirteen high school students, ages 15-18, participated in the validated Top Gun Surgeon Laparoscopic Skills and Suturing program. The students performed 3 preparatory drills 10 times each. The students' scores were then compared to a database of 393 surgeons. Performance graphs were prepared to allow comparison of skills acquisition between the 2 training groups. All 13 students successfully completed the tasks. The Students' performance (expressed as time/percentile range/average percentile) for each task were as follows: rope pass 101.8 seconds/3.8-47.1/11.8; bean drop 149.5 seconds/18.7-96.0/59.4; triangle transfer 303.2 seconds/1.3-16.0/5.8. The students started each drill with slower times, but their average improvement (decreased time to complete tasks) was more rapid than that of the surgeons between the first and second trials for each drill (-83 seconds vs -25 seconds, -120 seconds vs -53 seconds, -100 seconds vs -60 seconds). Average student times compared to average surgeon times during the last trials measured were not significantly different in the triangle transfer and rope pass drills ( P = .40 and .18, respectively). Students' times were significantly faster than surgeons' in the last measured trial of the bean drop ( P = .039). Despite the small sample size, this investigation suggests that high school students can successfully complete skill-building programs in minimally invasive surgery. Further study is needed to evaluate the appropriateness of starting surgical training of future residents at an earlier stage of their careers.

Acute meningitis prognosis using cerebrospinal fluid interleukin-6 levels.

PubMed

Vázquez, Jorge Alejandro; Adducci, Maria del Carmen; Coll, Carlos; Godoy Monzón, Daniel; Iserson, Kenneth V

2012-08-01

Improved diagnostic tests would aid in diagnosing and treating community-acquired meningitis. To analyze the diagnostic value of interleukin-6 (IL-6) in the cerebrospinal fluid (CSF) of patients presenting with symptoms of acute meningitis. In a 6-month prospective, observational, cross-sectional emergency department (ED) study, serum and CSF samples were obtained from all patients with a headache and fever in whom the physician suspected meningitis. Patients were excluded if computed tomography findings contraindicated a lumbar puncture, if they had bleeding disorders, or if their serum indicated bleeding. IL-6 levels were measured and compared in patients with (Group A) and without (Group B) bacterial meningitis. Samples were obtained from 53 patients, of whom 40 were ultimately found to have meningitis. These 40 patients averaged 49.6 ± 21.9 years, with number of men 18 (45%), hospitalizations 21 (52%), mortality 3 (.07%), and IL-6 average rating 491 (median: 14.5; range 0000-6000). Findings in the two groups were: Group A (with meningitis): n = 13, average IL-6 level: 1495 (median: 604; 25/75 percentiles: 232.5-2030; 95% confidence interval [CI] 371.7-2618.6; range 64-6000). Group B (with aseptic meningitis): n = 27, average IL-6 level: 7.34 (median: 5; 25/75 percentiles: 0.0/15.1; 95% CI 3.94-10.73; range 0-23.6). Mann-Whitney rank sum test: p < 0.0001. In patients with acute bacterial meningitis, CSF cytokine concentrations are elevated. Measuring CSF inflammatory cytokine levels in patients with acute meningitis could be a valuable ED diagnostic tool. Using this tool could improve the prognosis of patients with bacterial meningitis by allowing more rapid initiation of antibiotic treatment. Copyright © 2012 Elsevier Inc. All rights reserved.

Computed tomographic analysis of temporal maxillary stability and pterygomaxillary generate formation following pediatric Le Fort III distraction advancement.

PubMed

Hopper, Richard A; Sandercoe, Gavin; Woo, Albert; Watts, Robyn; Kelley, Patrick; Ettinger, Russell E; Saltzman, Babette

2010-11-01

Le Fort III distraction requires generation of bone in the pterygomaxillary region. The authors performed retrospective digital analysis on temporal fine-cut computed tomographic images to quantify both radiographic evidence of pterygomaxillary region bone formation and relative maxillary stability. Fifteen patients with syndromic midface hypoplasia were included in the study. The average age of the patients was 8.7 years; 11 had either Crouzon or Apert syndrome. The average displacement of the maxilla during distraction was 16.2 mm (range, 7 to 31 mm). Digital analysis was performed on fine-cut computed tomographic scans before surgery, at device removal, and at annual follow-up. Seven patients also had mid-consolidation computed tomographic scans. Relative maxillary stability and density of radiographic bone in the pterygomaxillary region were calculated between each scan. There was no evidence of clinically significant maxillary relapse, rotation, or growth between the end of consolidation and 1-year follow-up, other than a relatively small 2-mm subnasal maxillary vertical growth. There was an average radiographic ossification of 0.5 mm/mm advancement at the time of device removal, with a 25th percentile value of 0.3 mm/mm. The time during consolidation that each patient reached the 25th percentile of pterygomaxillary region bone density observed in this series of clinically stable advancements ranged from 1.3 to 9.8 weeks (average, 3.7 weeks). There was high variability in the amount of bone formed in the pterygomaxillary region associated with clinical stability of the advanced Le Fort III segment. These data suggest that a subsection of patients generate the minimal amount of pterygomaxillary region bone formation associated with advancement stability as early as 4 weeks into consolidation.

A single-institution experience: the integrated vascular surgery residency's effect on fellowship and general surgery resident case volume and diversity.

PubMed

Carroll, Megan I; Downes, Kathryne; Miladinovic, Branko; Illig, Karl A; Armstrong, Paul A; Back, Martin R; Johnson, Brad L; Shames, Murray L

2014-01-01

To determine whether the formation of an integrated vascular surgery residency (0 + 5) has negatively impacted the case volume and diversity of the vascular surgery fellows (5 + 2) and chief general surgeons at the same institution. Operative data from the vascular integrated (0 + 5), independent (5 + 2), and general surgery residencies at a single institution were retrospectively reviewed and analyzed to determine vascular surgery case volumes from 2006-2012. National operative data (Residency Review Committee) were used for comparison of diversity and volume. Standard statistical methods were applied. During this period, the 5 + 2 fellows at our institution performed on average 741 (range, 554-1002) primary cases and 1091 (range, 844-1479) combined primary and secondary cases for the 2-year fellowship. Our integrated residency began in July 2007. Our fellows' primary case volumes remained relatively stable between 2006 and 2011, with a 4% increase in the number of cases, although their total (primary and secondary) case volumes fell 15%; by comparison, the equivalent national 50th percentile rates rose 16% during this time frame. Our institution's general surgery residents performed an average of 116 (range, 56-221) vascular cases individually during their 5-year residency from 2005-2011. From 2006-2011, the total case volume fell only 5%, while the national 50th percentile rate fell 24%. Across all years, however, resident and fellow volumes both continue to be above Accreditation Council for Graduate Medical Education minimum requirements, and the major vascular case volume at our institution in all groups studied remained statistically greater than or equal to the national 50th percentile of cases. Our first integrated resident to graduate finished in June 2012 with 931 total vascular cases and 249 general surgery cases for a total operative experience of 1180 cases during the 5-year residency. Finally, after an 8-year period (2003-2010) in which none of our general surgery residents pursued vascular training, 1 resident in each of the 2011, 2012, and 2013 graduating years has now done so. At our institution, the introduction of a 0 + 5 vascular residency has correlated with a modest drop (15%) in overall case volume for the 5 + 2 fellows, but the number of primary cases have actually increased slightly and they continue to meet or exceed Accreditation Council for Graduate Medical Education requirements and national 50th percentile rates. General surgery residents' vascular volumes, by contrast, have remained stable, and interest in vascular surgery by residents has increased. Our integrated vascular residents are projected to exceed the fellows' 50th percentile case volume and diversity targets during their residency experience. Copyright © 2014 Elsevier Inc. All rights reserved.

Sleep duration from infancy to adolescence: reference values and generational trends.

PubMed

Iglowstein, Ivo; Jenni, Oskar G; Molinari, Luciano; Largo, Remo H

2003-02-01

The main purpose of the present study was to calculate percentile curves for total sleep duration per 24 hours, for nighttime and for daytime sleep duration from early infancy to late adolescence to illustrate the developmental course and age-specific variability of these variables among subjects. A total of 493 subjects from the Zurich Longitudinal Studies were followed using structured sleep-related questionnaires at 1, 3, 6, 9, 12, 18, and 24 months after birth and then at annual intervals until 16 years of age. Gaussian percentiles for ages 3 months to 16 years were calculated for total sleep duration (time in bed) and nighttime and daytime sleep duration. The mean sleep duration for ages 1 to 16 years was estimated by generalized additive models based on the loess smoother; a cohort effect also had to be included. The standard deviation (SD) was estimated from the loess smoothed absolute residuals from the mean curve. For ages 3, 6, and 9 months, an alternative approach with a simple model linear in age was used. For age 1 month, empirical percentiles were calculated. Total sleep duration decreased from an average of 14.2 hours (SD: 1.9 hours) at 6 months of age to an average of 8.1 hours (SD: 0.8 hours) at 16 years of age. The variance showed the same declining trend: the interquartile range at 6 months after birth was 2.5 hours, whereas at 16 years of age, it was only 1.0 hours. Total sleep duration decreased across the studied cohorts (1974-1993) because of increasingly later bedtime but unchanged wake time across decades. Consolidation of nocturnal sleep occurred during the first 12 months after birth with a decreasing trend of daytime sleep. This resulted in a small increase of nighttime sleep duration by 1 year of age (mean 11.0 +/- 1.1 hours at 1 month to 11.7 +/- 1.0 hours at 1 year of age). The most prominent decline in napping habits occurred between 1.5 years of age (96.4% of all children) and 4 years of age (35.4%). Percentile curves provide valuable information on developmental course and age-specific variability of sleep duration for the health care professional who deals with sleep problems in pediatric practice.

Occupational exposure to extremely low frequency magnetic fields and brain tumour risks in the INTEROCC study

PubMed Central

Turner, Michelle C; Benke, Geza; Bowman, Joseph D; Figuerola, Jordi; Fleming, Sarah; Hours, Martine; Kincl, Laurel; Krewski, Daniel; McLean, Dave; Parent, Marie-Elise; Richardson, Lesley; Sadetzki, Siegal; Schlaefer, Klaus; Schlehofer, Brigitte; Schüz, Joachim; Siemiatycki, Jack; van Tongeren, Martie; Cardis, Elisabeth

2014-01-01

Background Occupational exposure to extremely low frequency magnetic fields (ELF) is a suspected risk factor for brain tumours, however the literature is inconsistent. Few studies have assessed whether ELF in different time windows of exposure may be associated with specific histologic types of brain tumours. This study examines the association between ELF and brain tumours in the large-scale INTEROCC study. Methods Cases of adult primary glioma and meningioma were recruited in seven countries (Australia, Canada, France, Germany, Israel, New Zealand, United Kingdom) between 2000 and 2004. Estimates of mean workday ELF exposure based on a job exposure matrix assigned. Estimates of cumulative exposure, average exposure, maximum exposure, and exposure duration were calculated for the lifetime, and 1–4, 5–9, and 10+ years prior to the diagnosis/reference date. Results There were 3,761 included brain tumour cases (1,939 glioma, 1,822 meningioma) and 5,404 population controls. There was no association between lifetime cumulative ELF exposure and glioma or meningioma risk. However, there were positive associations between cumulative ELF 1–4 years prior to the diagnosis/reference date and glioma (odds ratio (OR) ≥ 90th percentile vs < 25th percentile = 1.67, 95% confidence interval (CI) 1.36–2.07, p < 0.0001 linear trend), and, somewhat weaker associations with meningioma (OR ≥ 90th percentile vs < 25th percentile = 1.23, 95% CI 0.97–1.57, p = 0.02 linear trend). Conclusions Results showed positive associations between ELF in the recent past and glioma. Impact Occupational ELF exposure may play a role in the later stages (promotion and progression) of brain tumourigenesis. PMID:24935666

New Reference Centiles for Left Ventricular Mass Relative to Lean Body Mass in Children.

PubMed

Foster, Bethany J; Khoury, Philip R; Kimball, Thomas R; Mackie, Andrew S; Mitsnefes, Mark

2016-05-01

Echocardiographic measurement of left ventricular (LV) mass is routinely performed in pediatric patients with elevated cardiovascular risk. The complex relationship between heart growth and body growth in children requires normalization of LV mass to determine its appropriateness relative to body size. LV mass is strongly determined by lean body mass (LBM). Using new LBM predictive equations, the investigators generated sex-specific LV mass-for-LBM centile curves for children 5 to 18 years of age. This retrospective study used M-mode echocardiographic data collected from 1995 through 2003 from 939 boys and 771 girls between 5 and 18 years of age (body mass index < 85th percentile for sex and age) to create smoothed sex-specific LV mass-for-LBM reference centile curves using the Lamda Mu Sigma method. The newly developed reference centiles were applied to children with essential hypertension and with chronic kidney disease, groups known to be at high risk for LV hypertrophy (LVH). The identification of LVH using two different normalization approaches was compared: LV mass-for-LBM and LV mass index-for-age percentiles. Among 231 children at risk for LVH, on average, relative LV mass was higher using the LV mass index-for-age percentile method than the LV mass-for-LBM percentile method. LVH was more likely to be diagnosed among overweight children and less likely among thin children. This study provides new LV mass reference centiles expressing LV mass relative to LBM, the strongest determinant of LV mass. These reference centiles may allow more accurate stratification of cardiovascular risk in children. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Determining Normal-Distribution Tolerance Bounds Graphically

NASA Technical Reports Server (NTRS)

Mezzacappa, M. A.

1983-01-01

Graphical method requires calculations and table lookup. Distribution established from only three points: mean upper and lower confidence bounds and lower confidence bound of standard deviation. Method requires only few calculations with simple equations. Graphical procedure establishes best-fit line for measured data and bounds for selected confidence level and any distribution percentile.

Soil concentrations of polybrominated diphenyl ethers and trace metals from an electronic waste dump site in the Greater Accra Region, Ghana: Implications for human exposure.

PubMed

Akortia, Eric; Olukunle, Olubiyi I; Daso, Adegbenro P; Okonkwo, Jonathan O

2017-03-01

Unregulated electronic waste (e-waste) recycling operations have become a significant environmental issue as well as human health risk in developing countries across the world. The present study evaluated the extent of pollution in Agbogbloshie e-waste recycling site in Accra, Ghana. The concentrations of polybrominated diphenyl ethers (PBDEs) and some selected trace metals were determined using gas chromatography electron impact ionization mass spectrometry and flame atomic absorption spectrophotometry, respectively. The concentrations of ∑ PBDEs ranged from 15.6 to 96.8ngg -1 dry weight, with an overall mean of 54.8ngg -1 dw. BDE-28 was the dominant congener followed by BDE-209 and BDE-47. The order of mean concentrations of the abundant trace metals was Fe>Cu>Pb≫Mn, with a mean range of .531-289mgkg -1 . Geoaccumulation index suggested that the surface soils deteriorated from moderate to high metal pollution, particularly for Cu, Pb and Fe. Of the trace metals analysed, Fe exhibited the highest concentration ranging from 3.97 to 918mgkg -1 . Correlation and principal component analyses suggested possible interactions between PBDEs and the trace metals analysed, while source assessment suggested that PBDEs and trace metals were mostly derived from inputs from the e-waste recycling activities. Average daily dose (ADD) was estimated using concentrations corresponding to 5th percentile, median and 95th percentile. Hazard quotients of 380 and 862 were obtained for adults and children respectively, for Cu and Pb which is a cause for concern especially for local children. Copyright © 2016. Published by Elsevier Inc.

Obesity and Hypertension among School-going Adolescents in Peru.

PubMed

Nam, Eun Woo; Sharma, Bimala; Kim, Ha Yun; Paja, Doris Jackeline Vasquez; Yoon, Young Min; Lee, Sun Ha; Kim, Eun Hwan; Oh, Chung Hyeon; Kim, Yun Seop; Song, Chang Hoon; Kim, Jong Koo

2015-09-01

Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

A new sensitive automated assay for procalcitonin detection: LIAISON® BRAHMS PCT® II GEN.

PubMed

Fortunato, Antonio

2016-12-01

To assess the performance of LIAISON ® BRAHMS PCT ® II GEN (DiaSorin, Saluggia, Italy) in procalcitonin (PCT) determination by comparing it to the assay reference method B·R·A·H·M·S PCT KRYPTOR (Thermo Fisher Scientific Clinical Diagnostics, Hennigsdorf, Germany) and assessing its ability to discriminate between healthy subjects and patients with suspected infection. Diagnostic performance was evaluated on: a) 193 selected samples covering the assay range, whose procalcitonin levels were already evaluated with the B·R·A·H·M·S PCT ® KRYPTOR; b) prospective samples: 150 apparently healthy specimens obtained from a blood bank, 161 hospitalized patients (not with specific pathologies), 243 apparently healthy children. The comparison of LIAISON ® BRAHMS PCT ® II GEN to the reference method B·R·A·H·M·S PCT KRYPTOR yielded high correlation coefficients: slope of Deming fit equal to 1.04 (95% CI: 0.99-1.09) with an intercept equal to 0.05 (95% CI: -0.09 to 0.19) and a high concordance (98.4% (95% CI: 95.5-99.7%)) at the 0.5 ng/mL cut-off. Moreover, the results obtained using prospective samples showed: (i) no samples with PCT concentration >0.5 ng/mL (cut-off) for the apparently healthy adults (highest value=0.033 ng/mL, 95th percentile and 97.5th percentile <0.02 ng/mL); (ii) 2 samples >0.5 ng/mL for hospitalized patients (highest value=0.715 ng/mL, 95th percentile: 0.054 ng/mL; 97.5th percentile: 0.088 ng/mL); (iii) 3 samples >0.5 ng/mL for the healthy children population (highest value=0.713 ng/mL, 95th percentile: 0.155 ng/mL; 97.5th percentile: 0.275 ng/mL). The fully automated LIAISON ® BRAHMS PCT ® II GEN agrees well with the reference method and is suitable for early diagnosis of sepsis, severe bacterial infection and guiding antibiotic therapy.

Selection of meteorological conditions to apply in an Ecotron facility

NASA Astrophysics Data System (ADS)

Leemans, Vincent; De Cruz, Lesley; Dumont, Benjamin; Hamdi, Rafiq; Delaplace, Pierre; Heinesh, Bernard; Garré, Sarah; Verheggen, François; Theodorakopoulos, Nicolas; Longdoz, Bernard

2017-04-01

This presentation aims to propose a generic method to produce meteorological input data that is useful for climate research infrastructures such as an Ecotron, where researchers will face the need to generate representative actual or future climatic conditions. Depending on the experimental objectives and the research purposes, typical conditions or more extreme values such as dry or wet climatic scenarios might be requested. Four variables were considered here, the near-surface air temperature, the near-surface relative humidity, the cloud cover and precipitation. The meteorological datasets, among which a specific meteorological year can be picked up, are produced by the ALARO-0 model from the RMIB (Royal Meteorological Institute of Belgium). Two future climate scenarios (RCP 4.5 and 8.5) and two time periods (2041-2070 and 2071-2100) were used as well as a historical run of the model (1981-2010) which is used as a reference. When the data from a historical run were compared to the observed historical data, biases were noticed. A linear correction was proposed for all the variables except for precipitation, for which a non-linear correction (using a power function) was chosen to maintain a zero-precipitation occurrences. These transformations were able to remove most of the differences between the observed and historical run of the model for the means and for the standard deviations. For the relative humidity, because of non-linearities, only one half of the average bias was corrected and a different path might have to be chosen. For the selection of a meteorological year, a position and a dispersion parameter have been proposed to characterise each meteorological year for each variable. For precipitation, a third parameter quantifying the importance of dry and wet periods has been defined. In order to select a specific climate, for each of these nine parameters the experimenter should provide a percentile and a weight to prioritize the importance of each variable in the process of a global climate selection. The proposed algorithm computed the weighted distance for each year between the parameters and the point representing the position of the percentile in the nine-dimensional space. The five closest values were then selected and represented in different graphs. The proposed method is able to provide a decision aid in the selection of the meteorological conditions to be generated within an Ecotron. However, with a limited number of years available in each case (thirty years for each RCP and each time period), there is no perfect match and the ultimate trade-off will be the responsibility of the researcher. For typical years, close to the median, the relative frequency is higher and the trade-off is more easy than for more extreme years where the relative frequency is low.

Exaggerated Health Benefits of Physical Fitness and Activity dueto Self-selection.

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

Williams, Paul T.

Background: The predicted health benefits of becomingphysically active or fit will be exaggerated if health outcomes causefitness and activity rather than the converse in prospective andcross-sectional epidemiological studies. Objective: Assess whether therelationships of adiposity to fitness and activity are explained byadiposity prior to exercising. Design: Cross-sectional study of physicalfitness (running speed during 10km foot race) and physical activity(weekly running distance) to current BMI (BMIcurrent) and BMI at thestart of running (BMIstarting) in 44,370 male and 25,252 femaleparticipants of the National Runners' Health Study. Results: BMIstartingexplained all of the association between fitness and BMIcurrent in bothsexes, but less than a thirdmore » of the association between physical activityand BMIcurrent in men. In women, BMIstarting accounted for 58 percent ofthe association between BMIcurrent and activity levels. The 95thpercentile of BMIcurrent showed substantially greater declines withfitness and activity levels than the 5th percentile of BMIcurrent in men(i.e., the negative slope for 95th percentile was 2.6-fold greater thanthe 5th percentile for fitness and 3-fold greater for activity) and women(6-fold and 3.4-fold greater, respectively). At all percentiles, theregression slopes relating BMIstarting to fitness were comparable orgreater (more negative) than the slopes relating BMIcurrent to fitness,whereas the converse was true for activity. Conclusion: Self-selectionbias accounts for all of the association between fitness and adiposityand probably a portion of other health outcomes, but has less affect onassociations involving physical activity« less

Modelling Ecuador's rainfall distribution according to geographical characteristics.

NASA Astrophysics Data System (ADS)

Tobar, Vladimiro; Wyseure, Guido

2017-04-01

It is known that rainfall is affected by terrain characteristics and some studies had focussed on its distribution over complex terrain. Ecuador's temporal and spatial rainfall distribution is affected by its location on the ITCZ, the marine currents in the Pacific, the Amazon rainforest, and the Andes mountain range. Although all these factors are important, we think that the latter one may hold a key for modelling spatial and temporal distribution of rainfall. The study considered 30 years of monthly data from 319 rainfall stations having at least 10 years of data available. The relatively low density of stations and their location in accessible sites near to main roads or rivers, leave large and important areas ungauged, making it not appropriate to rely on traditional interpolation techniques to estimate regional rainfall for water balance. The aim of this research was to come up with a useful model for seasonal rainfall distribution in Ecuador based on geographical characteristics to allow its spatial generalization. The target for modelling was the seasonal rainfall, characterized by nine percentiles for each one of the 12 months of the year that results in 108 response variables, later on reduced to four principal components comprising 94% of the total variability. Predictor variables for the model were: geographic coordinates, elevation, main wind effects from the Amazon and Coast, Valley and Hill indexes, and average and maximum elevation above the selected rainfall station to the east and to the west, for each one of 18 directions (50-135°, by 5°) adding up to 79 predictors. A multiple linear regression model by the Elastic-net algorithm with cross-validation was applied for each one of the PC as response to select the most important ones from the 79 predictor variables. The Elastic-net algorithm deals well with collinearity problems, while allowing variable selection in a blended approach between the Ridge and Lasso regression. The model fitting produced explained variances of 59%, 81%, 49% and 17% for PC1, PC2, PC3 and PC4, respectively, backing up the hypothesis of good correlation between geographical characteristics and seasonal rainfall patterns (comprised in the four principal components). With the obtained coefficients from the regression, the 108 rainfall percentiles for each station were back estimated giving very good results when compared with the original ones, with an overall 60% explained variance.

Change in the Body Mass Index Distribution for Women: Analysis of Surveys from 37 Low- and Middle-Income Countries

PubMed Central

Razak, Fahad; Corsi, Daniel J.; SV Subramanian

2013-01-01

Background There are well-documented global increases in mean body mass index (BMI) and prevalence of overweight (BMI≥25.0 kg/m2) and obese (BMI≥30.0 kg/m2). Previous analyses, however, have failed to report whether this weight gain is shared equally across the population. We examined the change in BMI across all segments of the BMI distribution in a wide range of countries, and assessed whether the BMI distribution is changing between cross-sectional surveys conducted at different time points. Methods and Findings We used nationally representative surveys of women between 1991–2008, in 37 low- and middle-income countries from the Demographic Health Surveys ([DHS] n = 732,784). There were a total of 96 country-survey cycles, and the number of survey cycles per country varied between two (21/37) and five (1/37). Using multilevel regression models, between countries and within countries over survey cycles, the change in mean BMI was used to predict the standard deviation of BMI, the prevalence of underweight, overweight, and obese. Changes in median BMI were used to predict the 5th and 95th percentile of the BMI distribution. Quantile-quantile plots were used to examine the change in the BMI distribution between surveys conducted at different times within countries. At the population level, increasing mean BMI is related to increasing standard deviation of BMI, with the BMI at the 95th percentile rising at approximately 2.5 times the rate of the 5th percentile. Similarly, there is an approximately 60% excess increase in prevalence of overweight and 40% excess in obese, relative to the decline in prevalence of underweight. Quantile-quantile plots demonstrate a consistent pattern of unequal weight gain across percentiles of the BMI distribution as mean BMI increases, with increased weight gain at high percentiles of the BMI distribution and little change at low percentiles. Major limitations of these results are that repeated population surveys cannot examine weight gain within an individual over time, most of the countries only had data from two surveys and the study sample only contains women in low- and middle-income countries, potentially limiting generalizability of findings. Conclusions Mean changes in BMI, or in single parameters such as percent overweight, do not capture the divergence in the degree of weight gain occurring between BMI at low and high percentiles. Population weight gain is occurring disproportionately among groups with already high baseline BMI levels. Studies that characterize population change should examine patterns of change across the entire distribution and not just average trends or single parameters. Please see later in the article for the Editors' Summary PMID:23335861

Effects of trimming weight-for-height data on growth-chart percentiles1–3

PubMed Central

Flegal, Katherine M; Carroll, Margaret D; Ogden, Cynthia L

2016-01-01

Background Before estimating smoothed percentiles of weight-for-height and BMI-for-age to construct the WHO growth charts, WHO excluded observations that were considered to represent unhealthy weights for height. Objective The objective was to estimate the effects of similar data trimming on empirical percentiles from the CDC growth-chart data set relative to the smoothed WHO percentiles for ages 24–59 mo. Design We used the nationally representative US weight and height data from 1971 to 1994, which was the source data for the 2000 CDC growth charts. Trimming cutoffs were calculated on the basis of weight-for-height for 9722 children aged 24–71 mo. Empirical percentiles for 7315 children aged 24–59 mo were compared with the corresponding smoothed WHO percentiles. Results Before trimming, the mean empirical percentiles for weight-for-height in the CDC data set were higher than the corresponding smoothed WHO percentiles. After trimming, the mean empirical 95th and 97th percentiles of weight-for-height were lower than the WHO percentiles, and the proportion of children in the CDC data set above the WHO 95th percentile decreased from 7% to 5%. The findings were similar for BMI-for-age. However, for weight-for-age, which had not been trimmed by the WHO, the empirical percentiles before trimming agreed closely with the upper percentiles from the WHO charts. Conclusion WHO data-trimming procedures may account for some of the differences between the WHO growth charts and the 2000 CDC growth charts. PMID:22990032

Tendencies of extreme values on rainfall and temperature and its relationship with teleconnection patterns

NASA Astrophysics Data System (ADS)

Taboada, J. J.; Cabrejo, A.; Guarin, D.; Ramos, A. M.

2009-04-01

It is now very well established that yearly averaged temperatures are increasing due to anthropogenic climate change. In the area of Galicia (NW Spain) this trend has also been determined. Rainfall does not show a clear tendency in its yearly accumulated values. The aim of this work is to study different extreme indices of rainfall and temperatures analysing variability and possible trends associated to climate change. Station data for the study was provided by the CLIMA database of the regional government of Galicia (NW Spain). The definition of the extreme indices was taken from the joint CCl/CLIVAR/JCOMM Expert Team (ET) on Climate Change Detection and Indices (ETCCDI) This group has defined a set of standard extreme values to simplify intercomparison of data from different regions of the world. For the temperatures in the period 1960-2006, results show a significant increase of the number of days with maximum temperatures above the 90th percentile. Furthermore, a significant decrease of the days with maximum temperatures below the 10th percentile has been found. The tendencies of minimum temperatures are reverse: fewer nights with minimum temperatures below 10th percentile, and more with minimum temperatures above 90th percentile. Those tendencies can be observed all over the year, but are more pronounced in summer. This trend is expected to continue in the next decades because of anthropogenic climate change. We have also calculated the relationship between the above mentioned extreme values and different teleconnection patterns appearing in the North Atlantic area. Results show that local tendencies are associated with trends of EA (Eastern Atlantic) and SCA (Scandinavian) patterns. NAO (North Atlantic Oscillation) has also some relationship with these tendencies, but only related with cold days and nights in winter. Rainfall index do not show any clear tendency on the annual scale. Nevertheless, the count of days when precipitation is greater than 20mm (R20mm) and the total precipitation when rainfall is greater than 95th percentile (R95pTOT) diminishes in winter and spring, but increases in autumn. This trend is related with NAO in winter and spring and with SCA in autumn.

Trends in group inequalities and interindividual inequalities in BMI in the United States, 1993-2012.

PubMed

Krishna, Aditi; Razak, Fahad; Lebel, Alexandre; Smith, George Davey; Subramanian, S V

2015-03-01

Marked increases in mean body mass index (BMI) and prevalence of obesity and overweight in the United States are well known. However, whether these average increases were accompanied by changing dispersion (or SD) remains understudied. We investigated population-level changes in the BMI distribution over time to understand how changes in dispersion reflect between-group compared with within-group inequalities in weight gain in the United States. Using data from the Behavioral Risk Factor Surveillance System survey (1993-2012), we analyzed associations between mean, SD, and median BMI and BMI at the 5th and 95th percentiles for 3,050,992 non-Hispanic white, non-Hispanic black, and Hispanic men and women aged 25-64 y. Overall, an increase of 1.0 in mean BMI (in kg/m²) was associated with an increase of 0.70 (95% CI: 0.67, 0.73) in the SD of BMI. A change of 1.0 in median BMI was associated with a change of 0.18 (95% CI: 0.14, 0.21) in the BMI value at the 5th percentile compared with a change of 2.94 (95% CI: 2.81, 3.07) at the 95th percentile. Quantile-quantile plots showed unequal changes in the BMI distribution, with pronounced changes at higher percentiles. Similar patterns were observed in subgroups stratified by sex, race-ethnicity, and education with non-Hispanic black women and women with less than a high school education having highest mean BMI, SD of BMI, and BMI values at the 5th and 95th percentiles. Mean BMI and the percentage of overweight and obese individuals do not fully describe population changes in BMI. Increases in within-group inequality in BMI represent an underrecognized characteristic of population-level weight gain. Crucially, similar increases in dispersion within groups suggest that growing inequalities in BMI at the population level are not driven by these socioeconomic and demographic factors. Future research should focus on understanding factors driving inequalities in weight gain between individuals. © 2015 American Society for Nutrition.

Anthropometry and Biomechanics Facility Presentation to Open EVA Research Forum

NASA Technical Reports Server (NTRS)

Rajulu, Sudhakar

2017-01-01

NASA is required to accommodate individuals who fall within a 1st to 99th percentile range on a variety of critical dimensions. The hardware the crew interacts with must therefore be designed and verified to allow these selected individuals to complete critical mission tasks safely and at an optimal performance level. Until now, designers have been provided simpler univariate critical dimensional analyses. The multivariate characteristics of intra-individual and inter-individual size variation must be accounted for, since an individual who is 1st percentile in one body dimension will not be 1st percentile in all other dimensions. A more simplistic approach, assuming every measurement of an individual will fall within the same percentile range, can lead to a model that does not represent realistic members of the population. In other words, there is no '1st percentile female' or '99th percentile male', and designing for these unrealistic body types can lead to hardware issues down the road. Furthermore, due to budget considerations, designers are normally limited to providing only 1 size of a prototype suit, thus requiring other possible means to ensure that a given suit architecture would yield the necessary suit sizes to accommodate the entire user population. Fortunately, modeling tools can be used to more accurately model the types of human body sizes and shapes that will be encountered in a population. Anthropometry toolkits have been designed with a variety of capabilities, including grouping the population into clusters based on critical dimensions, providing percentile information given test subject measurements, and listing measurement ranges for critical dimensions in the 1st-99th percentile range. These toolkits can be combined with full body laser scans to allow designers to build human models that better represent the astronaut population. More recently, some rescaling and reposing capabilities have been developed, to allow reshaping of these static laser scans in more representative postures, such as an abducted shoulder. All of the hardware designed for use with the crew must be sized to accommodate the user population, but the interaction between subject size and hardware fit is complicated with multi-component, complex systems like a space suit. Again, prototype suits are normally only provided in a limited size range, and suited testing is an expensive endeavor; both of these factors limit the number and size of people who can be used to benchmark a spacesuit. However, modeling tools for assessing suit-human interaction can allow potential issues to be modeled and visualized. These types of modeling tools can be used for analysis of a larger combination of anthropometries and hardware types than could feasibly be done with actual human subjects and physical mockups.

PBPK-Based Probabilistic Risk Assessment for Total Chlorotriazines in Drinking Water

PubMed Central

Breckenridge, Charles B.; Campbell, Jerry L.; Clewell, Harvey J.; Andersen, Melvin E.; Valdez-Flores, Ciriaco; Sielken, Robert L.

2016-01-01

The risk of human exposure to total chlorotriazines (TCT) in drinking water was evaluated using a physiologically based pharmacokinetic (PBPK) model. Daily TCT (atrazine, deethylatrazine, deisopropylatrazine, and diaminochlorotriazine) chemographs were constructed for 17 frequently monitored community water systems (CWSs) using linear interpolation and Krieg estimates between observed TCT values. Synthetic chemographs were created using a conservative bias factor of 3 to generate intervening peaks between measured values. Drinking water consumption records from 24-h diaries were used to calculate daily exposure. Plasma TCT concentrations were updated every 30 minutes using the PBPK model output for each simulated calendar year from 2006 to 2010. Margins of exposure (MOEs) were calculated (MOE = [Human Plasma TCTPOD] ÷ [Human Plasma TCTEXP]) based on the toxicological point of departure (POD) and the drinking water-derived exposure to TCT. MOEs were determined based on 1, 2, 3, 4, 7, 14, 28, or 90 days of rolling average exposures and plasma TCT Cmax, or the area under the curve (AUC). Distributions of MOE were determined and the 99.9th percentile was used for risk assessment. MOEs for all 17 CWSs were >1000 at the 99.9th percentile. The 99.9th percentile of the MOE distribution was 2.8-fold less when the 3-fold synthetic chemograph bias factor was used. MOEs were insensitive to interpolation method, the consumer’s age, the water consumption database used and the duration of time over which the rolling average plasma TCT was calculated, for up to 90 days. MOEs were sensitive to factors that modified the toxicological, or hyphenated appropriately no-observed-effects level (NOEL), including rat strain, endpoint used, method of calculating the NOEL, and the pharmacokinetics of elimination, as well as the magnitude of exposure (CWS, calendar year, and use of bias factors). PMID:26794141

Consumer exposure to substances in plastic packaging. I. Assessment of the contribution of styrene from yogurt pots.

PubMed

Vitrac, Olivier; Leblanc, Jean-Charles

2007-02-01

A generic methodology for the assessment of consumer exposure to substances migrating from packaging materials into foodstuffs during storage is presented. Consumer exposure at the level of individual households is derived from the probabilistic modeling of the contamination of all packed food product units (e.g. yogurt pot, milk bottle, etc.) consumed by a given household over 1 year. Exposure of a given population is estimated by gathering the exposure distributions of individual households to suitable weights (conveniently, household sizes). Calculations are made by combining (i) an efficient resolution of migration models and (ii) a methodology utilizing different sources of uncertainty and variability. The full procedure was applied to the assessment of consumer exposure to styrene from yogurt pots based on yearly purchase data of more than 5400 households in France (about 2 million yogurt pots) and an initial concentration c0 of styrene in yogurt pot walls, which is assumed to be normally distributed with an average value of 500 mg kg-1 and a standard deviation of 150 mg kg-1. Results are discussed regarding both sensitivity of the migration model to boundary conditions and household practices. By assuming a partition coefficient of 1 and a Biot number of 100, the estimated median household exposure to styrene ranged between 1 and 35 microg day-1 person-1 (5th and 95th percentiles) with a likely value of 12 microg day-1 person-1 (50th percentile). It was found that exposure does not vary independently with the average consumption rate and contact times. Thus, falsely assuming a uniform contact time equal to the sell-by-date for all yogurts overestimates significantly the daily exposure (5th and 95th percentiles of 2 and 110 microg day-1 person-1, respectively) since high consumers showed quicker turnover of stock.

PBPK-Based Probabilistic Risk Assessment for Total Chlorotriazines in Drinking Water.

PubMed

Breckenridge, Charles B; Campbell, Jerry L; Clewell, Harvey J; Andersen, Melvin E; Valdez-Flores, Ciriaco; Sielken, Robert L

2016-04-01

The risk of human exposure to total chlorotriazines (TCT) in drinking water was evaluated using a physiologically based pharmacokinetic (PBPK) model. Daily TCT (atrazine, deethylatrazine, deisopropylatrazine, and diaminochlorotriazine) chemographs were constructed for 17 frequently monitored community water systems (CWSs) using linear interpolation and Krieg estimates between observed TCT values. Synthetic chemographs were created using a conservative bias factor of 3 to generate intervening peaks between measured values. Drinking water consumption records from 24-h diaries were used to calculate daily exposure. Plasma TCT concentrations were updated every 30 minutes using the PBPK model output for each simulated calendar year from 2006 to 2010. Margins of exposure (MOEs) were calculated (MOE = [Human Plasma TCTPOD] ÷ [Human Plasma TCTEXP]) based on the toxicological point of departure (POD) and the drinking water-derived exposure to TCT. MOEs were determined based on 1, 2, 3, 4, 7, 14, 28, or 90 days of rolling average exposures and plasma TCT Cmax, or the area under the curve (AUC). Distributions of MOE were determined and the 99.9th percentile was used for risk assessment. MOEs for all 17 CWSs were >1000 at the 99.9(th)percentile. The 99.9(th)percentile of the MOE distribution was 2.8-fold less when the 3-fold synthetic chemograph bias factor was used. MOEs were insensitive to interpolation method, the consumer's age, the water consumption database used and the duration of time over which the rolling average plasma TCT was calculated, for up to 90 days. MOEs were sensitive to factors that modified the toxicological, or hyphenated appropriately no-observed-effects level (NOEL), including rat strain, endpoint used, method of calculating the NOEL, and the pharmacokinetics of elimination, as well as the magnitude of exposure (CWS, calendar year, and use of bias factors). © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology.

An Assessment of Dietary Exposure to Cadmium in Residents of Guangzhou, China.

PubMed

Zhang, Weiwei; Liu, Yungang; Liu, Yufei; Liang, Boheng; Zhou, Hongwei; Li, Yingyue; Zhang, Yuhua; Huang, Jie; Yu, Chao; Chen, Kuncai

2018-03-20

Cadmium and its compounds are human carcinogens with severe organ toxicity, and their contamination of agricultural soil in China has been frequently reported; however, the dietary exposure to cadmium in residents and the relevant health risk have seldom been reported. In this study, the concentration of cadmium in various types of food collected from 2013 to 2015 were analyzed using graphite furnace atomic absorption spectrometry, and the dietary exposure to cadmium assessed based on a dietary survey in 2976 Guangzhou residents. In total, 3074 out of 4039 food samples had cadmium levels above the limit of detection. The mean ± standard deviation (50th, 95th percentile) cadmium content in all samples was 159.0 ± 112.7 (8.6, 392.4) μg/kg, with levels ranging from 1.0 to 7830 μg/kg. Using the mean cadmium concentrations, the average monthly dietary exposure of Guangzhou residents to cadmium was 14.4 (μg/kg body weight (BW), accounting for 57.6% of the provisional tolerable monthly intake (PTMI). Rice, laver, vegetables, and live aquatic products were the main sources of cadmium intake, on average accounting for 89% of the total value. The dietary cadmium exposure in high consumers (95th percentile food consumption) was 41.0 μg/kg·BW/month, accounting for 163% of the PTMI. Additionally, dietary cadmium exposure at mean consumption but high cadmium food concentration (95th percentile) was 32.3 μg/kg·BW/month, corresponding to 129% of the PTMI. The level of dietary exposure to cadmium in most Guangzhou residents was within the safety limit, thus increased health risk from dietary cadmium exposure is low at present. However, continued efforts by local governments to monitor the levels of cadmium in the four main food categories contributing to exposure are necessary.

Systematic monitoring of male circumcision scale-up in Nyanza, Kenya: exploratory factor analysis of service quality instrument and performance ranking.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2014-01-01

Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of facilities and circumcision procedure using a composite index based on these items indicates that majority performed above average.

An Assessment of Dietary Exposure to Cadmium in Residents of Guangzhou, China

PubMed Central

Zhang, Weiwei; Liu, Yungang; Liu, Yufei; Liang, Boheng; Zhou, Hongwei; Li, Yingyue; Zhang, Yuhua; Huang, Jie; Yu, Chao; Chen, Kuncai

2018-01-01

Cadmium and its compounds are human carcinogens with severe organ toxicity, and their contamination of agricultural soil in China has been frequently reported; however, the dietary exposure to cadmium in residents and the relevant health risk have seldom been reported. In this study, the concentration of cadmium in various types of food collected from 2013 to 2015 were analyzed using graphite furnace atomic absorption spectrometry, and the dietary exposure to cadmium assessed based on a dietary survey in 2976 Guangzhou residents. In total, 3074 out of 4039 food samples had cadmium levels above the limit of detection. The mean ± standard deviation (50th, 95th percentile) cadmium content in all samples was 159.0 ± 112.7 (8.6, 392.4) μg/kg, with levels ranging from 1.0 to 7830 μg/kg. Using the mean cadmium concentrations, the average monthly dietary exposure of Guangzhou residents to cadmium was 14.4 (μg/kg body weight (BW), accounting for 57.6% of the provisional tolerable monthly intake (PTMI). Rice, laver, vegetables, and live aquatic products were the main sources of cadmium intake, on average accounting for 89% of the total value. The dietary cadmium exposure in high consumers (95th percentile food consumption) was 41.0 μg/kg·BW/month, accounting for 163% of the PTMI. Additionally, dietary cadmium exposure at mean consumption but high cadmium food concentration (95th percentile) was 32.3 μg/kg·BW/month, corresponding to 129% of the PTMI. The level of dietary exposure to cadmium in most Guangzhou residents was within the safety limit, thus increased health risk from dietary cadmium exposure is low at present. However, continued efforts by local governments to monitor the levels of cadmium in the four main food categories contributing to exposure are necessary. PMID:29558399

Extreme wind-wave modeling and analysis in the south Atlantic ocean

NASA Astrophysics Data System (ADS)

Campos, R. M.; Alves, J. H. G. M.; Guedes Soares, C.; Guimaraes, L. G.; Parente, C. E.

2018-04-01

A set of wave hindcasts is constructed using two different types of wind calibration, followed by an additional test retuning the input source term Sin in the wave model. The goal is to improve the simulation in extreme wave events in the South Atlantic Ocean without compromising average conditions. Wind fields are based on Climate Forecast System Reanalysis (CFSR/NCEP). The first wind calibration applies a simple linear regression model, with coefficients obtained from the comparison of CFSR against buoy data. The second is a method where deficiencies of the CFSR associated with severe sea state events are remedied, whereby "defective" winds are replaced with satellite data within cyclones. A total of six wind datasets forced WAVEWATCH-III and additional three tests with modified Sin in WAVEWATCH III lead to a total of nine wave hindcasts that are evaluated against satellite and buoy data for ambient and extreme conditions. The target variable considered is the significant wave height (Hs). The increase of sea-state severity shows a progressive increase of the hindcast underestimation which could be calculated as a function of percentiles. The wind calibration using a linear regression function shows similar results to the adjustments to Sin term (increase of βmax parameter) in WAVEWATCH-III - it effectively reduces the average bias of Hs but cannot avoid the increase of errors with percentiles. The use of blended scatterometer winds within cyclones could reduce the increasing wave hindcast errors mainly above the 93rd percentile and leads to a better representation of Hs at the peak of the storms. The combination of linear regression calibration of non-cyclonic winds with scatterometer winds within the cyclones generated a wave hindcast with small errors from calm to extreme conditions. This approach led to a reduction of the percentage error of Hs from 14% to less than 8% for extreme waves, while also improving the RMSE.

Assessing the Financial Condition of Provider-Sponsored Health Plans.

PubMed

McCue, Michael J

2015-06-01

The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

Automated algorithm for mapping regions of cold-air pooling in complex terrain

NASA Astrophysics Data System (ADS)

Lundquist, Jessica D.; Pepin, Nicholas; Rochford, Caitlin

2008-11-01

In complex terrain, air in contact with the ground becomes cooled from radiative energy loss on a calm clear night and, being denser than the free atmosphere at the same elevation, sinks to valley bottoms. Cold-air pooling (CAP) occurs where this cooled air collects on the landscape. This article focuses on identifying locations on a landscape subject to considerably lower minimum temperatures than the regional average during conditions of clear skies and weak synoptic-scale winds, providing a simple automated method to map locations where cold air is likely to pool. Digital elevation models of regions of complex terrain were used to derive surfaces of local slope, curvature, and percentile elevation relative to surrounding terrain. Each pixel was classified as prone to CAP, not prone to CAP, or exhibiting no signal, based on the criterion that CAP occurs in regions with flat slopes in local depressions or valleys (negative curvature and low percentile). Along-valley changes in the topographic amplification factor (TAF) were then calculated to determine whether the cold air in the valley was likely to drain or pool. Results were checked against distributed temperature measurements in Loch Vale, Rocky Mountain National Park, Colorado; in the Eastern Pyrenees, France; and in Yosemite National Park, Sierra Nevada, California. Using CAP classification to interpolate temperatures across complex terrain resulted in improvements in root-mean-square errors compared to more basic interpolation techniques at most sites within the three areas examined, with average error reductions of up to 3°C at individual sites and about 1°C averaged over all sites in the study areas.

Preterm newborns at Kangaroo Mother Care: a cohort follow-up from birth to six months

PubMed Central

Menezes, Maria Alexsandra da S.; Garcia, Daniela Cavalcante; de Melo, Enaldo Vieira; Cipolotti, Rosana

2014-01-01

OBJECTIVE: To evaluate clinical outcomes, growth and exclusive breastfeeding rates in premature infants assisted by Kangaroo Mother Care at birth, at discharge and at six months of life. METHODS: Prospective study of a premature infants cohort assisted by Kangaroo Mother Care in a tertiary public maternity in Northeast Brazil with birth weight ≤1750g and with clinical conditions for Kangaroo care. RESULTS: The sample was composed by 137 premature infants, being 62.8% female, with average birth weight of 1365±283g, average gestational age of 32±3 weeks and 26.2% were adequate for gestational age. They have been admitted in the Kangaroo Ward with a median of 13 days of life, weighing 1430±167g and, at this time, 57.7% were classified as small for corrected gestational age. They were discharged with 36.8±21.8 days of chronological age, weighing 1780±165g and 67.9% were small for corrected gestational age. At six months of life (n=76), they had an average weight of 5954±971g, and 68.4% presented corrected weight for gestational age between percentiles 15 and 85 of the World Health Organization (WHO) weight curve. Exclusive breastfeeding rate at discharge was 56.2% and, at six months of life, 14.4%. CONCLUSIONS: In the studied sample, almost two thirds of the children assisted by Kangaroo Mother Care were, at six months of life, between percentiles 15 and 85 of the WHO weight curves. The frequency of exclusive breastfeeding at six months was low. PMID:25119747

Occurrence and distribution of algal biomass and Its relation to nutrients and selected basin characteristics in Indiana streams, 2001-2005

USGS Publications Warehouse

Lowe, B. Scott; Leer, Donald R.; Frey, Jeffrey W.; Caskey, Brian J.

2008-01-01

The seasonal values for nutrients (nitrate, TKN, TN, and TP) and algal biomass (periphyton CHLa, AFDM, seston CHLa, and POC) were compared to published U. S. Environmental Protection Agency (USEPA) values for their respective ecoregions. Algal biomass values either were greater than the 25th percentile published USEPA values or extended the range of data in Aggregate Nutrient Ecoregions VI, VII, IX and USEPA Level III Ecoregions 54, 55, 56, 71, and 72. If the values for the 25th percentile proposed by the USEPA were adopted as nutrient water-quality criteria, then about 71 percent of the nutrient samples and 57 percent of the CHLa samples within the eight study basins would be considered nutrient enriched.

Relationships between weekly walking distance and adiposity in27,596 women are nonlinear with respect to both distance andadiposity

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

Williams, Paul T.

2004-12-01

The cross-sectional relationships of weekly walking distance to BMI, body circumferences, and bra cup sizes are reported for 27,596 women. The percent reductions between walking 40-50 km/wk and < 10km/wk were greatest for BMI, substantial for waist circumference and cupsize, and least for hip and chest circumferences. The relationships between distance and adiposity were nonlinear with respect to both the independent (quadratic function of distance) and dependent variables(slope and curvilinearity depending upon the percentile of BMI, circumference, or cup size). The slope relating adiposity to km/wk were greatest (most negative) in overweight sedentary women and least in lean active women.more » For example, compared to women averaging 10 km/wk, the slope of BMI versus km/wk was 43 percent less at 25 km/wk and 87 percent less at 40 km/wk in overweight women (95th BMI percentile), but negligible at all distances in lean women (5th BMI percentile). The greater estimated decrease in BMI per km/wk in walkers than runners was largely accounted for (over 75 percent) by the walkers greater adiposity. Thus classical representations of the relationship between adiposity and moderate physical activity are inadequate for either statistical analyses or descriptive purposes. The clinical implications of these results and their statistical ramifications are discussed.« less

Ultrasound Accuracy in Diagnosing Appendicitis in Obese Pediatric Patients.

PubMed

Love, Bryan E; Camelo, Monica; Nouri, Sarvenaz; Kriger, Diego; Ludi, Daniel; Nguyen, Henry

2017-10-01

The use of ultrasound to diagnose appendicitis in pediatric patients has been growing with the improvement of ultrasound technology and operator skills, but its utility in the increasingly obese pediatric population has not been thoroughly investigated. A retrospective review of all pediatric (≤18 years old) patients with appendicitis who were admitted at a single hospital from 2014 to 2016 was conducted. Patients were stratified into body mass index (BMI) percentile categories based on the centers for disease control guidelines. Comparisons were then made. There were 231 patients with an average BMI percentile of 72.6; 99 (42.9%) who had an ultrasound, of which 54 (54.5%) were positive for acute appendicitis, whereas 43 (43.4%) were nondiagnostic. In patients who had a nondiagnostic ultrasound, 37 had a CT demonstrating acute appendicitis. These were compared with 123 patients who had CT alone demonstrating acute appendicitis. The CT-only group was older (12 vs 9, P < 0.005), tended to be male (78 (63%) vs 15 (41%), P = 0.019), had fewer operations performed (81 (66%) vs 30 (81%), P = 0.048) but had no significant difference in BMI percentile (75.8 vs 71.7, P = 0.465). Ultrasound had a 100 per cent positive predictive value in obese and overweight children. Ultrasound is a reliable study in obese and overweight pediatric patients with acute appendicitis.

Selection of a Man-Modelling CAD (Computer-Aided Design),

DTIC Science & Technology

1985-09-01

OPTIONS link-length input options internal dimensions - V V external dimensions V V V percentile values V V V absolute values (mm) V V/ V somatotypes V...specific data .035 A3 somatotype representation .020 A4 a-typical postures possible .035 * A5 flesh contour representation .040 A6 multiple number of

Selecting a Variable for Predicting the Diagnosis of PTB Patients From Comparison of Chest X-ray Images

NASA Astrophysics Data System (ADS)

Mohd. Rijal, Omar; Mohd. Noor, Norliza; Teng, Shee Lee

A statistical method of comparing two digital chest radiographs for Pulmonary Tuberculosis (PTB) patients has been proposed. After applying appropriate image registration procedures, a selected subset of each image is converted to an image histogram (or box plot). Comparing two chest X-ray images is equivalent to the direct comparison of the two corresponding histograms. From each histogram, eleven percentiles (of image intensity) are calculated. The number of percentiles that shift to the left (NLSP) when second image is compared to the first has been shown to be an indicator of patients` progress. In this study, the values of NLSP is to be compared with the actual diagnosis (Y) of several medical practitioners. A logistic regression model is used to study the relationship between NLSP and Y. This study showed that NLSP may be used as an alternative or second opinion for Y. The proposed regression model also show that important explanatory variables such as outcomes of sputum test (Z) and degree of image registration (W) may be omitted when estimating Y-values.

Job Exposure Matrix for Electric Shock Risks with Their Uncertainties

PubMed Central

Vergara, Ximena P.; Fischer, Heidi J.; Yost, Michael; Silva, Michael; Lombardi, David A.; Kheifets, Leeka

2015-01-01

We present an update to an electric shock job exposure matrix (JEM) that assigned ordinal electric shocks exposure for 501 occupational titles based on electric shocks and electrocutions from two available data sources and expert judgment. Using formal expert elicitation and starting with data on electric injury, we arrive at a consensus-based JEM. In our new JEM, we quantify exposures by adding three new dimensions: (1) the elicited median proportion; (2) the elicited 25th percentile; and (3) and the elicited 75th percentile of those experiencing occupational electric shocks in a working lifetime. We construct the relative interquartile range (rIQR) based on uncertainty interval and the median. Finally, we describe overall results, highlight examples demonstrating the impact of cut point selection on exposure assignment, and evaluate potential impacts of such selection on epidemiologic studies of the electric work environment. In conclusion, novel methods allowed for consistent exposure estimates that move from qualitative to quantitative measures in this population-based JEM. Overlapping ranges of median exposure in various categories reflect our limited knowledge about this exposure. PMID:25856552

Job exposure matrix for electric shock risks with their uncertainties.

PubMed

Vergara, Ximena P; Fischer, Heidi J; Yost, Michael; Silva, Michael; Lombardi, David A; Kheifets, Leeka

2015-04-08

We present an update to an electric shock job exposure matrix (JEM) that assigned ordinal electric shocks exposure for 501 occupational titles based on electric shocks and electrocutions from two available data sources and expert judgment. Using formal expert elicitation and starting with data on electric injury, we arrive at a consensus-based JEM. In our new JEM, we quantify exposures by adding three new dimensions: (1) the elicited median proportion; (2) the elicited 25th percentile; and (3) and the elicited 75th percentile of those experiencing occupational electric shocks in a working lifetime. We construct the relative interquartile range (rIQR) based on uncertainty interval and the median. Finally, we describe overall results, highlight examples demonstrating the impact of cut point selection on exposure assignment, and evaluate potential impacts of such selection on epidemiologic studies of the electric work environment. In conclusion, novel methods allowed for consistent exposure estimates that move from qualitative to quantitative measures in this population-based JEM. Overlapping ranges of median exposure in various categories reflect our limited knowledge about this exposure.

Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study.

PubMed

Baya Botti, A; Pérez-Cueto, F J A; Vasquez Monllor, P A; Kolsteren, P W

2009-01-01

Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time.

Measuring urinary N-acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine (IPMA3) as a potential biomarker of isoprene exposure.

PubMed

Alwis, K Udeni; Bailey, T Liz; Patel, Dhrusti; Wang, Liqun; Blount, Benjamin C

2016-10-19

Isoprene, the 2-methyl analog of 1,3-butadiene, is identified as a possible human carcinogen by the International Agency for Research on Cancer (IARC). Isoprene is ubiquitous in the environment with numerous natural and anthropogenic sources. Tobacco smoke is the main exogenous source of isoprene exposure in indoor environments. Among smoke constituents, isoprene is thought to contribute significantly to cancer risk; however, no selective urinary biomarkers of isoprene exposure have been identified for humans. In this manuscript, we measured the minor isoprene metabolite IPMA1 (mixture of N-acetyl-S-(1-[hydroxymethyl]-2-methyl-2-propen-1-yl)-L-cysteine and N-acetyl-S-(2-hydroxy-3-methyl-3-buten-1-yl)-L-cysteine), and we identified IPMA3 (N-acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine) as a major isoprene metabolite and novel isoprene exposure biomarker for humans. Urinary isoprene metabolites were measured using ultra high performance liquid chromatography coupled with electrospray ionization triple quad tandem mass spectrometry (UPLC/ESI-MSMS). The detection rates of IPMA1 and IPMA3 are <20% and 82%, respectively. The selectivity and abundance of IPMA3 make it a useful urinary biomarker of isoprene exposure. The limit of detection of IPMA3 in urine was 0.5 ng mL -1 . IPMA3 was stable under different storage temperatures and following ten freeze-thaw cycles. The average recovery of urine spiked with IPMA3 at three different levels was 99%. IPMA3 was measured in urine samples received from 75 anonymous subjects; the median (25th percentile, 75th percentile) IPMA3 level in smokers was 36.2 (18.2, 56.8) ng mL -1 and non-smokers 2.31 (2.31, 4.38) ng mL -1 . Application of this method to large population studies will help to characterize isoprene exposure and assess potential health impact. Published by Elsevier B.V.

Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a systematic review with meta-analysis of randomised controlled trials

PubMed Central

Kelley, Kristi S; Callahan, Leigh F

2018-01-01

Background/purpose Given conflicting findings, the purpose of this study was to use the meta-analytic approach to examine the effects of exercise (aerobic, strength training or both) on anxiety in adults with arthritis and other rheumatic diseases (AORD). Methods Randomised controlled exercise intervention trials ≥4weeks in adults ≥18 years of age with osteoarthritis, rheumatoid arthritis or fibromyalgia were included. Studies were located by searching eight electronic databases, cross-referencing and expert review. Dual selection and data abstraction of studies were performed. Hedge’s standardised effect size (ES) was calculated for each result and pooled using the recently developed inverse heterogeneity model. Two-tailed z-alpha values ≤0.05 and non-overlapping 95% CI were considered statistically significant. Heterogeneity was estimated using Q and I2 with alpha values ≤0.10 for Q considered statistically significant. Small-study effects were examined using funnel plots and Egger’s regression test. In addition, the number needed to treat (NNT), percentile improvement and meta-regression were conducted. Results Of the 639 citations screened, 14 studies representing 926 initially enrolled participants (539 exercise, 387 control) met the criteria for inclusion. Length of training (mean±SD) averaged 15.8±6.7 weeks, frequency 3.3±1.3 times per week and duration 28.8±14.3 min per session. Overall, statistically significant reductions in anxiety were found (exercise minus control changes ES=−0.40, 95% CI −0.65 to −0.15, tau2=0.14; Q=40.3, P=0.0004; I2=62.8%). The NNT was 6 with a percentile improvement of 15.5% and an estimated 5.3 million inactive US adults with AORD improving their anxiety if they started exercising regularly. Statistically significant small-study effects were observed (P<0.0001). Conclusions Exercise is associated with reductions in anxiety among adults with selected types of AORD. However, a need exists for additional, well-designed, randomised controlled trials on this topic. PROSPERO registration number CRD42016048728. PMID:29455165

Estimated water use and availability in the Pawcatuck Basin, southern Rhode Island and southeastern Connecticut, 1995-99

USGS Publications Warehouse

Wild, Emily C.; Nimiroski, Mark T.

2004-01-01

In 1988, the Pawcatuck Basin (302.4 square miles) in southern Rhode Island (245.3 square miles) and southeastern Connecticut (57.12 square miles) was defined as a sole-source aquifer for 14 towns in southern Rhode Island and 4 towns in southeastern Connecticut. To determine water use and availability, the six subbasins in the Pawcatuck Basin were delineated on the basis of the surface- and ground-water system drainage areas. From 1995 through 1999, five major water suppliers in the basin withdrew an average of 6.768 million gallons per day from the aquifers. The estimated water withdrawals from minor water suppliers during the study period were 0.099 million gallons per day. Self-supplied domestic, industrial, commercial, and agricultural withdrawals from the basin averaged 4.386 million gallons per day. Water use in the basin averaged 7.401 million gallons per day. The average return flow in the basin was 7.855 million gallons per day, which included effluent from permitted facilities and self-disposed water users. The PART program, a computerized hydrographseparation application, was used for five selected index streamgaging stations to determine water availability on the basis of the 75th, 50th, and 25th percentiles of the total base flow, the base flow minus the 7-day, 10-year flow criteria, and the base flow minus the Aquatic Base Flow criteria at the index stations. The differences in the surface- and ground-water system drainage areas in the summer were applied to the water availability calculated at the index stations and subbasins. The base-flow contributions from sand and gravel deposits at the index stations were computed for June, July, August, and September, and applied to the percentage of surficial deposits at each index station. The base-flow contributions were converted to a per unit area at the station for the till, and for the sand and gravel deposits, and applied to the subbasins. The statistics used to estimate the gross yield of base flow, as well as subtracting out the two low-flow criteria, resulted in various wateravailability values at each index station, which were present in the subbasin after applying the per unit area rates from the index station. The results from the Chipuxet and Arcadia streamgaging stations were lowest in September at the 75th and 25th percentiles, and August flows were lowest for the summer at the 50th percentile. For the other three index stations, September flows were the lowest for the summer. Because water withdrawals and use are greater during the summer than other times of the year, water availability in June, July, August, and September was assessed and compared to water withdrawals in the basin and subbasins. The ratios were calculated by using the water-availability flow scenarios at the 75th, 50th, and 25th percentiles for the subbasins, which are based on total water available from base-flow contributions from till deposits and sand and gravel deposits in the subbasins. For the study period, the withdrawals in August were higher than the other summer months. The ratios were close to one in August for the estimated gross yield and 7-day, 10-year flow criterion, and were close to one in September for the estimated Aquatic Base Flow criterion water-availability scenarios in the Pawcatuck Basin. The closer the ratio is to one, the closer the withdrawals are to the estimated water available, and the net water available decreases. To determine the effects of streamflow depletion from continuous water withdrawals, the program STRMDEPL was used to simulate public wells and well fields at a constant pumping rate based on the 1999 summer average for each withdrawal, over a period of 180 days. The streamflow depletion was 86, 95, 93, 96, and 98 percent at 30 days for Kingston wells 1 and 2, Westerly well fields 1 and 2, and well 3, respectively. A long-term hydrologic budget was calculated for the Pawcatuck Basin to identify and assess the basin and subbasin inflow and outflows. The water withdrawals and return flows used in the budget were from 1995 through 1999. For the hydrologic budget, it was assumed that inflow equals outflow, which resulted in 723.1 million gallons per day in the basin. The estimated inflows from precipitation and water return flow were 99 and 1 percent in the basin, respectively. The estimated outflows from evapotranspiration, streamflow, and water withdrawals were 43, 56, and 1 percent, respectively.

Drought sensitivities of dominant plant functional types in the Colorado Plateau

NASA Astrophysics Data System (ADS)

Hoover, D. L.; Duniway, M.; Belnap, J.

2014-12-01

Drylands of the Southwestern US are predicted to experience greater water limitations with climate change due to changes in precipitation and increased warming. Certain plants may be living at or near their tolerance thresholds in these ecosystems and thus subtle changes in water availability may have dramatic effects on their performances. We imposed a four-year experiment in the Colorado Plateau to assess the vulnerability of this dryland ecosystem to chronic, but subtle drought using 40 sites varying in plant communities, parent materials and soil textures. Within a site, two plots were selected with matching cover of target species, which were randomly assigned to either control (ambient precipitation) or drought (35% reduction) treatments. Drought treatments were imposed year-round from 2011 through 2014. Over the course of the experiment, we examined plant cover changes and mortality of four dominant plant functional types (PFT's): C3 grasses, C4 grasses, C3 shrubs and C4 shrubs. We hypothesized that overall, grasses would be more sensitive to drought than shrubs, and that within these two groups, plants with C3 photosynthesis would be more sensitive than plants with C4 photosynthesis. During three of the four years, precipitation inputs were either near average (50th percentile, control) or dry (25th percentile, drought). However in 2012, both treatments experienced extremely dry growing season precipitation with the control and drought below the 5th and 1st percentiles, respectively. We observed three general responses to drought in this experiment: 1. change in cover with mortality (C3 grasses), 2. change in cover without mortality (C4 grasses and C4 shrubs) and 3. no change in cover or mortality (C3 shrubs). The dramatic responses of the C3 grasses suggest that this PFT is very sensitive to drought and it is living at or near its tolerance threshold in this region. While the C4 grasses also experienced cover changes, they did not experience widespread mortality and thus have higher tolerance to drought than the C3 grasses. Finally, contrary to our hypothesis, C3 shrubs were more drought tolerant than C4 shrubs. These results suggest that subtle changes in water availability may differentially impact key plant functional types and potentially alter the structure and function of this ecosystem.

Estimated water use and availability in the Pawtuxet and Quinebaug River basins, Rhode Island, 1995-99

USGS Publications Warehouse

Wild, Emily C.; Nimiroski, Mark T.

2007-01-01

Water availability became a concern in Rhode Island during a drought in 1999, and an investigation was needed to assess demands on the hydrologic system from withdrawals during periods of little to no precipitation. The low water levels during the drought prompted the U.S. Geological Survey and the Rhode Island Water Resources Board to begin a series of studies on water use and availability in each drainage area in Rhode Island for 1995–99. The study area for this report, which includes the Pawtuxet River Basin in central Rhode Island (231.6 square miles) and the Quinebaug River Basin in western Rhode Island (60.97 square miles), was delineated as the surface-water drainage areas of these basins. During the study period from 1995 through 1999, two major water suppliers withdrew an average of 71.86 million gallons per day (Mgal/d) from the Pawtuxet River Basin; of this amount, about 35.98 Mgal/d of potable water were exported to other basins in Rhode Island. The estimated water withdrawals from minor water suppliers were 0.026 Mgal/d in the Pawtuxet River Basin and 0.003 Mgal/d in the Quinebaug River Basin. Total self-supply withdrawals were 2.173 Mgal/d in the Pawtuxet River Basin and 0.360 Mgal/d in the Quinebaug River Basin, which has no public water supply. Total water use averaged 18.07 Mgal/d in the Pawtuxet River Basin and 0.363 Mgal/d in the Quinebaug River Basin. Total return flow in the Pawtuxet River Basin was 30.64 Mgal/d, which included about 12.28 Mgal/d that were imported from other basins in Rhode Island. Total return flow was 0.283 Mgal/d in the Quinebaug River Basin. During times of little to no recharge in the form of precipitation, the surface- and ground-water flows are from storage primarily in the stratified sand and gravel deposits; water also flows through the till deposits, but at a slower rate. The ground water discharging to the streams during times of little to no recharge from precipitation is referred to as base flow. The PART program, a computerized hydrograph-separation application, was used to analyze the data collected at two selected index stream-gaging stations to determine water availability on the basis of the 75th, 50th, and 25th percentiles of the total base flow; the base flow for the 7-day, 10-year low-flow scenario; and the base flow for the Aquatic Base Flow scenario for both stations. The index stream-gaging stations used in the analysis were the Branch River at Forestdale, Rhode Island (period of record 1957–1999) and the Nooseneck River at Nooseneck, Rhode Island (period of record 1964–1980). A regression equation was used to estimate unknown base-flow contributions from sand and gravel deposits at the two stations. The base-flow contributions from sand and gravel deposits and till deposits at the index stations were computed for June, July, August, and September within the periods of record, and divided by the area of each type of surficial deposit at each index station. These months were selected because they define a period when there is usually an increased demand for water and little to no precipitation. The base flows at the stream-gaging station Branch River at Forestdale, Rhode Island were lowest in August at the 75th, 50th, and 25th percentiles (29.67, 21.48, and 13.30 Mgal/d, respectively). The base flows at the stream-gaging station Nooseneck River at Nooseneck, Rhode Island were lowest in September at the 75th percentile (3.551 Mgal/d) and lowest in August at the 50th and 25th percentiles (2.554 and 1.811 Mgal/d). The base flows per unit area for the index stations were multiplied by the areas of sand and gravel and till in the studyarea subbasins to determine the amount of available water for each scenario. The water availability in the Pawtuxet River Basin at the 50th percentile ranged from 126.5 Mgal/d in August to 204.7 Mgal/d in June, and the total gross water availability for the 7-day, 10-year low-flow scenario at the 50th percentile ranged from 112.2 Mgal/d in August to 190.4 Mgal/d in June. The Scituate Reservoir safe yield was 83 Mgal/d in all scenarios. Water availability in the Quinebaug River Basin ranged from 13.94 Mgal/d in August to 30.53 Mgal/d in June at the 50th percentile. The total gross water availability for the 7-day, 10-year low-flow scenario at the 50th percentile ranged from 14.26 Mgal/d in August to 42.69 Mgal/d in June. Because water withdrawals and use are greater during the summer than other times of the year, water availability in June, July, August, and September was compared to water withdrawals in the basin and subbasins. The ratios of water withdrawn to water available were calculated for the 75th, 50th, and 25th percentiles for the subbasins; the closer the ratio is to 1, the closer the withdrawals are to the estimated water available, and the less net water is available. Withdrawals in July were higher than in the other summer months in both basins. In the Pawtuxet River Basin, the ratios were close to 1 in July for the estimated gross yield (from sand and gravel and from till and from the Scituate Reservoir safe yield), 7-day, 10-year low-flow scenario, and Aquatic Base Flow scenario at the 75th percentile and in August for all three scenarios at the 50th and 25th percentiles. In the Quinebaug River Basin, the ratios were close to 1 in August for the estimated gross yield; 7-day, 10-year low-flow scenario; and Aquatic Base Flow scenario. A long-term water budget was calculated for 1941 through 1999 to identify and assess the basin and subbasin inflow and outflows for the Pawtuxet and Quinebaug River Basins. The water withdrawals and return flows used in the budget were from 1995 through 1999. Inflow was assumed to be equal to outflow; total inflows and outflows were 574.9 Mgal/d in the Pawtuxet River Basin and 148.4 Mgal/d in the Quinebaug River Basin. Precipitation and return flow were 95 and 5 percent of the estimated inflows to the Pawtuxet River Basin, respectively. Precipitation was 100 percent of the estimated inflow to the Quinebaug River Basin; return flow was less than 1 percent of the inflow. Evapotranspiration, streamflow, and water withdrawals were 46, 41, and 13 percent, respectively, of the estimated outflows in the Pawtuxet River Basin. Evapotranspiration and streamflow were 49 and 51 percent, respectively, of the estimated outflows in the Quinebaug River Basin. Water withdrawals were less than 1 percent of outflows in the Quinebaug River Basin. 

A 6-year trend of the healthcare costs of arthritis in a population-based cohort of older women.

PubMed

Lo, Tkt; Parkinson, Lynne; Cunich, Michelle; Byles, Julie

2016-06-01

To provide an accurate representation of the economic burden of arthritis by estimating the adjusted incremental healthcare cost of arthritis at multiple percentiles and reporting the cost trends across time. A healthcare cost study based on health survey and linked administrative data, where costs were estimated from the government's perspective in dollars per person per year. Quantile regression was used to estimate the adjusted incremental cost at the 25th, 50th, 75th, 90th, and 95th percentiles. Data from 4287 older Australian women were included. The median incremental healthcare cost of arthritis was, in 2012 Australian dollars, $480 (95% CI: $498-759) in 2009; however, 5% of individuals had 5-times higher costs than the 'average individual' with arthritis. Healthcare cost of arthritis did not increase significantly from 2003 to 2009. Healthcare cost of arthritis represents a substantial burden for the governments. Future research should continue to monitor the economic burden of arthritis.

Childhood overweight or obesity increases the risk of IIH recurrence fivefold.

PubMed

Stiebel-Kalish, H; Serov, I; Sella, R; Chodick, G; Snir, M

2014-11-01

Overweight and obesity are less closely associated with idiopathic intracranial hypertension (IIH) in young children than in post-pubescent children and adults. We examined the hypothesis that being overweight or obese (body mass index (BMI) ⩾ 85th percentile) in children is a risk factor for IIH recurrence. A total of 43 children with IIH who were followed up for an average of 9 ± 3.4 years were evaluated in a retrospective case-control series. The rate of IIH recurrence was compared between children of healthy weight and children presenting with overweight or obesity, using survival curve analysis. The overall risk for long-term IIH recurrence in children is ~20%. Following weight stratification, the risk for IIH recurrence in our cohort was fivefold higher in children with a BMI ⩾ 85th percentile (57%) than in healthy weight children (11%; log-rank test P = 0.04). Pediatricians may consider counseling families that weight control may be a means of decreasing the risk of IIH recurrence.

Extent of areal inundation of riverine wetlands along Cypress Creek and the Peace, Alafia, North Prong Alafia, and South Prong Alafia Rivers, west-central Florida

USGS Publications Warehouse

Lewelling, B.R.

2003-01-01

Riverine and palustrine system wetlands are a major ecological component of river basins in west-central Florida. Healthy wetlands are dependent upon the frequency and duration of periodic flooding or inundation. This report assesses the extent, area, depth, frequency, and duration of periodic flooding and the effects of potential surface-water withdrawals on the wetlands along Cypress Creek and the Peace, Alafia, North Prong Alafia, and South Prong Alafia Rivers. Results of the study were derived from step-backwater analysis performed at each of the rivers using the U.S. Army Corps of Engineers Hydrologic Engineering Center-River Analysis System (HEC-RAS) one-dimensional model. The step-backwater analysis was performed using selected daily mean discharges at the 10th, 50th, 70th, 80th, 90th, 98th, 99.5th, and 99.9th percentiles to compute extent of areal inundation, area of inundation, and hydraulic depth to assess the net reduction of areal inundation if 10 percent of the total river flow were diverted for potential withdrawals. The extent of areal inundation is determined by cross-sectional topography and the degree to which the channel is incised. Areal inundation occurs along the broad, low relief of the Cypress Creek floodplain during all selected discharge percentiles. However, areal inundation of the Peace and Alafia Rivers floodplains, which generally have deeply incised channels, occurs at or above discharges at the 80th percentile. The greatest area of inundation along the three rivers generally occurs between the 90th and 98th percentile discharges. The decrease in inundated area resulting from a potential 10-percent withdrawal in discharge ranged as follows: Cypress Creek, 22 to 395 acres (1.7 to 8.4 percent); Peace River, 17 to 1,900 acres (2.1 to 13.6 percent); Alafia River, 1 to 90 acres (1 to 19.6 percent); North Prong Alafia River, 1 to 46 acres (0.7 to 23.4 percent); and South Prong Alafia River, 1 to 75 acres (1.5 to 13.4 percent).

A method to improve the accuracy of pair-wise combinations of anthropometric elements when only limited data are available.

PubMed

Albin, Thomas J

2013-01-01

Designers and ergonomists occasionally must produce anthropometric models of workstations with only summary percentile data available regarding the intended users. Until now the only option available was adding or subtracting percentiles of the anthropometric elements, e.g. heights and widths, used in the model, despite the known resultant errors in the estimate of the percent of users accommodated. This paper introduces a new method, the Median Correlation Method (MCM) that reduces the error. Compare the relative accuracy of MCM to combining percentiles for anthropometric models comprised of all possible pairs of five anthropometric elements. Describe the mathematical basis of the greater accuracy of MCM. MCM is described. 95th percentile accommodation percentiles are calculated for the sums and differences of all combinations of five anthropometric elements by combining percentiles and using MCM. The resulting estimates are compared with empirical values of the 95th percentiles, and the relative errors are reported. The MCM method is shown to be significantly more accurate than adding percentiles. MCM is demonstrated to have a mathematical advantage estimating accommodation relative to adding or subtracting percentiles. The MCM method should be used in preference to adding or subtracting percentiles when limited data prevent more sophisticated anthropometric models.

Growth reference for Saudi preschool children: LMS parameters and percentiles.

PubMed

Shaik, Shaffi Ahamed; El Mouzan, Mohammad Issa; AlSalloum, Abdullah Abdulmohsin; AlHerbish, Abdullah Sulaiman

2016-01-01

Previous growth charts for Saudi children have not included detailed tables and parameters needed for research and incorporation in electronic records. The objective of this report is to publish the L, M, and S parameters and percentiles as well as the corresponding growth charts for Saudi preschool children. Community-based survey and measurement of growth parameters in a sample selected by a multistage probability procedure. A stratified listing of the Saudi population. Raw data from the previous nationally-representative sample were reanalyzed using the Lambda-Mu-Sigma (LMS) methodology to calculate the L, M, and S parameters of percentiles (from 3rd to 97th) for weight, length/height, head circumference, and body mass index-for-age, and weight for-length/height for boys and girls from birth to 60 months. Length or height and weight of Saudi preschool children. There were 15601 Saudi children younger than 60 months of age, 7896 (50.6 %) were boys. The LMS parameters for weight for age from birth to 60 months (5 years) are reported for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentiles as well as the corresponding graphs. Similarly, the LMS parameters for length/height-for-age, head circumference-for-age, weight-for-length/height and body mass index-for-age (BMi) are shown with the corresponding graphs for boys and girls. Using the data in this report, clinicians and researchers can assess the growth of Saudi preschool children. The report does not reflect interregional variations in growth.

Workers on the margin: who drops health coverage when prices rise?

PubMed

Okeke, Edward N; Hirth, Richard A; Grazier, Kyle

2010-01-01

We revisit the question of price elasticity of employer-sponsored insurance (ESI) take-up by directly examining changes in the take-up of ESI at a large firm in response to exogenous changes in employee premium contributions. We find that, on average, a 10% increase in the employee's out-of-pocket premium increases the probability of dropping coverage by approximately 1%. More importantly, we find heterogeneous impacts: married workers are much more price-sensitive than single employees, and lower-paid workers are disproportionately more likely to drop coverage than higher-paid workers. Elasticity estimates for employees below the 25th percentile of salary distribution in our sample are nearly twice the average.

Relationships Among Student Ability, School Performance, and Fleet Supervisor Ratings for Navy ’A’ School Graduates.

DTIC Science & Technology

1982-11-01

April 1980. 9 NEMA ._ Technical Report 136 Subsequent reports in the series will present: " an analysis of relationships among training effectiveness...individualized courses were above the standardized norm (i.e., 50). Graduates 20 Technical Report 136 of the TO and MM600 courses had the highest...Ability Characteristics. The average AFQT percentile scores for all the conventional courses were above the standardized norm (50). Graduates of the FTM

Definition of temperature thresholds: the example of the French heat wave warning system.

PubMed

Pascal, Mathilde; Wagner, Vérène; Le Tertre, Alain; Laaidi, Karine; Honoré, Cyrille; Bénichou, Françoise; Beaudeau, Pascal

2013-01-01

Heat-related deaths should be somewhat preventable. In France, some prevention measures are activated when minimum and maximum temperatures averaged over three days reach city-specific thresholds. The current thresholds were computed based on a descriptive analysis of past heat waves and on local expert judgement. We tested whether a different method would confirm these thresholds. The study was set in the six cities of Paris, Lyon, Marseille, Nantes, Strasbourg and Limoges between 1973 and 2003. For each city, we estimated the excess in mortality associated with different temperature thresholds, using a generalised additive model, controlling for long-time trends, seasons and days of the week. These models were used to compute the mortality predicted by different percentiles of temperatures. The thresholds were chosen as the percentiles associated with a significant excess mortality. In all cities, there was a good correlation between current thresholds and the thresholds derived from the models, with 0°C to 3°C differences for averaged maximum temperatures. Both set of thresholds were able to anticipate the main periods of excess mortality during the summers of 1973 to 2003. A simple method relying on descriptive analysis and expert judgement is sufficient to define protective temperature thresholds and to prevent heat wave mortality. As temperatures are increasing along with the climate change and adaptation is ongoing, more research is required to understand if and when thresholds should be modified.

Economic consequences incurred by living kidney donors: a Canadian multi-center prospective study.

PubMed

Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

2014-04-01

Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th-75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th-75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs. © 2014 The Authors. American Journal of Transplantation Published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Head impact exposure in youth football: elementary school ages 7-8 years and the effect of returning players.

PubMed

Young, Tyler J; Daniel, Ray W; Rowson, Steven; Duma, Stefan M

2014-09-01

To provide data describing the head impact exposure of 7- to 8-year-old football players. Head impact data were collected from 19 players over the course of 2 seasons using helmet-mounted accelerometer arrays. Data were collected from 2 youth football teams in Blacksburg, VA, spanning 2 seasons. A total of 19 youth football players aged 7-8 years. Type of session (practice or game) and the player's experience. Head impact frequency, acceleration magnitude, and impact location for games, practices, and the season as a whole were measured. The average instrumented player sustained 9 ± 6 impacts per practice, 11 ± 11 impacts per game, and 161 ± 111 impacts per season. The average instrumented player had a median impact of 16 ± 2 g and 686 ± 169 rad/s and a 95th percentile impact of 38 ± 13 g and 2052 ± 664 rad/s throughout a season. Impacts of 40 g or greater tended to occur more frequently in practices than in games, and practices had a significantly higher 95th percentile impact magnitude than games (P = 0.023). Returning players had significantly more impacts than first time players (P = 0.007). These data are a further step toward developing effective strategies to reduce the incidence of concussion in youth football and have applications toward youth-specific football helmet designs.

Low-Value Service Use in Provider Organizations.

PubMed

Schwartz, Aaron L; Zaslavsky, Alan M; Landon, Bruce E; Chernew, Michael E; McWilliams, J Michael

2018-02-01

To assess whether provider organizations exhibit distinct profiles of low-value service provision. 2007-2011 Medicare fee-for-service claims and enrollment data. Use of 31 services that provide minimal clinical benefit was measured for 4,039,733 beneficiaries served by 3,137 provider organizations. Variation across organizations, persistence within organizations over time, and correlations in use of different types of low-value services within organizations were estimated via multilevel modeling, with adjustment for beneficiary sociodemographic and clinical characteristics. Organizations provided 45.6 low-value services per 100 beneficiaries on average, with considerable variation across organizations (90th/10th percentile ratio, 1.78; 95 percent CI, 1.72-1.84), including substantial between-organization variation within hospital referral regions (90th/10th percentile ratio, 1.66; 95 percent CI, 1.60-1.71). Low-value service use within organizations was highly correlated over time (r, 0.98; 95 percent CI, 0.97-0.99) and positively correlated between 13 of 15 pairs of service categories (average r, 0.26; 95 percent CI, 0.24-0.28), with the greatest correlation between low-value imaging and low-value cardiovascular testing and procedures (r, 0.54). Use of low-value services in provider organizations exhibited substantial variation, high persistence, and modest consistency across service types. These findings are consistent with organizations shaping the practice patterns of affiliated physicians. © Health Research and Educational Trust.

Residential traffic density and childhood leukemia risk.

PubMed

Von Behren, Julie; Reynolds, Peggy; Gunier, Robert B; Rull, Rudolph P; Hertz, Andrew; Urayama, Kevin Y; Kronish, Daniel; Buffler, Patricia A

2008-09-01

Exposures to carcinogenic compounds from vehicle exhaust may increase childhood leukemia risk, and the timing of this exposure may be important. We examined the association between traffic density and childhood leukemia risk for three time periods: birth, time of diagnosis, and lifetime average, based on complete residential history in a case-control study. Cases were rapidly ascertained from participating hospitals in northern and central California between 1995 and 2002. Controls were selected from birth records, individually matched on age, sex, race, and Hispanic ethnicity. Traffic density was calculated by estimating total vehicle miles traveled per square mile within a 500-foot (152 meter) radius area around each address. We used conditional logistic regression analyses to account for matching factors and to adjust for household income. We included 310 cases of acute lymphocytic leukemias (ALL) and 396 controls in our analysis. The odds ratio for ALL and residential traffic density above the 75th percentile, compared with subjects with zero traffic density, was 1.17 [95% confidence interval (95% CI), 0.76-1.81] for residence at diagnosis and 1.11 (95% CI, 0.70-1.78) for the residence at birth. For average lifetime traffic density, the odds ratio was 1.24 (95% CI, 0.74-2.08) for the highest exposure category. Living in areas of high traffic density during any of the exposure time periods was not associated with increased risk of childhood ALL in this study.

Tissue distribution of HCH and DDT congeners and human health risk associated with consumption of fish collected from Kabul River, Pakistan.

PubMed

Aamir, Muhammad; Khan, Sardar; Nawab, Javed; Qamar, Zahir; Khan, Anwarzeb

2016-03-01

Distribution of hexachlorocyclohexane (HCH) and dichlorodiphenyltrichloroethane (DDT) congeners in tissues of four different fish species and their associated potential health risks to local consumers are presented in this paper. The average ∑(HCHs+DDTs) concentration in Glyptothorax punjabensis (214ngg(-1) wet weight (ww)) (carnivores) was found higher than Tor putitora (155ngg(-1) ww) (herbivores). The distribution of ∑(HCHs+DDTs) in all fish tissues was found in order of liver>muscle>stomach>gills. The profile of congeners (β-HCH/∑HCH from 0.29-0.47) indicated that all selected fish species were contaminated with HCH because of its recent usage in the study area. Furthermore, DDT profile ((DDE+DDD)/∑DDT from 0.61-0.78) showed that fish contamination with DDT originated from past usage and long-time degradation mechanism. The average estimated daily dietary intake of ∑HCHs (15.0ngkg(-1) day(-1)) was higher than ∑DDTs (12.5ngkg(-1) day(-1)) by the local consumers via fish consumption. On the basis of both 50th and 95th percentile exposure levels, the carcinogenic hazard ratios for DDT and its congeners were exceeded one (safe limit) for all fish species, indicating a great potential cancer risk for local consumers with life time consumption of contaminated fish collected from Kabul River. Copyright © 2015 Elsevier Inc. All rights reserved.

Maximum speed limits. Volume 4, An implementation method for setting a speed limit based on the 85th percentile speed

DOT National Transportation Integrated Search

1970-10-01

This volume contains an explanation of a method for setting a speed limit which was developed as a part of the project conducted by the Institute for Research in Public Safety under Contract No. FH-11-7275, "A Study for the Selection of Maximum Speed...

Selected mesostructure properties in loblolly pine from Arkansas plantations

Treesearch

David E. Kretschmann; Steven M. Cramer; Roderic Lakes; Troy Schmidt

2006-01-01

Design properties of wood are currently established at the macroscale, assuming wood to be a homogeneous orthotropic material. The resulting variability from the use of such a simplified assumption has been handled by designing with lower percentile values and applying a number of factors to account for the wide statistical variation in properties. With managed...

PROGRAM FOR CHILDREN WITH HIGH ACHIEVEMENT POTENTIAL.

ERIC Educational Resources Information Center

Duarte Unified School District, CA.

THE DUARTE UNIFIED SCHOOL DISTRICT OFFERS SPECIAL OPPORTUNITIES TO DEVELOP GREATER SELF-DIRECTION, CONFIDENCE, PERSONAL RESPONSIBILITY, AND A DEGREE OF SKILL IN ALL AREAS OF THE CURRICULUM RELATIVE TO THE STUDENTS' ABILITIES. THE SELECTION OF STUDENTS SHOULD BE BASED ON AN INDIVIDUAL TEST, A SCORE AT OR ABOVE THE 98TH PERCENTILE ON A GROUP TEST OF…

Demographic Norms for Metropolitan, Nonmetropolitan and Rural Counties. Mental Health Demographic Profile System Working Paper No. 24, July 1975.

ERIC Educational Resources Information Center

Goldsmith, Harold F.; And Others

Utilizing 1970 census statistics for metropolitan, nonmetropolitan, rural, and "all" counties, this paper presents the selected percentile values for the 130 statistics (social indicators) in the Mental Health Demographic Profile System (the MHDPS is a system which allows the delineation of residential areas with common social rank, life…

Food brand recognition and BMI in preschoolers.

PubMed

Harrison, Kristen; Moorman, Jessica; Peralta, Mericarmen; Fayhee, Kally

2017-07-01

Children's food brand recognition predicts health-related outcomes such as preference for obesogenic foods and increased risk for overweight. However, it is uncertain to what degree food brand recognition acts as a proxy for other factors such as parental education and income, child vocabulary, child age, child race/ethnicity, parent healthy eating guidance, child commercial TV viewing, and child dietary intake, all of which may influence or be influenced by food brand recognition. U.S. preschoolers (N = 247, average age 56 months) were measured for BMI and completed the Peabody Picture Vocabulary Test plus recognition and recall measures for a selection of U.S. food brands. Parents completed measures of healthy eating guidance, child dietary intake, child commercial TV viewing, parent education, household income, parent BMI, and child age and race/ethnicity. Controlling these variables, child food brand recognition predicted higher child BMI percentile. Further, qualitative examination of children's incorrect answers to recall items demonstrated perceptual confusion between brand mascots and other fantasy characters to which children are exposed during the preschool years, extending theory on child consumer development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Caution regarding the choice of standard deviations to guide sample size calculations in clinical trials.

PubMed

Chen, Henian; Zhang, Nanhua; Lu, Xiaosun; Chen, Sophie

2013-08-01

The method used to determine choice of standard deviation (SD) is inadequately reported in clinical trials. Underestimations of the population SD may result in underpowered clinical trials. This study demonstrates how using the wrong method to determine population SD can lead to inaccurate sample sizes and underpowered studies, and offers recommendations to maximize the likelihood of achieving adequate statistical power. We review the practice of reporting sample size and its effect on the power of trials published in major journals. Simulated clinical trials were used to compare the effects of different methods of determining SD on power and sample size calculations. Prior to 1996, sample size calculations were reported in just 1%-42% of clinical trials. This proportion increased from 38% to 54% after the initial Consolidated Standards of Reporting Trials (CONSORT) was published in 1996, and from 64% to 95% after the revised CONSORT was published in 2001. Nevertheless, underpowered clinical trials are still common. Our simulated data showed that all minimal and 25th-percentile SDs fell below 44 (the population SD), regardless of sample size (from 5 to 50). For sample sizes 5 and 50, the minimum sample SDs underestimated the population SD by 90.7% and 29.3%, respectively. If only one sample was available, there was less than 50% chance that the actual power equaled or exceeded the planned power of 80% for detecting a median effect size (Cohen's d = 0.5) when using the sample SD to calculate the sample size. The proportions of studies with actual power of at least 80% were about 95%, 90%, 85%, and 80% when we used the larger SD, 80% upper confidence limit (UCL) of SD, 70% UCL of SD, and 60% UCL of SD to calculate the sample size, respectively. When more than one sample was available, the weighted average SD resulted in about 50% of trials being underpowered; the proportion of trials with power of 80% increased from 90% to 100% when the 75th percentile and the maximum SD from 10 samples were used. Greater sample size is needed to achieve a higher proportion of studies having actual power of 80%. This study only addressed sample size calculation for continuous outcome variables. We recommend using the 60% UCL of SD, maximum SD, 80th-percentile SD, and 75th-percentile SD to calculate sample size when 1 or 2 samples, 3 samples, 4-5 samples, and more than 5 samples of data are available, respectively. Using the sample SD or average SD to calculate sample size should be avoided.

Tabulations of ambient ozone data obtained by GASP (Global Air Sampling Program) airliners, March 1975 to July 1979

NASA Technical Reports Server (NTRS)

Jasperson, W. H.; Holdeman, J. D.

1984-01-01

Tabulations are given of GASP ambient ozone mean, standard deviation, median, 84th percentile, and 98th percentile values, by month, flight level, and geographical region. These data are tabulated to conform to the temporal and spatial resolution required by FAA Advisory Circular 120-38 (monthly by 2000 ft in altitude by 5 deg in latitude) for climatological data used to show compliance with cabin ozone regulations. In addition seasonal x 10 deg latitude tabulations are included which are directly comparable to and supersede the interim GASP ambient ozone tabulations given in appendix B of FAA-EE-80-43 (NASA TM-81528). Selected probability variations are highlighted to illustrate the spatial and temporal variability of ambient ozone and to compare results from the coarse and fine grid analyses.

Observation-based trends in ambient ozone in the Czech Republic over the past two decades

NASA Astrophysics Data System (ADS)

Hůnová, Iva; Bäumelt, Vít

2018-01-01

We present the trends in ambient ozone concentrations based on high quality data measured continuously at 26 long-term monitoring sites (9 urban, 17 rural including 10 mountain stations) in the Czech Republic in 1994-2015. We considered annual and summer medians, the 10th and 98th percentiles, maximum daily 8-h running mean concentrations and exposure index AOT40F. For all indicators taken into account except for the 10th percentile, our results showed a similar pattern with significant decreasing trends for about one half of the examined sites. We obtained similar results for all types of sites. The most pronounced decrease in O3 concentrations was recorded at mountain sites. Namely, at the Šerlich mountain site, with an overall decrease per year in annual median by 0.43 ppb, summer median by 1.17 ppb, maximal daily 8-h average by 0.45 ppb, the 10th percentile by 0.62 ppb. The peak concentrations indicated by the 98th percentile and AOT40F decreased most at urban site České Budějovice by 0.75 ppb and 0.84 ppb h per year, respectively. For sites exhibiting significant decreasing trends, an overall decrease per year in annual median was 0.22 ppb, in summer median 0.41 ppb, in the 10th percentile 0.23 ppb, in the 98th percentile 0.53 ppb, and in AOT40F 0.51 ppb h. A significant increasing trend was detected only in the 10th percentile at just three sites, with the highest increase of 0.19 ppb per year recorded at the rural site Sněžník. Moreover, a consistent decrease in limit value exceedances was detected, with by far the highest violation recorded in the meteorologically exceptional year of 2003. Out of the 26 sites under review, seven have not recorded a significant decreasing trend in O3 in any of the considered statistics. The lack of trends in O3 at these seven sites is likely associated with changing time patterns in local NO and NO2 emissions: in particular, with the increasing ratio in NO2/NOx. There is an obvious geographical pattern in recorded O3 trends: most of the sites with no trend detected are situated in the North-western region of the CR with numerous energy-producing large emission sources, partly denitrified recently. Our results clearly indicated that, for O3 decrease, the ratio between individual NO and NO2 forms is critical, and that a simultaneous significant decrease in both NO and NO2 concentrations is not a sufficient prerequisite. Apart from changes in car fleet in urban areas or near motorways, this factor might be of particular relevance in formerly highly polluted areas, where emissions from large power plants recently substantially decreased.

Windows of achievement for development milestones of Sri Lankan infants and toddlers: estimation through statistical modelling.

PubMed

Thalagala, N

2015-11-01

The normative age ranges during which cohorts of children achieve milestones are called windows of achievement. The patterns of these windows of achievement are known to be both genetically and environmentally dependent. This study aimed to determine the windows of achievement for motor, social emotional, language and cognitive development milestones for infants and toddlers in Sri Lanka. A set of 293 milestones identified through a literature review were subjected to content validation using parent and expert reviews, which resulted in the selection of a revised set of 277 milestones. Thereafter, a sample of 1036 children from 2 months to 30 months was examined to see whether or not they had attained the selected milestones. Percentile ages of attaining milestone were determined using a rearranged closed form equation related to the logistic regression. The parameters required for calculations were derived through the logistic regression of milestone achievement statuses against ages of children. These percentile ages were used to define the respective windows of achievement. A set of 178 robust indicators that represent motor, socio emotional, language and cognitive development skills and their windows of achievement relevant to 2 to 24 months of age were determined. Windows of achievement for six gross motor milestones determined in the study were shown to closely overlap a similar set of windows of achievement published by the World Health Organization indicating the validity of some findings. A methodology combining the content validation based on qualitative techniques and age validation based on regression modelling found to be effective for determining age percentiles for realizing milestones and determining respective windows of achievement. © 2015 John Wiley & Sons Ltd.

Faculty and resident evaluations of medical students on a surgery clerkship correlate poorly with standardized exam scores.

PubMed

Goldstein, Seth D; Lindeman, Brenessa; Colbert-Getz, Jorie; Arbella, Trisha; Dudas, Robert; Lidor, Anne; Sacks, Bethany

2014-02-01

The clinical knowledge of medical students on a surgery clerkship is routinely assessed via subjective evaluations from faculty members and residents. Interpretation of these ratings should ideally be valid and reliable. However, prior literature has questioned the correlation between subjective and objective components when assessing students' clinical knowledge. Retrospective cross-sectional data were collected from medical student records at The Johns Hopkins University School of Medicine from July 2009 through June 2011. Surgical faculty members and residents rated students' clinical knowledge on a 5-point, Likert-type scale. Interrater reliability was assessed using intraclass correlation coefficients for students with ≥4 attending surgeon evaluations (n = 216) and ≥4 resident evaluations (n = 207). Convergent validity was assessed by correlating average evaluation ratings with scores on the National Board of Medical Examiners (NBME) clinical subject examination for surgery. Average resident and attending surgeon ratings were also compared by NBME quartile using analysis of variance. There were high degrees of reliability for resident ratings (intraclass correlation coefficient, .81) and attending surgeon ratings (intraclass correlation coefficient, .76). Resident and attending surgeon ratings shared a moderate degree of variance (19%). However, average resident ratings and average attending surgeon ratings shared a small degree of variance with NBME surgery examination scores (ρ(2) ≤ .09). When ratings were compared among NBME quartile groups, the only significant difference was for residents' ratings of students with the lower 25th percentile of scores compared with the top 25th percentile of scores (P = .007). Although high interrater reliability suggests that attending surgeons and residents rate students with consistency, the lack of convergent validity suggests that these ratings may not be reflective of actual clinical knowledge. Both faculty members and residents may benefit from training in knowledge assessment, which will likely increase opportunities to recognize deficiencies and make student evaluation a more valuable tool. Copyright © 2014 Elsevier Inc. All rights reserved.

Estimated water use and availability in the lower Blackstone River basin, northern Rhode Island and south-central Massachusetts, 1995-99

USGS Publications Warehouse

Barolw, Lora K.

2003-01-01

The Blackstone River basin includes approximately 475 square miles in northern Rhode Island and south-central Massachusetts. The study area (198 square miles) comprises six subbasins of the lower Blackstone River basin. The estimated population for the study period 1995?99 was 149,651 persons. Water-use data including withdrawals, use, and return flows for the study area were collected. Withdrawals averaged 29.869 million gallons per day (Mgal/d) with an estimated 12.327 Mgal/d exported and an estimated 2.852 Mgal/d imported; this resulted in a net export of 9.475 Mgal/d. Public-supply withdrawals were 22.694 Mgal/d and self-supply withdrawals were 7.170 Mgal/d, which is about 24 percent of total withdrawals. Two users withdrew 4.418 Mgal/d of the 7.170 Mgal/d of self-supply withdrawals. Total water use averaged 20.388 Mgal/d. The largest aggregate water use was for domestic supply (10.113 Mgal/d, 50 percent of total water use), followed by industrial water use (4.127 Mgal/d, 20 percent), commercial water use (4.026 Mgal/d, 20 percent), non-account water use (1.866 Mgal/d, 9 percent) and agricultural water use (0.252 Mgal/d, 1 percent). Wastewater disposal averaged 15.219 Mgal/d with 10.395 Mgal/d or 68 percent disposed at National Pollution Discharge Elimination System (NPDES) outfalls for municipal wastewater-treatment facilities. The remaining 4.824 Mgal/d or 32 percent was self-disposed, 1.164 Mgal/d of which was disposed through commercial and industrial NPDES outfalls. Water availability (base flow plus safe-yield estimates minus streamflow criteria) was estimated for the low-flow period, which included June, July, August, and September. The median base flow for the low-flow period from 1957 to 1999 was estimated at 0.62 Mgal/d per square mile for sand and gravel deposits and 0.19 Mgal/d per square mile for till deposits. Safe-yield estimates for public-supply reservoirs totaled 20.2 Mgal/d. When the 7-day, 10-year low flow (7Q10) was subtracted from base flow, an estimated median rate of 50.5 Mgal/d of water was available for the basin during August, the lowest base-flow month. In addition, basin-wide water-availability estimates were calculated with and without streamflow criteria for each month of the low-flow period at the 75th, 50th, and 25th percentiles of base flow. These water availability estimates ranged from 42.3 to 181.7 Mgal/d in June; 20.2 to 96.7 Mgal/d in July; 20.2 to 85.4 Mgal/d in August, and 20.2 to 97.5 Mgal/d in September. Base flow was less than the Aquatic Base Flow (ABF), minimum flow considered adequate to protect aquatic fauna, from July through September at the 25th percentile and in August and September at the 50th percentile. A basin-stress ratio, which is equal to total withdrawals divided by water availability, was also calculated. The basin-stress ratio for August at the 50th percentile of base flow minus the 7Q10 was 0.68 for the study area. For individual subbasins, the ratio ranged from 0.13 in the Chepachet River subbasin to 0.95 in the Abbot Run subbasin. In addition, basin-stress ratios with and without streamflow criteria for all four months of the low-flow period were calculated at the 75th, 50th, and 25th percentiles of base flow. These values ranged from 0.19 to 0.83 in June, 0.36 to 1.50 in July, 0.40 to 1.14 in August, and 0.31 to 0.78 in September. Ratios could not be calculated by using the ABF at the 50th and 25th percentiles in August and September because the estimated base flow was less than the ABF. The depletion of the Blackstone River flows by Cumberland Water Department Manville well no. 1 in Rhode Island was estimated with the computer program STRMDEPL and specified daily pumping rates. STRMDEPL uses analytical solutions to calculate time-varying rates of streamflow depletion caused by pumping at wells. Results show that streamflow depletions were about 97 percent of average daily pumping rates for 1995 through 1999. Relative streamflow depletions for

A method superior to adding percentiles when only limited anthropometric data such as percentile tables are available for design models.

PubMed

Albin, Thomas J; Vink, Peter

2014-11-01

Designers and ergonomists may occasionally be limited to using tables of percentiles of anthropometric data to model users. Design models that add or subtract percentiles produce unreliable estimates of the proportion of users accommodated, in part because they assume a perfect correlation between variables. Percentile data do not allow the use of more reliable modeling methods such as Principle Component Analysis. A better method is needed. A new method for modeling with limited data is described. It uses measures of central tendency (median or mean) of the range of possible correlation values to estimate the combined variance is shown to reduce error compared to combining percentiles. Second, use of the Chebyshev inequality allows the designer to more reliably estimate the percent accommodation when the distributions of the underlying anthropometric data are unknown than does combining percentiles. This paper describes a modeling method that is more accurate than combining percentiles when only limited data are available. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Sex Differences in the Impact of Thinness, Overweight, Obesity, and Parental Height on Adolescent Height.

PubMed

Pinhas-Hamiel, Orit; Reichman, Brian; Shina, Avi; Derazne, Estela; Tzur, Dorit; Yifrach, Dror; Wiser, Itay; Afek, Arnon; Shamis, Ari; Tirosh, Amir; Twig, Gilad

2017-08-01

The secular trend of increasing weight may lead to a decline in height gain compared with the genetic height potential. The impact of weight on height in healthy male and female adolescents compared with their genetic height was assessed. Height and weight were measured in Israeli adolescent military recrutees aged 16-19 years between 1967 and 2013. The study population comprised 355,229 recrutees for whom parental height measurements were documented. Subjects were classified into four body mass index percentile groups according to the U.S. Centers for Disease Control and Prevention body mass index percentiles for age and sex:<5th (underweight), 5th-49th (low-normal), 50th-84th (high-normal), and ≥85th (overweight-obese). Short stature was defined as height ≤ third percentile and tall stature as height ≥ 90th percentile for age and sex. Overweight-obese females had a 73% increased risk for short stature (odds ratio [OR]: 1.73, 95% confidence interval [CI] = 1.51-1.97, p < .001). Conversely, underweight females had a 56% lower risk of short stature (OR: .44, 95% CI = .28-.70, p = .001) and a twofold increased risk for being tall (OR: 2.08, 95% CI = 1.86-2.32, p < .001). Overweight-obese males had a 23% increased risk of being short (OR: 1.23, 95% CI = 1.10-1.37, p < .001). Underweight females were on average 4.1 cm taller than their mid-parental height. Overweight-obese males and females had an increased risk of being short, and underweight females were significantly taller compared with their genetic height. The significantly increased height among underweight healthy females may reflect a potential loss of height gain in overweight-obese females. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Age-related nomograms for antral follicle count and anti-Mullerian hormone for subfertile Chinese women in Singapore.

PubMed

Loy, See Ling; Cheung, Yin Bun; Fortier, Marielle Valerie; Ong, Chiou Li; Tan, Heng Hao; Nadarajah, Sadhana; Chan, Jerry Kok Yen; Viardot-Foucault, Veronique

2017-01-01

Antral follicle count (AFC) and anti-Mullerian hormone (AMH) are known as the most reliable markers of a woman's ovarian reserve and are related to age. There is currently no specific local age-related centile charts for AFC and AMH. Therefore, we aim to examine the relationship between AFC and AMH with age and construct age-related nomograms among a subfertile Asian population. This is a study involving Chinese women who had their AFC and AMH measured as part of their subfertility screening from December 2010 until November 2014 in KK Women's and Children's Hospital, Singapore. Ordinary least squares regression analysis was used to estimate the relationship of AFC and AMH with age, while age-related AFC and AMH nomograms for the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were produced using the lambda-mu-sigma method. A total of 1,009 women, aged 26 to 44 year-old, were included. On average, the AFC and AMH decreased respectively by 0.79 follicle (95% confidence interval -0.93, -0.64) and 0.38 ng/mL (95% confidence interval -0.43, -0.32) per year of age. The age-related nomograms of AFC showed an approximately linear pattern, inversely correlated with age, regardless of the percentile. For AMH, the pattern is linear for the 75th percentile and below but shows a slightly accelerating decline for the 90th and 97th percentile. Overall, there were large inter-individual variations in AFC and AMH up to about 40 year-old. The declines of AFC and AMH over age are mostly linear among subfertile Chinese women in Singapore. The age-related AFC and AMH nomograms could be used as a reference chart by fertility practitioners. However, future validation with longitudinal data is required.

Gender mix in twins and fetal growth, length of gestation and adult cancer risk.

PubMed

Luke, Barbara; Hediger, Mary; Min, Sung-Joon; Brown, Morton B; Misiunas, Ruta B; Gonzalez-Quintero, Victor Hugo; Nugent, Clark; Witter, Frank R; Newman, Roger B; Hankins, Gary D V; Grainger, David A; Macones, George A

2005-01-01

This study evaluated the effect of gender mix (the gender combinations of twin pairs) on fetal growth and length of gestation, and reviewed the literature on the long-term effects of this altered fetal milieu on cancer risk. In singletons, it is well established that females weigh less than males at all gestations, averaging 125-135 g less at full term. This gender difference is generally believed to be the result of the effect of androgens on fetal growth. The gender difference in fetal growth is greater before the third trimester and less towards term, with males growing not only more, but also earlier than females. Plurality is a known risk factor for reduced fetal growth and birthweight. Compared with singletons, the mean birthweight percentiles of twins fall substantially (by 10% or more) below the singleton 10th percentile by 28 weeks, below the singleton 50th percentile by 30 weeks, and below the singleton 90th percentile by 34 weeks. In unlike-gender twin pairs, it has been reported that the female prolongs gestation for her brother, resulting in a higher birthweight for the male twin than that of like-gender male twins. Other researchers have demonstrated that females in unlike-gender pairs had higher birthweights than females in like-gender pairs. Analyses from our consortium on 2491 twin pregnancies with known chorionicity showed longer gestations and faster rates of fetal growth in both males and females in unlike-gender pairs compared with like-gender male or female pairs, although these differences were not statistically significant. The post-natal effects for females growing in an androgenic-anabolic environment include increased sensation-seeking behaviour and aggression, lowered visual acuity, more masculine attitudes and masculinising effects of the auditory system and craniofacial growth. In contrast, there is no evidence to suggest that there might be a similar feminising effect on males from unlike-gender pairs. This hormonal exposure in utero may influence adult body size and susceptability to breast cancer.

Dependence of subject-specific parameters for a fast helical CT respiratory motion model on breathing rate: an animal study

NASA Astrophysics Data System (ADS)

O'Connell, Dylan; Thomas, David H.; Lamb, James M.; Lewis, John H.; Dou, Tai; Sieren, Jered P.; Saylor, Melissa; Hofmann, Christian; Hoffman, Eric A.; Lee, Percy P.; Low, Daniel A.

2018-02-01

To determine if the parameters relating lung tissue displacement to a breathing surrogate signal in a previously published respiratory motion model vary with the rate of breathing during image acquisition. An anesthetized pig was imaged using multiple fast helical scans to sample the breathing cycle with simultaneous surrogate monitoring. Three datasets were collected while the animal was mechanically ventilated with different respiratory rates: 12 bpm (breaths per minute), 17 bpm, and 24 bpm. Three sets of motion model parameters describing the correspondences between surrogate signals and tissue displacements were determined. The model error was calculated individually for each dataset, as well asfor pairs of parameters and surrogate signals from different experiments. The values of one model parameter, a vector field denoted α which related tissue displacement to surrogate amplitude, determined for each experiment were compared. The mean model error of the three datasets was 1.00  ±  0.36 mm with a 95th percentile value of 1.69 mm. The mean error computed from all combinations of parameters and surrogate signals from different datasets was 1.14  ±  0.42 mm with a 95th percentile of 1.95 mm. The mean difference in α over all pairs of experiments was 4.7%  ±  5.4%, and the 95th percentile was 16.8%. The mean angle between pairs of α was 5.0  ±  4.0 degrees, with a 95th percentile of 13.2 mm. The motion model parameters were largely unaffected by changes in the breathing rate during image acquisition. The mean error associated with mismatched sets of parameters and surrogate signals was 0.14 mm greater than the error achieved when using parameters and surrogate signals acquired with the same breathing rate, while maximum respiratory motion was 23.23 mm on average.

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

Ezzati, M.; Mbinda, B.M.; Kammen, D.M.

Suspended particulate matter and carbon emissions from the combustion of biomass, in addition to their environmental consequences, have been causally associated with the incidence of respiratory and eye infections. Improved stoves offer the potential for emissions reduction. The authors compare the emissions of suspended particulate matter and carbon monoxide from traditional and improved biofuel stoves in Kenya under the actual conditions of household use. Data for analysis is from 137 14-h days of continuous real-time emission concentration monitoring in a total of 38 households. Their analysis shows that improved (ceramic) wood-burning stoves reduce daily average suspended particulate matter concentration bymore » 48% during the active burning period and by 77% during the smoldering phase. Ceramic stoves also reduce the median and the 75th and 95th percentiles of daily emission concentration during the burning period and the 95th percentile during the smoldering phase, and therefore shift the overall emission profile downward. Improved charcoal-burning stoves also offer reductions in indoor air pollution compared to the traditional metal stove, but these are not statistically significant. The greatest reduction in emission concentration is achieved as a result of transition from wood to charcoal where mean emission concentrations drop by 87% during the burning period and by 92% when smoldering as well as large reductions in the median and 75th and 95th percentiles. These results indicate that transition to charcoal, followed by the use of improved wood stoves, are viable options for reduction of human exposure to indoor air pollution in many developing nations.« less

Brief report: a cost analysis of neuraxial anesthesia to facilitate external cephalic version for breech fetal presentation.

PubMed

Carvalho, Brendan; Tan, Jonathan M; Macario, Alex; El-Sayed, Yasser Y; Sultan, Pervez

2013-07-01

In this study, we sought to determine whether neuraxial anesthesia to facilitate external cephalic version (ECV) increased delivery costs for breech fetal presentation. Using a computer cost model, which considers possible outcomes and probability uncertainties at the same time, we estimated total expected delivery costs for breech presentation managed by a trial of ECV with and without neuraxial anesthesia. From published studies, the average probability of successful ECV with neuraxial anesthesia was 60% (with individual studies ranging from 44% to 87%) compared with 38% (with individual studies ranging from 31% to 58%) without neuraxial anesthesia. The mean expected total delivery costs, including the cost of attempting/performing ECV with anesthesia, equaled $8931 (2.5th-97.5th percentile prediction interval $8541-$9252). The cost was $9207 (2.5th-97.5th percentile prediction interval $8896-$9419) if ECV was attempted/performed without anesthesia. The expected mean incremental difference between the total cost of delivery that includes ECV with anesthesia and ECV without anesthesia was $-276 (2.5th-97.5th percentile prediction interval $-720 to $112). The total cost of delivery in women with breech presentation may be decreased (up to $720) or increased (up to $112) if ECV is attempted/performed with neuraxial anesthesia compared with ECV without neuraxial anesthesia. Increased ECV success with neuraxial anesthesia and the subsequent reduction in breech cesarean delivery rate offset the costs of providing anesthesia to facilitate ECV.

Physical activity, motor function, and white matter hyperintensity burden in healthy older adults.

PubMed

Fleischman, Debra A; Yang, Jingyun; Arfanakis, Konstantinos; Arvanitakis, Zoe; Leurgans, Sue E; Turner, Arlener D; Barnes, Lisa L; Bennett, David A; Buchman, Aron S

2015-03-31

To test the hypothesis that physical activity modifies the association between white matter hyperintensity (WMH) burden and motor function in healthy older persons without dementia. Total daily activity (exercise and nonexercise physical activity) was measured for up to 11 days with actigraphy (Actical; Philips Respironics, Bend, OR) in 167 older adults without dementia participating in the Rush Memory and Aging Project. Eleven motor performances were summarized into a previously described global motor score. WMH volume was expressed as percent of intracranial volume. Linear regression models, adjusted for age, education, and sex, were performed with total WMH volume as the predictor and global motor score as the outcome. Terms for total daily physical activity and its interaction with WMH volume were then added to the model. Higher WMH burden was associated with lower motor function (p = 0.006), and total daily activity was positively associated with motor function (p = 0.002). Total daily activity modified the association between WMH and motor function (p = 0.007). WMH burden was not associated with motor function in persons with high activity (90th percentile). By contrast, higher WMH burden remained associated with lower motor function in persons with average (50th percentile; estimate = -0.304, slope = -0.133) and low (10th percentile; estimate = -1.793, slope = -0.241) activity. Higher levels of physical activity may reduce the effect of WMH burden on motor function in healthy older adults. © 2015 American Academy of Neurology.

Physical activity, motor function, and white matter hyperintensity burden in healthy older adults

PubMed Central

Yang, Jingyun; Arfanakis, Konstantinos; Arvanitakis, Zoe; Leurgans, Sue E.; Turner, Arlener D.; Barnes, Lisa L.; Bennett, David A.; Buchman, Aron S.

2015-01-01

Objective: To test the hypothesis that physical activity modifies the association between white matter hyperintensity (WMH) burden and motor function in healthy older persons without dementia. Methods: Total daily activity (exercise and nonexercise physical activity) was measured for up to 11 days with actigraphy (Actical; Philips Respironics, Bend, OR) in 167 older adults without dementia participating in the Rush Memory and Aging Project. Eleven motor performances were summarized into a previously described global motor score. WMH volume was expressed as percent of intracranial volume. Linear regression models, adjusted for age, education, and sex, were performed with total WMH volume as the predictor and global motor score as the outcome. Terms for total daily physical activity and its interaction with WMH volume were then added to the model. Results: Higher WMH burden was associated with lower motor function (p = 0.006), and total daily activity was positively associated with motor function (p = 0.002). Total daily activity modified the association between WMH and motor function (p = 0.007). WMH burden was not associated with motor function in persons with high activity (90th percentile). By contrast, higher WMH burden remained associated with lower motor function in persons with average (50th percentile; estimate = −0.304, slope = −0.133) and low (10th percentile; estimate = −1.793, slope = −0.241) activity. Conclusions: Higher levels of physical activity may reduce the effect of WMH burden on motor function in healthy older adults. PMID:25762710

Blast Mitigation Seat Analysis - Assessment of the Effect of Personal Protective Equipment on the 5th Percentile Female Anthropomorphic Test Devices Performance in Drop Tower Evaluations (Briefing Charts)

DTIC Science & Technology

2015-08-01

for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data ...sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden...UNCLASSIFIED UNCLASSIFIED • Baseline drop tower data collected from Anthropomorphic Test Devices (ATDs) seated in 12 models of Commercial Off-The-Shelf

Using the LMS method to calculate z-scores for the Fenton preterm infant growth chart.

PubMed

Fenton, T R; Sauve, R S

2007-12-01

The use of exact percentiles and z-scores permit optimal assessment of infants' growth. In addition, z-scores allow the precise description of size outside of the 3rd and 97th percentiles of a growth reference. To calculate percentiles and z-scores, health professionals require the LMS parameters (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation; Cole, 1990). The objective of this study was to calculate the LMS parameters for the Fenton preterm growth chart (2003). Secondary data analysis of the Fenton preterm growth chart data. The Cole methods were used to produce the LMS parameters and to smooth the L parameter. New percentiles were generated from the smooth LMS parameters, which were then compared with the original growth chart percentiles. The maximum differences between the original percentile curves and the percentile curves generated from the LMS parameters were: for weight; a difference of 66 g (2.9%) at 32 weeks along the 90th percentile; for head circumference; some differences of 0.3 cm (0.6-1.0%); and for length; a difference of 0.5 cm (1.6%) at 22 weeks on the 97th percentile. The percentile curves generated from the smoothed LMS parameters for the Fenton growth chart are similar to the original curves. These LMS parameters for the Fenton preterm growth chart facilitate the calculation of z-scores, which will permit the more precise assessment of growth of infants who are born preterm.

Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort.

PubMed

Vohr, Betty R; Heyne, Roy; Bann, Carla M; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R

2018-05-21

To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed. Three groups were compared, those with a BMI ≥85th percentile (overweight or obese for age, height, and sex) and ≥95th percentile (obese) vs <85th percentile. Multiple regression analyses estimated the relative risks of BMI ≥85th percentile and ≥95th percentile associated with perinatal and early childhood factors. Of 388 children, 22% had a BMI of ≥85th percentile and 10% were obese. Children with obesity and overweight compared with normal weight children had higher body fat (subscapular skinfold and triceps skinfold >85th percentile), central fat (waist circumference >90th percentile), spent more time in sedentary activity (20.5 vs 18.2 vs 16.7 hours/week), and had either systolic and/or diastolic hypertension (24% vs 26% vs 14%), respectively. Postdischarge weight gain velocities from 36 weeks postmenstrual age to 18 months, and 18 months to 6-7 years were independently associated with a BMI of ≥85th percentile, whereas weight gain velocity from 18 months to 6-7 years was associated with obesity. One in 5 former extremely preterm infants is overweight or obese and has central obesity at early school age. Postdischarge weight gain velocities were associated with overweight and obesity. These findings suggest the obesity epidemic is spreading to the most extremely preterm infants. ClinicalTrials.govNCT00063063 and NCT0000. Copyright © 2018 Elsevier Inc. All rights reserved.

Positive School Climate Is Associated With Lower Body Mass Index Percentile Among Urban Preadolescents

PubMed Central

Gilstad-Hayden, Kathryn; Carroll-Scott, Amy; Rosenthal, Lisa; Peters, Susan M.; McCaslin, Catherine; Ickovics, Jeannette R.

2015-01-01

BACKGROUND Schools are an important environmental context in children’s lives and are part of the complex web of factors that contribute to childhood obesity. Increasingly, attention has been placed on the importance of school climate (connectedness, academic standards, engagement, and student autonomy) as 1 domain of school environment beyond health policies and education that may have implications for student health outcomes. The purpose of this study is to examine the association of school climate with body mass index (BMI) among urban preadolescents. METHODS Health surveys and physical measures were collected among fifth- and sixth-grade students from 12 randomly selected public schools in a small New England city. School climate surveys were completed district-wide by students and teachers. Hierarchical linear modeling was used to test the association between students’ BMI and schools’ climate scores. RESULTS After controlling for potentially confounding individual-level characteristics, a 1-unit increase in school climate score (indicating more positive climate) was associated with a 7-point decrease in students’ BMI percentile. CONCLUSIONS Positive school climate is associated with lower student BMI percentile. More research is needed to understand the mechanisms behind this relationship and to explore whether interventions promoting positive school climate can effectively prevent and/or reduce obesity. PMID:25040118

Positive school climate is associated with lower body mass index percentile among urban preadolescents.

PubMed

Gilstad-Hayden, Kathryn; Carroll-Scott, Amy; Rosenthal, Lisa; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R

2014-08-01

Schools are an important environmental context in children's lives and are part of the complex web of factors that contribute to childhood obesity. Increasingly, attention has been placed on the importance of school climate (connectedness, academic standards, engagement, and student autonomy) as 1 domain of school environment beyond health policies and education that may have implications for student health outcomes. The purpose of this study is to examine the association of school climate with body mass index (BMI) among urban preadolescents. Health surveys and physical measures were collected among fifth- and sixth-grade students from 12 randomly selected public schools in a small New England city. School climate surveys were completed district-wide by students and teachers. Hierarchical linear modeling was used to test the association between students' BMI and schools' climate scores. After controlling for potentially confounding individual-level characteristics, a 1-unit increase in school climate score (indicating more positive climate) was associated with a 7-point decrease in students' BMI percentile. Positive school climate is associated with lower student BMI percentile. More research is needed to understand the mechanisms behind this relationship and to explore whether interventions promoting positive school climate can effectively prevent and/or reduce obesity. © 2014, American School Health Association.

Projected changes in significant wave height toward the end of the 21st century: Northeast Atlantic

NASA Astrophysics Data System (ADS)

Aarnes, Ole Johan; Reistad, Magnar; Breivik, Øyvind; Bitner-Gregersen, Elzbieta; Ingolf Eide, Lars; Gramstad, Odin; Magnusson, Anne Karin; Natvig, Bent; Vanem, Erik

2017-04-01

Wind field ensembles from six CMIP5 models force wave model time slices of the northeast Atlantic over the last three decades of the 20th and the 21st centuries. The future wave climate is investigated by considering the RCP4.5 and RCP8.5 emission scenarios. The CMIP5 model selection is based on their ability to reconstruct the present (1971-2000) extratropical cyclone activity, but increased spatial resolution has also been emphasized. In total, the study comprises 35 wave model integrations, each about 30 years long, in total more than 1000 years. Here annual statistics of significant wave height are analyzed, including mean parameters and upper percentiles. There is general agreement among all models considered that the mean significant wave height is expected to decrease by the end of the 21st century. This signal is statistically significant also for higher percentiles, but less evident for annual maxima. The RCP8.5 scenario yields the strongest reduction in wave height. The exception to this is the north western part of the Norwegian Sea and the Barents Sea, where receding ice cover gives longer fetch and higher waves. The upper percentiles are reduced less than the mean wave height, suggesting that the future wave climate has higher variance than the historical period.

Mothers' Behaviors and Sons' Reading Achievement and Projected Feelings.

ERIC Educational Resources Information Center

Oidick, Michael Stanley

Two groups of fourth-grade boys, one group reading at grade level or above, the other reading below grade level, were selected for this study. All boys in both groups had scored at the 30th percentile or below on a kindergarten reading-readiness test. The mothers of these boys were interviewed to assess their participation, instigation, and level…

Selecting Growth Measures for School and Teacher Evaluations. Working Paper 80

ERIC Educational Resources Information Center

Ehlert, Mark; Koedel, Cory; Parsons, Eric; Podgursky, Michael

2012-01-01

The specifics of how growth models should be constructed and used to evaluate schools and teachers is a topic of lively policy debate in states and school districts nationwide. In this paper we take up the question of model choice and examine three competing approaches. The first approach, reflected in the popular student growth percentiles (SGPs)…

The development and implementation of stroke risk prediction model in National Health Insurance Service's personal health record.

PubMed

Lee, Jae-Woo; Lim, Hyun-Sun; Kim, Dong-Wook; Shin, Soon-Ae; Kim, Jinkwon; Yoo, Bora; Cho, Kyung-Hee

2018-01-01

The purpose of this study was to build a 10-year stroke prediction model and categorize a probability of stroke using the Korean national health examination data. Then it intended to develop the algorithm to provide a personalized warning on the basis of each user's level of stroke risk and a lifestyle correction message about the stroke risk factors. Subject to national health examinees in 2002-2003, the stroke prediction model identified when stroke was first diagnosed by following-up the cohort until 2013 and estimated a 10-year probability of stroke. It sorted the user's individual probability of stroke into five categories - normal, slightly high, high, risky, very risky, according to the five ranges of average probability of stroke in comparison to total population - less than 50 percentile, 50-70, 70-90, 90-99.9, more than 99.9 percentile, and constructed the personalized warning and lifestyle correction messages by each category. Risk factors in stroke risk model include the age, BMI, cholesterol, hypertension, diabetes, smoking status and intensity, physical activity, alcohol drinking, past history (hypertension, coronary heart disease) and family history (stroke, coronary heart disease). The AUC values of stroke risk prediction model from the external validation data set were 0.83 in men and 0.82 in women, which showed a high predictive power. The probability of stroke within 10 years for men in normal group (less than 50 percentile) was less than 3.92% and those in very risky group (top 0.01 percentile) was 66.2% and over. The women's probability of stroke within 10 years was less than 3.77% in normal group (less than 50 percentile) and 55.24% and over in very risky group. This study developed the stroke risk prediction model and the personalized warning and the lifestyle correction message based on the national health examination data and uploaded them to the personal health record service called My Health Bank in the health information website - Health iN. By doing so, it urged medical users to strengthen the motivation of health management and induced changes in their health behaviors. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Visual field progression in glaucoma: total versus pattern deviation analyses.

PubMed

Artes, Paul H; Nicolela, Marcelo T; LeBlanc, Raymond P; Chauhan, Balwantray C

2005-12-01

To compare visual field progression with total and pattern deviation analyses in a prospective longitudinal study of patients with glaucoma and healthy control subjects. A group of 101 patients with glaucoma (168 eyes) with early to moderately advanced visual field loss at baseline (average mean deviation [MD], -3.9 dB) and no clinical evidence of media opacity were selected from a prospective longitudinal study on visual field progression in glaucoma. Patients were examined with static automated perimetry at 6-month intervals for a median follow-up of 9 years. At each test location, change was established with event and trend analyses of total and pattern deviation. The event analyses compared each follow-up test to a baseline obtained from averaging the first two tests, and visual field progression was defined as deterioration beyond the 5th percentile of test-retest variability at three test locations, observed on three consecutive tests. The trend analyses were based on point-wise linear regression, and visual field progression was defined as statistically significant deterioration (P < 5%) worse than -1 dB/year at three locations, confirmed by independently omitting the last and the penultimate observation. The incidence and the time-to-progression were compared between total and pattern deviation analyses. To estimate the specificity of the progression analyses, identical criteria were applied to visual fields obtained in 102 healthy control subjects, and the rate of visual field improvement was established in the patients with glaucoma and the healthy control subjects. With both event and trend methods, pattern deviation analyses classified approximately 15% fewer eyes as having progressed than did the total deviation analyses. In eyes classified as progressing by both the total and pattern deviation methods, total deviation analyses tended to detect progression earlier than the pattern deviation analyses. A comparison of the changes observed in MD and the visual fields' general height (estimated by the 85th percentile of the total deviation values) confirmed that change in the glaucomatous eyes almost always comprised a diffuse component. Pattern deviation analyses of progression may therefore underestimate the true amount of glaucomatous visual field progression. Pattern deviation analyses of visual field progression may underestimate visual field progression in glaucoma, particularly when there is no clinical evidence of increasing media opacity. Clinicians should have access to both total and pattern deviation analyses to make informed decisions on visual field progression in glaucoma.

Levels in the U.S. population of those persistent organic pollutants (2003-2004) included in the Stockholm Convention or in other long range transboundary air pollution agreements.

PubMed

Patterson, Donald G; Wong, Lee-Yang; Turner, Wayman E; Caudill, Samuel P; Dipietro, Emily S; McClure, Patricia C; Cash, Troy P; Osterloh, John D; Pirkle, James L; Sampson, Eric J; Needham, Larry L

2009-02-15

We report human serum levels of selected persistent organic pollutants (POPs) categorized by age, sex, and race/ ethnicity from a statistically representative sampling of the U.S. population during 2003 and 2004. The serum levels are for several chemicals listed in the Stockholm Convention on Persistent Organic Pollutants, in the Geneva Convention on Long-Range Transboundary Air Pollution, or in both. Population data for each chemical are described by geometric means and percentiles and are categorized by age, sex, and race/ ethnicity. At the 90th and 95th percentile, the dioxin total toxic equivalency (TEQ), using the 2005 toxic equivalency factors (TEFs) for all persons 12 years of age and older was 30.9 pg/g lipid (95% confidence interval (CI): 28.2-33.9 pg/g lipid) and 37.8 pg/g lipid (95% CI: 35.3-43.4 pg/g lipid), respectively. At both the 90th and 95th percentiles total TEQ increased significantly with increasing age. The population geometric mean (GM) for the total PCB concentration (sum of 35 congeners) for all persons 12 years of age and older was 0.820 ng/g whole-weight (95% CI: 0.782-0.863 ng/g whole-weight) and 134.4 ng/g lipid (95% CI: 128.9-140.0 ng/g lipid). The population 95th percentile for the total PCB concentration for all persons 12 years of age and older was 3.53 ng/g whole-weight (95% CI: 3.23-3.92 ng/g whole-weight) and 531 ng/g lipid (95% CI: 498-570 ng/g lipid). The concentrations of aldrin, endrin, gamma-HCH, and o,p'-DDT were

Stratification of Fat-Free Mass Index Percentiles for Body Composition Based on National Health and Nutrition Examination Survey III Bioelectric Impedance Data.

PubMed

Kudsk, Kenneth A; Munoz-Del-Rio, Alejandro; Busch, Rebecca A; Kight, Cassandra E; Schoeller, Dale A

2017-02-01

Loss of protein mass and lower fat-free mass index (FFMI) are associated with longer length of stay, postsurgical complications, and other poor outcomes in hospitalized patients. Normative data for FFMI of U.S. populations do not exist. This work aims to create a stratified FFMI percentile table for the U.S. population using the large bioelectric impedance analysis data obtained from National Health and Nutrition Examination Surveys (NHANES). Fat-free mass (FFM) was calculated from the NHANES III bioelectric impedance analysis and anthropometric data for males and females ages 12 to >90 years for 3 race/ethnicities (non-Hispanic white, non-Hispanic black, and Mexican American). FFM was normalized by subject height to create an FFMI distribution table for the U.S. Selected percentiles were obtained by age, sex, and race/ethnicity. Data were collapsed by race/ethnicity before and after removing obese and underweight participants to create an FFMI decile table for males and females 12 years and older for the healthy-weight U.S. FFMI increased during adolescent growth but stabilized in the early 20s. The FFMI deciles were similar by race/ethnicity, with age group remaining relatively stable between ages 25 and 80 years. The FFMI deciles for males and females were significantly different. After eliminating the obese and extremely thin, FFMI percentiles remain stable during adult years allowing creation of age- and race/ethnicity-independent decile tables for males and females. These tables allow stratification of individuals for nutrition intervention trials to depict changing nutrition status during medical, surgical, and nutrition interventions.

Neuropsychological performance in solvent-exposed vehicle collision repair workers in New Zealand.

PubMed

Keer, Samuel; Glass, Bill; McLean, Dave; Harding, Elizabeth; Babbage, Duncan; Leathem, Janet; Brinkmann, Yanis; Prezant, Bradley; Pearce, Neil; Douwes, Jeroen

2017-01-01

To assess whether contemporary solvent exposures in the vehicle collision repair industry are associated with objectively measured neuropsychological performance in collision repair workers. The RBANS battery and additional tests were administered to 47 vehicle collision repair and 51 comparison workers randomly selected from a previous questionnaire study. Collision repair workers performed lower on tests of attention (digit span backwards: -1.5, 95% CI -2.4, -0.5; digit span total: -1.7, CI -3.3, -0.0; coding: -6.1, CI -9.9, -2.8; total attention scale: -9.3, CI -15.9, -2.8) and the RBANS total scale (-5.1, CI -9.1, -1.2). Additional tests also showed deficits in visual attention and reaction time (Trails B: -11.5, CI -22.4, -0.5) and motor speed/dexterity (coin rotation dominant hand & non-dominant: -2.9, CI -5.3, -0.4 and -3.1, CI -5.6, -0.7 respectively). The strongest associations were observed in panel beaters. Applying dichotomised RBANS outcomes based on the lowest percentile scores of a normative comparison group showed strongly increased risks for attention (5th percentile: OR 20.1, 95% CI 1.5, 263.3; 10th percentile: 8.8, CI 1.7, 46.2; and 20th percentile: 5.1, CI 1.5, 17.6, respectively). Those employed in the industry for ≤ 17 years (the median work duration) generally had lower scores in the attention domain scale and RBANS total scale compared to those employed >17 years suggesting a healthy worker survivor bias, but trends were inconsistent for other domains. This study has found significant deficits in cognitive performance in collision repair workers despite low current airborne exposures in New Zealand.

Stratification of fat-free mass index percentiles for body composition based on NHANES III bioelectric impedance data

PubMed Central

Kudsk, Kenneth A.; Munoz-del-Rio, Alejandro; Busch, Rebecca A.; Kight, Cassandra E.; Schoeller, Dale A.

2015-01-01

Background Loss of protein mass and lower fat-free mass index (FFMI) are associated with longer length of stay, post-surgical complications and other poor outcomes in hospitalized patients Normative data for FFMI of U.S. populations does not exist. This work aims to create a stratified FFMI percentile table for the U.S. population using the large bioelectric impedance analysis data obtained from National Health and Nutrition Examination Surveys (NHANES). Methods Fat-free mass (FFM) was calculated from the NHANES III bioelectric impedance analysis and anthropometric data for males and females ages 12 to over 90 years for three race-ethnicities (non-Hispanic white, non-Hispanic black, and Mexican-American). FFM was normalized by subject height to create a FFMI distribution table for the U.S. population. Selected percentiles were obtained by age, sex, and race-ethnicity. Data was collapsed by race-ethnicity before and after removing obese and underweight subjects to create a FFMI decile table for males and females aged 12 and over for the healthy weight U.S. population. Results FFMI increased during adolescent growth but stabilized in the early 20s. The FFMI deciles were similar by race-ethnicity and age group remaining relatively stable between ages of 22 and 80 years. The FFMI deciles for males and females were significantly different. Conclusions After eliminating the obese and extremely thin, FFMI percentiles remain stable during adult years allowing creation of age- and race/ethnicity-independent decile tables for males and females. These tables allow stratification of individuals for nutrition intervention trials to depict changing nutrition status during medical, surgical and nutritional interventions. PMID:26092851

An empirical description of the dispersion of 5th and 95th percentiles in worldwide anthropometric data applied to estimating accommodation with unknown correlation values.

PubMed

Albin, Thomas J; Vink, Peter

2015-01-01

Anthropometric data are assumed to have a Gaussian (Normal) distribution, but if non-Gaussian, accommodation estimates are affected. When data are limited, users may choose to combine anthropometric elements by Combining Percentiles (CP) (adding or subtracting), despite known adverse effects. This study examined whether global anthropometric data are Gaussian distributed. It compared the Median Correlation Method (MCM) of combining anthropometric elements with unknown correlations to CP to determine if MCM provides better estimates of percentile values and accommodation. Percentile values of 604 male and female anthropometric data drawn from seven countries worldwide were expressed as standard scores. The standard scores were tested to determine if they were consistent with a Gaussian distribution. Empirical multipliers for determining percentile values were developed.In a test case, five anthropometric elements descriptive of seating were combined in addition and subtraction models. Percentile values were estimated for each model by CP, MCM with Gaussian distributed data, or MCM with empirically distributed data. The 5th and 95th percentile values of a dataset of global anthropometric data are shown to be asymmetrically distributed. MCM with empirical multipliers gave more accurate estimates of 5th and 95th percentiles values. Anthropometric data are not Gaussian distributed. The MCM method is more accurate than adding or subtracting percentiles.

Combining uncertainty factors in deriving human exposure levels of noncarcinogenic toxicants.

PubMed

Kodell, R L; Gaylor, D W

1999-01-01

Acceptable levels of human exposure to noncarcinogenic toxicants in environmental and occupational settings generally are derived by reducing experimental no-observed-adverse-effect levels (NOAELs) or benchmark doses (BDs) by a product of uncertainty factors (Barnes and Dourson, Ref. 1). These factors are presumed to ensure safety by accounting for uncertainty in dose extrapolation, uncertainty in duration extrapolation, differential sensitivity between humans and animals, and differential sensitivity among humans. The common default value for each uncertainty factor is 10. This paper shows how estimates of means and standard deviations of the approximately log-normal distributions of individual uncertainty factors can be used to estimate percentiles of the distribution of the product of uncertainty factors. An appropriately selected upper percentile, for example, 95th or 99th, of the distribution of the product can be used as a combined uncertainty factor to replace the conventional product of default factors.

Monitoring and Evaluation of Smolt Migration in the Columbia Basin : Volume IX : Evaluation of the 2001 Predictions of the Run-Timing of Wild and Hatchery-Reared Migrant Salmon and Steelhead Trout Migrating to Lower Granite, Rock Island, McNary, and John Day Dams using Program RealTime.

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

Burgess, Caitlin; Skalski, John R.

2001-12-01

Program RealTime provided tracking and forecasting of the 2001 inseason outmigration via the internet for eighteen PIT-tagged stocks of wild salmon and steelhead to Lower Granite and/or McNary dams and eleven passage-indexed stocks to Rock Island, McNary, or John Day dams. Nine of the PIT-tagged stocks tracked this year were new to the project. Thirteen ESUs of wild subyearling and yearling chinook salmon and steelhead, and one ESU of hatchery-reared sockeye salmon were tracked and forecasted to Lower Granite Dam. Eight wild ESUs of subyearling and yearling chinook salmon, sockeye salmon and steelhead were tracked to McNary Dam for themore » first time this year. Wild PIT-tagged ESUs tracked to Lower Granite Dam included yearling spring/summer chinook salmon release-recovery stocks (from Bear Valley Creek, Catherine Creek, Herd Creek, Imnaha River, Johnson Creek, Lostine River, Minam River, South Fork Salmon River, Secesh River, and Valley Creek), PIT-tagged wild runs-at-large of yearling chinook salmon and steelhead, and a PIT-tagged stock of subyearling fall chinook salmon. The stock of hatchery-reared PIT-tagged summer-run sockeye salmon smolts outmigrating to Lower Granite Dam, consisted this year of a new stock of fish from Alturas Lake Creek, Redfish Lake Creek Trap and Sawtooth Trap. The passage-indexed stocks, counted using FPC passage indices, included combined wild- and hatchery-reared runs-at-large of subyearling and yearling chinook, coho, and sockeye salmon, and steelhead migrating to Rock Island and McNary dams, and, new this year, combined wild and hatchery subyearling chinook salmon to John Day Dam. Unusual run-timing and fish passage characteristics were observed in this low-flow, negligible-spill migration year. The period for the middle 80% of fish passage (i.e., progress from the 10th to the 90th percentiles) was unusually short for nine out of ten PIT-tagged yearling spring/summer chinook salmon stocks tracked to Lower Granite Dam. It was the shortest on record for seven of these ten stocks. The nine stocks recording unusually short middle 80% periods also recorded higher-than-average recovery percentages. However the opposite trend was observed for the PIT-tagged wild subyearling chinook salmon and hatchery sockeye salmon stocks whose middle 80% period of passage to Lower Granite Dam was average to above average. Recovery percentages for these two stocks were average, compared to historical recoveries. The performance results of Program RealTime to make accurate predictions of percentiles of fish passage at an index site were mixed this year. The release-recovery stocks of wild PIT-tagged spring/summer chinook salmon tracked to Lower Granite Dam were predicted less accurately than usual, on average, with two exceptions. One of these exceptions was a stock that had its best prediction (first-half, last-half, and season-wide) ever to occur. On average, however, performance was down for predicting these stocks. The RealTime Select composite season-wide MAD was 4.3%, larger than the historical average of 2.1%. Passage percentiles for PIT-tagged runs-at-large of wild Snake River yearling and subyearling chinook salmon and of wild steelhead outmigrating to Lower Granite Dam were predicted very well this year, their second year of inclusion in the project, with season-wide MADs of 3.6%, 4.7%, and 1.8% respectively. These results, too, were mixed with respect to comparison with last year's performance. The yearling chinook stock was predicted somewhat better last year (up from 1.7% last year to 3.6% this year) but the subyearling chinook salmon and steelhead stocks were predicted better this year than last, season-wide. The steelhead stock, in particular, was predicted much better this year than last year, down to 1.8% this year from 4.8% last year. The PIT-tagged runs-at-large of wild salmon and steelhead tracked to McNary Dam in 2001 for the first time, were also well-predicted. In particular, the Snake River stocks were well-predicted, with season-wide MADs of 4.7% for subyearling chinook salmon, 3.3% for yearling chinook salmon, and 1.4% for steelhead. All three Snake River stocks were better predicted at McNary Dam than they were at Lower Granite Dam. The Upper Columbia River PIT-tagged runs-at-large of wild subyearling chinook salmon and wild steelhead were not predicted with the remarkable accuracy of the Snake River stocks, but RealTime performance for these stocks was still good, with season-wide MADs of 7.9% and 4.9%, respectively. The results of RealTime predictions of FPC passage-indexed percentiles of combined wild and hatchery-reared salmonids to Rock Island and McNary dams were comparable to last year with respect to the large variability in performance. Like last year some runs were predicted very well while others were predicted very poorly. The stocks predicted best and worst last year were not necessarily the stocks predicted best and worst this year.« less

Implications of the 2015 European drought on groundwater storage

NASA Astrophysics Data System (ADS)

Rangecroft, S.; Van Loon, A.; Kumar, R.; Mishra, V.

2016-12-01

In 2015 central and eastern Europe were affected by severe drought. Impacts of the drought were felt across many sectors, incl. agriculture, drinking water supply, electricity production, navigation, fisheries, and recreation. This drought event has recently been studied from meteorological and streamflow perspective, but no analysis of the groundwater (GW) drought has been performed. This is not surprising because real-time GW level observations often are not available. In this study we use previously established spatially-explicit relationships between meteorological drought and GW drought to quantify the 2015 GW drought over two regions in southern Germany and eastern Netherlands. We use the monthly GW observations from 2040 wells to establish the spatially varying optimal accumulation period between the Standardized Groundwater Index (SGI) and the Standardized Precipitation Evapotranspiration Index (SPEI) at a 0.250 gridded scale. The resulting optimal accumulation periods range between 1 and more than 24 months, indicating strong spatial differences in GW response time to meteorological input over the region. Based on these optimal accumulation periods, we found that in Germany a uniform severe GW drought persisted for several months (i.e. SGI below the drought threshold of 20th percentile for almost all grid cells in August, September and October 2015), whereas the Netherlands appeared to had relatively high GW levels (never below the drought threshold of 20th percentile). The differences between this event and the European 2003 benchmark drought are striking. The 2003 GW drought was less uniformly pronounced, both in the Netherlands and Germany, with the regional averaged SGI above the 50th percentile. This is because slowly responding wells still were above average from the wet year of 2002-2003, which experienced severe flooding in central Europe. Our study shows that the relationship between meteorological drought and GW drought can be used to quantify GW drought and that the 2015 GW drought in southern Germany was more severe than the 2003 drought, because of preconditions in slowly responding GW wells. For sustainable GW drought management strategies the use of GW level monitoring is needed to study the spatial variability of local GW drought, which mostly coincides with drought impacts.

Influence of domestic violence on the association between malnutrition and low cognitive development.

PubMed

Silva, Rita de C R; Assis, Ana M O; Hasselmann, Maria H; dos Santos, Letícia M; Pinto, Elizabete de J; Rodrigues, Laura C

2012-01-01

To investigate the size and direction of the association between malnutrition and low cognitive performance and to evaluate the effect of domestic violence on this association. This cross-sectional study enrolled students of both sexes, aged 7 to 14 years old, attending public elementary schools. The Raven's Progressive Matrices Test was used to measure cognitive development, the Revised Conflict Tactics Scales (CTS2), to measure domestic violence, and the body mass index (BMI) for age and sex, to define anthropometric indices. Socioeconomic data and information about food intake were also collected. Malnutrition was defined as BMI < 3rd percentile. Cognitive deficit was defined when the results of Raven's test were ≤ 25th percentile. Family violence was defined as a positive answer in at least one item about severe physical violence in the last 12 months. The size of the associations of interest was expressed as prevalence ratio (PR) and 95% confidence interval (95%CI). Below-average intellectual development was found for 63.3% of the participants. Malnutrition was identified in 9.5%. Malnutrition had a negative effect on cognitive performance (adjusted prevalence ratio [aPR] = 1.60, 95% CI = 1.01 - 2.52; p = 0.042) when adjusted for the association between exposure to domestic violence and age. The association between malnutrition and below-average intellectual development found in this study was affected by domestic violence, which must be taken into account when addressing the problem.

[APHAB scores for individual assessment of the benefit of hearing aid fitting].

PubMed

Löhler, J; Wollenberg, B; Schönweiler, R

2017-11-01

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment on four different subscales pertaining to different listening situations. Using a very large patient cohort, this study aims to show how answers are distributed within the four subscales before and after hearing aid fitting, and what benefit the patients experience. The results are discussed on the basis of the available literature. Between April 2013 and March 2016, 35,000 APHAB questionnaires from nine German statutory health insurance providers were evaluated. The average values before and after hearing aid fitting, as well as the benefit, were determined for all four APHAB subscales and analyzed graphically. The results of the subjective evaluation of hearing impairment before and after hearing aid fitting and the resultant benefit were plotted by percentile distribution graphs and boxplots. The data were analyzed statistically. There was no overlap of the interquartile ranges before and after hearing aid fitting in any of the APHAB subscales. In three scales (EC, BN and RV), the median improvement after hearing aid fitting was nearly 30 percentage points. In the AV subscale, this value was slightly negative. The percentile distribution graphs used in this study allow individual evaluation of subjective hearing impairment before and after hearing aid fitting, as well as of the resultant benefit, on the background of a huge database. Additionally, it is demonstrated why presentation as boxplots and the average benefit values calculated from these is problematic.

Economic Consequences Incurred by Living Kidney Donors: A Canadian Multi-Center Prospective Study

PubMed Central

Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

2014-01-01

Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th–75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th–75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs. In a prospective costing study, the authors find that economic consequences incurred by living kidney donors are frequent and nontrivial, and a notable proportion of donors experience significant costs. PMID:24597854

Probabilistic risk assessment of exposure to leucomalachite green residues from fish products.

PubMed

Chu, Yung-Lin; Chimeddulam, Dalaijamts; Sheen, Lee-Yan; Wu, Kuen-Yuh

2013-12-01

To assess the potential risk of human exposure to carcinogenic leucomalachite green (LMG) due to fish consumption, the probabilistic risk assessment was conducted for adolescent, adult and senior adult consumers in Taiwan. The residues of LMG with the mean concentration of 13.378±20.56 μg kg(-1) (BFDA, 2009) in fish was converted into dose, considering fish intake reported for three consumer groups by NAHSIT (1993-1996) and body weight of an average individual of the group. The lifetime average and high 95th percentile dietary intakes of LMG from fish consumption for Taiwanese consumers were estimated at up to 0.0135 and 0.0451 μg kg-bw(-1) day(-1), respectively. Human equivalent dose (HED) of 2.875 mg kg-bw(-1) day(-1) obtained from a lower-bound benchmark dose (BMDL10) in mice by interspecies extrapolation was linearly extrapolated to oral cancer slope factor (CSF) of 0.035 (mgkg-bw(-1)day(-1))(-1) for humans. Although, the assumptions and methods are different, the results of lifetime cancer risk varying from 3×10(-7) to 1.6×10(-6) were comparable to those of margin of exposures (MOEs) varying from 410,000 to 4,800,000. In conclusions, Taiwanese fish consumers with the 95th percentile LADD of LMG have greater risk of liver cancer and need to an action of risk management in Taiwan. Copyright © 2013 Elsevier Ltd. All rights reserved.

Lung cancer and environmental tobacco smoke: occupational risk to nonsmokers.

PubMed

Brown, K G

1999-12-01

The principal epidemiologic evidence that environmental tobacco smoke (ETS) increases the risk of lung cancer in (lifelong) nonsmokers is from studies of nonsmoking women married to smokers. This article estimates exposure-response curves for 14 studies (1, 249+ cases, 7 countries) with data on lung cancer categorized by the number of cigarettes/day smoked by the husband. The pooled results from the five U.S. studies alone are extrapolated to ETS levels in the workplace using measures of serum cotinine and nicotine samples from personal monitors as markers of exposure to ETS. It is predicted that the increase in lung cancer risk for nonsmoking women from average ETS exposure at work (among those exposed at work) is on the order of 25% (95% confidence interval (CI) = 8, 41) relative to background risk (i.e., with no ETS exposure from any source). This compares to an estimate of 39% (95% CI = 5, 65) for nonsmoking women whose husbands smoke at the adult male smoker's average of 25 cigarettes/day. At the 95th percentiles of exposure, the estimate from spousal smoking is 85% (95% CI = 32, 156), compared to 91% (95% CI = 34, 167) from workplace ETS exposure. Subject to the validity of the assumptions required in this approach, the outcome supports the conclusion that there is a significant excess risk from occupational exposure to ETS. The excess risk from ETS at work is typically lower than that from spousal smoking, but may be higher at the 95th percentiles of exposure.

Motor Events during Healthy Sleep: A Quantitative Polysomnographic Study

PubMed Central

Frauscher, Birgit; Gabelia, David; Mitterling, Thomas; Biermayr, Marlene; Bregler, Deborah; Ehrmann, Laura; Ulmer, Hanno; Högl, Birgit

2014-01-01

Study Objectives: Many sleep disorders are characterized by increased motor activity during sleep. In contrast, studies on motor activity during physiological sleep are largely lacking. We quantitatively investigated a large range of motor phenomena during polysomnography in physiological sleep. Design: Prospective polysomnographic investigation. Setting: Academic referral sleep laboratory. Participants: One hundred healthy sleepers age 19-77 y were strictly selected from a representative population sample by a two-step screening procedure. Interventions: N/A. Measurements and Results: Polysomnography according to American Academy of Sleep Medicine (AASM) standards was performed, and quantitative normative values were established for periodic limb movements in sleep (PLMS), high frequency leg movements (HFLM), fragmentary myoclonus (FM), neck myoclonus (NM), and rapid eye movement (REM)-related electromyographic (EMG) activity. Thirty-six subjects had a PLMS index > 5/h, 18 had a PLMS index > 15/h (90th percentile: 24.8/h). Thirty-three subjects had HFLM (90th percentile: four sequences/night). All subjects had FM (90th percentile 143.7/h sleep). Nine subjects fulfilled AASM criteria for excessive FM. Thirty-five subjects had NM (90th percentile: 8.8/h REM sleep). For REM sleep, different EMG activity measures for the mentalis and flexor digitorum superficialis muscles were calculated: the 90th percentile for phasic mentalis EMG activity for 30-sec epochs according to AASM recommendation was 15.6%, and for tonic mentalis EMG activity 2.6%. Twenty-five subjects exceeded the recently proposed phasic mentalis cutoff of 11%. None of the subjects exceeded the tonic mentalis cutoff of 9.6%. Conclusion: Quantification of motor phenomena is a basic prerequisite to develop normative values, and is a first step toward a more precise description of the various motor phenomena present during sleep. Because rates of motor events were unexpectedly high even in physiological sleep, the future use of normative values for both research and clinical routine is essential. Citation: Frauscher B; Gabelia D; Mitterling T; Biermayr M; Bregler D; Ehrmann L; Ulmer H; Högl B. Motor events during healthy sleep: a quantitative polysomnographic study. SLEEP 2014;37(4):763-773. PMID:24744455

3D tumor localization through real-time volumetric x-ray imaging for lung cancer radiotherapy.

PubMed

Li, Ruijiang; Lewis, John H; Jia, Xun; Gu, Xuejun; Folkerts, Michael; Men, Chunhua; Song, William Y; Jiang, Steve B

2011-05-01

To evaluate an algorithm for real-time 3D tumor localization from a single x-ray projection image for lung cancer radiotherapy. Recently, we have developed an algorithm for reconstructing volumetric images and extracting 3D tumor motion information from a single x-ray projection [Li et al., Med. Phys. 37, 2822-2826 (2010)]. We have demonstrated its feasibility using a digital respiratory phantom with regular breathing patterns. In this work, we present a detailed description and a comprehensive evaluation of the improved algorithm. The algorithm was improved by incorporating respiratory motion prediction. The accuracy and efficiency of using this algorithm for 3D tumor localization were then evaluated on (1) a digital respiratory phantom, (2) a physical respiratory phantom, and (3) five lung cancer patients. These evaluation cases include both regular and irregular breathing patterns that are different from the training dataset. For the digital respiratory phantom with regular and irregular breathing, the average 3D tumor localization error is less than 1 mm which does not seem to be affected by amplitude change, period change, or baseline shift. On an NVIDIA Tesla C1060 graphic processing unit (GPU) card, the average computation time for 3D tumor localization from each projection ranges between 0.19 and 0.26 s, for both regular and irregular breathing, which is about a 10% improvement over previously reported results. For the physical respiratory phantom, an average tumor localization error below 1 mm was achieved with an average computation time of 0.13 and 0.16 s on the same graphic processing unit (GPU) card, for regular and irregular breathing, respectively. For the five lung cancer patients, the average tumor localization error is below 2 mm in both the axial and tangential directions. The average computation time on the same GPU card ranges between 0.26 and 0.34 s. Through a comprehensive evaluation of our algorithm, we have established its accuracy in 3D tumor localization to be on the order of 1 mm on average and 2 mm at 95 percentile for both digital and physical phantoms, and within 2 mm on average and 4 mm at 95 percentile for lung cancer patients. The results also indicate that the accuracy is not affected by the breathing pattern, be it regular or irregular. High computational efficiency can be achieved on GPU, requiring 0.1-0.3 s for each x-ray projection.

Use of food labels by adolescents to make healthier choices on snacks: a cross-sectional study from Sri Lanka.

PubMed

Talagala, Ishanka A; Arambepola, Carukshi

2016-08-08

Unhealthy snacking is commonly seen among adolescents. Therefore, use of food labels is promoted for making healthier choices on packaged snacks. This study was conducted to assess the use of food labels in making choices on packaged snack and its associated factors among adolescents. A cross-sectional study was conducted in 2012 among 542 Grade 12 students in Sri Lanka. Eight classes were selected as 'clusters' for the study (two classes each from two schools that were selected randomly from each list of 'Girls only' and 'Boys only' schools in Colombo district). A self-administered questionnaire assessed their socio-demography, snacking behaviour, attitudes and nutrition knowledge related to food labels. Adolescents' use of labels was assessed by three practices (label reading frequency, attention paid to label contents and correct interpretation of six hypothetical labels of snacks). Based on total scores obtained for the three practices, 'satisfactory' (score ≥75(th) percentile mark) and 'unsatisfactory' (score <75(th) percentile mark) label users were identified. Using SPSS, associations were assessed at 0.05 significance level using Chi-square-test. Of the participants, 51 % were males; 61 % spent their pocket money at least once/week on packaged snacks; predominantly on biscuits (85 %) and cola-drinks (77 %) and 88 % selected snacks on their own. The majority (74.5 %) was frequent ('always' or 'most often') label readers with female predominance (p < 0.05). Over 74 % paid attention frequently to the brand name (75 %), price (85 %) and nutrition panel (81 %). Over 64 % were able to select the better food label when given a choice between two snacks, although some did it for reasons such as attractive label (63 %). The majority (84 %) had good knowledge (obtaining more than the 75(th) percentile mark) on interpreting labels. Although not statistically significant, 'unsatisfactory' label use was higher among males (73 %), purchasing power (70.4 %) and unhealthy snacking behaviour (73 %). In contrast, among the marketing strategies, identifying known brands (73.2 %) and imported products (75.8 %) as 'good' products were significantly associated with 'unsatisfactory' label use (p < 0.05). Despite having good knowledge and positive attitudes, food label use is unsatisfactory among adolescents. Skills in reading labels should be addressed in the 'School canteen policy' in Sri Lanka.

Chronic sensitivity of white sturgeon (Acipenser transmontanus) and rainbow trout (Oncorhynchus mykiss) to cadmium, copper, lead, or zinc in laboratory water-only exposures

USGS Publications Warehouse

Wang, Ning; Ingersoll, Christopher G.; Dorman, Rebecca A.; Brumbaugh, William G.; Mebane, Christopher A.; Kunz, James L.; Hardesty, Douglas K.

2014-01-01

Chronic toxicity of cadmium, copper, lead, or zinc to white sturgeon (Acipenser transmontanus) and rainbow trout (Oncorhynchus mykiss) was evaluated in water-only exposures started with newly hatched larvae or approximately 1-mo-old juveniles. The 20% effect concentration (EC20) for cadmium from the sturgeon tests was higher than the EC20 from the trout tests, whereas the EC20 for copper, lead, or zinc for the sturgeon were lower than those EC20s for the trout. When the EC20s from the present study were included in compiled toxicity databases for all freshwater species, species mean chronic value for white sturgeon was in a relatively low percentile of the species sensitivity distribution for copper (9th percentile) and in the middle percentile for cadmium (55th percentile), zinc (40th percentile), or lead (50th percentile). However, the species mean chronic value for rainbow trout was in a high percentile for copper, lead, and zinc (∼68th–82nd percentile), but in a low percentile for cadmium (23rd percentile). The trout EC20s for each of the 4 metals and the sturgeon EC20s for cadmium or lead were above US Environmental Protection Agency chronic ambient water quality criteria (AWQC) or Washington State chronic water quality standards (WQS), whereas the sturgeon EC20s for copper or zinc were approximately equal to or below the chronic AWQC and WQS. In addition, acute 50% effect concentrations (EC50s) for copper obtained in the first 4 d of the chronic sturgeon test were below the final acute value used to derive acute AWQC and below acute WQS for copper.

Waist circumference percentile curves for Malaysian children and adolescents aged 6.0-16.9 years.

PubMed

Poh, Bee Koon; Jannah, Ahmad Nurul; Chong, Lai Khuen; Ruzita, Abd Talib; Ismail, Mohd Noor; McCarthy, David

2011-08-01

The prevalence of obesity is increasing rapidly and abdominal obesity especially is known to be a risk factor for metabolic syndrome and other non-communicable diseases. Waist circumference percentile curves are useful tools which can help to identify abdominal obesity among the childhood and adolescent populations. To develop age- and sex-specific waist circumference (WC) percentile curves for multi-ethnic Malaysian children and adolescents aged 6.0-16.9 years. Subjects and methods. A total of 16,203 participants comprising 8,093 boys and 8,110 girls recruited from all regions of Malaysia were involved in this study. Height, weight, WC were measured and BMI calculated. Smoothed WC percentile curves and values for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th percentiles were constructed using the LMS Method. WC was found to increase with age in both sexes, but boys had higher WC values at every age and percentile. Z-scores generated using the UK reference data shows that Chinese children had the highest WC compared to Malays, Indians and other ethnicities. Comparisons with other studies indicate that at the 50th percentile, Malaysian curves did not differ from the UK, Hong Kong and Turkish curves, but at the 90th percentile, Malaysian curves were higher compared with other countries, starting at 10 years of age. The 90th percentile was adopted as the cut-off point to indicate abdominal obesity in Malaysian children and adolescents. These curves represent the first WC percentiles reported for Malaysian children, and they can serve as a reference for future studies.

The prices people pay for medicines in Zimbabwe.

PubMed

Gavaza, P; Simoyi, T; Makunike, B; Maponga, C C

2009-01-01

To collect, analyse and compare prices of medicines in different sectors and parts of the country and to compare them with the medicine prices in other countries. A prospective cross sectional study. Pharmacy outlets in Zimbabwe comprising 27 retail pharmacies, 23 dispensing doctors, eight public hospital pharmacies and seven municipal clinics. Median price ratios, 25th percentiles and 75th percentiles. Innovator brands in the private sector were priced 10 times the International References Prices (IRP) and more than three times the price of generic medicines. Dispensing doctors were charging the highest prices for medicines and the public sector had the least prices. The national procurement agency, NatPharm, procured medicines at prices slightly below the Management Sciences for Health (MSH) prices. Prices of medicines in the public sector were higher than average prices for medicines from seven other African countries. Medicine prices in Zimbabwe are high, a scenario that may compromise affordability and accessibility to medicines especially by the poor. Urgent steps are needed to reduce the level and effect of the high prices on the population, especially the poor.

Variation in the cost of care for primary total knee arthroplasties.

PubMed

Haas, Derek A; Kaplan, Robert S

2017-03-01

The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

Wide variation in payments for Medicare beneficiary oncology services suggests room for practice-level improvement.

PubMed

Clough, Jeffrey D; Patel, Kavita; Riley, Gerald F; Rajkumar, Rahul; Conway, Patrick H; Bach, Peter B

2015-04-01

In recent years many policy makers have recommended alternative payment models in medical oncology in order to reduce costs and improve patient outcomes. Yet information on how oncology practices differ in their use of key service categories is limited. We measured annual payments for key service categories delivered to fee-for-service Medicare beneficiaries receiving care from 1,534 medical oncology practices in 2011-12. In 2012, differences in payments per beneficiary at the seventy-fifth-percentile practice compared to the twenty-fifth-percentile practice were $3,866 for chemotherapy (including administration and supportive care drugs), $1,872 for acute medical hospitalizations, and $439 for advanced imaging. Supportive care drugs, bevacizumab, and positron-emission tomography accounted for the greatest percentage of variation. Average practice payments for service categories were highly correlated across years but not correlated with each other, which suggests that service categories may be affected by different physician practice characteristics. These differences, even when clinical guidelines exist, demonstrate the potential for quality improvement that could be accelerated through alternative payment models. Project HOPE—The People-to-People Health Foundation, Inc.

Across the continuum of satisfaction with work-family balance: Work hours, flexibility-fit, and work-family culture.

PubMed

McNamara, Tay K; Pitt-Catsouphes, Marcie; Matz-Costa, Christina; Brown, Melissa; Valcour, Monique

2013-03-01

This study investigated the association between hours worked per week and satisfaction with work-family balance, using data from a 2007-2008 survey of employees nested within organizations. We tested hypotheses informed by the resource drain and resources-and-demands perspectives using quantile regression. We found that the negative association between hours worked per week and satisfaction with work-family balance was significantly stronger at the 25th percentile, as compared to at the 75th percentile, of satisfaction with work-family balance. Further, there was some evidence that perceived flexibility-fit (i.e., the fit between worker needs and flexible work options available) and supportive work-family culture attenuated the relationship between hours worked and satisfaction with work-family balance. The results suggest that analyses focusing on the average relationship between long work hours (such as those using ordinary least squares regression) and satisfaction with work-family balance may underestimate the importance of long work hours for workers with lower satisfaction levels. Copyright © 2012 Elsevier Inc. All rights reserved.

Differences in Achievement Motivation and Academic and Social Self-Concept in Gifted Students of Higher Education

ERIC Educational Resources Information Center

Sierra, María Dolores Valadez; Cuervo, Angel Alberto Valdés; Amezaga, Teodoro Rafael Wendlandt; Sánchez, Ana Carolina Reyes; Guzmán, Rogelio Zambrano; Agraz, Juan Pedro Navarro

2015-01-01

The purpose of this study is to identify groups of gifted university students that differ in their self-concept and achievement motivation. For this, 80 students who achieved scores of the 95th percentile or higher in the Raven's Progressive Matrices test were selected. Two groups were identified in terms of their social self-concept and the…

Assessing the value of customized birth weight percentiles.

PubMed

Hutcheon, Jennifer A; Walker, Mark; Platt, Robert W

2011-02-15

Customized birth weight percentiles are weight-for-gestational-age percentiles that account for the influence of maternal characteristics on fetal growth. Although intuitively appealing, the incremental value they provide in the identification of intrauterine growth restriction (IUGR) over conventional birth weight percentiles is controversial. The objective of this study was to assess the value of customized birth weight percentiles in a simulated cohort of 100,000 infants aged 37 weeks whose IUGR status was known. A cohort of infants with a range of healthy birth weights was first simulated on the basis of the distributions of maternal/fetal characteristics observed in births at the Royal Victoria Hospital in Montreal, Canada, between 2000 and 2006. The occurrence of IUGR was re-created by reducing the observed birth weights of a small percentage of these infants. The value of customized percentiles was assessed by calculating true and false positive rates. Customizing birth weight percentiles for maternal characteristics added very little information to the identification of IUGR beyond that obtained from conventional weight-for-gestational-age percentiles (true positive rates of 61.8% and 61.1%, respectively, and false positive rates of 7.9% and 8.5%, respectively). For the process of customization to be worthwhile, maternal characteristics in the customization model were shown through simulation to require an unrealistically strong association with birth weight.

Iron status of young children in Europe.

PubMed

van der Merwe, Liandré F; Eussen, Simone R

2017-12-01

Iron deficiency (ID) is common in young children aged 6-36 mo. Although the hazards associated with iron deficiency anemia (IDA) are well known, concerns about risks associated with excess iron intake in young children are emerging. To characterize iron status in Europe, we describe the prevalence of ID, IDA, iron repletion, and excess stores with the use of published data from a systematic review on iron intake and deficiency rates, combined with other selected iron status data in young European children. Various definitions for ID and IDA were applied across studies. ID prevalence varied depending on socioeconomic status and type of milk fed (i.e., human or cow milk or formula). Without regard to these factors, ID was reported in 3-48% of children aged ≥12 mo across the countries. For 6- to 12-mo-old infants, based on studies that did not differentiate these factors, ID prevalence was 4-18%. IDA was <5% in most studies in Northern and Western Europe but was considerably higher in Eastern Europe (9-50%). According to current iron status data from a sample of healthy Western European children aged 12-36 mo, 69% were iron replete, and the 97.5th percentile for serum ferritin (SF) was 64.3 μg/L. In another sample, 79% of 24-mo-old children were iron replete, and the 97.5th percentile for SF was 57.3 μg/L. Average iron intake in most countries studied was close to or below the UK's Recommended Dietary Allowance. In conclusion, even in healthy European children aged 6-36 mo, ID is still common. In Western European populations for whom data were available, approximately three-quarters of children were found to be iron replete, and excess iron stores (SF >100 μg/L) did not appear to be a concern. Consensus on the definitions of iron repletion and excess stores, as well as on ID and IDA, is needed. © 2017 American Society for Nutrition.

Observations of Europe wide Trends in background and peak O3, CO and NO2 levels

NASA Astrophysics Data System (ADS)

Fleming, Z. L.; Monks, P. S.; Brunsdon, C.; Henne, S.; Buchmann, B.; Konovalov, I.; Beekman, M.

2009-04-01

The GEOMON (Global Earth Observation and MONitoring) project has produced a harmonised data set of trace gases from various ground-based measurement stations. These stations belong to a variety of regional, national and European air quality networks (e.g. EMEP, GAW). Investigations into instrumental calibration and data quality have been carried out in order to make comparison between the sites as accurate as possible for a long time-scale trend analysis. Ozone seasonal cycles at the various sites have been compared, showing characteristic cycles according to latitude, elevation, vicinity to coastal areas and pollution sources and population nearby. A de-trending of this seasonal cycle revealed long-term variations in ozone and a considerable difference between background and peak ozone trends between sites. National, European and international legislation has aimed at reducing CO and NO2 and correspondingly, reduce O3 levels over the last 20 years but the trends are not as clear cut and reveal that there is not a homogeneous reduction in these species across Europe. Splitting the data into seasonal periods and also into lower and upper concentration percentiles shows us more clearly how the species vary across Europe. There is a tendency for peak ozone levels to decrease, whilst the background levels have mostly increased. Averages, lower and upper percentiles of these species at the GEOMON stations are shown on European maps and the distribution of annual ozone trends is evaluated. Comparisons with models that estimate the lower and upper percentiles of ozone during summer overestimate ozone levels but not uniformly across Europe.

Prevalence of overweight and obesity among high-school girls in Tabriz, Iran, in 2001.

PubMed

Gargari, Bahram Pourghassem; Behzad, Mahdiyeh Hamed; Ghassabpour, Saeideh; Ayat, Arezoo

2004-09-01

Overweight and obesity are among the most prevalent nutritional problems in developed and developing countries. In this descriptive study, we attempted to determine the prevalence of overweight and obesity in Iranian adolescent girls attending high school in Tabriz. A sample of 1,650 (final study group, 1,518) high-school girls aged 14 to 20 years was selected by stepwise random sampling from five districts of Tabriz. Overweight and obesity were defined according to body mass index (BMI) percentiles from the First National Health and Nutrition Examination Survey (NHANES I) and the International Obesity Task Force (IOTF) BMI cutoffs. According to the NHANES I criteria, 14.6% of the study subjects were overweight or obese. Overweight and obesity was seen in 11. 1% and 3.6% of the students, respectively. By the IOTF cutoffs, 14% of the subjects were overweight or obese. Overweight and obesity were seen in 10.1% and 3.9% of the students, respectively. Of the study subjects, 8% had a BMI below the 15th percentile of NHANES I, an indicator of underweight. The prevalence of overweight and obesity in Tabriz high-school girls is higher than in many, but not all, parts of Iran, but lower than in some neighboring countries such as Saudi Arabia. In this age group, in addition to overweight and obesity, underweight (BMI < or = 15th percentile) is also present.

Do parents understand growth charts? A national, Internet-based survey.

PubMed

Ben-Joseph, Elana Pearl; Dowshen, Steven A; Izenberg, Neil

2009-10-01

The objective of this study was to assess parental knowledge and understanding of growth charts. An online survey was conducted with 1000 parents selected to be demographically representative of the US population. Questions explored awareness of, knowledge of, and attitudes toward growth monitoring, as well as the ability to interpret growth chart data. Seventy-nine percent of parents surveyed claimed to have seen a growth chart before, with the majority thinking that they understood it well. Sixty-four percent of parents thought it was important to be shown growth charts to see how their child was growing, and 40% expressed the need to see their child's growth chart as confirmation of their health care provider's verbal interpretation. However, when provided with multiple-choice questions and answers, only 64% could identify a child's weight when shown a plotted point on a growth chart. Ninety-six percent had heard of the term "percentile," but only 68% identified the percentile of the plotted point, and only 56% could identify the definition of percentile. Up to 77% interpreted incorrectly charts containing height/weight measurements in tandem. Although growth charts are used frequently as visual aids to educate parents about their children's growth, many parents cannot comprehend the data. This finding is significant because many parents prefer to be shown growth charts by their health care provider, and many parents report recording their children's measurements on growth charts at home.

Physical fitness percentile charts for children aged 6-10 from Portugal.

PubMed

Roriz De Oliveira, M S; Seabra, A; Freitas, D; Eisenmann, J C; Maia, J

2014-12-01

The present study aims (1) to provide reference percentile charts for the following measures of Physical Fitness (PF): the sit-and-reach, handgrip, standing long jump, 50 yards' dash, 4x10m shuttle run and 1-mile run/walk tests in children aged 6 to 10 years, and (2) to compare the performance of the Portuguese children with their age- and sex peers. A total of 3804 Portuguese children (1985 boys and 1819 girls) aged 6-10 years old participated in this study. The sample was stratified from 20 public elementary schools and children were randomly selected in each school. Charts were separately built for each sex using the LMS method. Boys showed better results than girls in handgrip, standing long jump, 50 yards' dash, 4x10 m shuttle run and 1-mile run/walk, while girls are better performers than boys in sit-and-reach. Age- and gender- percentiles for a set of physical fitness tests for 6-10 year old (primary school) Portuguese children have been established. Boys showed greater overall PF than girls, except in the flexibility test, in which girls performed better. The reported normative values provide ample opportunities to accurately detect individual changes during childhood. These reference values are especially important in healthcare and educational settings, and can be added to the worldwide literature on physical fitness values in children.

Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a systematic review with meta-analysis of randomised controlled trials.

PubMed

Kelley, George A; Kelley, Kristi S; Callahan, Leigh F

2018-02-17

Given conflicting findings, the purpose of this study was to use the meta-analytic approach to examine the effects of exercise (aerobic, strength training or both) on anxiety in adults with arthritis and other rheumatic diseases (AORD). Randomised controlled exercise intervention trials ≥4weeks in adults ≥18 years of age with osteoarthritis, rheumatoid arthritis or fibromyalgia were included. Studies were located by searching eight electronic databases, cross-referencing and expert review. Dual selection and data abstraction of studies were performed. Hedge's standardised effect size (ES) was calculated for each result and pooled using the recently developed inverse heterogeneity model. Two-tailed z -alpha values ≤0.05 and non-overlapping 95% CI were considered statistically significant. Heterogeneity was estimated using Q and I 2 with alpha values ≤0.10 for Q considered statistically significant. Small-study effects were examined using funnel plots and Egger's regression test. In addition, the number needed to treat (NNT), percentile improvement and meta-regression were conducted. Of the 639 citations screened, 14 studies representing 926 initially enrolled participants (539 exercise, 387 control) met the criteria for inclusion. Length of training (mean±SD) averaged 15.8±6.7 weeks, frequency 3.3±1.3 times per week and duration 28.8±14.3 min per session. Overall, statistically significant reductions in anxiety were found (exercise minus control changes ES=-0.40, 95% CI -0.65 to -0.15, tau 2 =0.14; Q=40.3, P=0.0004; I 2 =62.8%). The NNT was 6 with a percentile improvement of 15.5% and an estimated 5.3 million inactive US adults with AORD improving their anxiety if they started exercising regularly. Statistically significant small-study effects were observed (P<0.0001). Exercise is associated with reductions in anxiety among adults with selected types of AORD. However, a need exists for additional, well-designed, randomised controlled trials on this topic. CRD42016048728. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluation of the DoD Safety Program: DoD Civilian Safety Survey

DTIC Science & Technology

2008-12-12

DoD 2007 Letter) Leadership Participation 7(G), 14(N), 21( U ), 31(AE), 34(AH), 40(AN), 49(AW) Supervisor Participation 5(E), 12(L), 19(S), 24 (X), 28...Civilian scores were above the 50th percentile for 24 of the 50 survey items. Overall, this ranks the perception of civilian personnel as average; a...Please direct questions to Mr. Gregory D. Sampson at (703) 604-9104 (DSN 664-9104) or Mr. George P . Marquardt at (703) 604-9159 (DSN 664-9159

Evaluation of the DoD Safety Program: DoD Guard & Reserve Safety Survey

DTIC Science & Technology

2008-12-12

Alexandria,VA,22350-1500 8 . PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S... 8 -98) Prescribed by ANSI Std Z39-18 hot line D E PA R T M E N T O F D E F E N S E To report fraud, waste, mismanagement, and abuse of authority...Results 2007 Table 1 Percentile Scores, Percent Distribution of Responses, and Average Response Scores - 8 - sse oe LP oe sse SP LP SSA sse

BMI percentile curves for Chinese children aged 7-18 years, in comparison with the WHO and the US Centers for Disease Control and Prevention references.

PubMed

Ma, Jun; Wang, Zhiqiang; Song, Yi; Hu, Peijin; Zhang, Bing

2010-12-01

To establish BMI percentile curves that describe the contemporary BMI distribution among Chinese children, and to compare their BMI percentile curves with those in two recently developed international references: the WHO and the US Centers for Disease Control and Prevention (US CDC) growth references. A cross-sectional national survey. Thirty provinces, municipalities and autonomous regions in China. Nationally representative sample of 232 140 school students aged 7-18 years. BMI percentile curves were established using the LMS method, and were compared with the percentiles of the WHO and the US CDC references. BMI distributions and growth patterns in Chinese children were dramatically different from those in the two international reference populations. Compared with the international reference populations, younger Chinese boys (7-12 years of age) had higher values of the percentiles above the median and lower values of the percentiles below the median, suggesting that they had larger proportions of extreme BMI values in both directions. Chinese girls and older Chinese boys (15-18 years of age) had substantially lower BMI percentiles than their counterparts in the reference populations, particularly those high percentiles among older age groups. The present study described the unique patterns of BMI curves at the national level, and these curves are useful as a reference for comparing different regions and for monitoring changes over time in Chinese children. Higher proportions of children with extreme values in both directions indicate that China is currently facing both an increasing level of obesity and a high level of undernutrition, simultaneously.

Using BMI to Determine Cardiovascular Risk in Childhood: How Do the BMI Cutoffs Fare?

PubMed Central

Skinner, Asheley Cockrell; Mayer, Michelle L.; Flower, Kori; Perrin, Eliana M.; Weinberger, Morris

2010-01-01

OBJECTIVE Although adverse health outcomes are increased among children with BMI above the 85th (overweight) and 95th (obese) percentiles, previous studies have not clearly defined the BMI percentile at which adverse health outcomes begin to increase. We examined whether the existing BMI percentile cutoffs are optimal for defining increased risk for dyslipidemia, dysglycemia, and hypertension. METHODS This was a cross-sectional analysis of the National Health and Nutrition Examination Survey from 2001 to 2006. Studied were 8216 children aged 6 to 17 years, representative of the US population. BMI was calculated by using measured height and weight and converted to percentiles for age in months and gender. Outcome measures (dyslipidemia, dysglycemia, and hypertension) were based on laboratory and physical examination results; these were analyzed as both continuous and categorical outcomes. RESULTS Significant increases for total cholesterol values and prevalence of abnormal cholesterol begin at the 80th percentile. Significant increases in glycohemoglobin values and prevalence of abnormal values begin at the 99th percentile. Consistent significant increases in the prevalence of high or borderline systolic blood pressure begin at the 90th percentile. CONCLUSIONS Intervening for overweight children and their health requires clinical interventions that target the right children. On the basis of our data, a judicious approach to screening could include consideration of lipid screening for children beginning at the 80th percentile but for dysglycemia at the 99th percentile. Current definitions of overweight and obese may be more useful for general recognition of potential health problems and discussions with parents and children about the need to address childhood obesity. WHAT'S KNOWN ON THIS SUBJECT: Previous research has shown that cardiovascular risk factors are related to the currently used definitions of obesity in children but has not specified the BMI percentiles at which risk increases.WHAT THIS STUDY ADDS: Nationally representative data indicate greater risk for abnormal lipid values in children who are not considered overweight by current definitions, risk for diabetes only in very obese children, and risk for hypertension at the 90th percentile of BMI. PMID:19858150

Trends in precipitation and streamflow and changes in stream morphology in the Fountain Creek watershed, Colorado, 1939-99

USGS Publications Warehouse

Stogner, Sr., Robert W.

2000-01-01

The Fountain Creek watershed, located in and along the eastern slope of the Front Range section of the southern Rocky Mountains, drains approximately 930 square miles of parts of Teller, El Paso, and Pueblo Counties in eastern Colorado. Streamflow in the watershed is dominated by spring snowmelt runoff and storm runoff during the summer monsoon season. Flooding during the 1990?s has resulted in increased streambank erosion. Property loss and damage associated with flooding and bank erosion has cost area residents, businesses, utilities, municipalities, and State and Federal agencies millions of dollars. Precipitation (4 stations) and streamflow (6 stations) data, aerial photographs, and channel reconnaissance were used to evaluate trends in precipitation and streamflow and changes in channel morphology. Trends were evaluated for pre-1977, post-1976, and period-of-record time periods. Analysis revealed the lack of trend in total annual and seasonal precipitation during the pre-1977 time period. In general, the analysis also revealed the lack of trend in seasonal precipitation for all except the spring season during the post-1976 time period. Trend analysis revealed a significant upward trend in long-term (period of record) total annual and spring precipitation data, apparently due to a change in total annual precipitation throughout the Fountain Creek watershed. During the pre-1977 time period, precipitation was generally below average; during the post- 1976 time period, total annual precipitation was generally above average. During the post- 1976 time period, an upward trend in total annual and spring precipitation was indicated at two stations. Because two of four stations evaluated had upward trends for the post-1976 period and storms that produce the most precipitation are isolated convection storms, it is plausible that other parts of the watershed had upward precipitation trends that could affect trends in streamflow. Also, because of the isolated nature of convection storms that hit some areas of the watershed and not others, it is difficult to draw strong conclusions on relations between streamflow and precipitation. Trends in annual instantaneous peak streamflow, 70th percentile, 90th percentile, maximum daily-mean streamflow (100th percentile), 7-, 14-, and 30-day high daily-mean stream- flow duration, minimum daily-mean streamflow (0th percentile), 10th percentile, 30th percentile, and 7-, 14-, 30-day low daily-mean streamflow duration were evaluated. In general, instantaneous peak streamflow has not changed significantly at most of the stations evaluated. Trend analysis revealed the lack of a significant upward trend in streamflow at all stations for the pre-1977 time period. Trend tests indicated a significant upward trend in high and low daily-mean streamflow statistics for the post-1976 period. Upward trends in high daily-mean streamflow statistics may be an indication that changes in land use within the watershed have increased the rate and magnitude of runoff. Upward trends in low daily-mean 2 Trends in Precipitation and Streamflow and Changes in Stream Morphology in the Fountain Creek Watershed, Colorado, 1939-99 streamflow statistics may be related to changes in water use and management. An analysis of the relation between streamflow and precipitation indicated that changes in water management have had a marked effect on streamflow. Observable change in channel morphology and changes in distribution and density of vegetation varied with magnitude, duration, and frequency of large streamflow events, and increases in the magnitude and duration of low streamflows. Although more subtle, low stream- flows were an important component of day-to-day channel erosion. Substantial changes in channel morphology were most often associated with infrequent large or catastrophic streamflow events that erode streambed and banks, alter stream course, and deposit large amounts of sediment in the flood plain.

Determining Nurse Aide Staffing Requirements to Provide Care Based on Resident Workload: A Discrete Event Simulation Model.

PubMed

Schnelle, John F; Schroyer, L Dale; Saraf, Avantika A; Simmons, Sandra F

2016-11-01

Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs. This study had 2 primary objectives: (1) to describe the relationship between ADL workload and the level of nurse aide staffing reported by NHs; and, (2) to use a DES model to determine the relationship between ADL workload and nurse aide staffing necessary for consistent, timely ADL care. Minimum Data Set data related to the level of dependency on staff for ADL care for residents in over 13,500 NHs nationwide were converted into 7 workload categories that captured 98% of all residents. In addition, data related to the time to provide care for the ADLs within each workload category was used to calculate a workload score for each facility. The correlation between workload and reported nurse aide staffing levels was calculated to determine the association between staffing reported by NHs and workload. Simulations to project staffing requirements necessary to provide ADL care were then conducted for 65 different workload scenarios, which included 13 different nurse aide staffing levels (ranging from 1.6 to 4.0 total hours per resident day) and 5 different workload percentiles (ranging from the 5th to the 95th percentile). The purpose of the simulation model was to determine the staffing necessary to provide care within each workload percentile based on resident ADL care needs and compare the simulated staffing projections to the NH reported staffing levels. The percentage of scheduled care time that was omitted was estimated by the simulation model for each of the 65 workload scenarios using optimistic assumptions about staff productivity and efficiency. There was a low correlation between ADL workload and reported nurse aide staffing (Pearson = .11; P < .01), which suggests that most of the 13,500 NHs were not using ADL acuity to determine nurse aide staffing levels. Based on the DES model, the nurse aide staffing required for ADL care that would result in a rate of care omissions below 10% ranged from 2.8 hours/resident/day for NHs with a low workload (5th percentile) to 3.6 hours/resident/day for NHs with a high workload (95th percentile). In contrast, NHs reported staffing levels that ranged from an average of 2.3 to 2.5 hours/resident/day across all 5 workload percentiles. Higher workload NHs had the largest discrepancies between reported and predicted nurse aide staffing levels. The average nurse aide staffing levels reported by NHs falls below the level of staffing predicted as necessary to provide consistent ADL care to all residents in need. DES methodology can be used to determine nurse aide staffing requirements to provide ADL care and simulate management interventions to improve care efficiency and quality. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Reference intervals for plasma-free amino acid in a Japanese population.

PubMed

Yamamoto, Hiroyuki; Kondo, Kazuhiro; Tanaka, Takayuki; Muramatsu, Takahiko; Yoshida, Hiroo; Imaizumi, Akira; Nagao, Kenji; Noguchi, Yasushi; Miyano, Hiroshi

2016-05-01

Plasma amino acid concentrations vary with various diseases. Although reference intervals are useful in daily clinical practice, no reference intervals have been reported for plasma amino acids in a large Japanese population. Reference individuals were selected from 7685 subjects examined with the Japanese Ningen Dock in 2008. A total of 1890 individuals were selected based on exclusion criteria, and the reference samples were selected after the outlier samples for each amino acid concentration were excluded. The lower limit of the reference intervals for the plasma amino acid concentrations was set at the 2.5th percentile and the upper limit at the 97.5th percentile. By use of the nested analysis of variance, we analysed a large dataset of plasma samples and the effects of background factors (sex, age and body mass index [BMI]) on the plasma amino acid concentrations. Most amino acid concentrations were related to sex, especially those of branched-chained amino acid. The citrulline, glutamine, ornithine and lysine concentrations were related to age. The glutamate concentration was related to body mass index. The concentrations of most amino acids are more strongly related to sex than to age or body mass index. Our results indicate that the reference intervals for plasma amino acid concentrations should be stratified by sex when the background factors of age and body mass index are considered. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Development of a percentile based three-dimensional model of the buttocks in computer system

NASA Astrophysics Data System (ADS)

Wang, Lijing; He, Xueli; Li, Hongpeng

2016-05-01

There are diverse products related to human buttocks, which need to be designed, manufactured and evaluated with 3D buttock model. The 3D buttock model used in present research field is just simple approximate model similar to human buttocks. The 3D buttock percentile model is highly desired in the ergonomics design and evaluation for these products. So far, there is no research on the percentile sizing system of human 3D buttock model. So the purpose of this paper is to develop a new method for building three-dimensional buttock percentile model in computer system. After scanning the 3D shape of buttocks, the cloud data of 3D points is imported into the reverse engineering software (Geomagic) for the reconstructing of the buttock surface model. Five characteristic dimensions of the buttock are measured through mark-points after models being imported into engineering software CATIA. A series of space points are obtained by the intersecting of the cutting slices and 3D buttock surface model, and then are ordered based on the sequence number of the horizontal and vertical slices. The 1st, 5th, 50th, 95th, 99th percentile values of the five dimensions and the spatial coordinate values of the space points are obtained, and used to reconstruct percentile buttock models. This research proposes a establishing method of percentile sizing system of buttock 3D model based on the percentile values of the ischial tuberosities diameter, the distances from margin to ischial tuberosity and the space coordinates value of coordinate points, for establishing the Nth percentile 3D buttock model and every special buttock types model. The proposed method also serves as a useful guidance for the other 3D percentile models establishment for other part in human body with characteristic points.

Relationship between Urbanization and Cancer Incidence in Iran Using Quantile Regression.

PubMed

Momenyan, Somayeh; Sadeghifar, Majid; Sarvi, Fatemeh; Khodadost, Mahmoud; Mosavi-Jarrahi, Alireza; Ghaffari, Mohammad Ebrahim; Sekhavati, Eghbal

2016-01-01

Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (β=0.13, p-value<0.001), for colorectal cancer was in the 75th percentile (β=0.048, p-value<0.001), for prostate cancer the 95th percentile (β=0.55, p-value<0.001), for lung cancer was in 95th percentile (β=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (β=0.011, p-value<0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(β=0.003, p-value<0.001), for esophageal cancer the 95th (β=0.04, p-value=0.4) and for skin cancer also the 95th (β=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made.

Emotion Awareness Predicts Body Mass Index Percentile Trajectories in Youth.

PubMed

Whalen, Diana J; Belden, Andy C; Barch, Deanna; Luby, Joan

2015-10-01

To examine the rate of change in body mass index (BMI) percentile across 3 years in relation to emotion identification ability and brain-based reactivity in emotional processing regions. A longitudinal sample of 202 youths completed 3 functional magnetic resonance imaging-based facial processing tasks and behavioral emotion differentiation tasks. We examined the rate of change in the youth's BMI percentile as a function of reactivity in emotional processing brain regions and behavioral emotion identification tasks using multilevel modeling. Lower correct identification of both happiness and sadness measured behaviorally predicted increases in BMI percentile across development, whereas higher correct identification of both happiness and sadness predicted decreases in BMI percentile, while controlling for children's pubertal status, sex, ethnicity, IQ score, exposure to antipsychotic medication, family income-to-needs ratio, and externalizing, internalizing, and depressive symptoms. Greater neural activation in emotional reactivity regions to sad faces also predicted increases in BMI percentile during development, also controlling for the aforementioned covariates. Our findings provide longitudinal developmental data demonstrating links between both emotion identification ability and greater neural reactivity in emotional processing regions with trajectories of BMI percentiles across childhood. Copyright © 2015 Elsevier Inc. All rights reserved.

Selective upregulation of endothelin B receptor gene expression in severe pulmonary hypertension.

PubMed

Bauer, Michael; Wilkens, Heinrike; Langer, Frank; Schneider, Sven O; Lausberg, Henning; Schäfers, Hans-Joachim

2002-03-05

The pulmonary circulation is an important site for the production and clearance of endothelin (ET)-1, a potent vasoactive and mitogenic peptide. Increased plasma ET-1 levels are observed in pulmonary arterial hypertension (PHT) and may contribute to the regulation of pulmonary vascular resistance, as well as to proliferative changes in the pulmonary vascular bed. We prospectively assessed changes in plasma big ET-1 levels and changes in ET(A) and ET(B) receptor gene expression in 14 consecutive patients undergoing pulmonary thromboendarterectomy for thromboembolic PHT. Plasma big ET-1 levels were higher in patients with PHT (median, 2.2 pg/mL; 25th to 75th percentile, 1.5 to 3.0 pg/mL) compared with age-matched controls (median, 1.2 pg/mL; 25th to 75th percentile, 1.0 to 1.4 pg/mL; P=0.002). In addition to increased plasma big ET-1 levels, selective upregulation of ET(B) receptor mRNA transcripts and immunoreactive protein in the pulmonary artery was observed in the patients; however, ET(A) receptor gene expression was unaffected. These data suggest that changes in the ET signaling system in PHT caused by thromboembolic disease are not limited to an increased production of ET-1: they also affect ET receptor gene expression.

Reference intervals and percentiles for carotid-femoral pulse wave velocity in a healthy population aged between 9 and 87 years.

PubMed

Diaz, Alejandro; Zócalo, Yanina; Bia, Daniel; Wray, Sandra; Fischer, Edmundo Cabrera

2018-04-01

There is little information regarding age-related reference intervals (RIs) of carotid-femoral pulse wave velocity (cfPWV) for large healthy populations in South America. The aims of this study were to determine cfPWV RIs and percentiles in a cohort of healthy children, adolescents, and adults and to generate year-to-year percentile curves and body-height percentile curves for children and adolescents. cfPWV was measured in 1722 healthy participants with no cardiovascular risk factors (9-87 years, 60% men). First, RIs were evaluated for males and females through correlation and covariate analysis. Then, mean and standard deviation age-related equations were obtained for cfPWV using parametric regression methods based on fractional polynomials and age-specific (year-to-year) percentile curves that were defined using the standard normal distribution. Age-specific first, 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97.5th, and 99th percentile curves were calculated. Finally, height-related cfPWV percentile curves for children and adolescents (<21 years) were established. After adjusting for age and blood pressure differences with respect to females, males showed higher cfPWV levels (6.60 vs 6.45 m/s; P < .01). Thus, specific RIs for males and females were reported. The study provides the largest database to date concerning cfPWV in healthy people from Argentina. Specific RIs and percentiles of cfPWV are now available according to age and sex. Specific percentiles of cfPWV according to body height were reported for people younger than 21 years. ©2018 Wiley Periodicals, Inc.

Biomechanics of volunteers subject to loading by a motorized shoulder belt tensioner.

PubMed

Good, Craig A; Viano, David C; Ronsky, Janet L

2008-04-15

A biomechanical study using human volunteers. Motorized shoulder belt tensioning is a new seatbelt technology that is likely to be incorporated into future vehicles. The objective of this study was to characterize the upper torso biomechanics of 3 sizes of adult volunteers (5th percentile female, 50th percentile male, and 95th percentile male) subjected to motorized shoulder belt tensioning in the static environment. There is a lack of volunteer data concerning the biomechanics of occupants subject to motorized precrash shoulder belt tensioning. Studies of torso repositioning by the air force for ejection seats are much too aggressive to be relevant to motorized systems. Low-level motorized shoulder belt tensioning is well tolerated by vehicle occupants but optimized performance by occupant size is unknown. Nineteen male and 6 female subjects were instrumented in a fixture designed to support the occupant leaning forward and apply seatbelt tension. The subjects were 5th percentile females, 50th percentile males, and 95th percentile males. Reflective markers were placed on the subjects to monitor torso kinematics during tensioning. Changes in spinal curvature were small during shoulder belt tensioning and the angular motion of the torso originated within 4.2 cm of the pelvis-femur junction or H-point. Torso repositioning and retraction timing was found to be: 54.3 degrees in 0.78 seconds for the 5th percentile female, 57.6 degrees in 0.95 seconds for the 50th percentile male, and 42.2 degrees in 0.92 seconds for the 95th percentile male. Occupant size has a significant effect on retraction time to reposition the torso during shoulder belt tensioning. Larger vehicle occupants require more time because of a slower retraction velocity. The results are sufficiently simple that a lumped-mass model can predict tensioning kinetics.

Cold-related mortality vs heat-related mortality in a changing climate: A case study in Vilnius (Lithuania).

PubMed

Martinez, Gerardo Sanchez; Diaz, Julio; Hooyberghs, Hans; Lauwaet, Dirk; De Ridder, Koen; Linares, Cristina; Carmona, Rocio; Ortiz, Cristina; Kendrovski, Vladimir; Adamonyte, Dovile

2018-06-21

Direct health effects of extreme temperatures are a significant environmental health problem in Lithuania, and could worsen further under climate change. This paper attempts to describe the change in environmental temperature conditions that the urban population of Vilnius could experience under climate change, and the effects such change could have on excess heat-related and cold-related mortality in two future periods within the 21st century. We modelled the urban climate of Vilnius for the summer and winter seasons during a sample period (2009-2015) and projected summertime and wintertime daily temperatures for two prospective periods, one in the near (2030-2045) and one in the far future (2085-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the historical relationship between temperature and mortality for the period 2009-2015, and estimated the projected mortality in the near future and far future periods under a changing climate and population, assuming alternatively no acclimatisation and acclimatisation to heat and cold based on a constant-percentile threshold temperature. During the sample period 2009-2015 in summertime we observed an increase in daily mortality from a maximum daily temperature of 30 °C (the 96th percentile of the series), with an average of around 7 deaths per year. Under a no acclimatisation scenario, annual average heat-related mortality would rise to 24 deaths/year (95% CI: 8.4-38.4) in the near future and to 46 deaths/year (95% CI: 16.4-74.4) in the far future. Under a heat acclimatisation scenario, mortality would not increase significantly in the near or in the far future. Regarding wintertime cold-related mortality in the sample period 2009-2015, we observed increased mortality on days on which the minimum daily temperature fell below - 12 °C (the 7th percentile of the series), with an average of around 10 deaths a year. Keeping the threshold temperature constant, annual average cold-related mortality would decrease markedly in the near future, to 5 deaths/year (95% CI: 0.8-7.9) and even more in the far future, down to 0.44 deaths/year (95% C: 0.1-0.8). Assuming a "middle ground" between the acclimatisation and non-acclimatisation scenarios, the decrease in cold-related mortality will not compensate the increase in heat-related mortality. Thermal extremes, both heat and cold, constitute a serious public health threat in Vilnius, and in a changing climate the decrease in mortality attributable to cold will not compensate for the increase in mortality attributable to heat. Study results reinforce the notion that public health prevention against thermal extremes should be designed as a dynamic, adaptive process from the inception. Copyright © 2018 Elsevier Inc. All rights reserved.

Alternative Statistical Frameworks for Student Growth Percentile Estimation

ERIC Educational Resources Information Center

Lockwood, J. R.; Castellano, Katherine E.

2015-01-01

This article suggests two alternative statistical approaches for estimating student growth percentiles (SGP). The first is to estimate percentile ranks of current test scores conditional on past test scores directly, by modeling the conditional cumulative distribution functions, rather than indirectly through quantile regressions. This would…

Effect of vitamin D supplementation on selected inflammatory biomarkers in older adults: a secondary analysis of data from a randomised, placebo-controlled trial.

PubMed

Waterhouse, Mary; Tran, Bich; Ebeling, Peter R; English, Dallas R; Lucas, Robyn M; Venn, Alison J; Webb, Penelope M; Whiteman, David C; Neale, Rachel E

2015-09-14

Observational studies have suggested that 25-hydroxyvitamin D (25(OH)D) levels are associated with inflammatory markers. Most trials reporting significant associations between vitamin D intake and inflammatory markers used specific patient groups. Thus, we aimed to determine the effect of supplementary vitamin D using secondary data from a population-based, randomised, placebo-controlled, double-blind trial (Pilot D-Health trial 2010/0423). Participants were 60- to 84-year-old residents of one of the four eastern states of Australia. They were randomly selected from the electoral roll and were randomised to one of three trial arms: placebo (n 214), 750 μg (n 215) or 1500 μg (n 215) vitamin D3, each taken once per month for 12 months. Post-intervention blood samples for the analysis of C-reactive protein (CRP), IL-6, IL-10, leptin and adiponectin levels were available for 613 participants. Associations between intervention group and biomarker levels were evaluated using quantile regression. There were no statistically significant differences in distributions of CRP, leptin, adiponectin, leptin:adiponectin ratio or IL-10 levels between the placebo group and either supplemented group. The 75th percentile IL-6 level was 2·8 pg/ml higher (95 % CI 0·4, 5·8 pg/ml) in the 1500 μg group than in the placebo group (75th percentiles:11·0 v. 8·2 pg/ml), with a somewhat smaller, non-significant difference in 75th percentiles between the 750 μg and placebo groups. Despite large differences in serum 25(OH)D levels between the three groups after 12 months of supplementation, we found little evidence of an effect of vitamin D supplementation on cytokine or adipokine levels, with the possible exception of IL-6.

Trend Estimates of AERONET-Observed and Model-Simulated AOTs Between 1993 and 2013

NASA Technical Reports Server (NTRS)

Yoon, J.; Pozzer, A.; Chang, D. Y.; Lelieveld, J.; Kim, J.; Kim, M.; Lee, Y. G.; Koo, J.-H.; Lee, J.; Moon, K. J.

2015-01-01

Recently, temporal changes in Aerosol Optical Thickness (AOT) have been investigated based on model simulations, satellite and ground-based observations. Most AOT trend studies used monthly or annual arithmetic means that discard details of the generally right-skewed AOT distributions. Potentially, such results can be biased by extreme values (including outliers). This study additionally uses percentiles (i.e., the lowest 5%, 25%, 50%, 75% and 95% of the monthly cumulative distributions fitted to Aerosol Robotic Network (AERONET)-observed and ECHAM/MESSy Atmospheric Chemistry (EMAC)-model simulated AOTs) that are less affected by outliers caused by measurement error, cloud contamination and occasional extreme aerosol events. Since the limited statistical representativeness of monthly percentiles and means can lead to bias, this study adopts the number of observations as a weighting factor, which improves the statistical robustness of trend estimates. By analyzing the aerosol composition of AERONET-observed and EMAC-simulated AOTs in selected regions of interest, we distinguish the dominant aerosol types and investigate the causes of regional AOT trends. The simulated and observed trends are generally consistent with a high correlation coefficient (R = 0.89) and small bias (slope+/-2(sigma) = 0.75 +/- 0.19). A significant decrease in EMAC-decomposed AOTs by water-soluble compounds and black carbon is found over the USA and the EU due to environmental regulation. In particular, a clear reversal in the AERONET AOT trend percentiles is found over the USA, probably related to the AOT diurnal cycle and the frequency of wildfires. In most of the selected regions of interest, EMAC-simulated trends are mainly attributed to the significant changes of the dominant aerosols; e.g., significant decrease in sea salt and water soluble compounds over Central America, increase in dust over Northern Africa and Middle East, and decrease in black carbon and organic carbon over Australia.

Novel Equations to Estimate Lean Body Mass in Maintenance Hemodialysis Patients

PubMed Central

Noori, Nazanin; Kovesdy, Csaba P; Bross, Rachelle; Lee, Martin; Oreopoulos, Antigone; Benner, Deborah; Mehrotra, Rajnish; Kopple, Joel D; Kalantar-Zadeh, Kamyar

2010-01-01

Background Lean body mass (LBM) is an important nutritional measure representing muscle mass and somatic protein in hemodialysis patients, in whom we developed and tested equations to estimate LBM. Study Design A study of diagnostic test accuracy. Setting and Participants The development cohort included 118 hemodialysis patients, with LBM measured using dual-energy -X-ray absorptiometry (DEXA) and near-infrared (NIR) interactance. The validation cohort included 612 additional hemodialysis patients with LBM measured using portable NIR interactance technique during hemodialysis. Index Tests 3-month averaged serum concentrations of creatinine, albumin and prealbumin, normalized protein-nitrogen-appearance, mid-arm muscle circumference (MAMC), handgrip strength, and subjective global assessment of nutrition. Reference Test LBM measured via DEXA in the development cohort and via NIR interactance in validation cohorts. Results In the development cohort, DEXA and NIR interactance were strongly correlated (r=0.94, p<0.001). DEXA-measured LBM correlated with serum creatinine, MAMC, handgrip strength but not with other nutritional markers. Three regression equations to estimate DEXA-measured LBM were developed based on each of these three surrogates and gender, height, weight, and age (and urea reduction ratio for the serum creatinine regression). In the validation cohort, the validity of the equations were tested against the NIR interactance measured LBM. The equation estimates correlated well with NIR interactance measured LBM (R221 ≥0.88), although in higher LBM ranges they tended to underestimate it. Median differences between equation estimates and NIR interactance-measured LBM were 3.4 (25th–75th percentile, −3.2 to 12.0) and 3.0 (25th–75th percentile, 1.1–5.1) kg for serum creatinine and 4.0 (25th–75th percentile, −2.6 to 13.6) and 3.7 (25th–75th percentile, 1.3–6.0) kg for MAMC. Limitations DEXA measurements were performed on a non-dialysis day whereas NIR interactance was obtained during the hemodialysis treatment, with likelihood of confounding by volume status variations. Conclusions Comparing to reference measures of LBM, equations using serum creatinine, MAMC, or handgrip strength and demographic variables can accurately estimate LBM in long-term hemodialysis patients. PMID:21184920

Effects of prenatal exposure to air pollution on preeclampsia in Shenzhen, China.

PubMed

Wang, Qiong; Zhang, Huanhuan; Liang, Qianhong; Knibbs, Luke D; Ren, Meng; Li, Changchang; Bao, Junzhe; Wang, Suhan; He, Yiling; Zhu, Lei; Wang, Xuemei; Zhao, Qingguo; Huang, Cunrui

2018-06-01

The impact of ambient air pollution on pregnant women is a concern in China. However, little is known about the association between air pollution and preeclampsia and the potential modifying effects of meteorological conditions have not been assessed. This study aimed to assess the effects of prenatal exposure to air pollution on preeclampsia, and to explore whether temperature and humidity modify the effects. We performed a retrospective cohort study based on 1.21 million singleton births from the birth registration system in Shenzhen, China, between 2005 and 2012. Daily average measurements of particulate matter <10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), air temperature (T), and dew point (T d ) were collected. Logistic regression models were performed to estimate associations between air pollution and preeclampsia during the first and second trimesters, and during the entire pregnancy. In each time window, we observed a positive gradient of increasing preeclampsia risk with increasing quartiles of PM 10 and SO 2 exposure. When stratified by T and T d in three categories (<5th, 5th -95th, and >95th percentile), we found a significant interaction between PM 10 and T d on preeclampsia; the adverse effects of PM 10 increased with T d . During the entire pregnancy, there was a null association between PM 10 and preeclampsia under T d  < 5th percentile. Preeclampsia risk increased by 23% (95% CI: 19-26%) when 5th < T d  < 95th percentile, and by 34% (16-55%) when T d  > 95th percentile. We also found that air pollution effects on preeclampsia in autumn/winter seasons were stronger than those in the spring/summer. This is the first study to address modifying effects of meteorological factors on the association between air pollution and preeclampsia. Findings indicate that prenatal exposure to PM 10 and SO 2 increase preeclampsia risk in Shenzhen, China, and the effects could be modified by humidity. Pregnant women should limit air pollution exposure, particularly during humid periods. Copyright © 2018 Elsevier Ltd. All rights reserved.

Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario.

PubMed

Kreder, Hans J; Grosso, Paul; Williams, Jack I; Jaglal, Susan; Axcell, Tami; Wal, Eugene K; Stephen, David J G

2003-02-01

Because of rationing of the limited pool of health care resources, access to total knee arthroplasty (TKA) is limited, but investigation of variables that predict complications, length of hospital stay, cost and outcomes of TKA may allow us to optimize the available resources. The objective of this study was to examine the effect of various factors on complication rates after TKA in patients managed in Ontario. Patients who had undergone an elective TKA between 1993 and 1996, as captured in the Canadian Institute for Health Information (CIHI) database, formed the study cohort. The CIHI dataset was used to obtain information regarding in-hospital complications, hospital length of stay, revision rates, infection rates and mortality. Generalized estimating linear or logistic regression equations were used to model outcomes as a function of age, gender, comorbidity, diagnosis and provider volume. During the study period, 14,352 patients in Ontario underwent TKA. Mortality at 3 months was associated with patient age, gender and comorbidity. There was no association between provider volume and mortality or the infection rate. Higher revision rates at 1 and 3 years were significantly associated with lower patient age and low hospital volume (p < 0.05). Hospitals in which fewer than 48 TKA procedures were done per year (< 40th percentile) had 2.2-fold greater 1-year revision rates than hospitals performing more than 113 TKAs annually (> 80th percentile). Complications during admission were associated with increased patient age and comorbidity, and higher hospital volume. Longer hospital stay was associated with female gender, increasing patient comorbidity and age, and lower provider volume. Surgeons who performed fewer than 14 TKAs annually (< 40th percentile) kept patients in hospital an average of 1.4 days longer than surgeons performing more than 42 TKAs annually (> 80th percentile). Patient variables significantly affect the rate of complications. Age, sex and comorbidity were significant predictors of complications, length of hospital stay and mortality after TKA. Although low surgeon volume was related to longer hospital stay, there was no association between surgeon volume and complication rates. The increased early revision rate for low-volume hospitals demands further study.

Quantifying home range habitat requirements for bobcats (Lynx rufus) in Vermont, USA

USGS Publications Warehouse

Donovan, Therese; Freeman, Mark; Abouelezz, Hanem; Royar, Kim; Howard, Alan D.; Mickey, R.

2011-01-01

We demonstrate how home range and habitat use analysis can inform landscape-scale conservation planning for the bobcat, Lynx rufus, in Vermont USA. From 2005 to 2008, we outfitted fourteen bobcats with GPS collars that collected spatially explicit locations from individuals every 4 h for 3–4 months. Kernel home range techniques were used to estimate home range size and boundaries, and to quantify the utilization distribution (UD), which is a spatially explicit, topographic mapping of how different areas within the home range are used. We then used GIS methods to quantify both biotic (e.g. habitat types, stream density) and abiotic (e.g. slope) resources within each bobcat’s home range. Across bobcats, upper 20th UD percentiles (core areas) had 18% less agriculture, 42% less development, 26% more bobcat habitat (shrub, deciduous, coniferous forest, and wetland cover types), and 33% lower road density than lower UD percentiles (UD valleys). For each bobcat, we used Akaike’s Information Criterion (AIC) to evaluate and compare 24 alternative Resource Utilization Functions (hypotheses) that could explain the topology of the individual’s UD. A model-averaged population-level Resource Utilization Function suggested positive responses to shrub, deciduous, coniferous forest, and wetland cover types within 1 km of a location, and negative responses to roads and mixed forest cover types within 1 km of a location. Applying this model-averaged function to each pixel in the study area revealed habitat suitability for bobcats across the entire study area, with suitability scores ranging between −1.69 and 1.44, where higher values were assumed to represent higher quality habitat. The southern Champlain Valley, which contained ample wetland and shrub habitat, was a concentrated area of highly suitable habitat, while areas at higher elevation areas were less suitable. Female bobcat home ranges, on average, had an average habitat suitability score of near 0, indicating that home ranges consisted of both beneficial and detrimental habitat types. We discuss the application of habitat suitability mapping and home range requirements for bobcat conservation and landscape scale management.

Quantifying home range habitat requirements for bobcats (Lynx rufus) in Vermont, USA

USGS Publications Warehouse

Donovan, T.M.; Freeman, M.; Abouelezz, H.; Royar, Kim; Howard, A.; Mickey, R.

2011-01-01

We demonstrate how home range and habitat use analysis can inform landscape-scale conservation planning for the bobcat, Lynx rufus, in Vermont USA. From 2005 to 2008, we outfitted fourteen bobcats with GPS collars that collected spatially explicit locations from individuals every 4. h for 3-4. months. Kernel home range techniques were used to estimate home range size and boundaries, and to quantify the utilization distribution (UD), which is a spatially explicit, topographic mapping of how different areas within the home range are used. We then used GIS methods to quantify both biotic (e.g. habitat types, stream density) and abiotic (e.g. slope) resources within each bobcat's home range. Across bobcats, upper 20th UD percentiles (core areas) had 18% less agriculture, 42% less development, 26% more bobcat habitat (shrub, deciduous, coniferous forest, and wetland cover types), and 33% lower road density than lower UD percentiles (UD valleys). For each bobcat, we used Akaike's Information Criterion (AIC) to evaluate and compare 24 alternative Resource Utilization Functions (hypotheses) that could explain the topology of the individual's UD. A model-averaged population-level Resource Utilization Function suggested positive responses to shrub, deciduous, coniferous forest, and wetland cover types within 1. km of a location, and negative responses to roads and mixed forest cover types within 1. km of a location. Applying this model-averaged function to each pixel in the study area revealed habitat suitability for bobcats across the entire study area, with suitability scores ranging between -1.69 and 1.44, where higher values were assumed to represent higher quality habitat. The southern Champlain Valley, which contained ample wetland and shrub habitat, was a concentrated area of highly suitable habitat, while areas at higher elevation areas were less suitable. Female bobcat home ranges, on average, had an average habitat suitability score of near 0, indicating that home ranges consisted of both beneficial and detrimental habitat types. We discuss the application of habitat suitability mapping and home range requirements for bobcat conservation and landscape scale management. ?? 2011.

Overweight/obesity and gastric fluid characteristics in pediatric day surgery: implications for fasting guidelines and pulmonary aspiration risk.

PubMed

Cook-Sather, Scott D; Gallagher, Paul R; Kruge, Lydia E; Beus, Jonathan M; Ciampa, Brian P; Welch, Kevin Conor; Shah-Hosseini, Sina; Choi, Jieun S; Pachikara, Reshma; Minger, Kim; Litman, Ronald S; Schreiner, Mark S

2009-09-01

The safety of 2-h preoperative clear liquid fasts has not been established for overweight/obese pediatric day surgical patients. Healthy children and obese adults who fasted 2 h have small residual gastric fluid volumes (GFVs), which are thought to reflect low pulmonary aspiration risk. We sought to measure the prevalence of overweight/obesity in our day surgery population. We hypothesized that neither body mass index (BMI) percentile nor fasting duration would significantly affect GFV or gastric fluid pH. In children who were allowed clear liquids up until 2 h before surgery, we hypothesized that overweight/obese subjects would not have increased GFV over lean/normal subjects and that emesis/pulmonary aspiration events would be rare. Demographics, medical history, height, and weight were recorded for 1000 consecutive day surgery patients aged 2-12 yr. In addition, 1000 day surgery patients (age 2-12 yr) undergoing general endotracheal anesthesia were enrolled. After tracheal intubation, a 14-18F orogastric tube was inserted and gastric contents evacuated. Medications, fasting interval, GFV, pH, and emetic episodes were documented. Age- and gender-specific Center for Disease Control and Prevention growth charts (2000) were used to determine ideal body weight (IBW = 50th percentile) and to classify patients as lean/normal (BMI 25th-75th percentile), overweight (BMI > or = 85th to <95th percentile), or obese (BMI > or = 95th percentile). Of all day surgery patients, 14.0% were overweight and 13.3% were obese. Obese children had lower GFV per total body weight (P < 0.001). When corrected for IBW, however, volumes GFV(IBW) were identical across all BMI categories (mean 0.96 mL/kg, sd 0.71; median 0.86 mL/kg, IQR 0.96). Preoperative acetaminophen and midazolam contributed to increased GFV(IBW) (P = 0.025 and P = 0.001). Lower GFV(IBW) was associated with ASA physical status III (P = 0.024), male gender (P = 0.012), gastroesophageal reflux disease (P = 0.049), and proton pump inhibitor administration (P = 0.018). GFV(IBW) did not correlate with fasting duration or age. Decreased gastric fluid acidity was associated with younger age (P = 0.005), increased BMI percentile (P = 0.036), and African American race (P = 0.033). Emesis on induction occurred in eight patients (50% of whom were obese, P = 0.052, and 75% of whom had obstructive sleep apnea, P = 0.061). Emesis was associated with increased ASA physical status (P = 0.006) but not with fasting duration. There were no pulmonary aspiration events. Twenty-seven percent of pediatric day surgery patients are overweight/obese. These children may be allowed clear liquids 2 h before surgery as GFV(IBW) averages 1 mL/kg regardless of BMI and fasting interval. Rare emetic episodes were not associated with shortened fasting intervals in this population.

Discrepancy in fetal head biometry between ultrasound and MRI in suspected microcephalic fetuses.

PubMed

Yaniv, Gal; Katorza, Eldad; Tsehmaister Abitbol, Vered; Eisenkraft, Arik; Bercovitz, Ronen; Bader, Salim; Hoffmann, Chen

2017-12-01

Background Microcephaly is one of the most common fetal structural abnormalities, and prenatal microcephaly is considered a group I malformation of cortical development diagnosed according to ultrasound (US) skull measurements. Purpose To evaluate the agreement between fetal head US and magnetic resonance imaging (MRI) biometric measurements of suspected microcephalic fetuses. Material and Methods This institutional review board-approved retrospective study with waived informed consent included 180 pregnant women and was conducted at our medical center from March 2011 to April 2013. Biparietal diameter (BPD) and occipitofrontal diameter (OFD) results of fetal head US normograms were compared to normograms for MRI. We used Pearson and Spearman rho non-parametric correlation coefficients to assess the association between two quantitative variables, paired t-test for paired quantitative variables, and McNemar test for paired qualitative variables. Results The average BPD but not the average OFD percentiles in fetal head US differed significantly from the MRI results ( P < 0.0001). When looking at the accepted microcephaly threshold, both BPD and OFD percentiles differed significantly from MRI ( P < 0.0001 and P < 0.004, respectively). There was no correlation between US-measured skull biometry and MRI-measured brain biometry. Estimated cerebrospinal fluid volumes were significantly lower in the study group compared to 120 fetuses with normal findings in prenatal head US and MRI. Also, we have created a MRI-based normogram of fetal head circumference and gestational age. Conclusion The diagnosis of microcephaly by US alone may be insufficient and ideally should be validated by MRI before a final diagnosis is established.

Comparison of Indoor Mercury Vapor in Common Areas of Residential Buildings with Outdoor Levels in a Community Where Mercury Is Used for Cultural Purposes

PubMed Central

Garetano, Gary; Gochfeld, Michael; Stern, Alan H.

2006-01-01

Elemental mercury has been imbued with magical properties for millennia, and various cultures use elemental mercury in a variety of superstitious and cultural practices, raising health concerns for users and residents in buildings where it is used. As a first step in assessing this phenomenon, we compared mercury vapor concentration in common areas of residential buildings versus outdoor air, in two New Jersey cities where mercury is available and is used in cultural practices. We measured mercury using a portable atomic absorption spectrometer capable of quantitative measurement from 2 ng/m3 mercury vapor. We evaluated the interior hallways in 34 multifamily buildings and the vestibule in an additional 33 buildings. Outdoor mercury vapor averaged 5 ng/m3; indoor mercury was significantly higher (mean 25 ng/m3; p < 0.001); 21% of buildings had mean mercury vapor concentration in hallways that exceeded the 95th percentile of outdoor mercury vapor concentration (17 ng/m3), whereas 35% of buildings had a maximum mercury vapor concentration that exceeded the 95th percentile of outdoor mercury concentration. The highest indoor average mercury vapor concentration was 299 ng/m3, and the maximum point concentration was 2,022 ng/m3. In some instances, we were able to locate the source, but we could not specifically attribute the elevated levels of mercury vapor to cultural use or other specific mercury releases. However, these findings provide sufficient evidence of indoor mercury source(s) to warrant further investigation. PMID:16393659

Head impacts in a junior rugby league team measured with a wireless head impact sensor: an exploratory analysis.

PubMed

King, Doug; Hume, Patria; Gissane, Conor; Clark, Trevor

2017-01-01

OBJECTIVE The aim of this study was to investigate the frequency, magnitude, and distribution of head impacts sustained by players in a junior rugby league over a season of matches. METHODS The authors performed a prospective cohort analysis of impact magnitude, frequency, and distribution on data collected with instrumented XPatches worn behind the ear of players in an "under-11" junior rugby league team (players under 11 years old). RESULTS A total of 1977 impacts were recorded. Over the course of the study, players sustained an average of 116 impacts (average of 13 impacts per player per match). The measured linear acceleration ranged from 10g to 123g (mean 22g, median 16g, and 95th percentile 57g). The rotational acceleration ranged from 89 rad/sec 2 to 22,928 rad/sec 2 (mean 4041 rad/sec 2 , median 2773 rad/sec 2 , and 95th percentile 11,384 rad/sec 2 ). CONCLUSIONS The level of impact severity based on the magnitude of impacts for linear and rotational accelerations recorded was similar to the impacts reported in studies of American junior and high school football, collegiate football, and youth ice hockey players, but the players in the rugby league cohort were younger, had less body mass, and played at a slower speed than the American players. Junior rugby league players are required to tackle the player to the ground and use a different tackle technique than that used in American football, likely increasing the rotational accelerations recorded at the head.

Head impact exposure in youth football: middle school ages 12-14 years.

PubMed

Daniel, Ray W; Rowson, Steven; Duma, Stefan M

2014-09-01

The head impact exposure experienced by football players at the college and high school levels has been well documented; however, there are limited data regarding youth football despite its dramatically larger population. The objective of this study was to investigate head impact exposure in middle school football. Impacts were monitored using a commercially available accelerometer array installed inside the helmets of 17 players aged 12-14 years. A total of 4678 impacts were measured, with an average (±standard deviation) of 275 ± 190 impacts per player. The average of impact distributions for each player had a median impact of 22 ± 2 g and 954 ± 122 rad/s², and a 95th percentile impact of 54 ± 9 g and 2525 ± 450 rad/s². Similar to the head impact exposure experienced by high school and collegiate players, these data show that middle school football players experience a greater number of head impacts during games than practices. There were no significant differences between median and 95th percentile head acceleration magnitudes experienced during games and practices; however, a larger number of impacts greater than 80 g occurred during games than during practices. Impacts to the front and back of the helmet were most common. Overall, these data are similar to high school and college data that have been collected using similar methods. These data have applications toward youth football helmet design, the development of strategies designed to limit head impact exposure, and child-specific brain injury criteria.

Driver speed selection on high-speed two-lane highways: Comparing speed profiles between uniform and differential speed limits.

PubMed

Russo, Brendan J; Savolainen, Peter T; Gates, Timothy J; Kay, Jonathan J; Frazier, Sterling

2017-07-04

Although a considerable amount of prior research has investigated the impacts of speed limits on traffic safety and operations, much of this research, and nearly all of the research related to differential speed limits, has been specific to limited access freeways. The unique safety and operational issues on highways without access control create difficulty relating the conclusions from prior freeway-related speed limit research to 2-lane highways, particularly research on differential limits due to passing limitations and subsequent queuing. Therefore, the objective of this study was to assess differences in driver speed selection with respect to the posted speed limit on rural 2-lane highways, with a particular emphasis on the differences between uniform and differential speed limits. Data were collected from nearly 59,000 vehicles across 320 sites in Montana and 4 neighboring states. Differences in mean speeds, 85th percentile speeds, and the standard deviation in speeds for free-flowing vehicles were examined across these sites using ordinary least squares regression models. Ultimately, the results of the analysis show that the mean speed, 85th percentile speed, and variability in travel speeds for free-flowing vehicles on 2-lane highways are generally lower at locations with uniform 65 mph speed limits, compared to locations with differential limits of 70 mph for cars and 60 mph for trucks. In addition to posted speed limits, several site characteristics were shown to influence speed selection including shoulder widths, frequency of horizontal curves, percentage of the segment that included no passing zones, and hourly volumes. Differences in vehicle speed characteristics were also observed between states, indicating that speed selection may also be influenced by local factors, such as driver population or enforcement.

How to estimate exposure when studying the temperature-mortality relationship? A case study of the Paris area.

PubMed

Schaeffer, Laura; de Crouy-Chanel, Perrine; Wagner, Vérène; Desplat, Julien; Pascal, Mathilde

2016-01-01

Time series studies assessing the effect of temperature on mortality generally use temperatures measured by a single weather station. In the Paris region, there is a substantial measurement network, and a variety of exposure indicators created from multiple stations can be tested. The aim of this study is to test the influence of exposure indicators on the temperature-mortality relationship in the Paris region. The relationship between temperature and non-accidental mortality was assessed based on a time series analysis using Poisson regression and a generalised additive model. Twenty-five stations in Paris and its three neighbouring departments were used to create four exposure indicators. These indicators were (1) the temperature recorded by one reference station, (2) a simple average of the temperatures of all stations, (3) an average weighted on the departmental population and (4) a classification of the stations based on land use and an average weighted on the population in each class. The relative risks and the Akaike criteria were similar for all the exposure indicators. The estimated temperature-mortality relationship therefore did not appear to be significantly affected by the indicator used, regardless of study zone (departments or region) or age group. The increase in temperatures from the 90(th) to the 99(th) percentile of the temperature distribution led to a significant increase in mortality over 75 years (RR = 1.10 [95% CI, 1.07; 1.14]). Conversely, the decrease in temperature between the 10(th) and 1(st) percentile had a significant effect on the mortality under 75 years (RR = 1.04 [95% CI, 1.01; 1.06]). In the Paris area, there is no added value in taking multiple climatic stations into account when estimating exposure in time series studies. Methods to better represent the subtle temperature variations in densely populated areas in epidemiological studies are needed.

[Evaluation of the nutrition mode in children during the pubertal period with BMI < or = 5 percentile in the city of Szczecin].

PubMed

Goluch-Koniuszy, Zuzanna

2010-01-01

This research was aimed at evaluation of the method of nutrition in the children aged 13 during the period of pubertal spurt who had their body mass, body weight and this values led to calculation of BMI indicator which was related to centile distribution of children from Warszawa. From the group 1464 children selected 79 persons (5.4% the whole of investigated) with BMI < or = 5 percentile with underweight and considerable underweight. Their menus of three chosen at random weekdays were obtained. Analysis of the nutrition method of children with underweight and considerable underweight showed low energy value of the diet, cellulose, mineral components (K, Ca, Mg) also liquids deficiency at simultaneously occurrent the general and animal protein, the fat, the cholesterol, mineral components (Na, P, Fe, Cu, Zn), vitamins A, C, E (girls) and from the group B. The children have undergone a special pro health education in the form "live" workshop.

Face Preferences for Infant- and Adult-Directed Speakers in Infants of Depressed and Nondepressed Mothers: Association with Infant Cognitive Development.

PubMed

Kaplan, Peter S; Asherin, Ryan M; Vogeli, Jo M; Fekri, Shiva M; Scheyer, Kathryn E; Everhart, Kevin D

2018-01-01

Face preferences for speakers of infant-directed and adult-directed speech (IDS and ADS) were investigated in 4- to 13.5-month-old infants of depressed and non-depressed mothers. Following 1-min of exposure to an ID or AD speaker (order counterbalanced), infants had an immediate paired-comparison test with a still, silent image of the familiarized versus a novel face. In the test phase, ID face preference ratios were significantly lower in infants of depressed than non-depressed mothers. Infants' ID face preference ratios, but not AD face preference ratios, correlated with their percentile scores on the cognitive ( Cog ) scale of the Bayley Scales of Infant & Toddler Development (3 rd Edition; BSID III), assessed concurrently. Regression analyses revealed that infant ID face preferences significantly predicted infant Cog percentiles even after demographic risk factors and maternal depression had been controlled. Infants may use IDS to select social partners who are likely to support and facilitate cognitive development.

Extreme values in the Chinese and American stock markets based on detrended fluctuation analysis

NASA Astrophysics Data System (ADS)

Cao, Guangxi; Zhang, Minjia

2015-10-01

This paper focuses on the comparative analysis of extreme values in the Chinese and American stock markets based on the detrended fluctuation analysis (DFA) algorithm using the daily data of Shanghai composite index and Dow Jones Industrial Average. The empirical results indicate that the multifractal detrended fluctuation analysis (MF-DFA) method is more objective than the traditional percentile method. The range of extreme value of Dow Jones Industrial Average is smaller than that of Shanghai composite index, and the extreme value of Dow Jones Industrial Average is more time clustering. The extreme value of the Chinese or American stock markets is concentrated in 2008, which is consistent with the financial crisis in 2008. Moreover, we investigate whether extreme events affect the cross-correlation between the Chinese and American stock markets using multifractal detrended cross-correlation analysis algorithm. The results show that extreme events have nothing to do with the cross-correlation between the Chinese and American stock markets.

Contrasting OLS and Quantile Regression Approaches to Student "Growth" Percentiles

ERIC Educational Resources Information Center

Castellano, Katherine Elizabeth; Ho, Andrew Dean

2013-01-01

Regression methods can locate student test scores in a conditional distribution, given past scores. This article contrasts and clarifies two approaches to describing these locations in terms of readily interpretable percentile ranks or "conditional status percentile ranks." The first is Betebenner's quantile regression approach that results in…

Adolescent obesity adversely affects blood pressure and resting heart rate.

PubMed

Baba, Reizo; Koketsu, Masaaki; Nagashima, Masami; Inasaka, Hiroshi; Yoshinaga, Masao; Yokota, Mitsuhiro

2007-05-01

Obesity is associated with hypertension (HT) and high resting heart rate (HR), as well as metabolic disturbances. However, little is known about how strongly these hemodynamic abnormalities are associated with the degree of obesity in adolescents. Height, body weight, resting HR, and systolic and diastolic blood pressures were measured in 20,165 male and 19,683 female high-school students. Adiposity levels were classified into 6 groups by body mass index: group 1 (<20th percentile), group 2 (20th-39.9th percentile), group 3 (40th-59.9th percentile), group 4 (60th-79.9th percentile), group 5 (80th-98.9th percentile), and group 6 (> or =99th percentile). Systolic and diastolic hypertensions were defined as > or =140 mmHg and > or =85 mmHg, respectively. Resting tachycardia was defined as the corresponding 95th percentile or greater. Resting HR and systolic and diastolic blood pressures increased with adiposity level in both sexes (p<0.0001). Both systolic HT and diastolic HT were associated with high resting HR, and the clustering of these unfavorable conditions increased with the degree of obesity. Hemodynamic abnormalities, such as HT and a high resting HR, are closely associated with adolescent obesity and are probably explained by impaired autonomic nerve function.

Metabolic syndrome in adolescents: definition based on regression of IDF adult cut-off points.

PubMed

Benmohammed, K; Valensi, P; Balkau, B; Lezzar, A

2016-12-01

The objective of this study was to derive a sex- and age-specific definition of the metabolic syndrome (MetS) and its abnormalities for adolescents. This is a cross-sectional study. A total of 1100 adolescent students, aged 12-18 y, were randomly selected from schools and classrooms in the city of Constantine, Algeria; all had anthropometric measurements taken, and 989 had blood tests. Gender-specific growth curves for components of the MetS were derived, using the LMS (lambda-mu-sigma) method, and the percentiles corresponding to the thresholds of the MetS components proposed for adults by the International Diabetes Federation (IDF) were identified. The prevalence of the MetS using this new definition was 4.3% for boys and 3.7% for girls (P = 0.64). Overall, a high waist circumference was the most frequent of the syndrome components, but the frequency was much higher in girls than that in boys, 33.6% and 6.9%, respectively. In contrast, a high systolic blood pressure was seen in 26.8% of the boys and only 11.4% of the girls. The prevalence of the MetS was higher among adolescents with a body mass index (BMI) ≥95th percentile of the study population, 28.8%, against 9.8% in adolescents with a BMI between the 95th and 85th percentile and 1.8% in those with a BMI <85th percentile (P < 0.0001). MetS during adolescence requires more studies to establish a consensus definition. For clinical practice, we propose a simplified definition for boys and girls based on regression of IDF adult cut-off points. This definition should be tested in further studies with other adolescent populations. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

A cross-sectional study of equol producer status and self-reported vasomotor symptoms.

PubMed

Newton, Katherine M; Reed, Susan D; Uchiyama, Shigeto; Qu, Conghui; Ueno, Tomomi; Iwashita, Soh; Gunderson, Gabrielle; Fuller, Sharon; Lampe, Johanna W

2015-05-01

This study aims to evaluate the associations of vasomotor symptom (VMS) frequency, bother, and severity with equol producer status and dietary daidzein intake. This is an observational study. This study included women aged 45 to 55 years, in postmenopause or in the menopausal transition, who had soy food intake of three or more servings per week. Exclusion criteria included severe concurrent disease, pregnancy or planned pregnancy, and current use of oral or transdermal hormones or selective estrogen receptor modulators. After screening, 375 participants completed a 3-day VMS diary and a 24-hour urine collection. Women with a urine daidzein or genistein concentration of 100 ng/mL or higher were included. We evaluated the association of VMS--dichotomized as lower than or equal to versus higher than the mean number of VMS per day (<2.33, ≥ 2.33)--with quartiles of daidzein intake. Overall, 129 (35%) of 365 women were equol producers. The mean (SD) urinary equol excretion was 0.67 (1.57) mg/day (50th percentile, 0 mg/d; 95th percentile, 4.12 mg/d). Among equol producers, the mean (SD) urinary equol excretion was 1.91 (2.15) mg/day (50th percentile, 1.09 mg/d; 95th percentile, 6.27 mg/d). Among equol producers, compared with those in the lowest quartile of dietary daidzein intake (mean, 4.9 mg/d), those in the highest quartile (mean, 28.5 mg/d) were 76% less likely to have VMS higher than the mean number of VMS (odds ratio, 0.24; 95% CI, 0.07-0.83; trend test across all daidzein levels, P = 0.06). Among equol nonproducers, there were no associations between daidzein intake and VMS frequency. There were no differences in VMS bother or severity among equol producers or nonproducers by dietary daidzein level. Among equol producers, higher equol availability attributable to higher soy consumption contributes to decreased VMS.

The economic benefits of disease triggered early harvest: A case study of pancreas disease in farmed Atlantic salmon from Norway.

PubMed

Pettersen, J M; Rich, K M; Jensen, B Bang; Aunsmo, A

2015-10-01

Pancreas disease (PD) is an important viral disease in Norwegian, Scottish and Irish aquaculture causing biological losses in terms of reduced growth, mortality, increased feed conversion ratio, and carcass downgrading. We developed a bio-economic model to investigate the economic benefits of a disease triggered early harvesting strategy to control PD losses. In this strategy, the salmon farm adopts a PCR (Polymerase Chain Reaction) diagnostic screening program to monitor the virus levels in stocks. Virus levels are used to forecast a clinical outbreak of pancreas disease, which then initiates a prescheduled harvest of the stock to avoid disease losses. The model is based on data inputs from national statistics, literature, company data, and an expert panel, and use stochastic simulations to account for the variation and/or uncertainty associated with disease effects and selected production expenditures. With the model, we compared the impacts of a salmon farm undergoing prescheduled harvest versus the salmon farm going through a PD outbreak. We also estimated the direct costs of a PD outbreak as the sum of biological losses, treatment costs, prevention costs, and other additional costs, less the costs of insurance pay-outs. Simulation results suggests that the economic benefit from a prescheduled harvest is positive once the average salmon weight at the farm has reached 3.2kg or more for an average Norwegian salmon farm stocked with 1,000,000smolts and using average salmon sales prices for 2013. The direct costs from a PD outbreak occurring nine months (average salmon weight 1.91kg) after sea transfer and using 2013 sales prices was on average estimated at NOK 55.4 million (5%, 50% and 90% percentile: 38.0, 55.8 and 72.4) (NOK=€0.128 in 2013). Sensitivity analyses revealed that the losses from a PD outbreak are sensitive to feed- and salmon sales prices, and that high 2013 sales prices contributed to substantial losses associated with a PD outbreak. Copyright © 2015 Elsevier B.V. All rights reserved.

Sudden Death in Heart Failure With Preserved Ejection Fraction: A Competing Risks Analysis From the TOPCAT Trial.

PubMed

Vaduganathan, Muthiah; Claggett, Brian L; Chatterjee, Neal A; Anand, Inder S; Sweitzer, Nancy K; Fang, James C; O'Meara, Eileen; Shah, Sanjiv J; Hegde, Sheila M; Desai, Akshay S; Lewis, Eldrin F; Rouleau, Jean; Pitt, Bertram; Pfeffer, Marc A; Solomon, Scott D

2018-03-04

This study investigated the rates and predictors of SD or aborted cardiac arrest (ACA) in HFpEF. Sudden death (SD) may be an important mode of death in heart failure with preserved ejection fraction (HFpEF). We studied 1,767 patients with HFpEF (EF ≥45%) enrolled in the Americas region of the TOPCAT (Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function) trial. We identified independent predictors of composite SD/ACA with stepwise backward selection using competing risks regression analysis that accounted for nonsudden causes of death. During a median 3.0-year (25 th to 75 th percentile: 1.9 to 4.4 years) follow-up, 77 patients experienced SD/ACA, and 312 experienced non-SD/ACA. Corresponding incidence rates were 1.4 events/100 patient-years (25 th to 75 th percentile: 1.1 to 1.8 events/100 patient-years) and 5.8 events/100 patient-years (25 th to 75 th percentile: 5.1 to 6.4 events/100 patient-years). SD/ACA was numerically lower but not statistically reduced in those randomized to spironolactone: 1.2 events/100 patient-years (25 th to 75 th percentile: 0.9 to 1.7 events/100 patient-years) versus 1.6 events/100 patient-years (25 th to 75 th percentile: 1.2 to 2.2 events/100 patient-years); the subdistributional hazard ratio was 0.74 (95% confidence interval: 0.47 to 1.16; p = 0.19). After accounting for competing risks of non-SD/ACA, male sex and insulin-treated diabetes mellitus were independently predictive of composite SD/ACA (C-statistic = 0.65). Covariates, including eligibility criteria, age, ejection fraction, coronary artery disease, left bundle branch block, and baseline therapies, were not independently associated with SD/ACA. Sex and diabetes mellitus status remained independent predictors in sensitivity analyses, excluding patients with implantable cardioverter-defibrillators and when predicting SD alone. SD accounted for ∼20% of deaths in HFpEF. Male sex and insulin-treated diabetes mellitus identified patients at higher risk for SD/ACA with modest discrimination. These data might guide future SD preventative efforts in HFpEF. (Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function [TOPCAT]); NCT00094302. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Climate Extreme Events over Northern Eurasia in Changing Climate

NASA Astrophysics Data System (ADS)

Bulygina, O.; Korshunova, N. N.; Razuvaev, V. N.; Groisman, P. Y.

2014-12-01

During the period of widespread instrumental observations in Northern Eurasia, the annual surface air temperature has increased by 1.5°C. Close to the north in the Arctic Ocean, the late summer sea ice extent has decreased by 40% providing a near-infinite source of water vapor for the dry Arctic atmosphere in the early cold season months. The contemporary sea ice changes are especially visible in the Eastern Hemisphere All these factors affect the change extreme events. Daily and sub-daily data of 940 stations to analyze variations in the space time distribution of extreme temperatures, precipitation, and wind over Russia were used. Changing in number of days with thaw over Russia was described. The total seasonal numbers of days, when daily surface air temperatures (wind, precipitation) were found to be above (below) selected thresholds, were used as indices of climate extremes. Changing in difference between maximum and minimum temperature (DTR) may produce a variety of effects on biological systems. All values falling within the intervals ranged from the lowest percentile to the 5th percentile and from the 95th percentile to the highest percentile for the time period of interest were considered as daily extremes. The number of days, N, when daily temperatures (wind, precipitation, DTR) were within the above mentioned intervals, was determined for the seasons of each year. Linear trends in the number of days were calculated for each station and for quasi-homogeneous climatic regions. Regional analysis of extreme events was carried out using quasi-homogeneous climatic regions. Maps (climatology, trends) are presented mostly for visualization purposes. Differences in regional characteristics of extreme events are accounted for over a large extent of the Russian territory and variety of its physical and geographical conditions. The number of days with maximum temperatures higher than the 95% percentile has increased in most of Russia and decreased in Siberia in spring and autumn. Reducing the number of days with extremely low air temperatures dominated in all seasons. At the same time, the number of days with abnormally low air temperatures has increased in Middle Volga region and south of Western Siberia. In most parts of European Russia observed increase in the number of days with heavy snowfalls.

Nutritional status improvement in neurologically impaired patients by percutaneous endoscopic gastrostomy feeding.

PubMed

Nakao, F S; Brant, C Q; Stanich, P; Ferrari Júnior, A P

1999-01-01

With increased use of percutaneous endoscopic gastrostomy, it became clear that neurologically impaired patients might benefit from its use. From August 1996 to July 1997, we performed 19 percutaneous endoscopic gastrostomies in patients with neurological sequelae, who were incapable to maintain their nutritional status by oral ingestion or had repeated episodes of aspiration. Sixteen patients were followed prospectively, from 30 days to 11 months (median: 6.4 months). Average weight (38.2 kg to 44.8 kg), BMI (14.8 kg/m2 to 17.8 kg/m2), weight/height ratio (23.5 kg/cm to 28 kg/cm), mid-upper arm circumference (19.4 cm to 21.6 cm) and triceps skinfold thickness (10.3 mm to 12.6 mm) were significantly increased (P < 0.01). Before percutaneous endoscopic gastrostomy, there were 10 (10/16, 62.5%) patients with grade III thinness. In this group, 3/10 patients (30%) showed improvement to grade I (two individuals) and II (one patient). All but five patients (68.75%) were below the fifth percentile of normal distribution for mid-upper arm circumference. One patient (6.2%) showed improvement of her status (between 25th and 50th percentiles). Four patients (25%) started the follow-up below the fifth percentile for normal distribution of triceps skinfold thickness, and showed no improvement. There were no early complications secondary the procedure. Late complications included granulation tissue on ostomy site (18.8%) and ostomy infection (6.2%). Statistical analysis showed significant improvement of anthropometric data. Percutaneous endoscopic gastrostomy is a simple, highly successful and safe procedure, when performed in neurologically impaired patients. It is efficient as a long-term enteral feeding method.

The relationship between preadmission indicators and basic math skills at a new school of pharmacy.

PubMed

Grillo, J A; Latif, D A; Stolte, S K

2001-02-01

To examine the relationship between preadmission indicators of 49 PharmD students entering their first professional year at a new school of pharmacy and their scores on a Basic Math Skills Test (BMST). A secondary objective was to determine what factors, if any, contributed to the successful completion of the BMST. This cross-sectional investigation used a convenience sample of PharmD students entering the first professional year at a three-year-old, private, southeastern school of pharmacy. All first-year students who took the mandatory BMST, as part of a math mentor plot program, were eligible for enrollment. The BMST covered nine different competencies and was validated at the grade-8 level. Math test scores, the student's Pharmacy College Admissions Test (PCAT), and other demographic and scholastic information was obtained from the student's application file in a retrospective manner. All identifiers were removed before the data were submitted to the investigators. Statistical analysis suggested that two preadmission indicators strongly influenced BMST performance: percentile scores on the quantitative section of the PCAT (POAT-OP) and whether the student attended a private or public university prior to admission to the pharmacy school. In addition, four factors significantiy contributed to successful completion of the BMST: math/science grade point average (MS-GPA), PCAT percentile scores, PCAT-QP percentile scores, and the number of BMST Items left blank. A relationship exists between preadmission indicators of PharmD students entering their first professional year and their BMST score. In addition, certain identifiable factors impact BMST scores of first-year PharmD students. Admissions committees may find this useful in identifying students who may need remedial math assistance prior to beginning math-intensive courses such as pharmaceutical calculations and pharmacokinetics.

Levels and profiles of organochlorines and flame retardants in car and house dust from Kuwait and Pakistan: implication for human exposure via dust ingestion.

PubMed

Ali, Nadeem; Ali, Lulwa; Mehdi, Toufeer; Dirtu, Alin C; Al-Shammari, Fatema; Neels, Hugo; Covaci, Adrian

2013-05-01

There are only few studies documenting indoor pollution in the Middle East and the Indian subcontinent. In present study, we have evaluated the occurrence of various organochlorines (OCs) and flame retardants (FRs) in dust from cars and houses of Pakistan and Kuwait. Polybrominated diphenyl ethers (PBDEs), novel brominated flame retardants (NBFRs), organophosphate FRs (PFRs), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs) were investigated in indoor dust from urban houses (N=15 per country) and cars (N=15 per country). PFRs were the major analytes in all four microenvironments, followed by PBDEs>NBFRs>OCPs>PCBs. For all classes of analytes, relatively lower levels were observed in car and house dust from Pakistan than Kuwait. Levels of ∑PBDEs, ∑NBFRs and ∑PFRs were higher in car dust, while ∑OCPs and ∑PCBs were higher in house dust from both countries. ∑PFRs occurred at average concentrations of 16,900, 87,900, 475, and 2500ng/g in Kuwaiti house and car, and Pakistani house and car dust, respectively. For both countries, the profiles of analytes in car dust were different from those in the house dust. Different exposure scenarios using 5th percentile, median, mean, and 95th percentile levels were estimated for adult, taxi drivers and toddlers. For Kuwaiti toddlers, assuming high dust intake and mean and 95th percentile concentrations, the values computed for ∑OCPs (1500ng/kg bw/day) were higher than RfD values, while for ∑PCBs (14.5ng/kg bw/day) it was only two-fold lower than the corresponding RfDs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparing exposure metrics for classifying ‘dangerous heat’ in heat wave and health warning systems

PubMed Central

Zhang, Kai; Rood, Richard B.; Michailidis, George; Oswald, Evan M.; Schwartz, Joel D.; Zanobetti, Antonella; Ebi, Kristie L.; O’Neill, Marie S.

2012-01-01

Heat waves have been linked to excess mortality and morbidity, and are projected to increase in frequency and intensity with a warming climate. This study compares exposure metrics to trigger heat wave and health warning systems (HHWS), and introduces a novel multi-level hybrid clustering method to identify potential dangerously hot days. Two-level and three-level hybrid clustering analysis as well as common indices used to trigger HHWS, including spatial synoptic classification (SSC); and 90th, 95th, and 99th percentiles of minimum and relative minimum temperature (using a 10 day reference period), were calculated using a summertime weather dataset in Detroit from 1976 to 2006. The days classified as ‘hot’ with hybrid clustering analysis, SSC, minimum and relative minimum temperature methods differed by method type. SSC tended to include the days with, on average, 2.6 °C lower daily minimum temperature and 5.3 °C lower dew point than days identified by other methods. These metrics were evaluated by comparing their performance in predicting excess daily mortality. The 99th percentile of minimum temperature was generally the most predictive, followed by the three-level hybrid clustering method, the 95th percentile of minimum temperature, SSC and others. Our proposed clustering framework has more flexibility and requires less substantial meteorological prior information than the synoptic classification methods. Comparison of these metrics in predicting excess daily mortality suggests that metrics thought to better characterize physiological heat stress by considering several weather conditions simultaneously may not be the same metrics that are better at predicting heat-related mortality, which has significant implications in HHWSs. PMID:22673187

Home Sweet Home: Parent and Home Environmental Factors in Adolescent Consumption of Sugar-Sweetened Beverages.

PubMed

Bogart, Laura M; Elliott, Marc N; Ober, Allison J; Klein, David J; Hawes-Dawson, Jennifer; Cowgill, Burton O; Uyeda, Kimberly; Schuster, Mark A

2017-07-01

Sugar-sweetened beverages (SSBs) are key contributors to obesity among youth. We investigated associations among parental and home-related factors (parental attitudes and consumption; home availability) regarding 3 types of SSBs-soda, sports drinks, and fruit-flavored drinks-with consumption of each type of SSB in a general school-based sample of adolescents. Data were collected across 3 school semesters, from 2009 to 2011. A total of 1313 seventh grade student-parent dyads participated. Students completed in-class surveys across 9 schools in a large Los Angeles school district; their parents completed telephone interviews. Youth were asked about their SSB consumption (soda, sports drinks, and fruit-flavored drinks), and parents were asked about their attitudes, consumption, and home availability of SSBs. We estimated expected rates of youth SSB consumption for hypothetical parents at very low (5th) and very high (95th) percentiles for home/parental risk factors (ie, they consumed little, had negative attitudes, and did not keep SSBs in the home; or they consumed a lot, had positive attitudes, and did keep SSBs in the home). Youth of lower-risk parents (at the 5th percentile) were estimated to drink substantially less of each type of beverage than did youth of higher-risk parents (at the 95th percentile). For example, youth with higher-risk parents averaged nearly double the SSB consumption of youth of lower-risk parents (2.77 vs 1.37 glasses on the previous day; overall model significance F 22,1312  = 3.91, P < .001). Results suggest a need to focus on parental and home environmental factors when intervening to reduce youths' SSB consumption. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Cardiac computed tomography in patients with symptomatic new-onset atrial fibrillation, rule-out acute coronary syndrome, but with intermediate pretest probability for coronary artery disease admitted to a chest pain unit.

PubMed

Koopmann, Matthias; Hinrichs, Liane; Olligs, Jan; Lichtenberg, Michael; Eckardt, Lars; Böse, Dirk; Möhlenkamp, Stefan; Waltenberger, Johannes; Breuckmann, Frank

2018-01-24

Atrial fibrillation (AF) and coronary artery disease (CAD) may be encountered coincidently in a large portion of patients. However, data on coronary artery calcium burden in such patients are lacking. Thus, we sought to determine the value of cardiac computed tomography (CCT) in patients presenting with new-onset AF associated with an intermediate pretest probability for CAD admitted to a chest pain unit (CPU). Calcium scores (CS) of 73 new-onset, symptomatic AF subjects without typical clinical, electrocardiographic, or laboratory signs of acute coronary syndrome (ACS) admitted to our CPU were analyzed. In addition, results from computed tomography angiography (CTA) were related to coronary angiography findings whenever available. Calcium scores of zero were found in 25%. Median Agatston score was 77 (interquartile range: 1-270) with gender- and territory-specific dispersal. CS scores above average were present in about 50%, high (> 400)-to-very high (> 1000) CS scores were found in 22%. Overall percentile ranking showed a relative accordance to the reference percentile distribution. Additional CTA was performed in 47%, revealing stenoses in 12%. Coronary angiography was performed in 22% and resulted in coronary intervention or surgical revascularization in 7%. On univariate analysis, CS > 50th percentile failed to serve as an independent determinant of significant stenosis during catheterization. Within a CPU setting, relevant CAD was excluded or confirmed in almost 50%, the latter with a high proportion of coronary angiographies and subsequent coronary interventions, underlining the diagnostic value of CCT in symptomatic, non-ACS, new-onset AF patients when admitted to a CPU.

The association of weather and mortality in Bangladesh from 1983–2009

PubMed Central

Alam, Nurul; Begum, Dilruba; Streatfield, Peter Kim

2012-01-01

Introduction The association of weather and mortality have not been widely studied in subtropical monsoon regions, particularly in Bangladesh. This study aims to assess the association of weather and mortality (measured with temperature and rainfall), adjusting for time trend and seasonal patterns in Abhoynagar, Bangladesh. Material and methods A sample vital registration system (SVRS) was set up in 1982 to facilitate operational research in family planning and maternal and child health. SVRS provided data on death counts and population from 1983–2009. The Bangladesh Meteorological Department provided data on daily temperature and rainfall for the same period. Time series Poisson regression with cubic spline functions was used, allowing for over-dispersion, including lagged weather parameters, and adjusting for time trends and seasonal patterns. Analysis was carried out using R statistical software. Results Both weekly mean temperature and rainfall showed strong seasonal patterns. After adjusting for seasonal pattern and time trend, weekly mean temperatures (lag 0) below the 25th percentile and between the 25th and 75th percentiles were associated with increased mortality risk, particularly in females and adults aged 20–59 years by 2.3–2.4% for every 1°C decrease. Temperature above the 75th percentile did not increase the risk. Every 1 mm increase in rainfall up to 14 mm of weekly average rainfall over lag 0–4 weeks was associated with decreased mortality risks. Rainfall above 14 mm was associated with increased mortality risk. Conclusion The relationships between temperature, rainfall and mortality reveal the importance of understanding the current factors contributing to adaptation and acclimatization, and how these can be enhanced to reduce negative impacts from weather. PMID:23195512

Ambient air quality status in Raniganj-Asansol area, India.

PubMed

Reddy, G S; Ruj, Biswajit

2003-12-01

This investigation presents the assessment of ambient air quality with respect to suspended particulate matter (SPM), sulphur dioxide (SO2) and oxides of nitrogen (NOx) at four sites (RGC, SRS, BBC and BCC) in the Raniganj-Asansol area in West Bengal, India. Ambient air was monitored with a sampling frequency of twenty four hours (3 x 8 hours) at each site on every alternate day (3 days a week) covering a period of one year. A total of 429 samples were collected from RGC, 429 from SRS and 435 each from the BBC and BCC sites. Meteorological parameters such as temperature, relative humidity, wind-speed and wind-direction were also recorded simultaneously during the sampling period. Monthly and seasonal variation of these pollutants have been observed and recorded. The annual average and range values have also been calculated. Results of the investigation indicates that the 95th percentile values of SPM levels exceed the limits (200 microg m(-3)) at RGC, SRS and BBC sites and is within the limit of 500 microg m(-3) at the BCC sites. The 95th percentile values of SO2 levels did not exceed the reference level at any of the monitoring stations. The 95th percentile values of NOx are found to be exceeding the limit (80 microg m(-3)) at RGC, SRS and BBC sites but is within the prescribed limit of 120 microg m(-3) at the BCC site. Further, it has been observed that the concentrations of the pollutants are high in winter in comparison to the summer or the monsoon seasons. Results of the investigation indicates that industrial activities, indiscriminate open air burning of coal by the local inhabitants for cooking as well as coking purposes, vehicular traffic, etc. are responsible for the high concentration of pollutants in this area.

Early efficacy of the ketogenic diet is not affected by initial body mass index percentile.

PubMed

Shull, Shastin; Diaz-Medina, Gloria; Wong-Kisiel, Lily; Nickels, Katherine; Eckert, Susan; Wirrell, Elaine

2014-05-01

Predictors of the ketogenic diet's success in treating pediatric intractable epilepsy are not well understood. The aim of this study was to determine whether initial body mass index and weight percentile impact early efficacy of the traditional ketogenic diet in children initiating therapy for intractable epilepsy. This retrospective study included all children initiating the ketogenic diet at Mayo Clinic, Rochester from January 2001 to December 2010 who had body mass index (children ≥2 years of age) or weight percentile (those <2 years of age) documented at diet initiation and seizure frequency recorded at diet initiation and one month. Responders were defined as achieving a >50% seizure reduction from baseline. Our cohort consisted of 48 patients (20 male) with a median age of 3.1 years. There was no significant correlation between initial body mass index or weight percentile and seizure frequency reduction at one month (P = 0.72, r = 0.26 and P = 0.91, r = 0.03). There was no significant association between body mass index or weight percentile quartile and responder rates (P = 0.21 and P = 0.57). Children considered overweight or obese at diet initiation (body mass index or weight percentile ≥85) did not have lower responder rates than those with body mass index or weight percentiles <85 (6/14 vs 19/34, respectively, P = 0.41). Greater initial body mass index and weight-for-age percentiles do not adversely affect the efficacy of the ketogenic diet. Copyright © 2014 Elsevier Inc. All rights reserved.

The importance of extreme weight percentile in postoperative morbidity in children.

PubMed

Stey, Anne M; Moss, R Lawrence; Kraemer, Kari; Cohen, Mark E; Ko, Clifford Y; Lee Hall, Bruce

2014-05-01

Anthropometric data are important indicators of child health. This study sought to determine whether anthropometric data of extreme weight were significant predictors of perioperative morbidity in pediatric surgery. This was a cohort study of children 29 days up to 18 years of age undergoing surgical procedures at participating American College of Surgeons' NSQIP Pediatric hospitals in 2011 and 2012. The primary outcomes were composite morbidity and surgical site infection. The primary predictor of interest was weight percentile, which was divided into the following categories: ≤5(th) percentile, 6(th) to 94(th), or ≥95(th) percentile. A hierarchical multivariate logistic model, adjusting for procedure case mix, demographic, and clinical patient characteristic variables, was used to quantify the relationship between weight percentile category and outcomes. Children in the ≤5th weight percentile had 1.19-fold higher odds of overall postoperative morbidity developing than children in the nonextreme range (95% CI, 1.10-1.30) when controlling for clinical variables. Yet these children did not have higher odds of surgical site infection developing. Children in the ≥95(th) weight percentile did not have a significant increase in overall postoperative morbidity. However, they were at 1.35-fold increased odds of surgical site infection compared with those in the nonextreme range when controlling for clinical variables (95% CI, 1.16-1.57). Both extremely high and extremely low weight percentile scores can be associated with increased postoperative complications after controlling for clinical variables. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A study of perceptual and verbal skills of disabled readers in grades 4, 5 and 6.

PubMed

Solan, H A; Ficarra, A P

1990-08-01

This investigation addresses the role of the optometrist in diagnosing and treating children in grades 4, 5, and 6 who have been identified as reading disabled. Fifty-one subjects with average intelligence, but whose reading comprehension skills were below the 31st percentile (mean, 20th percentile), were evaluated using verbal and perceptual tests. When the performance of this experimental group was compared with the mean scores from standardized test norms for each of the various tasks, the disabled readers scored significantly lower in seven of the eight perceptual and five of the six verbal tasks. These results lend support to the hypothesis that both perceptual and verbal deficits are related to reading comprehension. Using step-wise multiple correlation analysis, three perceptual factors; eye-movements, Auditory-Visual Integration Test (AVIT), and grooved peg-board, contributed 38 percent of the variance whereas the addition of two verbal factors (digit span and token test) provided just 2 percent. That is, 38 percent of the variations in reading comprehension could be accounted for by variations in perceptual skills in the disabled readers. The results were interpreted in terms of spatial-simultaneous and verbal-successive processing skills.

Air concentrations of PBDEs on in-flight airplanes and assessment of flight crew inhalation exposure.

PubMed

Allen, Joseph G; Sumner, Ann Louise; Nishioka, Marcia G; Vallarino, Jose; Turner, Douglas J; Saltman, Hannah K; Spengler, John D

2013-07-01

To address the knowledge gaps regarding inhalation exposure of flight crew to polybrominated diphenyl ethers (PBDEs) on airplanes, we measured PBDE concentrations in air samples collected in the cabin air at cruising altitudes and used Bayesian Decision Analysis (BDA) to evaluate the likelihood of inhalation exposure to result in the average daily dose (ADD) of a member of the flight crew to exceed EPA Reference Doses (RfDs), accounting for all other aircraft and non-aircraft exposures. A total of 59 air samples were collected from different aircraft and analyzed for four PBDE congeners-BDE 47, 99, 100 and 209 (a subset were also analyzed for BDE 183). For congeners with a published RfD, high estimates of ADD were calculated for all non-aircraft exposure pathways and non-inhalation exposure onboard aircraft; inhalation exposure limits were then derived based on the difference between the RfD and ADDs for all other exposure pathways. The 95th percentile measured concentrations of PBDEs in aircraft air were <1% of the derived inhalation exposure limits. Likelihood probabilities of 95th percentile exposure concentrations >1% of the defined exposure limit were zero for all congeners with published RfDs.

Water use and availability in the West Narragansett Bay area, coastal Rhode Island, 1995-99

USGS Publications Warehouse

Nimiroski, Mark T.; Wild, Emily C.

2006-01-01

During the 1999 drought in Rhode Island, belowaverage precipitation caused a drop in ground-water levels and streamflow was below long-term averages. The low water levels prompted the U. S. Geological Survey and the Rhode Island Water Resources Board to conduct a series of cooperative water-use studies. The purpose of these studies is to collect and analyze water-use and water-availability data in each drainage area in the State of Rhode Island. The West Narragansett Bay study area, which covers 118 square miles in part or all of 14 towns in coastal Rhode Island, is one of nine areas investigated as part of this effort. The study area includes the western part of Narragansett Bay and Conanicut Island, which is the town of Jamestown. The area was divided into six subbasins for the assessment of water-use data. In the calculation of hydrologic budget and water availability, the Hunt, Annaquatucket, and Pettaquamscutt River Basins were combined into one subbasin because they are hydraulically connected. Eleven major water suppliers served customers in the study area, and they supplied an average of 19.301 million gallons per day during 1995–99. The withdrawals from the only minor supplier, which was in the town of East Greenwich in the Hunt River Basin, averaged 0.002 million gallons per day. The remaining withdrawals were estimated as 1.186 million gallons per day from self-supplied domestic, commercial, industrial, and agricultural users. Return flows from self-disposed water (individual sewage-disposal systems) and permitted discharges accounted for 5.623 million gallons per day. Most publicly disposed water (13.711 million gallons per day) was collected by the Rhode Island Economic Development Corporation, and by the East Greenwich, Fields Point, Jamestown, Narragansett, and Scarborough wastewater-treatment facilities. This wastewater was disposed in Narragansett Bay outside of the study area. The PART program, a computerized hydrograph-separation application, was used to determine water availability in the study area on the basis of low flows measured at a nearby index station, the Pawcatuck River at Wood River Junction, Rhode Island. Water availability was defined as the 75th, 50th, and 25th percentiles of the total base flow; the base flow minus the 7-day, 10-year flow; and the base flow minus the Aquatic Base Flow at the index station. The base-flow contributions per unit area of sand and gravel deposits and of till were computed for June, July, August, and September for the index station and multiplied by the areas of sand and gravel and till in the subbasins. The calculated base flows at the index station were lowest in August at the 75th, 50th, and 25th percentiles for total base flow and for two additional low-flow scenarios. Because water withdrawals and use are greater during June, July, August, and September than at other times of the year, water availability was compared to water withdrawals in the subbasins for these summer months. Ratios were calculated by dividing the summer withdrawals by the water availability at the 75th, 50th, and 25th percentiles, and these percentiles of the base flow minus the two low flows for each subbasin. The closer this ratio is to one, the closer the withdrawals are to the estimated water available. These ratios allow comparisons of the use of water to the available water from one subbasin to another. The ratios were highest in July for the 50th percentile of the estimated gross yield minus the Aquatic Base Flow. The ratios ranged from 0.01 in the Providence and Seekonk subbasin to 0.38 in the Hunt-Annaquatucket-Pettaquamscutt subbasin for the 50th percentile of the gross yield minus the 7Q10 for August. A long-term (1941–2000) water budget was calculated for the study area to assess the basin inflows and outflows. The water withdrawals and return flows used in the budget were from 1995 through 1999. Inflow was assumed to equal outflow. The total water budget was 146.29 million gallons per day for the combined Hunt-Annaquatucket-Pettaquamscutt subbasin, 48.71 million gallons per day for the Greenwich Bay subbasin, 238.98 million gallons per day for the Providence and Seekonk Rivers subbasin, and 21.32 million gallons per day for the Conanicut Island subbasin. The estimated inflows from precipitation, streamflow from upstream basins, and wastewater return flow for the entire study area were 59.3, 38.5, and 2.2 percent, respectively. The estimated outflows for the study area from evapotranspiration, streamflow, and water withdrawals were 24.9, 73.9, and 1.2 percent, respectively.

BMI is not a good indicator for metabolic risk in adolescent girls

USDA-ARS?s Scientific Manuscript database

BMI (kg/m2) does not provide information about body fat percentile.Adolescents with BMI <85th percentile for age are considered lean and at low risk for metabolic complications. Adolescent girls with low BMI can have high body fat percentile. We hypothesized that these girls are already insulin resi...

Percentile curves for skinfold thickness for Canadian children and youth.

PubMed

Kuhle, Stefan; Ashley-Martin, Jillian; Maguire, Bryan; Hamilton, David C

2016-01-01

Background. Skinfold thickness (SFT) measurements are a reliable and feasible method for assessing body fat in children but their use and interpretation is hindered by the scarcity of reference values in representative populations of children. The objective of the present study was to develop age- and sex-specific percentile curves for five SFT measures (biceps, triceps, subscapular, suprailiac, medial calf) in a representative population of Canadian children and youth. Methods. We analyzed data from 3,938 children and adolescents between 6 and 19 years of age who participated in the Canadian Health Measures Survey cycles 1 (2007/2009) and 2 (2009/2011). Standardized procedures were used to measure SFT. Age- and sex-specific centiles for SFT were calculated using the GAMLSS method. Results. Percentile curves were materially different in absolute value and shape for boys and girls. Percentile girls in girls steadily increased with age whereas percentile curves in boys were characterized by a pubertal centered peak. Conclusions. The current study has presented for the first time percentile curves for five SFT measures in a representative sample of Canadian children and youth.

Percentile curves for skinfold thickness for Canadian children and youth

PubMed Central

Ashley-Martin, Jillian; Maguire, Bryan; Hamilton, David C.

2016-01-01

Background. Skinfold thickness (SFT) measurements are a reliable and feasible method for assessing body fat in children but their use and interpretation is hindered by the scarcity of reference values in representative populations of children. The objective of the present study was to develop age- and sex-specific percentile curves for five SFT measures (biceps, triceps, subscapular, suprailiac, medial calf) in a representative population of Canadian children and youth. Methods. We analyzed data from 3,938 children and adolescents between 6 and 19 years of age who participated in the Canadian Health Measures Survey cycles 1 (2007/2009) and 2 (2009/2011). Standardized procedures were used to measure SFT. Age- and sex-specific centiles for SFT were calculated using the GAMLSS method. Results. Percentile curves were materially different in absolute value and shape for boys and girls. Percentile girls in girls steadily increased with age whereas percentile curves in boys were characterized by a pubertal centered peak. Conclusions. The current study has presented for the first time percentile curves for five SFT measures in a representative sample of Canadian children and youth. PMID:27547554

Marginal versus joint Box-Cox transformation with applications to percentile curve construction for IgG subclasses and blood pressures.

PubMed

He, Xuming; Ng, K W; Shi, Jian

2003-02-15

When age-specific percentile curves are constructed for several correlated variables, the marginal method of handling one variable at a time has typically been used. We address the question, frequently asked by practitioners, of whether we can achieve efficiency gains by joint estimation. We focus on a simple but common method of Box-Cox transformation and assess the statistical impact of a joint transformation to multivariate normality on the percentile curve estimation for correlated variables. We find that there is little gain from the joint transformation for estimating percentiles around the median but a noticeable reduction in variances is possible for estimating extreme percentiles that are usually of main interest in medical and biological applications. Our study is motivated by problems in constructing percentile charts for IgG subclasses of children and for blood pressures in adult populations, both of which are discussed in the paper as examples, and yet our general findings are applicable to a wide range of other problems. Copyright 2003 John Wiley & Sons, Ltd.

Assessment of the Compound Topographic Index CTI to predict Potential Ephemeral Gullies in Navarre (Spain)

NASA Astrophysics Data System (ADS)

Chahor, Y.; Casalí, J.; Giménez, R.

2012-04-01

Ephemeral gullies are relatively small (susceptible of being obliterated by conventional tillage operation) eroded channels that are able to generate however important in-site and off-site damages (removal of top soil and nutrients, degradation of drinking water quality, contamination of aquatic ecosystems, siltation, etc.). Gully initiation and development in a watershed is greatly driven by topographic factors. Precisely, several topographic indexes have been used to identify areas with risk of gully erosion. Among them, the Compound Topographic Index (CTI= A.S.PLANC; A: upstream drainage area, S: local slope, PLANC: planform curvature) is an approach recently implemented in the AnnAGNPS (Annualized Agricultural Nonpoint Source Pollution) model. It allows defining the location of potential ephemeral gullies (PEG). The aim of this work was to assess the capability of CTI for predicting PEG mouths (potential headcut) location in an agricultural field of Navarre (Spain) through AnnAGNPS. The study was carried out in a 450 ha area cultivated with wheat and located in Pitillas (southern Navarre). The climate is continental Mediterranean with a mean temperature of 13°C and annual rainfall of 500 mm. Top soil textures are mostly loamy and silt-loam. The 3 topographic components of the CTI were computed by TOPAZ program implemented in AnnAGNPS 5.10 using a digital elevation model of 5-m resolution. The CTI is computed for each raster grid. Then all the values are arranged from the smallest to the largest and then percentiles are calculated (for example, the 95th percentile is the threshold CTI value below which 95% of the CTI values may be found). Grid cells whose values correspond to a percentile lower than 90% are discarded by the model by default. On the other hand, 31 ephemeral gullies located within the studied agricultural field were selected from orthophotos (1:5,000). Natural drainage channels located in abandoned, steep pieces of terrain were not considered in our analysis. The model was run using alternatively CTI values with percentiles 97%, 98%, 99% and 99.9%. The PEG mouth points cloud generated each time was compared with the points obtained from the orthophoto depicting the selected gullies, looking for the best fit or conversely the smallest error in the prediction of gully location. Error of 29%, 42%, 68% and 87% were determined for CTI values of to 97%, 98%, 99% and 99.9%, respectively. Therefore, CTI values of 97% and 98% can be considered as the best predictor of PEG location for our local conditions.

Prescription duration and treatment episodes in oral glucocorticoid users: application of the parametric waiting time distribution.

PubMed

Laugesen, Kristina; Støvring, Henrik; Hallas, Jesper; Pottegård, Anton; Jørgensen, Jens Otto Lunde; Sørensen, Henrik Toft; Petersen, Irene

2017-01-01

Glucocorticoids are widely used medications. In many pharmacoepidemiological studies, duration of individual prescriptions and definition of treatment episodes are important issues. However, many data sources lack this information. We aimed to estimate duration of individual prescriptions for oral glucocorticoids and to describe continuous treatment episodes using the parametric waiting time distribution. We used Danish nationwide registries to identify all prescriptions for oral glucocorticoids during 1996-2014. We applied the parametric waiting time distribution to estimate duration of individual prescriptions each year by estimating the 80th, 90th, 95th and 99th percentiles for the interarrival distribution. These corresponded to the time since last prescription during which 80%, 90%, 95% and 99% of users presented a new prescription for redemption. We used the Kaplan-Meier survival function to estimate length of first continuous treatment episodes by assigning estimated prescription duration to each prescription and thereby create treatment episodes from overlapping prescriptions. We identified 5,691,985 prescriptions issued to 854,429 individuals of whom 351,202 (41%) only redeemed 1 prescription in the whole study period. The 80th percentile for prescription duration ranged from 87 to 120 days, the 90th percentile from 116 to 150 days, the 95th percentile from 147 to 181 days, and the 99th percentile from 228 to 259 days during 1996-2014. Based on the 80th, 90th, 95th and 99th percentiles of prescription duration, the median length of continuous treatment was 113, 141, 170 and 243 days, respectively. Our method and results may provide an important framework for future pharmacoepidemiological studies. The choice of which percentile of the interarrival distribution to apply as prescription duration has an impact on the level of misclassification. Use of the 80th percentile provides a measure of drug exposure that is specific, while the 99th percentile provides a sensitive measure.

Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years.

PubMed

Mitchell, J A; Pate, R R; Beets, M W; Nader, P R

2013-01-01

To determine if time spent in objectively measured sedentary behavior is associated with a change in body mass index (BMI) between ages 9 and 15 years, adjusting for moderate-to-vigorous physical activity (MVPA). Prospective observational study of children at ages 9 (2000), 11 (2002), 12 (2003) and 15 years (2006). Longitudinal quantile regression was used to model the influence of predictors on changes at the 10th, 25th, 50th, 75th and 90th BMI percentiles over time. Participants were enrolled in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development and include both boys and girls (n=789). Objectively measured BMI (kg m(-2)) was the outcome variable and objectively measured sedentary behavior was the main predictor. Adjustment was also made for MVPA, gender, race, maternal education, hours of sleep and healthy eating index. Increases in BMI were observed at all percentiles, with the greatest increase observed at the 90th BMI percentile. Spending more time in sedentary behavior (h per day) was associated with additional increases in BMI at the 90th, 75th and 50th BMI percentiles, independent of MVPA and the other covariates (90th percentile=0.59, 95% confidence interval (95% CI): 0.19-0.98 kg m(-2); 75th percentile=0.48, 95% CI: 0.25-0.72 kg m(-2); and 50th percentile=0.19, 95% CI: 0.05-0.33 kg m(-2)). No associations were observed between sedentary behavior and changes at the 25th and 10th BMI percentiles. Sedentary behavior was associated with greater increases in BMI at the 90th, 75th and 50th BMI percentiles between ages 9 and 15 years, independent of MVPA. Preventing an increase in sedentary behavior from childhood to adolescence may contribute to reducing the number of children classified as obese.

The test characteristics of head circumference measurements for pathology associated with head enlargement: a retrospective cohort study

PubMed Central

2012-01-01

Background The test characteristics of head circumference (HC) measurement percentile criteria for the identification of previously undetected pathology associated with head enlargement in primary care are unknown. Methods Electronic patient records were reviewed to identify children age 3 days to 3 years with new diagnoses of intracranial expansive conditions (IEC) and metabolic and genetic conditions associated with macrocephaly (MGCM). We tested the following HC percentile threshold criteria: ever above the 95th, 97th, or 99.6th percentile and ever crossing 2, 4, or 6 increasing major percentile lines. The Centers for Disease Control and World Health Organization growth curves were used, as well as the primary care network (PCN) curves previously derived from this cohort. Results Among 74,428 subjects, 85 (0.11%) had a new diagnosis of IEC (n = 56) or MGCM (n = 29), and between these 2 groups, 24 received intervention. The 99.6th percentile of the PCN curve was the only threshold with a PPV over 1% (PPV 1.8%); the sensitivity of this threshold was only 15%. Test characteristics for the 95th percentiles were: sensitivity (CDC: 46%; WHO: 55%; PCN: 40%), positive predictive value (PPV: CDC: 0.3%; WHO: 0.3%; PCN: 0.4%), and likelihood ratios positive (LR+: CDC: 2.8; WHO: 2.2; PCN: 3.9). Test characteristics for the 97th percentiles were: sensitivity (CDC: 40%; WHO: 48%; PCN: 34%), PPV (CDC: 0.4%; WHO: 0.3%; PCN: 0.6%), and LR+ (CDC: 3.6; WHO: 2.7; PCN: 5.6). Test characteristics for crossing 2 increasing major percentile lines were: sensitivity (CDC: 60%; WHO: 40%; PCN: 31%), PPV (CDC: 0.2%; WHO: 0.1%; PCN: 0.2%), and LR+ (CDC: 1.3; WHO: 1.1; PCN: 1.5). Conclusions Commonly used HC percentile thresholds had low sensitivity and low positive predictive value for diagnosing new pathology associated with head enlargement in children in a primary care network. PMID:22269214

Facility Practice Variation to Help Understand the Effects of Public Policy: Insights from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

PubMed

Fuller, Douglas S; Robinson, Bruce M

2017-01-06

Recent Centers for Medicare & Medicaid Services policies have used dialysis facility practice variation to develop public ratings and adjust payments. In the Dialysis Facility Compare star rating system (DFC SRS), facility-relative rates of performance-based clinical measures varied nearly two-fold for mortality (standardized mortality ratio; 10th/90th percentiles: 0.71, 1.34) and hospitalization (standardized hospitalization ratio; 10th/90th percentiles: 0.64, 1.37), and nearly four-fold for transfusion (standardized transfusion ratio; 10th/90th percentiles: 0.43, 1.65). Medicare claims data (from July of 2014) demonstrate that facility variation for the proportions of patients on hemodialysis hospitalized (10th/90th percentiles: 27%, 50%) and transfused (10th/90th percentiles: 3%, 17%) within 6 months that far exceeds relatively modest recent overall longitudinal trends. DFC SRS-rated facility variation is also substantial for fistula (10th/90th percentiles: 50%, 78%) and catheter use >90 days (10th/90th percentiles: 3%, 19%). By contrast, DFC SRS-rated facility distributions for adult hemodialysis Kt/V>1.2 (10th/90th percentiles: 84%, 97%) and total serum calcium >10.2 mg/dl (median, 1%; 75th/90th percentiles: 3%, 5%) are quite narrow and may be of questionable value. Likewise, variation in the US Dialysis Outcomes and Practice Patterns Study is over two-fold for facility median serum parathyroid hormone (10th/90th percentiles: 290 pg/ml, 629 pg/ml) and ferritin (10th/90th percentiles: 469 ng/ml, 1143 ng/ml) levels, and facility mean treatment time varies by 30 minutes (10th/90th percentiles: 204 minutes, 234 minutes). Rising serum parathyroid hormone and ferritin levels, and generally short dialysis treatment time, represent areas unchecked by existing policy; both overall trends and facility variation in these values may reflect unintended consequences of policy or reimbursement pressures and therefore raise concern. Additionally, outcomes in the transition period from advanced CKD to dialysis remain poor, and policy initiatives and performance accountability in this area remain insufficient. Innovative models of comprehensive care in advanced CKD and the early dialysis period which are more amenable to policy oversight are needed. In summary, facility variation is typically larger than prevailing longitudinal trends, and should not be overlooked. The combination of nationally representative observational databases (e.g., the Dialysis Outcomes and Practice Patterns Study) and ESRD registries can provide policy makers with additional tools to evaluate facility variation, develop policies, and monitor unintended effects. Copyright © 2016 by the American Society of Nephrology.

Chronic opiate use in pregnancy and newborn head circumference.

PubMed

Visconti, Kevin C; Hennessy, Kerry C; Towers, Craig V; Howard, Bobby C

2015-01-01

The aim of the study is to evaluate whether chronic opiate use in pregnancy affects newborn head circumference (HC). All newborns from January 1, 2010, to June 30, 2012, admitted to the neonatal intensive care unit for treatment of neonatal abstinence syndrome were prospectively collected. The demographic, obstetrical, neonatal, and perinatal ultrasound data were retrospectively obtained. A gestational age-matched control was used for comparison purposes. Of 332 neonates admitted for the treatment of neonatal abstinence syndrome, 98 (29.5%) had a HC ≤ 10th percentile for gestational age that was significantly increased when compared with controls (p < 0.001). Of these 98, 25 had a HC ≤ 3rd percentile. Of the case population, 141 had an ultrasound in the perinatal unit within 10 days of birth. A HC < 5th percentile was found in 38.3% of cases of which 74% were ≤ 10th percentile postdelivery. The ultrasound femur and humerus length measurements were also < 5th percentile in 36.2 and 28.9%, respectively. Chronic opiate use in pregnancy appears to increase the risk for a HC ≤ 10th percentile and ≤ 3rd percentile when compared with controls. From ultrasound findings, femur and humerus lengths also appear to be shortened suggesting a possible effect on bone growth. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Air toxics and birth defects: a Bayesian hierarchical approach to evaluate multiple pollutants and spina bifida.

PubMed

Swartz, Michael D; Cai, Yi; Chan, Wenyaw; Symanski, Elaine; Mitchell, Laura E; Danysh, Heather E; Langlois, Peter H; Lupo, Philip J

2015-02-09

While there is evidence that maternal exposure to benzene is associated with spina bifida in offspring, to our knowledge there have been no assessments to evaluate the role of multiple hazardous air pollutants (HAPs) simultaneously on the risk of this relatively common birth defect. In the current study, we evaluated the association between maternal exposure to HAPs identified by the United States Environmental Protection Agency (U.S. EPA) and spina bifida in offspring using hierarchical Bayesian modeling that includes Stochastic Search Variable Selection (SSVS). The Texas Birth Defects Registry provided data on spina bifida cases delivered between 1999 and 2004. The control group was a random sample of unaffected live births, frequency matched to cases on year of birth. Census tract-level estimates of annual HAP levels were obtained from the U.S. EPA's 1999 Assessment System for Population Exposure Nationwide. Using the distribution among controls, exposure was categorized as high exposure (>95(th) percentile), medium exposure (5(th)-95(th) percentile), and low exposure (<5(th) percentile, reference). We used hierarchical Bayesian logistic regression models with SSVS to evaluate the association between HAPs and spina bifida by computing an odds ratio (OR) for each HAP using the posterior mean, and a 95% credible interval (CI) using the 2.5(th) and 97.5(th) quantiles of the posterior samples. Based on previous assessments, any pollutant with a Bayes factor greater than 1 was selected for inclusion in a final model. Twenty-five HAPs were selected in the final analysis to represent "bins" of highly correlated HAPs (ρ > 0.80). We identified two out of 25 HAPs with a Bayes factor greater than 1: quinoline (ORhigh = 2.06, 95% CI: 1.11-3.87, Bayes factor = 1.01) and trichloroethylene (ORmedium = 2.00, 95% CI: 1.14-3.61, Bayes factor = 3.79). Overall there is evidence that quinoline and trichloroethylene may be significant contributors to the risk of spina bifida. Additionally, the use of Bayesian hierarchical models with SSVS is an alternative approach in the evaluation of multiple environmental pollutants on disease risk. This approach can be easily extended to environmental exposures, where novel approaches are needed in the context of multi-pollutant modeling.

[Application of uterine lower part breakwater-like suture operation in placenta previa].

PubMed

Zhao, Y; Zhu, J W; Wu, D; Wang, Q H; Lu, S S; Liu, X X; Zou, L

2018-04-25

Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time. Bilateral descending branches of uterine artery ligation and Cook balloon compression of uterine lower segment was conducted when necessary. The clinic data of the 47 cases were analyzed. Results: Thirty cases (63.8, 30/47) were diagnosed placenta inccreta or percreta by ultrasound or MRI preoperatively. Senventeen cases were diagnosed as placenta accreta (36.2%, 17/47) . Thirty-four cases had the previous history of cesarean section. The average cervical canal length of 47 patients was (2.8±0.9) cm. There were 19 cases (40.4%,19/47) with 1 time posterior wall breakwater-like sutured and 16 cases (34.0%,16/47) with 2 or 3 times posterior wall breakwater-like sutured; 12 cases (25.5%,12/47) were treated with anterior wall stitch suture simultaneously.Ten cases (21.3%, 10/47) underwent uterine artery ligation, 17 cases (36.2%, 17/47) underwent COOK balloon compression on the staxis surface of lower segment. None of them had postpartum hemorrhage or performed internal iliac artery embolization. The median blood loss in the operation was 700 ml, the percentiles 25 was 500 ml, and the percentiles 75 was 1 200 ml. The blood loss ≥1 000 ml in 18 (38.3%, 18/47) patients,and the most serious one was 2 500 ml. The median blood transfusion volume (including allogenetic transfusion and autotransfusion) was 450 ml, the percentiles 25 was 228 ml, and the percentiles 75 was 675 ml. The average vaginal bleeding volume was (150±63) ml first day after operation. The mean hospitalization time was (4.7±1.0) days. The mean gestational weeks of pregnancy termination was (36.1±1.5) weeks, and the mean birth weight of newborns was (2 817±492) g. Apgar score:1-minute 7.8±1.1, 5-minute 8.9±0.8. No neonatal death, 16 cases were transferred to neonatal ICU (34.0%, 16/47) mainly for premature delivery and low birth weight. No complication was found in 6 months post-operation. Conclusions: Uterine posterior wall breakwater-like suture technique is a simple, safe and effective way in controlling intraoperative bleeding of placental previa.Lower anterior wall stitch suture could effectively stop bleeding and restore the normal uterine shape. Combined application of various methods could significantly reduce the incidence of postpartum hemorrhage and hysterectomy, and improve maternal and fetal prognosis.

Head-circumference distribution in a large primary care network differs from CDC and WHO curves.

PubMed

Daymont, Carrie; Hwang, Wei-Ting; Feudtner, Chris; Rubin, David

2010-10-01

To compare currently available head-circumference growth curves to curves constructed from clinical measurements from patients in a large US primary care network (PCN). We performed a retrospective cohort study of 75 412 patients in an urban-suburban PCN. Patients with a birth weight of <1500 g or gestational age of <33 weeks at birth were excluded. We compared percentile values and the proportion of head-circumference observations above the 95th percentile and below the 5th percentile for the existing and PCN curves. The PCN curves were most similar to the National Center for Health Statistics (NCHS) curves and were substantially different from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) curves. The overall proportion of observations above the 95th percentile was 4.9% (PCN), 6.2% (NCHS), 8.6% (CDC), and 14.0% (WHO). The proportion below the 5th percentile was 4.4% (PCN), 5.1% (NCHS), 2.9% (CDC), and 2.3% (WHO). When using the CDC curves, the proportion above the 95th percentile increased from 0.2% for children younger than 2 weeks to 11.8% for children 12 months old. When using the WHO curves, the proportion above the 95th percentile was >5% at all ages, with a maximum of 18.0% for children older than 24 months. The CDC and WHO head-circumference curves describe different distributions than the clinical measurements in our PCN population, especially for children with larger heads. The resulting percentile misclassification may delay diagnosis in children with intracranial pathology in very young infants and spur unnecessary evaluation of healthy children older than 6 months.

Percentile Ranking and Citation Impact of a Large Cohort of NHLBI-funded Cardiovascular R01 Grants

PubMed Central

Danthi, Narasimhan; Wu, Colin O.; Shi, Peibei; Lauer, Michael

2014-01-01

Rationale Funding decisions for cardiovascular R01 grant applications at NHLBI largely hinge on percentile rankings. It is not known whether this approach enables the highest impact science. Objective To conduct an observational analysis of percentile rankings and bibliometric outcomes for a contemporary set of funded NHLBI cardiovascular R01 grants. Methods and results We identified 1492 investigator-initiated de novo R01 grant applications that were funded between 2001 and 2008, and followed their progress for linked publications and citations to those publications. Our co-primary endpoints were citations received per million dollars of funding, citations obtained within 2-years of publication, and 2-year citations for each grant’s maximally cited paper. In 7654 grant-years of funding that generated $3004 million of total NIH awards, the portfolio yielded 16,793 publications that appeared between 2001 and 2012 (median per grant 8, 25th and 75th percentiles 4 and 14, range 0 – 123), which received 2,224,255 citations (median per grant 1048, 25th and 75th percentiles 492 and 1,932, range 0 – 16,295). We found no association between percentile ranking and citation metrics; the absence of association persisted even after accounting for calendar time, grant duration, number of grants acknowledged per paper, number of authors per paper, early investigator status, human versus non-human focus, and institutional funding. An exploratory machine-learning analysis suggested that grants with the very best percentile rankings did yield more maximally cited papers. Conclusions In a large cohort of NHLBI-funded cardiovascular R01 grants, we were unable to find a monotonic association between better percentile ranking and higher scientific impact as assessed by citation metrics. PMID:24406983

[A study of Ververck index in 16 865 singleton neonates with a gestational age of 27-42 weeks in Shenzhen, China].

PubMed

Huang, Xiao-Yun; Liu, Hui-Long; Lei, Min; Lian, Zhao-Hui; Mai, Hui-Fen

2018-01-01

Ververck index (VI) reflects thoracic development, body type, and nutritional status. This study aimed to investigate the VI of singleton neonates with a gestational age (GA) of 27-42 weeks at birth, and to establish percentile curves of VI of the neonates. Cross-sectional cluster sampling was performed between April 2013 and September 2015. Body weight, body length, and chest circumference were measured for 16 865 singleton neonates with a GA of 27-42 weeks in two hospitals in Shenzhen, China. VI was calculated and the percentile curves of VI were plotted for the neonates. Mean VIs were obtained for singleton neonates with a gestational age of 27-42 weeks (in three groups of male, female, and both sexes), and related 3rd-97th percentile curves were plotted. As for the 50th percentile curve, the singleton neonates with a GA of 27 weeks had the lowest 50th percentile value of VI, which gradually increased with the increase in GA. The singleton neonates with a GA of 42 weeks had the highest 50th percentile value of VI. Girls had a slightly higher 50th percentile value of VI than boys in all GA groups. VI of neonates increases with the increase in GA. Female neonates may have a slightly better thoracic development, body type, and nutritional status than male neonates at birth. The percentile curves of VI plotted for singleton neonates with a GA of 27-42 weeks (in three groups of male, female, and both sexes) can provide a basis for evaluating thoracic development, body type, and nutritional status of neonates at birth in Shenzhen, China.

Percentile ranking and citation impact of a large cohort of National Heart, Lung, and Blood Institute-funded cardiovascular R01 grants.

PubMed

Danthi, Narasimhan; Wu, Colin O; Shi, Peibei; Lauer, Michael

2014-02-14

Funding decisions for cardiovascular R01 grant applications at the National Heart, Lung, and Blood Institute (NHLBI) largely hinge on percentile rankings. It is not known whether this approach enables the highest impact science. Our aim was to conduct an observational analysis of percentile rankings and bibliometric outcomes for a contemporary set of funded NHLBI cardiovascular R01 grants. We identified 1492 investigator-initiated de novo R01 grant applications that were funded between 2001 and 2008 and followed their progress for linked publications and citations to those publications. Our coprimary end points were citations received per million dollars of funding, citations obtained <2 years of publication, and 2-year citations for each grant's maximally cited paper. In 7654 grant-years of funding that generated $3004 million of total National Institutes of Health awards, the portfolio yielded 16 793 publications that appeared between 2001 and 2012 (median per grant, 8; 25th and 75th percentiles, 4 and 14; range, 0-123), which received 2 224 255 citations (median per grant, 1048; 25th and 75th percentiles, 492 and 1932; range, 0-16 295). We found no association between percentile rankings and citation metrics; the absence of association persisted even after accounting for calendar time, grant duration, number of grants acknowledged per paper, number of authors per paper, early investigator status, human versus nonhuman focus, and institutional funding. An exploratory machine learning analysis suggested that grants with the best percentile rankings did yield more maximally cited papers. In a large cohort of NHLBI-funded cardiovascular R01 grants, we were unable to find a monotonic association between better percentile ranking and higher scientific impact as assessed by citation metrics.

Maternal thyroid dysfunction during gestation, preterm delivery, and birthweight. The Infancia y Medio Ambiente Cohort, Spain.

PubMed

León, Gemma; Murcia, Mario; Rebagliato, Marisa; Álvarez-Pedrerol, Mar; Castilla, Ane M; Basterrechea, Mikel; Iñiguez, Carmen; Fernández-Somoano, Ana; Blarduni, Elizabeth; Foradada, Carles M; Tardón, Adonina; Vioque, Jesús

2015-03-01

Maternal clinical thyroid disorders can cause reproductive complications. However, the effects of mild thyroid dysfunctions are not yet well established. The aim was to evaluate the association of maternal thyroid function during the first half of pregnancy with birthweight and preterm delivery. We analysed data on 2170 pregnant women and their children from a prospective population-based cohort study in four Spanish areas. Mid-gestation maternal serum and urine samples were gathered to determine thyroid-stimulating hormone (TSH), free thyroxine (fT4 ), and urinary iodine concentration (UIC). Thyroid status was defined according to percentile distribution as: euthyroid (TSH and fT4 >5th and <95th percentiles); hypothyroxinaemia (fT4  < 5 th percentile and TSH normal), hypothyroidism (TSH > 95th percentile and fT4 normal or <5th percentile), hyperthyroxinaemia (fT4  > 95 th percentile and TSH normal), and hyperthyroidism (TSH < 5 th percentile and fT4 normal or >95th percentile). Response variables were birthweight, small and large for gestational age (SGA/LGA), and preterm delivery. An inverse association of fT4 and TSH with birthweight was found, the former remaining when restricted to euthyroid women. High fT4 levels were also associated with an increased risk of SGA [odds ratio, 95% confidence interval (CI) 1.28 (95% CI 1.08, 1.51)]. Mean birthweight was higher in the hypothyroxinaemic group (β = 109, P < 0.01). Iodine intake and UIC were not associated with birth outcomes. High maternal fT4 levels during the first half of pregnancy were related to lower birthweight and increased risk of SGA newborns, suggesting that maternal thyroid function may affect fetal growth, even within the normal range. © 2015 John Wiley & Sons Ltd.

Telomere length in patients with pulmonary fibrosis associated with chronic lung allograft dysfunction and post-lung transplantation survival.

PubMed

Newton, Chad A; Kozlitina, Julia; Lines, Jefferson R; Kaza, Vaidehi; Torres, Fernando; Garcia, Christine Kim

2017-08-01

Prior studies have shown that patients with pulmonary fibrosis with mutations in the telomerase genes have a high rate of certain complications after lung transplantation. However, few studies have investigated clinical outcomes based on leukocyte telomere length. We conducted an observational cohort study of all patients with pulmonary fibrosis who underwent lung transplantation at a single center between January 1, 2007, and December 31, 2014. Leukocyte telomere length was measured from a blood sample collected before lung transplantation, and subjects were stratified into 2 groups (telomere length <10th percentile vs ≥10th percentile). Primary outcome was post-lung transplant survival. Secondary outcomes included incidence of allograft dysfunction, non-pulmonary organ dysfunction, and infection. Approximately 32% of subjects had a telomere length <10th percentile. Telomere length <10th percentile was independently associated with worse survival (hazard ratio 10.9, 95% confidence interval 2.7-44.8, p = 0.001). Telomere length <10th percentile was also independently associated with a shorter time to onset of chronic lung allograft dysfunction (hazard ratio 6.3, 95% confidence interval 2.0-20.0, p = 0.002). Grade 3 primary graft dysfunction occurred more frequently in the <10th percentile group compared with the ≥10th percentile group (28% vs 7%; p = 0.034). There was no difference between the 2 groups in incidence of acute cellular rejection, cytopenias, infection, or renal dysfunction. Telomere length <10th percentile was associated with worse survival and shorter time to onset of chronic lung allograft dysfunction and thus represents a biomarker that may aid in risk stratification of patients with pulmonary fibrosis before lung transplantation. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Parent perception of healthy infant and toddler growth.

PubMed

Laraway, Kelly A; Birch, Leann L; Shaffer, Michele L; Paul, Ian M

2010-04-01

We hypothesized that parents of infants prefer growth at higher percentiles and are averse to growth at lower percentiles. Of 279 participating parents, only 10% desired their child's weight to be in the lowest quartile. For children weighing in the lowest quartile, 57% of parents thought their child's weight was "too low." In contrast, 66% of parents whose child's weight was in the top quartile preferred their child weigh that much. When viewing hypothetical infant growth trajectories, 47% ranked a growth chart demonstrating growth along the 10th percentile for weight as "least healthy" of 6 growth patterns, and 29% chose charts showing an infant at the 90th percentile for weight at age 1 as "healthiest." In conclusion, parents are averse to growth at the bottom of the weight growth chart but are much less likely to feel negatively about growth at higher percentiles. This is troubling given the childhood obesity epidemic.

Selective toxin effects on faster and slower growing individuals in the formation of hormesis at the population level - A case study with Lactuca sativa and PCIB.

PubMed

Belz, Regina G; Sinkkonen, Aki

2016-10-01

Natural plant populations have large phenotypic plasticity that enhances acclimation to local stress factors such as toxin exposures. While consequences of high toxin exposures are well addressed, effects of low-dose toxin exposures on plant populations are seldom investigated. In particular, the importance of 'selective low-dose toxicity' and hormesis, i.e. stimulatory effects, has not been studied simultaneously. Since selective toxicity can change the size distribution of populations, we assumed that hormesis alters the size distribution at the population level, and investigated whether and how these two low-dose phenomena coexist. The study was conducted with Lactuca sativa L. exposed to the auxin-inhibitor 2-(p-chlorophenoxy)-2-methylpropionic acid (PCIB) in vitro. In two separate experiments, L. sativa was exposed to 12 PCIB doses in 24 replicates (50 plants/replicate). Shoot/root growth responses at the population level were compared to the fast-growing (≥90% percentile) and the slow-growing subpopulations (≤10% percentile) by Mann-Whitney U testing and dose-response modelling. In the formation of pronounced PCIB hormesis at the population level, low-dose effects proved selective, but widely stimulatory which seems to counteract low-dose selective toxicity. The selectivity of hormesis was dose- and growth rate-dependent. Stimulation occurred at lower concentrations and stimulation percentage was higher among slow-growing individuals, but partly or entirely masked at the population level by moderate or negligible stimulation among the faster growing individuals. We conclude that the hormetic effect up to the maximum stimulation may be primarily facilitated by an increase in size of the most slow-growing individuals, while thereafter it seems that mainly the fast-growing individuals contributed to the observed hormesis at the population level. As size distribution within a population is related to survival, our study hints that selective effects on slow- and fast-growing individuals may change population dynamics, providing that similar effects can be repeated under field conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Insulin sensitivity indices: a proposal of cut-off points for simple identification of insulin-resistant subjects.

PubMed

Radikova, Z; Koska, J; Huckova, M; Ksinantova, L; Imrich, R; Vigas, M; Trnovec, T; Langer, P; Sebokova, E; Klimes, I

2006-05-01

Demanding measurement of insulin sensitivity using clamp methods does not simplify the identification of insulin resistant subjects in the general population. Other approaches such as fasting- or oral glucose tolerance test-derived insulin sensitivity indices were proposed and validated with the euglycemic clamp. Nevertheless, a lack of reference values for these indices prevents their wider use in epidemiological studies and clinical practice. The aim of our study was therefore to define the cut-off points of insulin resistance indices as well as the ranges of the most frequently obtained values for selected indices. A standard 75 g oral glucose tolerance test was carried out in 1156 subjects from a Caucasian rural population with no previous evidence of diabetes or other dysglycemias. Insulin resistance/sensitivity indices (HOMA-IR, HOMA-IR2, ISI Cederholm, and ISI Matsuda) were calculated. The 75th percentile value as the cut-off point to define IR corresponded with a HOMA-IR of 2.29, a HOMA-IR2 of 1.21, a 25th percentile for ISI Cederholm, and ISI Matsuda of 57 and 5.0, respectively. For the first time, the cut-off points for selected indices and their most frequently obtained values were established for groups of subjects as defined by glucose homeostasis and BMI. Thus, insulin-resistant subjects can be identified using this simple approach.

Does fluctuating asymmetry of antlers in white-tailed deer (Odocoileus virginianus) follow patterns predicted for sexually selected traits?

USGS Publications Warehouse

Ditchkoff, S.S.; Lochmiller, R.L.; Masters, R.E.; Starry, W.R.; Leslie, David M.

2001-01-01

Secondary sexual characters have been hypothesized to signal male quality and should demonstrate a negative relationship between the size of the trait and degree of fluctuating asymmetry because they are costly to produce. We collected morphometric and antler data from 439 white-tailed deer (Odocoileus virginianus) in Oklahoma, USA, in order to determine whether measures of antler asymmetry follow the patterns predicted for sexually selected characters. Relative fluctuating asymmetry was negatively related to antler size for all deer and within age groups up to five and a half years of age. We did not detect an association between asymmetry and antler size among deer that were six and a half years or older. When categorizing deer by antler size, we found that deer with small antlers (???33rd percentile) had greater levels of relative asymmetry than deer with large antlers (???67th percentile). The relative asymmetry of antlers was negatively related to age and was greatest in deer that were one and a half years old. Relative asymmetry was also negatively related to carcass mass, inside spread, skull length and body length. These data suggest that asymmetry in the antlers of white-tailed deer may be a reliable signal of quality and, as such, may be important in maintaining honesty in intrasexual advertisements during the breeding season.

Continuous glucose monitoring and its relationship to hemoglobin A1c and oral glucose tolerance testing in obese and prediabetic youth.

PubMed

Chan, Christine L; Pyle, Laura; Newnes, Lindsey; Nadeau, Kristen J; Zeitler, Philip S; Kelsey, Megan M

2015-03-01

The optimal screening test for diabetes and prediabetes in obese youth is controversial. We examined whether glycosylated hemoglobin (HbA1c) or the oral glucose tolerance test (OGTT) is a better predictor of free-living glycemia as measured by continuous glucose monitoring (CGM). This was a cross-sectional study of youth 10-18 years old, body mass index (BMI) 85th percentile or greater, with diabetes risk factors. Participants (n = 118) with BMI 85th percentile or greater, not on medications for glucose management, were recruited from primary care and pediatric endocrinology clinics around Denver, Colorado. HbA1c, fasting plasma glucose, and 2-hour glucose were collected and all participants wore a blinded CGM for 72 hours. CGM outcomes were determined and descriptive statistics calculated. Performance characteristics at current American Diabetes Association cutpoints were compared with CGM outcomes. CGM data were successfully collected on 98 obese youth. Those with prediabetes had significantly higher average glucose, area under the curve (AUC), peak glucose, and time greater than 120 and greater than 140 mg/dL (P < .01) on CGM than youth with normal HbA1c or OGTT. HbA1c had a greater magnitude of correlation to CGM average glucose, AUC, and minimum glucose; 2-hour glucose had a greater magnitude of correlation to CGM SD, peak glucose, and time greater than 140 and greater than 200 mg/dL. However, there were no overall differences in the strength comparisons between 2-hour glucose and HbA1c correlations to CGM outcomes. In obese youth, HbA1c and 2-hour glucose performed equally well at predicting free-living glycemia on CGM, suggesting that both are valid tests for dysglycemia screening.

Differentiating between Glioblastoma and Primary CNS Lymphoma Using Combined Whole-tumor Histogram Analysis of the Normalized Cerebral Blood Volume and the Apparent Diffusion Coefficient.

PubMed

Bao, Shixing; Watanabe, Yoshiyuki; Takahashi, Hiroto; Tanaka, Hisashi; Arisawa, Atsuko; Matsuo, Chisato; Wu, Rongli; Fujimoto, Yasunori; Tomiyama, Noriyuki

2018-05-31

This study aimed to determine whether whole-tumor histogram analysis of normalized cerebral blood volume (nCBV) and apparent diffusion coefficient (ADC) for contrast-enhancing lesions can be used to differentiate between glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL). From 20 patients, 9 with PCNSL and 11 with GBM without any hemorrhagic lesions, underwent MRI, including diffusion-weighted imaging and dynamic susceptibility contrast perfusion-weighted imaging before surgery. Histogram analysis of nCBV and ADC from whole-tumor voxels in contrast-enhancing lesions was performed. An unpaired t-test was used to compare the mean values for each type of tumor. A multivariate logistic regression model (LRM) was performed to classify GBM and PCNSL using the best parameters of ADC and nCBV. All nCBV histogram parameters of GBMs were larger than those of PCNSLs, but only average nCBV was statistically significant after Bonferroni correction. Meanwhile, ADC histogram parameters were also larger in GBM compared to those in PCNSL, but these differences were not statistically significant. According to receiver operating characteristic curve analysis, the nCBV average and ADC 25th percentile demonstrated the largest area under the curve with values of 0.869 and 0.838, respectively. The LRM combining these two parameters differentiated between GBM and PCNSL with a higher area under the curve value (Logit (P) = -21.12 + 10.00 × ADC 25th percentile (10 -3 mm 2 /s) + 5.420 × nCBV mean, P < 0.001). Our results suggest that whole-tumor histogram analysis of nCBV and ADC combined can be a valuable objective diagnostic method for differentiating between GBM and PCNSL.

A cross sectional study of the association between walnut consumption and cognitive function among adult US populations represented in NHANES.

PubMed

Arab, L; Ang, A

2015-03-01

To examine the association between walnut consumption and measures of cognitive function in the US population. Nationally representative cross sectional study using 24 hour dietary recalls of intakes to assess walnut and other nut consumption as compared to the group reporting no nut consumption. 1988-1994 and 1999-2002 rounds of the National Health and Nutrition Examination Survey (NHANES). Representative weighted sample of US adults 20 to 90 years of age. The Neurobehavioral Evaluation System 2 (NES2), consisting of simple reaction time (SRTT), symbol digit substitution (SDST), the single digit learning (SDLT), Story Recall (SRT) and digit-symbol substitution (DSST) tests. Adults 20-59 years old reporting walnut consumption of an average of 10.3 g/d required 16.4ms less time to respond on the SRTT, P=0.03, and 0.39s less for the SDST, P=0.01. SDLT scores were also significantly lower by 2.38s (P=0.05). Similar results were obtained when tertiles of walnut consumption were examined in trend analyses. Significantly better outcomes were noted in all cognitive test scores among those with higher walnut consumption (P < 0.01). Among adults 60 years and older, walnut consumers averaged 13.1 g/d, scored 7.1 percentile points higher, P=0.03 on the SRT and 7.3 percentile points higher on the DSST, P=0.05. Here also trend analyses indicate significant improvements in all cognitive test scores (P < 0.01) except for SRTT (P = 0.06) in the fully adjusted models. These significant, positive associations between walnut consumption and cognitive functions among all adults, regardless of age, gender or ethnicity suggest that daily walnut intake may be a simple beneficial dietary behavior.

Interactive and additive influences of Gender, BMI and Apolipoprotein 4 on cognition in children chronically exposed to high concentrations of PM2.5 and ozone. APOE 4 females are at highest risk in Mexico City.

PubMed

Calderón-Garcidueñas, Lilian; Jewells, Valerie; Galaz-Montoya, Carolina; van Zundert, Brigitte; Pérez-Calatayud, Angel; Ascencio-Ferrel, Eric; Valencia-Salazar, Gildardo; Sandoval-Cano, Marcela; Carlos, Esperanza; Solorio, Edelmira; Acuña-Ayala, Hilda; Torres-Jardón, Ricardo; D'Angiulli, Amedeo

2016-10-01

Children's air pollution exposures are associated with systemic and brain inflammation and the early hallmarks of Alzheimer's disease (AD). The Apolipoprotein E (APOE) 4 allele is the most prevalent genetic risk for AD, with higher risk for women. We assessed whether gender, BMI, APOE and metabolic variables in healthy children with high exposures to ozone and fine particulate matter (PM2.5) influence cognition. The Wechsler Intelligence Scale for Children (WISC-R) was administered to 105 Mexico City children (12.32±5.4 years, 69 APOE 3/3 and 36 APOE 3/4). APOE 4v 3 children showed decrements on attention and short-term memory subscales, and below-average scores in Verbal, Performance and Full Scale IQ. APOE 4 females had higher BMI and females with normal BMI between 75-94% percentiles had the highest deficits in Total IQ, Performance IQ, Digit Span, Picture Arrangement, Block Design and Object Assembly. Fasting glucose was significantly higher in APOE 4 children p=0.006, while Gender was the main variable accounting for the difference in insulin, HOMA-IR and leptin (p<.05). Gender, BMI and APOE influence children's cognitive responses to air pollution and glucose is likely a key player. APOE 4 heterozygous females with >75% to <94% BMI percentiles are at the highest risk of severe cognitive deficits (1.5-2SD from average IQ). Young female results highlight the urgent need for gender-targeted health programmes to improve cognitive responses. Multidisciplinary intervention strategies could provide paths for prevention or amelioration of female air pollution targeted cognitive deficits and possible long-term AD progression. Copyright © 2016 Elsevier Inc. All rights reserved.

Australian national birthweight percentiles by sex and gestational age for twins, 2001-2010.

PubMed

Li, Zhuoyang; Umstad, Mark P; Hilder, Lisa; Xu, Fenglian; Sullivan, Elizabeth A

2015-10-08

Birthweight remains one of the strongest predictors of perinatal mortality and disability. Birthweight percentiles form a reference that allows the detection of neonates at higher risk of neonatal and postneonatal morbidity. The aim of the study is to present updated national birthweight percentiles by gestational age for male and female twins born in Australia. Population data were extracted from the Australian National Perinatal Data Collection for twins born in Australia between 2001 and 2010. A total of 43,833 women gave birth to 87,666 twins in Australia which were included in the study analysis. Implausible birthweights were excluded using Tukey's methodology based on the interquartile range. Univariate analysis was used to examine the birthweight percentiles for liveborn twins born between 20 and 42 weeks gestation. Birthweight percentiles by gestational age were calculated for 85,925 live births (43,153 males and 42,706 females). Of these infants, 53.6% were born preterm (birth before 37 completed weeks of gestation) while 50.2% were low birthweight (<2500 g) and 8.7% were very low birthweight (<1500 g). The mean birthweight decreased from 2462 g in 2001 to 2440 g in 2010 for male twins, compared with 2485 g in 1991-94. For female twins, the mean birthweight decreased from 2375 g in 2001 to 2338 g in 2010, compared with 2382 g in 1991-94. The birthweight percentiles provide clinicians and researchers with up-to-date population norms of birthweight percentiles for twins in Australia.

Pediatric reference intervals for alkaline phosphatase.

PubMed

Zierk, Jakob; Arzideh, Farhad; Haeckel, Rainer; Cario, Holger; Frühwald, Michael C; Groß, Hans-Jürgen; Gscheidmeier, Thomas; Hoffmann, Reinhard; Krebs, Alexander; Lichtinghagen, Ralf; Neumann, Michael; Ruf, Hans-Georg; Steigerwald, Udo; Streichert, Thomas; Rascher, Wolfgang; Metzler, Markus; Rauh, Manfred

2017-01-01

Interpretation of alkaline phosphatase activity in children is challenging due to extensive changes with growth and puberty leading to distinct sex- and age-specific dynamics. Continuous percentile charts from birth to adulthood allow accurate consideration of these dynamics and seem reasonable for an analyte as closely linked to growth as alkaline phosphatase. However, the ethical and practical challenges unique to pediatric reference intervals have restricted the creation of such percentile charts, resulting in limitations when clinical decisions are based on alkaline phosphatase activity. We applied an indirect method to generate percentile charts for alkaline phosphatase activity using clinical laboratory data collected during the clinical care of patients. A total of 361,405 samples from 124,440 patients from six German tertiary care centers and one German laboratory service provider measured between January 2004 and June 2015 were analyzed. Measurement of alkaline phosphatase activity was performed on Roche Cobas analyzers using the IFCC's photometric method. We created percentile charts for alkaline phosphatase activity in girls and boys from birth to 18 years which can be used as reference intervals. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. The percentile charts provided enable the appropriate differential diagnosis of changes in alkaline phosphatase activity due to disease and changes due to physiological development. After local validation, integration of the provided percentile charts into result reporting facilitates precise assessment of alkaline phosphatase dynamics in pediatrics.

Evaluation of the sensitivity of the Amazonian diurnal cycle to convective intensity in reanalyses

NASA Astrophysics Data System (ADS)

Itterly, Kyle F.; Taylor, Patrick C.

2017-02-01

Model parameterizations of tropical deep convection are unable to reproduce the observed diurnal and spatial variability of convection in the Amazon, which contributes to climatological biases in the water cycle and energy budget. Convective intensity regimes are defined using percentiles of daily minimum 3-hourly averaged outgoing longwave radiation (OLR) from Clouds and the Earth's Radiant Energy System (CERES). This study compares the observed spatial variability of convective diurnal cycle statistics for each regime to MERRA-2 and ERA-Interim (ERA) reanalysis data sets. Composite diurnal cycle statistics are computed for daytime hours (06:00-21:00 local time) in the wet season (December-January-February). MERRA-2 matches observations more closely than ERA for domain averaged composite diurnal statistics—specifically precipitation. However, ERA reproduces mesoscale features of OLR and precipitation phase associated with topography and the propagation of the coastal squall line. Both reanalysis models are shown to underestimate extreme convection.

Arsenic in stream sediments of northern Alabama

USGS Publications Warehouse

Goldhaber, M.B.; Irwin, Elise; Atkins, Brian; Lee, Lopaka; Black, D.D.; Zappia, Humbert; Hatch, Joe; Pashin, Jack; Barwick, L.H.; Cartwright, W.E.; Sanzolone, Rick; Rupert, Leslie; Kolker, Allan; Finkelman, Robert

2001-01-01

OVERVIEW OF ARSENIC IN STREAM SEDIMENTS The overall range of arsenic in the NURE stream sediments was from 0.3 to 44 mg/kg sediment (ppm) As in the sample data set. The mean value was 4.3 ppm with a standard deviation of 4.1 ppm. For comparison, the crustal abundance of arsenic is 1.8 ppm (Taylor, 1964). Shale is higher, with average values of 15 ppm. Coal samples from the entire USGS National Coal Resource Data System coal database (Finkelman, 1994) average 24 ppm arsenic. A study of stream sediments from throughout the U.S. by the USGS NAWQA program reported that the 75th percentile for arsenic in 541 stream sediments was 9.5 ppm (Rice, 1999). Given the relatively low crustal abundance of arsenic, a number of stream-sediment samples in this study may be considered geochemically anomalous in this element.

Evaluation of the Sensitivity of the Amazonian Diurnal Cycle to Convective Intensity in Reanalyses

NASA Technical Reports Server (NTRS)

Itterly, Kyle F.; Taylor, Patrick C.

2016-01-01

Model parameterizations of tropical deep convection are unable to reproduce the observed diurnal and spatial variability of convection in the Amazon, which contributes to climatological biases in the water cycle and energy budget. Convective intensity regimes are defined using percentiles of daily minimum 3-hourly averaged outgoing longwave radiation (OLR) from Clouds and the Earth's Radiant Energy System (CERES). This study compares the observed spatial variability of convective diurnal cycle statistics for each regime to MERRA-2 and ERA-Interim (ERA) reanalysis data sets. Composite diurnal cycle statistics are computed for daytime hours (06:00-21:00 local time) in the wet season (December-January-February). MERRA-2 matches observations more closely than ERA for domain averaged composite diurnal statistics-specifically precipitation. However, ERA reproduces mesoscale features of OLR and precipitation phase associated with topography and the propagation of the coastal squall line. Both reanalysis models are shown to underestimate extreme convection.

Economic status and temperature-related mortality in Asia

NASA Astrophysics Data System (ADS)

Lim, Youn-Hee; Bell, Michelle L.; Kan, Haidong; Honda, Yasushi; Guo, Yue-Liang Leon; Kim, Ho

2015-10-01

In developed countries, low latitude and high temperature are positively associated with the population's ability to adapt to heat. However, few studies have examined the effect of economic status on the relationship between long-term exposure to high temperature and health. We compared heterogeneous temperature-related mortality effects relative to the average summer temperature in high-socioeconomic-status (SES) cities to temperature-related effects in low-SES cities. In the first stage of the research, we conducted a linear regression analysis to quantify the mortality effects of high temperature (at or above the 95th percentile) in 32 cities in Taiwan, China, Japan, and Korea. In the second stage, we used a meta-regression to examine the association between mortality risk with average summer temperature and gross domestic product (GDP) per capita. In cities with a low GDP per capita (less than 20,000 USD), the effects of temperature were detrimental to the population if the long-term average summer temperature was high. In contrast, in cities with a high GDP per capita, temperature-related mortality risk was not significantly related to average summer temperature. The relationship between long-term average summer temperature and the short-term effects of high temperatures differed based on the city-level economic status.

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

Nasehi Tehrani, J; Wang, J; McEwan, A

Purpose: In this study, we developed and evaluated a method for predicting lung surface deformation vector fields (SDVFs) based on surrogate signals such as chest and abdomen motion at selected locations and spirometry measurements. Methods: A Patient-specific 3D triangular surface mesh of the lung region at end-expiration (EE) phase was obtained by threshold-based segmentation method. For each patient, a spirometer recorded the flow volume changes of the lungs; and 192 selected points at a regular spacing of 2cm X 2cm matrix points over a total area of 34cm X 24cm on the surface of chest and abdomen was used tomore » detect chest wall motions. Preprocessing techniques such as QR factorization with column pivoting (QRCP) were employed to remove redundant observations of the chest and abdominal area. To create a statistical model between the lung surface and the corresponding surrogate signals, we developed a predictive model based on canonical ridge regression (CRR). Two unique weighting vectors were selected for each vertex on the surface of the lung, and they were optimized during the training process using the all other phases of 4D-CT except the end-inspiration (EI) phase. These parameters were employed to predict the vertices locations of a testing data set, which was the EI phase of 4D-CT. Results: For ten lung cancer patients, the deformation vector field of each vertex of lung surface mesh was estimated from the external motion at selected positions on the chest wall surface plus spirometry measurements. The average estimation of 98th percentile of error was less than 1 mm (AP= 0.85, RL= 0.61, and SI= 0.82). Conclusion: The developed predictive model provides a non-invasive approach to derive lung boundary condition. Together with personalized biomechanical respiration modelling, the proposed model can be used to derive the lung tumor motion during radiation therapy accurately from non-invasive measurements.« less

A Group Motor Skills Program for Children with Coordination Difficulties: Effect on Fundamental Movement Skills and Physical Activity Participation.

PubMed

Kane, Kyra J; Staples, Kerri L

2016-01-01

Children with coordination difficulties are at risk of low levels of physical activity (PA) participation. This intervention examined the effects of a multidisciplinary program that emphasized parent participation on motor skill performance and PA. Ten boys (5-7 years) completed a group program consisting of conditioning exercises and activities designed to address child-selected goals. Motor proficiency and PA participation were assessed before and after the program using the Test of Gross Motor Development (TGMD-2) and triaxial accelerometers, respectively. Rating scales captured child and parent perceptions of performance for each child's goals. TGMD-2 subtest raw scores, age equivalent and percentile scores improved, along with parent ratings of their child's performance. Six children reported skill improvements. On average, moderate to vigorous PA improved by 10 min per day although these gains were not significant. Time spent in sedentary activities was unchanged. None of the children met the Canadian PA and sedentary behaviour guidelines. The results support effectiveness of a group program to improve gross motor performance and levels of PA in children with coordination difficulties. Gains in both of these domains also have the potential to impact quality of life and reduce health risks associated with inactivity.

The relationship of all-cause mortality to average on-treatment systolic blood pressure is significantly related to baseline systolic blood pressure: implications for interpretation of the Systolic Blood Pressure Intervention Trial study.

PubMed

Okin, Peter M; Kjeldsen, Sverre E; Devereux, Richard B

2018-04-01

The SPRINT study demonstrated that targeting systolic blood pressure (SBP) less than 120 mmHg was associated with lower cardiovascular event and mortality rates. In the LIFE study, however, a lower achieved SBP was associated with increased mortality. Mean baseline SBP in SPRINT was 140 mmHg and a third of the population had a baseline SBP 132 mmHg or less, raising the question of whether the lower baseline SBP in SPRINT could in part account for these differences. All-cause mortality during 4.8 ± 0.9 years follow-up was examined in relation to tertiles of achieved on-treatment average SBP in patients with baseline SBP of 25th percentile or less versus greater than 25th percentile value of 164 mmHg in 7998 nondiabetic hypertensive patients with ECG left ventricular hypertrophy randomly assigned to losartan-based or atenolol-based treatment. Average on-treatment SBP less than 142 mmHg (lowest tertile) and average SBP 142 mmHg to less than 152 mmHg (middle tertile) were compared with average SBP at least 152 mmHg (highest tertile and reference group). In the overall population, there was a significant interaction between baseline SBP 164 mmHg or less and average on-treatment SBP less than 142 mmHg in Cox analysis (χ = 15.48, P < 0.001). Among patients with baseline SBP greater than 164 mmHg, in multivariate Cox analyses adjusting for other potential predictors of mortality and a propensity score for having baseline SBP 164 mmHg or less and compared with average on-treatment SBP at least 152 mmHg, average on-treatment SBP less than 142 mmHg was associated with 32% higher mortality (hazard ratio 1.32, 95% CI 1.01-1.65), whereas average SBP of 142 mmHg to less than 152 mmHg was associated with 24% lower mortality (hazard ratio 0.76, 95% CI 0.59-0.98). In contrast, among patients with baseline SBP 164 mmHg or less, both average on-treatment SBP less than 142 mmHg (hazard ratio 0.60, 95% CI 0.36-0.99) and average SBP of 142 mmHg to less than 152 mmHg (hazard ratio 0.51, 95% CI 0.30-0.89) were associated with significantly lower mortality compared with average SBP of at least 152 mmHg. Achievement of an average SBP less than 142 mmHg was associated with reduced mortality in patients with baseline SBP 164 mmHg or less but with increased mortality in those with higher baseline SBP in LIFE. These findings suggest that the lower mortality associated with a lower targeted SBP in SPRINT may not be applicable to patients with considerably higher baseline SBP than SPRINT patients. Further study is necessary to better understand these findings. http://clinicaltrials.gov/ct/show/NCT00338260?order=1.

[Sensory oral motor and global motor development of preterm infants].

PubMed

de Castro, Adriana Guerra; Lima, Marilia de Carvalho; de Aquino, Rebeca Raposo; Eickmann, Sophie Helena

2007-01-01

development assessment of preterm infants. to evaluate the association between the gestational ages (GA) of premature infants with the global motor development as well as with early signs of sensory oral motor development delay, and to verify a possible association between them. an exploratory study that assessed the development of 55 infants with corrected chronological ages between four to five months, born preterm at the Instituto Materno Infantil Professor Fernando Figueira (IMIP) and who were followed at the Kangaroo Mother Program Clinic between March and August of 2004. The assessment of the sensory oral motor development was performed through pre-selected indicators and of the global motor development through the Alberta Infant Motor Scale (AIMS). infants with lower GA (29 to 34 weeks) presented a higher median of risk signs in the sensory oral motor development assessment when compared to those with higher GA (35 to 36 weeks). Regarding the global motor development, infants born with lower GA presented a higher number of scores in the AIMS below percentile 10 (26%) when compared to those with a higher GA (4%) (p=0.009). The median index of the risk signs for the sensory oral motor development were significantly higher among infants with total AIMS scores below percentile 25 when compared to those with scores equal to or above percentile 25. the gestational age of infants at birth influenced the sensory oral motor and global motor development - infants with lower gestational ages presented worse performances. These findings suggest a possible association between both aspects of infant development.

Anthropometric data peculiarities in early school children population.

PubMed

Jorjoliani, L; Karseladze, R; Vekua, M; Chkhartishvili, E; Bigvava, T

2011-01-01

The anthropometric data were studied in early school aged (6-7 years old) children and the degree of harmonization during physical development was evaluated. Representative population of 400 otherwise healthy early school aged children was included in study group. Study period covered the end of school year. In the selected under observation focused population the level of individual anthropometric data was determined in percentile intervals according its position. Anthropometric data assessments by using percentile method it was revealed in early school aged (6-7 years of old children) excess in body height and weight in comparison with normal values. This phenomenon indicates the prevalence of acceleration and weight gain. Anthropometric data in boys were increased while comparing with physical development data in girls. This result difference has the tendency to statistically insignificant. Physical development harmonization values were studied in 200 children. Harmonized physical development revealed in 50 children (25%); disharmonized physical development I 50 children (15%), among them with I degree weight gain were 48 (24%), and with I degree weight deficit were 2 (1%). Markedly disharmonized development had 100 children (50%), among them with II degree weight gain were 98 (49%), and with II degree weight deficit were 2 (1%). According to the children's anthropometric data and assessment by physical development harmonization percentiles tables three groups of children were organized: main, risk group and the group with deviation in physical development. On the basis of resulted data the study of early school age children's physical development gives possibility for risk groups stratification, which in turn itself makes a strong basis for reasonable preventive measurements and stepwise monitoring implementation.

Flexible parametric survival models built on age-specific antimüllerian hormone percentiles are better predictors of menopause.

PubMed

Ramezani Tehrani, Fahimeh; Mansournia, Mohammad Ali; Solaymani-Dodaran, Masoud; Steyerberg, Ewout; Azizi, Fereidoun

2016-06-01

This study aimed to improve existing prediction models for age at menopause. We identified all reproductive aged women with regular menstrual cycles who met our eligibility criteria (n = 1,015) in the Tehran Lipid and Glucose Study-an ongoing population-based cohort study initiated in 1998. Participants were examined every 3 years and their reproductive histories were recorded. Blood levels of antimüllerian hormone (AMH) were measured at the time of recruitment. Age at menopause was estimated based on serum concentrations of AMH using flexible parametric survival models. The optimum model was selected according to Akaike Information Criteria and the realness of the range of predicted median menopause age. We followed study participants for a median of 9.8 years during which 277 women reached menopause and found that a spline-based proportional odds model including age-specific AMH percentiles as the covariate performed well in terms of statistical criteria and provided the most clinically relevant and realistic predictions. The range of predicted median age at menopause for this model was 47.1 to 55.9 years. For those who reached menopause, the median of the absolute mean difference between actual and predicted age at menopause was 1.9 years (interquartile range 2.9). The model including the age-specific AMH percentiles as the covariate and using proportional odds as its covariate metrics meets all the statistical criteria for the best model and provides the most clinically relevant and realistic predictions for age at menopause for reproductive-aged women.

Consumptive Water-Use Coefficients for the Great Lakes Basin and Climatically Similar Areas

USGS Publications Warehouse

Shaffer, Kimberly H.; Runkle, Donna L.

2007-01-01

Consumptive water use is the portion of water withdrawn (for a particular use) that is evaporated, transpired, incorporated into products or crops, consumed by humans or livestock, or otherwise removed from the immediate water environment. This report, which is organized by water?use categories, includes consumptive?use coefficients for the Great Lakes Basin (including Canada) and for areas climatically similar to the Great Lakes Basin. This report also contains an annotated bibliography of consumptive water?use coefficients. Selected references are listed for consumptive?use data from elsewhere in the world. For the industrial water?use category, the median consumptive?use coefficients were 10 percent for the Great Lakes Basin, climatically similar areas, and the world; the 25th and 75th percentiles for these geographic areas were comparable within 6 percent. The combined domestic and public?supply consumptive?use statistics (median, 25th and 75th percentiles) were between 10 to 20 percent for the various geographic areas. Although summary statistics were similar for coefficients in the livestock and irrigation water?use categories for the Great Lakes Basin and climatically similar areas, statistic values for the world on a whole were substantially lower (15 to 28 percent lower). Commercial and thermoelectric power consumptive?use coefficient statistics (median, 25th, and 75th percentile) also were comparable for the Great Lakes Basin and climatically similar areas, within 2 percent. References for other countries were not found for commercial and thermoelectric power water?use categories. The summary statistics for the mining consumptive?use coefficients varied, likely because of differences in types of mining, processes, or equipment.

Relationship between BMI and blood pressure in girls and boys.

PubMed

Gundogdu, Zuhal

2008-10-01

To investigate the relationship between BMI and blood pressure as this is of crucial interest in evaluating both public health and the clinical impact of the so-called obesity epidemic. Data were gathered from 1899 children aged between 6 and 14 years, analysing and evaluating a possible relationship between BMI and systolic and diastolic blood pressure values for both girls and boys. Each child was classified on the basis of age- and sex-specific BMI percentile as normal weight (<85th percentile), overweight (95th percentile). In comparisons among age BMI percentile groups, systolic and diastolic blood pressure values were higher in obese and overweight groups than in normal weight groups for both sexes. Although BMI among girls was higher than among boys in all three percentile groups, there were no significant differences between sexes with respect to blood pressure values. The present findings emphasize the importance of the prevention of obesity in order to prevent future related problems such as hypertension in children and adolescents.

Interactive effects of specific fine particulate matter compositions and airborne pollen on frequency of clinic visits for pollinosis in Fukuoka, Japan.

PubMed

Phosri, Arthit; Ueda, Kayo; Tasmin, Saira; Kishikawa, Reiko; Hayashi, Masahiko; Hara, Keiichiro; Uehara, Yamato; Phung, Vera Ling Hui; Yasukouchi, Shusuke; Konishi, Shoko; Honda, Akiko; Takano, Hirohisa

2017-07-01

Previous studies have revealed the interactive effects of airborne pollen and particulate matter on the daily consultations for pollinosis, but it is uncertain which compositions are responsible. This study aimed to investigate the interactive effects of specific PM 2.5 compositions and airborne pollen on the daily number of clinic visits for pollinosis in Fukuoka. We obtained daily data on pollen concentrations, PM 2.5 compositions, PM 2.5 mass, gaseous pollutants (SO 2 , NO 2 , CO, and O 3 ), and weather variables monitored in Fukuoka between February and April, 2002-2012. In total, 73,995 clinic visits for pollinosis were made at 10 clinics in Fukuoka Prefecture during the study period. A time-stratified case-crossover design was applied to examine the interactive effects. The concentrations of PM 2.5 and its compositions were stratified into low (<15th percentile), moderate (15th-85th percentile), and high (>85th percentile) levels, and the association between airborne pollen and daily clinic visits for pollinosis was analyzed within each level. We found a significant interaction between specific PM 2.5 compositions and airborne pollen. Specifically, the odds ratio of daily clinic visits for pollinosis per interquartile increase in pollen concentration (39.8 grains/cm 2 ) at the average cumulative lag of 0 and 2 days during high levels of non-sea-salt Ca 2+ was 1.446 (95% CI: 1.323-1.581), compared to 1.075 (95% CI: 1.067-1.083) when only moderate levels were observed. This result remained significant when other air pollutants were incorporated into the model and was fairly persistent even when different percentile cut-off points were used. A similar interaction was found when we stratified the data according to non-sea-salt SO 4 2- levels. This finding differed from estimates made according to PM 2.5 and NO 3 - levels, which predicted that the effects of pollen were strongest in the lower levels. Associations between airborne pollen and daily clinic visits for pollinosis could be enhanced by high levels of specific PM 2.5 compositions, especially non-sea-salt Ca 2+ . Copyright © 2017 Elsevier Inc. All rights reserved.

A risk index for pediatric patients undergoing diagnostic imaging with 99mTc-dimercaptosuccinic acid that accounts for body habitus

NASA Astrophysics Data System (ADS)

O'Reilly, Shannon E.; Plyku, Donika; Sgouros, George; Fahey, Frederic H.; Treves, S. Ted; Frey, Eric C.; Bolch, Wesley E.

2016-03-01

Published guidelines for administered activity to pediatric patients undergoing diagnostic nuclear medicine imaging are currently obtained through expert consensus of the minimum values as a function of body weight as required to yield diagnostic quality images. We have previously shown that consideration of body habitus is also important in obtaining diagnostic quality images at the lowest administered activity. The objective of this study was to create a series of computational phantoms that realistically portray the anatomy of the pediatric patient population which can be used to develop and validate techniques to minimize radiation dose while maintaining adequate image quality. To achieve this objective, we have defined an imaging risk index that may be used in future studies to develop pediatric patient dosing guidelines. A population of 48 hybrid phantoms consisting of non-uniform B-spline surfaces and polygon meshes was generated. The representative ages included the newborn, 1 year, 5 year, 10 year and 15 year male and female. For each age, the phantoms were modeled at their 10th, 50th, and 90th height percentile each at a constant 50th weight percentile. To test the impact of kidney size, the newborn phantoms were modeled with the following three kidney volumes:  -15%, average, and  +15%. To illustrate the impact of different morphologies on dose optimization, we calculated the effective dose for each phantom using weight-based 99mTc-DMSA activity administration. For a given patient weight, body habitus had a considerable effect on effective dose. Substantial variations were observed in the risk index between the 10th and 90th percentile height phantoms from the 50th percentile phantoms for a given age, with the greatest difference being 18%. There was a dependence found between kidney size and risk of radiation induced kidney cancer, with the highest risk indices observed in newborns with the smallest kidneys. Overall, the phantoms and techniques in this study can be used to provide data to refine dosing guidelines for pediatric nuclear imaging studies while taking into account the effects on both radiation dose and image quality. This work was supported by:R01 EB013558 with the National Institute for Biomedical Imaging and Bioengineering (NIBIB).

Extreme pressure differences at 0900 NZST and winds across New Zealand

NASA Astrophysics Data System (ADS)

Salinger, M. James; Griffiths, Georgina M.; Gosai, Ashmita

2005-07-01

Trends in extremes in station daily sea-level pressure differences at 0900 NZST are examined, and extreme daily wind gusts, across New Zealand, since the 1960s. Annual time series were examined (with indices of magnitude and frequency over threshold percentiles) from the daily indices selected. These follow from earlier indices of normalized monthly mean sea-level pressure differences between station pairs, except the daily indices are not normalized. The frequency statistics quantify the number of extreme zonal (westerly and easterly), or extreme meridional (southerly or northerly), pressure gradient events. The frequency and magnitude of extreme westerly episodes has increased slightly over New Zealand, with a significant increase in the westerly extremes to the south of New Zealand. In contrast, the magnitude and frequency of easterly extremes has decreased over New Zealand, but increased to the south, with some trends weakly significant. The frequency and magnitude of daily southerly extremes has decreased significantly in the region.Extreme daily wind gust events at key climate stations in New Zealand and at Hobart, Australia, are highly likely to be associated with an extreme daily pressure difference. The converse was less likely to hold: extreme wind gusts were not always observed on days with extreme daily pressure difference, probably due to the strong influence that topography has on localized station winds. Significant correlations exist between the frequency indices and both annual-average mean sea-level pressures around the Australasian region and annual-average sea surface temperature (SST) anomalies in the Southern Hemisphere. These correlations are generally stronger for indices of extreme westerly or extreme southerly airflows. Annual-average pressures in the Tasman Sea or Southern Ocean are highly correlated to zonal indices (frequency of extreme westerlies). SST anomalies in the NINO3 region or on either side of the South Island are significantly correlated with the frequency of extreme westerly airflows.

Exposure to ambient air pollution in Canada and the risk of adult leukemia.

PubMed

Winters, Nicholas; Goldberg, Mark S; Hystad, Perry; Villeneuve, Paul J; Johnson, Kenneth C

2015-09-01

There is a paucity of studies investigating adult leukemia and air pollution. To address this gap, we analyzed data from a Canadian population-based case-control study conducted in 1994-1997. Cases were 1064 adults with incident leukemia and controls were 5039 healthy adults. We used data from satellites and fixed-site monitoring stations to estimate residential concentrations of NO2 and fine particulate matter (PM2.5) for the period prior to diagnosis, starting in 1975 and ending in 1994. We modeled the average annual exposure of each subject. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using logistic regression, adjusted for age, gender, province, smoking, education, body mass index, income, and self-reported exposures to ionizing radiation and benzene. We found an 'n-shaped' response function between exposure to NO2 and all forms of leukemia: from the tenth percentile to the median (4.51 to 14.66 ppb), the OR was 1.20; 95% CI: 0.97-1.48 and from the 75th percentile to the 90th (22.75 to 29.7 ppb), the OR was 0.79; 95% CI 0.68-0.93. For PM2.5 we found a response function consistent with a linear model, with an OR per 10 μg/m(3) of 0.97 (95% CI 0.75-1.26). For chronic lymphocytic leukemia we found response functions that were consistent with a simple linear model, with an OR per 5 ppb of NO2 of 0.93 (95% CI 0.86-1.00) and an OR per 10 μg/m(3) of PM2.5 of 0.62 (95% CI 0.42-0.93). In summary, for chronic lymphocytic leukemia we found no evidence of an association with air pollution and with all forms of leukemia we found weak evidence of an association only at low concentrations of NO2. It is possible that these inconsistent results may have arisen because of unaccounted urban/rural differences or possibly from a selection effect, especially among controls. Copyright © 2015 Elsevier B.V. All rights reserved.

Skin temperature evaluation by infrared thermography: Comparison of two image analysis methods during the nonsteady state induced by physical exercise

NASA Astrophysics Data System (ADS)

Formenti, Damiano; Ludwig, Nicola; Rossi, Alessio; Trecroci, Athos; Alberti, Giampietro; Gargano, Marco; Merla, Arcangelo; Ammer, Kurt; Caumo, Andrea

2017-03-01

The most common method to derive a temperature value from a thermal image in humans is the calculation of the average of the temperature values of all the pixels confined within a demarcated boundary defined region of interest (ROI). Such summary measure of skin temperature is denoted as Troi in this study. Recently, an alternative method for the derivation of skin temperature from the thermal image has been developed. Such novel method (denoted as Tmax) is based on an automated (software-driven) selection of the warmest pixels within the ROI. Troi and Tmax have been compared under basal, steady-state conditions, resulting very well correlated and characterized by a bias of approximately 1 °C (Tmax > Troi). Aim of this study was to investigate the relationship between Tmax and Troi under the nonsteady-state conditions induced by physical exercise. Thermal images of quadriceps of 13 subjects performing a squat exercise were recorded for 120 s before (basal steady state) and for 480 s after the initiation of the exercise (nonsteady state). The thermal images were then analysed to extract Troi and Tmax. Troi and Tmax changed almost in parallel during the nonstead -state. At a closer inspection, it was found that during the nonsteady state the bias between the two methods slightly increased (from 0.7 to 1.1 °C) and the degree of association between them slightly decreased (from Pearson's r = 0.96 to 0.83). Troi and Tmax had different relationships with the skin temperature histogram. Whereas Tmax was the mean, which could be interpreted as the centre of gravity of the histogram, Tmax was related with the extreme upper tail of the histogram. During the nonsteady state, the histogram increased its spread and became slightly more asymmetric. As a result, Troi deviated a little from the 50th percentile, while Tmax remained constantly higher than the 95th percentile. Despite their differences, Troi and Tmax showed a substantial agreement in assessing the changes in skin temperature following physical exercise. Further studies are needed to clarify the relationship existing among Tmax, Troi and cutaneous blood flow during physical exercise.

Inequality, poverty and development.

PubMed

Ahluwalia, M S

1976-12-01

Dicussion explores the nature of the relationship between the distribution of income and the process of development on the basis of cross country data on income inequality. The results presented are based on a sample of 60 countries, including 40 developing countries, 14 developed countries, and 6 socialist countries. The approach adopted is essentially exploratory. Multivariate regression analysis was used to estimate cross country relationships between the income shares of different percentile groups and selected variables reflecting aspects of the development process which are likely to influence income inequality. The estimated equations are then used as a basis for broad generalizations about the relationship between income distribution and development. There was strong support for the proposition that relative inequaltiy increases substantially in the early stages of development, with a reversal of this tendency in the later stages. The propositions held whether the sample was restricted to developing countries or expanded to include developed and socialist countries. The process was most prolonged for the poorest group. There were a number of processes occurring "pari passu" with development which were correlated with income inequality and which can plausibly be interpreted as causal. These were intersectoral shifts in the structure of production, expansion in education attainment and skill level of the labor force; and reduction in the growth of population. The operation of these processes appeared to explain some of the improvement in income distribution observed in the later stages of development, but they did not serve to explain the marked deterioration observed in the earlier stages. The cross section results failed to support the stronger hypothesis that the deterioration in relative inequality reflected a prolonged absolute impoverishment of large sections of the population in the course of development. The cross country pattern showed average absolute incomes of the lower percentile groups rising as per capita gross national product rises, although slower than for upper income groups. The cross section results failed to support the view that a faster rate of growth is systematically associated with higher inequality than can be expected given the state of development realized. An appendix identifies data sources and problems.

Parental Feeding Patterns and Child Weight Status for Latino Preschoolers

PubMed Central

Karp, Sharon M.; Barry, Kathleen M.; Gesell, Sabina B.; Po’e, Eli K.; Dietrich, Mary S.; Barkin, Shari L.

2015-01-01

Objective To examine the relationships between parental patterns regarding child feeding and child Body Mass Index (BMI) percentile in Latino parent-preschooler dyads participating in a clinical trial. Methods This secondary analysis examined data collected during a randomized clinical trial of a culturally tailored healthy lifestyle intervention focused on childhood obesity prevention, Salud Con La Familia. We analyzed 77 Latino parent-child dyads who completed baseline and 3-month follow-up data collection, assessing associations between preschool child BMI percentile and parental response to the Child Feeding Questionnaire (CFQ) over time. Results Higher child BMI was related to higher parental CFQ concern scores (r = 0.41, p <.001). A general inverse association between child BMI percentile and parental responsibility was also observed (r = −0.23, p = .040). Over the 3-month period, no statistically significant associations between changes in the CFQ subscale scores and changes in child BMI percentile were identified. Conclusions Child BMI percentile consistent with overweight/obese is associated with parental concern about child weight and child BMI percentile consistent with normal weight is associated with perceived responsibility for feeding. Emphasizing parental responsibility to help children to develop healthy eating habits could be an important aspect of interventions aimed at both preventing and reducing pediatric obesity for Latino preschoolers. PMID:24548581

Assessment of dissolved-selenium concentrations and loads in the lower Gunnison River Basin, Colorado, as part of the Selenium Management Program, from 2011 to 2016

USGS Publications Warehouse

Henneberg, Mark F.

2018-04-23

The Gunnison Basin Selenium Management Program implemented a water-quality monitoring network in 2011 in the lower Gunnison River Basin in Colorado. Selenium is a trace element that bioaccumulates in aquatic food chains and can cause reproductive failure, deformities, and other harmful effects. This report presents the percentile values of selenium because regulatory agencies in Colorado make decisions based on the U.S. Environmental Protection Agency (EPA) Clean Water Act Section 303(d) that uses percentile values of concentration. Also presented are dissolved-selenium loads at 18 sites in the lower Gunnison River Basin for water years (WYs) 2011–2016 (October 1, 2010, through September 30, 2016). Annual dissolved-selenium loads were calculated for five sites with continuous U.S. Geological Survey (USGS) streamflow-gaging stations. Annual dissolved-selenium loads for WY 2011 through WY 2016 ranged from 179 and 391 pounds (lb) at Uncompahgre River at Colona to 11,100 and 17,300 lb at Gunnison River near Grand Junction (herein called Whitewater), respectively. Instantaneous loads were calculated for five sites with continuous U.S. Geological Survey (USGS) streamflow-gaging stations and 13 ancillary sites where discrete water-quality sampling also took place, using discrete water-quality samples and the associated discharge measurements collected during the period. Median instantaneous loads ranged from 0.01 pound per day (lb/d) at Smith Fork near Lazear to 33.0 lb/d at Whitewater. Mean instantaneous loads ranged from 0.06 lb/d at Smith Fork near Lazear to 36.2 lb/d at Whitewater. Most tributary sites in the basin had a median instantaneous dissolved-selenium load of less than 20.0 lb/day. In general, dissolved-selenium loads at Gunnison River main-stem sites showed an increase from upstream to downstream. The State of Colorado water-quality standard for dissolved selenium of 4.6 micrograms per liter (µg/L) was compared to the 85th percentiles for dissolved selenium at selected sites. Annual 85th percentiles for dissolved selenium were calculated for the five core sites having USGS streamflow-gaging stations using estimated dissolved-selenium concentrations from linear regression models. The 85th-percentile concentrations for WYs 2011–2016 based on this method ranged from 0.62 µg/L and 1.1µg/L at Uncompahgre River at Colona to 12.1 µg/L and 18.7 µg/L at Uncompahgre River at Delta. The 85th percentiles for dissolved selenium also were calculated for sites with sufficient data using water-quality samples collected during WYs 2011–2016. The annual 85th-percentile concentrations based on the discrete samples ranged from 0.16 µg/L and 0.17 µg/L at Gunnison River below Gunnison Tunnel to 62.2 µg/L and 170 µg/L at Loutzenhizer Arroyo at North River Road. A trend analysis was completed for Whitewater to determine if dissolved-selenium loads are increasing or decreasing. The trend analysis indicates a decrease of 9,100 lb from WY 1986 to WY 2016, a 40.8 percent reduction during the time period. The trend analysis for the annual dissolved-selenium load for WY 1994 to WY 2016 indicates a decrease of 6,300 lb per year, or 33.3 percent.

Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

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

Andersen, Erlend K.F.; Hole, Knut Hakon; Lund, Kjersti V.

Purpose: To systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods and Materials: This study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test,more » resulting in p value and relative risk maps of all percentile-time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile-time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee. Results: The p value maps of nRSI and nAUC showed a large continuous region of percentile-time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile-time interval of nRSI was associated with progression-free survival. Conclusions: The percentile-time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.« less

Percentile Curves for Anthropometric Measures for Canadian Children and Youth

PubMed Central

Kuhle, Stefan; Maguire, Bryan; Ata, Nicole; Hamilton, David

2015-01-01

Body mass index (BMI) is commonly used to assess a child's weight status but it does not provide information about the distribution of body fat. Since the disease risks associated with obesity are related to the amount and distribution of body fat, measures that assess visceral or subcutaneous fat, such as waist circumference (WC), waist-to-height ratio (WHtR), or skinfolds thickness may be more suitable. The objective of this study was to develop percentile curves for BMI, WC, WHtR, and sum of 5 skinfolds (SF5) in a representative sample of Canadian children and youth. The analysis used data from 4115 children and adolescents between 6 and 19 years of age that participated in the Canadian Health Measures Survey Cycles 1 (2007/2009) and 2 (2009/2011). BMI, WC, WHtR, and SF5 were measured using standardized procedures. Age- and sex-specific centiles were calculated using the LMS method and the percentiles that intersect the adult cutpoints for BMI, WC, and WHtR at age 18 years were determined. Percentile curves for all measures showed an upward shift compared to curves from the pre-obesity epidemic era. The adult cutoffs for overweight and obesity corresponded to the 72nd and 91st percentile, respectively, for both sexes. The current study has presented for the first time percentile curves for BMI, WC, WHtR, and SF5 in a representative sample of Canadian children and youth. The percentile curves presented are meant to be descriptive rather than prescriptive as associations with cardiovascular disease markers or outcomes were not assessed. PMID:26176769

Percentile Curves for Anthropometric Measures for Canadian Children and Youth.

PubMed

Kuhle, Stefan; Maguire, Bryan; Ata, Nicole; Hamilton, David

2015-01-01

Body mass index (BMI) is commonly used to assess a child's weight status but it does not provide information about the distribution of body fat. Since the disease risks associated with obesity are related to the amount and distribution of body fat, measures that assess visceral or subcutaneous fat, such as waist circumference (WC), waist-to-height ratio (WHtR), or skinfolds thickness may be more suitable. The objective of this study was to develop percentile curves for BMI, WC, WHtR, and sum of 5 skinfolds (SF5) in a representative sample of Canadian children and youth. The analysis used data from 4115 children and adolescents between 6 and 19 years of age that participated in the Canadian Health Measures Survey Cycles 1 (2007/2009) and 2 (2009/2011). BMI, WC, WHtR, and SF5 were measured using standardized procedures. Age- and sex-specific centiles were calculated using the LMS method and the percentiles that intersect the adult cutpoints for BMI, WC, and WHtR at age 18 years were determined. Percentile curves for all measures showed an upward shift compared to curves from the pre-obesity epidemic era. The adult cutoffs for overweight and obesity corresponded to the 72nd and 91st percentile, respectively, for both sexes. The current study has presented for the first time percentile curves for BMI, WC, WHtR, and SF5 in a representative sample of Canadian children and youth. The percentile curves presented are meant to be descriptive rather than prescriptive as associations with cardiovascular disease markers or outcomes were not assessed.

The Effect on Somatic Growth of Surgical and Catheter Treatment of Secundum Atrial Septal Defects.

PubMed

Chlebowski, Meghan M; Dai, Hongying; Kaine, Stephen F

2017-10-01

Historical studies suggest an association between atrial septal defect (ASD) and impaired growth with inconsistent improvement following closure. Limited data exist regarding the impact on growth in the era of transcatheter therapy. To evaluate the effect of closure on growth, we conducted a retrospective review of patients undergoing surgical or transcatheter closure during two time periods. Four hundred patients with isolated secundum ASD were divided into three cohorts: early surgical, contemporary surgical, and transcatheter. Data collected included demographics; height, weight, and body mass index (BMI) percentiles; catheterization hemodynamics; and co-morbidities. For all cohorts, there was no significant change in height or weight percentiles during two years after ASD closure. Age at repair was later for contemporary surgical and transcatheter cohorts (p < 0.0001). In the transcatheter cohort, mean Qp:Qs was 1.65 ± 0.54, but there was no correlation between greater Qp:Qs and decreased somatic growth. Subgroup analysis for patients with any initial growth percentile <5th percentile demonstrated a significant change in weight and BMI percentiles in the first two years after closure (p < 0.0004). The advent of transcatheter therapy shifted institutional practice to later age at repair for both surgical and transcatheter closure. There was no significant change in weight and height percentiles during two years after closure. Only patients with initial weight and BMI <5th percentile had improved growth after treatment. Concern for impaired growth should not generally be an indication for early ASD repair. However, early repair may be indicated in children with existing significant growth failure.

Potential of MR histogram analyses for prediction of response to chemotherapy in patients with colorectal hepatic metastases.

PubMed

Liang, He-Yue; Huang, Ya-Qin; Yang, Zhao-Xia; Ying-Ding; Zeng, Meng-Su; Rao, Sheng-Xiang

2016-07-01

To determine if magnetic resonance imaging (MRI) histogram analyses can help predict response to chemotherapy in patients with colorectal hepatic metastases by using response evaluation criteria in solid tumours (RECIST1.1) as the reference standard. Standard MRI including diffusion-weighted imaging (b=0, 500 s/mm(2)) was performed before chemotherapy in 53 patients with colorectal hepatic metastases. Histograms were performed for apparent diffusion coefficient (ADC) maps, arterial, and portal venous phase images; thereafter, mean, percentiles (1st, 10th, 50th, 90th, 99th), skewness, kurtosis, and variance were generated. Quantitative histogram parameters were compared between responders (partial and complete response, n=15) and non-responders (progressive and stable disease, n=38). Receiver operator characteristics (ROC) analyses were further analyzed for the significant parameters. The mean, 1st percentile, 10th percentile, 50th percentile, 90th percentile, 99th percentile of the ADC maps were significantly lower in responding group than that in non-responding group (p=0.000-0.002) with area under the ROC curve (AUCs) of 0.76-0.82. The histogram parameters of arterial and portal venous phase showed no significant difference (p>0.05) between the two groups. Histogram-derived parameters for ADC maps seem to be a promising tool for predicting response to chemotherapy in patients with colorectal hepatic metastases. • ADC histogram analyses can potentially predict chemotherapy response in colorectal liver metastases. • Lower histogram-derived parameters (mean, percentiles) for ADC tend to have good response. • MR enhancement histogram analyses are not reliable to predict response.

Accuracy of birth certificate head circumference measurements: Massachusetts, 2012-2013.

PubMed

Somerville, Nicholas J; Chen, Xiaoli; Heinke, Dominique; Stone, Sarah L; Higgins, Cathleen; Manning, Susan E; Pagnano, Sharon; Yazdy, Mahsa M; Anderka, Marlene

2018-03-15

Zika virus has recently emerged as a novel cause of microcephaly. CDC has asked states to rapidly ascertain and report cases of Zika-linked birth defects, including microcephaly. Massachusetts added head circumference to its birth certificate (BC) in 2011. The accuracy of head circumference measurements from state vital records data has not been reported. We sought to assess the accuracy of Massachusetts BC head circumference measurements by comparing them to measurements for 2,217 infants born during 2012-2013 captured in the Massachusetts Birth Defects Monitoring Program (BDMP) data system. BDMP contains information abstracted directly from infant medical records and served as the true head circumference value (i.e., gold standard) for analysis. We calculated the proportion of head circumference measurements in agreement between the BC and BDMP data. We assigned growth chart head circumference percentile categories to each BC and BDMP measurement, and calculated the sensitivity and specificity of BC-based categories to predict BDMP-based categories. No difference was found in head circumference measurements between the two sources in 77.9% (n = 1,727) of study infants. The sensitivity of BC-based head circumference percentile categories ranged from 85.6% (<3rd percentile) to 92.7% (≥90th percentile) and the specificity ranged from 97.6% (≥90th percentile) to 99.3% (<3rd percentile). BC head circumference measurements agreed with those abstracted from the medical chart the majority of the time. Head circumference measurements on the BC were more specific than sensitive across all standardized growth chart percentile categories. © 2017 Wiley Periodicals, Inc.

Increased nuchal translucency thickness and risk of neurodevelopmental disorders.

PubMed

Hellmuth, S G; Pedersen, L H; Miltoft, C B; Petersen, O B; Kjaergaard, S; Ekelund, C; Tabor, A

2017-05-01

To investigate the association between fetal nuchal translucency (NT) thickness and neurodevelopmental disorders in euploid children. This study included 222 505 euploid children who had undergone routine first-trimester screening during fetal life. Children were divided according to prenatal NT into three groups: NT < 95 th percentile (n = 217 103 (97.6%)); NT 95 th -99 th percentile (n = 4760 (2.1%)); and NT > 99 th percentile (n = 642 (0.3%)). All children were followed-up to a mean age of 4.4 years. Information on diagnoses of intellectual disability, autism spectrum disorders (ASD), cerebral palsy, epilepsy and febrile seizures was obtained from national patient registries. There was no excess risk of neurodevelopmental disorders among euploid children with first-trimester NT 95 th -99 th percentile. For children with NT > 99 th percentile, there were increased risks of intellectual disability (odds ratio (OR), 6.16 (95% CI, 1.51-25.0), 0.31%) and ASD (OR, 2.48 (95% CI, 1.02-5.99), 0.78%) compared with children with NT < 95 th percentile (incidence of 0.05% for intellectual disability and 0.32% for ASD), however, there was no detected increase in the risk of cerebral palsy (OR, 1.91 (95% CI, 0.61-5.95), 0.47%), epilepsy (OR, 1.51 (95% CI, 0.63-3.66), 0.78%) or febrile seizures (OR, 0.72 (95% CI, 0.44-1.16), 2.65%). In a large unselected cohort of euploid children, there was no increased risk of neurodevelopmental disorders among those with a first-trimester NT 95 th -99 th percentile. Among euploid children with first-trimester NT > 99 th percentile, there were increased risks of intellectual disability and ASD, but the absolute risk was reassuringly low (< 1%). Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Anthropometric changes in adolescents with anorexia nervosa in response to resistance training.

PubMed

Fernandez-del-Valle, Maria; Larumbe-Zabala, Eneko; Graell-Berna, Montserrat; Perez-Ruiz, Margarita

2015-09-01

The follow-up of anthropometric percentiles such as triceps and mid-thigh skinfold thickness (TSF, MTSF), mid-upper arm and mid-thigh circumferences (MUAC, MTC), and arm and mid-thigh muscle areas (AMA, MTMA) after a resistance training might allow for detecting nutritional progress of fat and muscular tissue during the treatment of anorexia nervosa restricting (AN-R) type patients. A total of 44 AN-R patients were randomized for control (CG 13.0 ± 0.6 years) and intervention (IG 12.7 ± 0.7 years) groups after hospitalization. The intervention group underwent a resistance training program of 8 weeks following the guidelines for healthy adolescents (3 days/week; 70 % of 6 RM). All measurements were obtained prior to starting the program (PRE) and after 8 weeks of training (POST) in both groups. TSF, MTSF, MUAC, and MTC were measured, and AMA and MTMA were calculated. Data were matched with percentile tables for general population. Changes were assessed using statistical tests for categorical data. The distribution of percentile categories within the groups did not differ statistically after 8 weeks (p > 0.05). After training, 73 % of the patients were at the same percentile interval of MUAC, 18 % higher and 9 % lower, while 30 % of CG was at lower percentile categories. Further, 54 % of the IG patients remained at the same percentile interval of MTC after training, and 36 % higher, while 20 % were at lower categories in the CG. The AMA increased (32 %) after training or remained at the same interval (59 %) in the IG, while the IG showed greater frequency of percentile decreases (45 %). Anthropometric measurements could be useful for assessing muscle status in AN-R patients during the treatment process. However, exact standard deviation scores should be used instead of percentile categories to increase the sensitivity to changes in TSF, MTSF, MUAC, MTC or AMA.

A quantile regression approach can reveal the effect of fruit and vegetable consumption on plasma homocysteine levels.

PubMed

Verly, Eliseu; Steluti, Josiane; Fisberg, Regina Mara; Marchioni, Dirce Maria Lobo

2014-01-01

A reduction in homocysteine concentration due to the use of supplemental folic acid is well recognized, although evidence of the same effect for natural folate sources, such as fruits and vegetables (FV), is lacking. The traditional statistical analysis approaches do not provide further information. As an alternative, quantile regression allows for the exploration of the effects of covariates through percentiles of the conditional distribution of the dependent variable. To investigate how the associations of FV intake with plasma total homocysteine (tHcy) differ through percentiles in the distribution using quantile regression. A cross-sectional population-based survey was conducted among 499 residents of Sao Paulo City, Brazil. The participants provided food intake and fasting blood samples. Fruit and vegetable intake was predicted by adjusting for day-to-day variation using a proper measurement error model. We performed a quantile regression to verify the association between tHcy and the predicted FV intake. The predicted values of tHcy for each percentile model were calculated considering an increase of 200 g in the FV intake for each percentile. The results showed that tHcy was inversely associated with FV intake when assessed by linear regression whereas, the association was different when using quantile regression. The relationship with FV consumption was inverse and significant for almost all percentiles of tHcy. The coefficients increased as the percentile of tHcy increased. A simulated increase of 200 g in the FV intake could decrease the tHcy levels in the overall percentiles, but the higher percentiles of tHcy benefited more. This study confirms that the effect of FV intake on lowering the tHcy levels is dependent on the level of tHcy using an innovative statistical approach. From a public health point of view, encouraging people to increase FV intake would benefit people with high levels of tHcy.

Association between the Medical College Admission Test scores and Alpha Omega Alpha Medical Honors Society membership.

PubMed

Gauer, Jacqueline L; Jackson, J Brooks

2017-01-01

Medical schools worldwide are faced with the challenge of selecting from among many qualified applicants. One factor that might help admissions committees identify future exceptional medical students is scores on standardized entrance exams. The purpose of this study was to determine the association between scores on the most commonly used standardized medical school entrance exam in the USA, the Medical College Admission Test (MCAT), and election to the US medical honors society, Alpha Omega Alpha (AOA). MCAT scores and AOA membership data were analyzed for all the students pursuing Doctor of Medicine degrees at the University of Minnesota Medical School and who graduated between 2012-2016 (n=1,309). An independent-samples t -test found a significant difference (t=6.132, p <0.001) in MCAT scores between those who were elected to AOA (n=179) and those who were not (n=1,130). On average, students who were elected to AOA had composite MCAT scores of 1.65 points higher than those who were not. Percentages of students elected to AOA gradually but inconsistently increased with MCAT score. No student who scored <27 on the MCAT was elected to AOA. Among students with MCAT scores at the 99th percentile or above (scores of ≥38), 13 of 48 (27.1%) were elected to AOA. Election to AOA during medical school was significantly associated with higher MCAT scores. Admissions committees should carefully consider the role of standardized entrance exam scores, in the context of a holistic review, when selecting for exceptional medical students.

Association between the Medical College Admission Test scores and Alpha Omega Alpha Medical Honors Society membership

PubMed Central

Gauer, Jacqueline L; Jackson, J Brooks

2017-01-01

Introduction Medical schools worldwide are faced with the challenge of selecting from among many qualified applicants. One factor that might help admissions committees identify future exceptional medical students is scores on standardized entrance exams. The purpose of this study was to determine the association between scores on the most commonly used standardized medical school entrance exam in the USA, the Medical College Admission Test (MCAT), and election to the US medical honors society, Alpha Omega Alpha (AOA). Method MCAT scores and AOA membership data were analyzed for all the students pursuing Doctor of Medicine degrees at the University of Minnesota Medical School and who graduated between 2012–2016 (n=1,309). Results An independent-samples t-test found a significant difference (t=6.132, p<0.001) in MCAT scores between those who were elected to AOA (n=179) and those who were not (n=1,130). On average, students who were elected to AOA had composite MCAT scores of 1.65 points higher than those who were not. Percentages of students elected to AOA gradually but inconsistently increased with MCAT score. No student who scored <27 on the MCAT was elected to AOA. Among students with MCAT scores at the 99th percentile or above (scores of ≥38), 13 of 48 (27.1%) were elected to AOA. Discussion Election to AOA during medical school was significantly associated with higher MCAT scores. Admissions committees should carefully consider the role of standardized entrance exam scores, in the context of a holistic review, when selecting for exceptional medical students. PMID:28979178

TU-F-BRF-07: Accuracy of Routine Treatment Planning 4D and DIBH CT Delineation of the Left Anterior Descending Artery in Radiotherapy

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

White, B; Lin, L; Freedmen, G

2014-06-15

Purpose: To assess the feasibility of routine treatment planning 4DCT and deep inspiration breath-hold (DIBH) to accurately contour the left anterior descending artery (LAD), a primary indicator of cardiac toxicity, for radiotherapy treatment planning of breast cancer. Methods: Ten subjects were imaged with a cardiac-gated MRI protocol to determine the displacement of a ROI that included the LAD. The subjects performed a series of breath-hold maneuvers to obtain short-axis and radial views, which were resampled to create a 3D-volume. Tissue motion was determined using a multi-resolution 3D optical flow deformable image registration algorithm. The ROI motion was then used asmore » a spatial boundary to characterize the blurring motion of the LAD in ten patients during clinical 4DCT and DIBH protocols. A radiologist contoured the LAD. Coronary motion-induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD despite motion-blurring. The 4DCT maximum inhalation and exhalation respiratory phases were co-registered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90{sup th} percentile heart motion for the ROI was 0.7±0.1mm(LR), 1.3±0.6mm(SI), 0.6±0.2mm(AP) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4±4.5% for the DIBH. During tidal respiration, the average relative increase in the LAD contour was 69.3±5.9% and 67.9±4.6% for inhalation and exhalation respiratory phases respectively. The average 90{sup th} percentile LAD motion was 4.8±1.1mm(LR), 0.9±0.4mm(SI), 1.9±0.6mm(AP) for the 4DCT cohort, in the absence of cardiac-gating. Conclusion: Uncompensated coronary motion was the dominant form of motion blurring present in the CT images due to the high frequency of the cardiac cycle relative to the respiratory cycle. The 4D and DIBH CT contour delineation of the LAD was consistently overestimated without cardiac-gating, which could have led to inaccurate dose volume histogram indicators in clinical practice.« less

Variable Trends in High Peak Flow Generation Across the Swedish Sub-Arctic

NASA Astrophysics Data System (ADS)

Matti, B.; Dahlke, H. E.; Lyon, S. W.

2015-12-01

There is growing concern about increased frequency and severity of floods and droughts globally in recent years. Improving knowledge on the complexity of hydrological systems and their interactions with climate is essential to be able to determine drivers of these extreme events and to predict changes in these drivers under altered climate conditions. This is particularly true in cold regions such as the Swedish Sub-Arctic where independent shifts in both precipitation and temperature can have significant influence on extremes. This study explores changes in the magnitude and timing of the annual maximum daily flows in 18 Swedish sub-arctic catchments. The Mann-Kendall trend test was used to estimate changes in selected hydrological signatures. Further, a flood frequency analysis was conducted by fitting a Gumbel (Extreme Value type I) distribution whereby selected flood percentiles were tested for stationarity using a generalized least squares regression approach. Our results showed that hydrological systems in cold climates have complex, heterogeneous interactions with climate. Shifts from a snowmelt-dominated to a rainfall-dominated flow regime were evident with all significant trends pointing towards (1) lower flood magnitudes in the spring flood; (2) earlier flood occurrence; (3) earlier snowmelt onset; and (4) decreasing mean summer flows. Decreasing trends in flood magnitude and mean summer flows suggest permafrost thawing and are in agreement with the increasing trends in annual minimum flows. Trends in the selected flood percentiles showed an increase in extreme events over the entire period of record, while trends were variable under shorter periods. A thorough uncertainty analysis emphasized that the applied trend test is highly sensitive to the period of record considered. As such, no clear overall regional pattern could be determined suggesting that how catchments are responding to changes in climatic drivers is strongly influenced by their physical characteristics.

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

White, Benjamin M., E-mail: benjamin.white@uphs.upenn.edu; Vennarini, Sabina; Lin, Lilie

Purpose: To assess the feasibility of radiation therapy treatment planning 4-dimensional computed tomography (4DCT) and deep-inspiration breath-hold (DIBH) CT to accurately contour the left anterior descending artery (LAD), a primary indicator of radiation-induced cardiac toxicity for patients undergoing radiation therapy. Methods and Materials: Ten subjects were prospectively imaged with a cardiac-gated MRI protocol to determine cardiac motion effects, including the displacement of a region of interest comprising the LAD. A series of planar views were obtained and resampled to create a 3-dimensional (3D) volume. A 3D optical flow deformable image registration algorithm determined tissue displacement during the cardiac cycle. Themore » measured motion was then used as a spatial boundary to characterize motion blurring of the radiologist-delineated LAD structure for a cohort of 10 consecutive patients enrolled prospectively on a breast study including 4DCT and DIBH scans. Coronary motion–induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD structure despite the presence of motion blurring. The 4DCT maximum inhalation and exhalation respiratory phases were coregistered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90th percentile heart motion for the region of interest was 0.7 ± 0.1 mm (left–right [LR]), 1.3 ± 0.6 mm (superior–inferior [SI]), and 0.6 ± 0.2 mm (anterior–posterior [AP]) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4% ± 4.5% for the DIBH. The LAD volume overestimation had the dosimetric impact of decreasing the reported mean LAD dose by 23% ± 9% on average in the DIBH. During tidal respiration the average relative LAD contour increase was 69.3% ± 5.9% and 67.9% ± 4.6% for inhalation and exhalation respiratory phases, respectively. The average 90th percentile LAD motion was 4.8 ± 1.1 mm (LR), 0.9 ± 0.4 mm (SI), and 1.9 ± 0.6 mm (AP) for the 4DCT cohort, in the absence of cardiac gating. Conclusions: An anisotropic margin of 2.7 mm (LR), 4.1 mm (SI), and 2.4 mm (AP) was quantitatively determined to account for motion blurring and patient setup error while placing minimum constraint on the plan optimization.« less

Skin exposure to aliphatic polyisocyanates in the auto body repair and refinishing industry: III. A personal exposure algorithm.

PubMed

Liu, Youcheng; Stowe, Meredith H; Bello, Dhimiter; Sparer, Judy; Gore, Rebecca J; Cullen, Mark R; Redlich, Carrie A; Woskie, Susan R

2009-01-01

Isocyanate skin exposure may play an important role in sensitization and the development of isocyanate asthma, but such exposures are frequently intermittent and difficult to assess. Exposure metrics are needed to better estimate isocyanate skin exposures. The goal of this study was to develop a semiquantitative algorithm to estimate personal skin exposures in auto body shop workers using task-based skin exposure data and daily work diaries. The relationship between skin and respiratory exposure metrics was also evaluated. The development and results of respiratory exposure metrics were previously reported. Using the task-based data obtained with a colorimetric skin exposure indicator and a daily work diary, we developed a skin exposure algorithm to estimate a skin exposure index (SEI) for each worker. This algorithm considered the type of personal protective equipment (PPE) used, the percentage of skin area covered by PPE and skin exposures without and underneath the PPE. The SEI was summed across the day (daily SEI) and survey week (weekly average SEI) for each worker, compared among the job title categories and also compared with the respiratory exposure metrics. A total of 893 person-days was calculated for 232 workers (49 painters, 118 technicians and 65 office workers) from 33 auto body shops. The median (10th-90th percentile, maximum) daily SEI was 0 (0-0, 1.0), 0 (0-1.9, 4.8) and 1.6 (0-3.5, 6.1) and weekly average SEI was 0 (0-0.0, 0.7), 0.3 (0-1.6, 4.2) and 1.9 (0.4-3.0, 3.6) for office workers, technicians and painters, respectively, which were significantly different (P < 0.0001). The median (10th-90th percentile, maximum) daily SEI was 0 (0-2.4, 6.1) and weekly average SEI was 0.2 (0-2.3, 4.2) for all workers. A relatively weak positive Spearman correlation was found between daily SEI and time-weighted average (TWA) respiratory exposure metrics (microg NCO m(-3)) (r = 0.380, n = 893, P < 0.0001) and between weekly SEI and TWA respiratory exposure metrics (r = 0.482, n = 232, P < 0.0001). The skin exposure algorithm developed in this study provides task-based personal daily and weekly average skin exposure indices that are adjusted for the use of PPE. These skin exposure indices can be used to assess isocyanate exposure-response relationships.

Using quantile regression to examine health care expenditures during the Great Recession.

PubMed

Chen, Jie; Vargas-Bustamante, Arturo; Mortensen, Karoline; Thomas, Stephen B

2014-04-01

To examine the association between the Great Recession of 2007-2009 and health care expenditures along the health care spending distribution, with a focus on racial/ethnic disparities. Secondary data analyses of the Medical Expenditure Panel Survey (2005-2006 and 2008-2009). Quantile multivariate regressions are employed to measure the different associations between the economic recession of 2007-2009 and health care spending. Race/ethnicity and interaction terms between race/ethnicity and a recession indicator are controlled to examine whether minorities encountered disproportionately lower health spending during the economic recession. The Great Recession was significantly associated with reductions in health care expenditures at the 10th-50th percentiles of the distribution, but not at the 75th-90th percentiles. Racial and ethnic disparities were more substantial at the lower end of the health expenditure distribution; however, on average the reduction in expenditures was similar for all race/ethnic groups. The Great Recession was also positively associated with spending on emergency department visits. This study shows that the relationship between the Great Recession and health care spending varied along the health expenditure distribution. More variability was observed in the lower end of the health spending distribution compared to the higher end. © Health Research and Educational Trust.

Using Quantile Regression to Examine Health Care Expenditures during the Great Recession

PubMed Central

Chen, Jie; Vargas-Bustamante, Arturo; Mortensen, Karoline; Thomas, Stephen B

2014-01-01

Objective To examine the association between the Great Recession of 2007–2009 and health care expenditures along the health care spending distribution, with a focus on racial/ethnic disparities. Data Sources/Study Setting Secondary data analyses of the Medical Expenditure Panel Survey (2005–2006 and 2008–2009). Study Design Quantile multivariate regressions are employed to measure the different associations between the economic recession of 2007–2009 and health care spending. Race/ethnicity and interaction terms between race/ethnicity and a recession indicator are controlled to examine whether minorities encountered disproportionately lower health spending during the economic recession. Principal Findings The Great Recession was significantly associated with reductions in health care expenditures at the 10th–50th percentiles of the distribution, but not at the 75th–90th percentiles. Racial and ethnic disparities were more substantial at the lower end of the health expenditure distribution; however, on average the reduction in expenditures was similar for all race/ethnic groups. The Great Recession was also positively associated with spending on emergency department visits. Conclusion This study shows that the relationship between the Great Recession and health care spending varied along the health expenditure distribution. More variability was observed in the lower end of the health spending distribution compared to the higher end. PMID:24134797

Metal working fluid exposure and diseases in Switzerland.

PubMed

Koller, Michael F; Pletscher, Claudia; Scholz, Stefan M; Schneuwly, Philippe

2016-07-01

Exposure to metal working fluids (MWF) is common in machining processes worldwide and may lead to diseases of the skin and the respiratory tract. The aim of the study was to investigate exposure and diseases due to MWF in Switzerland between 2004 and 2013. We performed descriptive statistics including determination of median and 90th percentile values of MWF concentrations listed in a database of Suva. Moreover, we clustered MWF-induced occupational diseases listed in a database from the Swiss Central Office for Statistics in Accident Insurance, and performed linear regression over time to investigate temporal course of the illnesses. The 90th percentile for MWF air concentration was 8.1 mg (aerosol + vapor)/m 3 and 0.9 mg aerosol/m 3 (inhalable fraction). One thousand two hundred and eighty skin diseases and 96 respiratory diseases were observed. This is the first investigation describing exposure to and diseases due to MWF in Switzerland over a timeframe of 10 years. In general, working conditions in the companies of this investigation were acceptable. Most measured MWF concentrations were below both the Swiss and most international occupational exposure limits of 2014. The percentage of workers declared unfit for work was 17% compared to the average of other occupational diseases (12%).

Efficient estimation of Pareto model: Some modified percentile estimators.

PubMed

Bhatti, Sajjad Haider; Hussain, Shahzad; Ahmad, Tanvir; Aslam, Muhammad; Aftab, Muhammad; Raza, Muhammad Ali

2018-01-01

The article proposes three modified percentile estimators for parameter estimation of the Pareto distribution. These modifications are based on median, geometric mean and expectation of empirical cumulative distribution function of first-order statistic. The proposed modified estimators are compared with traditional percentile estimators through a Monte Carlo simulation for different parameter combinations with varying sample sizes. Performance of different estimators is assessed in terms of total mean square error and total relative deviation. It is determined that modified percentile estimator based on expectation of empirical cumulative distribution function of first-order statistic provides efficient and precise parameter estimates compared to other estimators considered. The simulation results were further confirmed using two real life examples where maximum likelihood and moment estimators were also considered.

Quantitative Lesion-to-Fat Elasticity Ratio Measured by Shear-Wave Elastography for Breast Mass: Which Area Should Be Selected as the Fat Reference?

PubMed

Youk, Ji Hyun; Son, Eun Ju; Gweon, Hye Mi; Han, Kyung Hwa; Kim, Jeong-Ah

2015-01-01

To investigate whether the diagnostic performance of lesion-to-fat elasticity ratio (Eratio) was affected by the location of the reference fat. For 257 breast masses in 250 women who underwent shear-wave elastography before biopsy or surgery, multiple Eratios were measured with a fixed region-of-interest (ROI) in the mass along with multiple ROIs over the surrounding fat in different locations. Logistic regression analysis was used to determine that Eratio was independently associated with malignancy adjusted for the location of fat ROI (depth, laterality, and distance from lesion or skin). Mean (Emean) and maximum (Emax) elasticity values of fat were divided into four groups according to their interquartile ranges. Diagnostic performance of each group was evaluated using the area under the ROC curve (AUC). False diagnoses of Eratio were reviewed for ROIs on areas showing artifactual high or low stiffness and analyzed by logistic regression analysis to determine variables (associated palpable abnormality, lesion size, the vertical distance from fat ROI to skin, and elasticity values of lesion or fat) independently associated with false results. Eratio was independently associated with malignancy adjusted for the location of fat ROI (P<0.0001). Among four groups of fat elasticity values, the AUC showed no significant difference (<25th percentile, 25th percentile~median, median~75th percentile, and ≥75th percentile; 0.973, 0.982, 0.967, and 0.954 for Emean; 0.977, 0.967, 0.966, and 0.957 for Emax). Fat elasticity values were independently associated with false results of Eratio with the cut-off of 3.18 from ROC curve (P<0.0001). ROIs were set on fat showing artifactual high stiffness in 90% of 10 false negatives and on lesion showing vertical striped artifact or fat showing artifactual low stiffness in 77.5% of 71 false positives. Eratio shows good diagnostic performance regardless of the location of reference fat, except when it is placed in areas of artifacts.

Quantitative Lesion-to-Fat Elasticity Ratio Measured by Shear-Wave Elastography for Breast Mass: Which Area Should Be Selected as the Fat Reference?

PubMed Central

Youk, Ji Hyun; Son, Eun Ju; Gweon, Hye Mi; Han, Kyung Hwa; Kim, Jeong-Ah

2015-01-01

Objectives To investigate whether the diagnostic performance of lesion-to-fat elasticity ratio (Eratio) was affected by the location of the reference fat. Methods For 257 breast masses in 250 women who underwent shear-wave elastography before biopsy or surgery, multiple Eratios were measured with a fixed region-of-interest (ROI) in the mass along with multiple ROIs over the surrounding fat in different locations. Logistic regression analysis was used to determine that Eratio was independently associated with malignancy adjusted for the location of fat ROI (depth, laterality, and distance from lesion or skin). Mean (Emean) and maximum (Emax) elasticity values of fat were divided into four groups according to their interquartile ranges. Diagnostic performance of each group was evaluated using the area under the ROC curve (AUC). False diagnoses of Eratio were reviewed for ROIs on areas showing artifactual high or low stiffness and analyzed by logistic regression analysis to determine variables (associated palpable abnormality, lesion size, the vertical distance from fat ROI to skin, and elasticity values of lesion or fat) independently associated with false results. Results Eratio was independently associated with malignancy adjusted for the location of fat ROI (P<0.0001). Among four groups of fat elasticity values, the AUC showed no significant difference (<25th percentile, 25th percentile~median, median~75th percentile, and ≥75th percentile; 0.973, 0.982, 0.967, and 0.954 for Emean; 0.977, 0.967, 0.966, and 0.957 for Emax). Fat elasticity values were independently associated with false results of Eratio with the cut-off of 3.18 from ROC curve (P<0.0001). ROIs were set on fat showing artifactual high stiffness in 90% of 10 false negatives and on lesion showing vertical striped artifact or fat showing artifactual low stiffness in 77.5% of 71 false positives. Conclusion Eratio shows good diagnostic performance regardless of the location of reference fat, except when it is placed in areas of artifacts. PMID:26368920

Weight-Independent Percentile Chart of 2880 Gastric Bypass Patients: a New Look at Bariatric Weight Loss Results.

PubMed

van de Laar, Arnold W; de Brauw, Maurits; Bruin, Sjoerd C; Acherman, Yair I

2016-12-01

Percentile charts would be ideal for assessing sufficient weight loss in bariatric surgery. They allow comparing individual results to the outcome of many others, at any postoperative time. Unfortunately, percentile charts can be problematic when comparing unequally heavy peers, a circumstance not uncommon among bariatric patients. We investigate the relevance of this disadvantage and combine new insights to improve the practical use of percentile charts in bariatric surgery. Laparoscopic Roux-en-Y gastric bypass outcome expressed with body mass index (BMI), excess weight loss (%EWL), total weight loss (%TWL), and alterable weight loss (%AWL), a new metric rendering outcome independent of baseline BMI, is used to build percentile curves p97/p90/p75/p50/p25/p10/p03 with the lambda-mu-sigma method. We used the %AWL p25 curve as baseline BMI-independent reference for sufficient weight loss and compared it to p25 curves based on common metrics and to traditional criteria ≥50 % EWL, <25 % EWL, and BMI < 35 kg/m 2 . We operated 2880 patients, with baseline BMI of 43.4 kg/m 2 , follow-up 71 %, and mean of 23.3 (0-87.6) months. Independent %AWL outcome is presented in one percentile chart. Percentile curves p25/p50/p75 show 40/48/57 % AWL at nadir 15/16/19 months, 35/45/54 % AWL at 3 years, and 30/38/47 % AWL at 7 years. Traditional criteria and p25 curves based on %EWL and BMI match with most sufficient results (high sensitivities), but overlook many insufficient results (low specificities). We present the first baseline BMI-independent bariatric weight loss percentile chart. It allows comparing heavier patients to lighter peers and vice versa, at any postoperative time, up to 7 years. With these advantages, we compared it to traditional bariatric criteria like ≥50 % EWL and found that they are weak in recognizing insufficient weight loss. The visual aspect of consecutive results plotted on a chart among the percentile curves of peers conveys a strong, intuitive message on the personal progress of postoperative weight loss.

Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis).

PubMed

Budoff, Matthew J; Nasir, Khurram; McClelland, Robyn L; Detrano, Robert; Wong, Nathan; Blumenthal, Roger S; Kondos, George; Kronmal, Richard A

2009-01-27

In this study, we aimed to establish whether age-sex-specific percentiles of coronary artery calcium (CAC) predict cardiovascular outcomes better than the actual (absolute) CAC score. The presence and extent of CAC correlates with the overall magnitude of coronary atherosclerotic plaque burden and with the development of subsequent coronary events. MESA (Multi-Ethnic Study of Atherosclerosis) is a prospective cohort study of 6,814 asymptomatic participants followed for coronary heart disease (CHD) events including myocardial infarction, angina, resuscitated cardiac arrest, or CHD death. Time to incident CHD was modeled with Cox regression, and we compared models with percentiles based on age, sex, and/or race/ethnicity to categories commonly used (0, 1 to 100, 101 to 400, 400+ Agatston units). There were 163 (2.4%) incident CHD events (median follow-up 3.75 years). Expressing CAC in terms of age- and sex-specific percentiles had significantly lower area under the receiver-operating characteristic curve (AUC) than when using absolute scores (women: AUC 0.73 versus 0.76, p = 0.044; men: AUC 0.73 versus 0.77, p < 0.001). Akaike's information criterion indicated better model fit with the overall score. Both methods robustly predicted events (>90th percentile associated with a hazard ratio [HR] of 16.4, 95% confidence interval [CI]: 9.30 to 28.9, and score >400 associated with HR of 20.6, 95% CI: 11.8 to 36.0). Within groups based on age-, sex-, and race/ethnicity-specific percentiles there remains a clear trend of increasing risk across levels of the absolute CAC groups. In contrast, once absolute CAC category is fixed, there is no increasing trend across levels of age-, sex-, and race/ethnicity-specific categories. Patients with low absolute scores are low-risk, regardless of age-, sex-, and race/ethnicity-specific percentile rank. Persons with an absolute CAC score of >400 are high risk, regardless of percentile rank. Using absolute CAC in standard groups performed better than age-, sex-, and race/ethnicity-specific percentiles in terms of model fit and discrimination. We recommend using cut points based on the absolute CAC amount, and the common CAC cut points of 100 and 400 seem to perform well.

Exposure to air pollution and respiratory symptoms during the first 7 years of life in an Italian birth cohort

PubMed Central

Ranzi, Andrea; Porta, Daniela; Badaloni, Chiara; Cesaroni, Giulia; Lauriola, Paolo; Davoli, Marina; Forastiere, Francesco

2014-01-01

Background Ambient air pollution has been consistently associated with exacerbation of respiratory diseases in schoolchildren, but the role of early exposure to traffic-related air pollution in the first occurrence of respiratory symptoms and asthma is not yet clear. Methods We assessed the association between indexes of exposure to traffic-related air pollution during different periods of life and respiratory outcomes in a birth cohort of 672 newborns (Rome, Italy). Direct interviews of the mother were conducted at birth and at 6, 15 months, 4 and 7 years. Exposure to traffic-related air pollution was assessed for each residential address during the follow-up period using a Land-Use Regression model (LUR) for nitrogen dioxide (NO2) and a Geographic Information System (GIS) variable of proximity to high-traffic roads (HTR) (>10 000vehicles/day). We used age-specific NO2 levels to develop indices of exposure at birth, current, and lifetime time-weighted average. The association of NO2 and traffic proximity with respiratory disorders were evaluated using logistic regression in a longitudinal approach (Generalised Estimating Equation). The exposure indexes were used as continuous and categorical variables (cut-off points based on the 75th percentile for NO2 and the 25th percentile for distance from HTRs). Results The average NO2 exposure level at birth was 37.2 μg/m3 (SD 7.2, 10–90th range 29.2–46.1). There were no statistical significant associations between the exposure indices and the respiratory outcomes in the longitudinal model. The odds ratios for a 10-µg/m3 increase in time-weighted average NO2 exposure were: asthma incidence OR=1.09; 95 CI% 0.78 to 1.52, wheezing OR=1.07; 95 CI% 0.90 to 1.28, shortness of breath with wheezing OR=1.16; 95 CI% 0.94 to 1.43, cough or phlegm apart from cold OR=1.11; 95 CI% 0.92 to 1.33, and otitis OR=1.08; 95 CI% 0.89 to 1.32. Stronger but not significant associations were found considering the 75th percentile of the NO2 distribution as a cut-off, especially for incidence of asthma and prevalence of wheeze (OR=1.41; 95 CI% 0.88 to 2.28 and OR=1.27; 95 CI% 0.95 to 1.70, respectively); the highest OR was found for wheezing (OR=2.29; 95 CI% 1.15 to 4.56) at the 7-year follow-up. No association was found with distance from HTRs. Conclusions Exposure to traffic-related air pollution is only weakly associated with respiratory symptoms in young children in the first 7 years of life. PMID:24659182

Influence of the social and economical factors on the indicators of height and weight among the pupils, residents of the city and villages in eastern Georgia (Kakheti region).

PubMed

Kharabadze, M; Khetsuriani, R; Betaneli, M; Mekokishvili, L; Chkuaseli, N

2012-11-01

The research has been held in the city and its villages among schoolgirls and schoolboys out of them are city (n=613) and village (n=241) residents. The body height and mass, was calculated according to standard methods. Also research based on questionnaires has been held .This research determines social-economic statement, physical activities and diets of students. Statistical processing of data was done with the help of statistic method ANOVA. Data compared to WHO child grows standard percentage-charts, and to percentile diagram made for georgian children and adolescents in 2001-2003. Concerning the height indexes stunting was noticed among the village resident girls at the age 9-14 (8,9%) and 9-11 year old boys (3,8%) and it also prevails among girls that require further researches to reveal reasons. Also the amount of law height index among girls and boys is high in the cities as well as villages although it prevails in the villages, mostly among boys (30, 8%). Comparing with village residents high height index prevails among the city resident boys (18,7%) and among girls (11, 9%), and higher than 97 percentile indexes is revealed among 4,9% of boys living in the city. Mass deficiency was reveled among the city girls 2,4 % and the village resident girls 5,1%; accordingly it is prevailed among girls living in the villages. Mass deficiency among the boys was only revealed among the city residents and it was 3,9 %. According to our data, decrease of the body mass average index is fixed among girls but among the boys it increase. and among 2,4% of girls. So village resident girls are shorter and thinner, but boys are short and overweight, comparing with the city residents. Research based on questionnaires showed that city resident school children food ration, whose social-economic condition is better, is rich with proteins, when majority of village residents food ration lack proteins and mostly consist of those products which are rich of carbohydrates. According to surveys low physical activity was revealed among city as well as village resident school children, especially in boys. Average height indexes based on our researches have been compared to percentile diagrams for children and adolescents of Georgia , based on researches held in 2001-2003. The average height indexes of the students born in 2000 and following years (including from 6 - 13 years) are located between the percentage indexes 50-90 established for Georgian children, but at the ages 14-18 between 10-50 which indicates to the tendency of increasing height of schoolchildren in the city and villages During the last years, tendency in the increasing of height is fixed in India and Sri Lanka.

Park size and disturbance: impact on soil heterogeneity - a case study Tel-Aviv- Jaffa.

NASA Astrophysics Data System (ADS)

Zhevelev, Helena; Sarah, Pariente; Oz, Atar

2015-04-01

Parks and gardens are poly-functional elements of great importance in urban areas, and can be used for optimization of physical and social components in these areas. This study aimed to investigate alteration of soil properties with land usages within urban park and with area size of park. Ten parks differed by size (2 - 50 acres) were chosen, in random, in Tel-Aviv- Jaffa city. Soil was sampled in four microenvironments ((lawn, path, picnic and peripheral area (unorganized area) of each the park)), in three points and three depth (0-2, 5-10 and 10-20 cm). Penetration depth was measured in all point of sampling. For each soil sample electrical conductivity and organic matter content were determined. Averages of penetration depth drastically increased from the most disturbed microenvironments (path and picnic) to the less disturbed ones (lawn and peripheral). The maximal heterogeneity (by variances and percentiles) of penetration depth was found in the peripheral area. In this area, penetration depth increased with increasing park size, i.e., from 2.6 cm to 3.7 cm in the small and large parks, respectively. Averages of organic matter content and electrical conductivity decreased with soil depth in all microenvironments and increased with decreasing disturbance of microenvironments. Maximal heterogeneity for both of these properties was found in the picnic area. Increase of park size was accompanied by increasing of organic matter content in the upper depth in the peripheral area, i.e., from 2.4% in the small parks to 4.5% in the large ones. In all microenvironments the increasing of averages of all studied soil properties was accompanied by increasing heterogeneity, i.e., variances and upper percentiles. The increase in the heterogeneity of the studied soil properties is attributed to improved ecological soil status in the peripheral area, on the one hand, and to the high anthropogenic pressure in the picnic area, on the other. This means that the urban park offers "islands" with better ecological conditions which improve the urban system.

Effects of parallelogram-shaped pavement markings on vehicle speed and safety of pedestrian crosswalks on urban roads in China.

PubMed

Guo, Yanyong; Liu, Pan; Liang, Qiyu; Wang, Wei

2016-10-01

The primary objective of this study was to evaluate the effects of parallelogram-shaped pavement markings on vehicle speed and crashes in the vicinity of urban pedestrian crosswalks. The research team measured speed data at twelve sites, and crash data at eleven sites. Observational cross-sectional studies were conducted to identify if the effects of parallelogram-shaped pavement markings on vehicle speeds and speed violations were statistically significant. The results showed that parallelogram-shaped pavement markings significantly reduced vehicle speeds and speed violations in the vicinity of pedestrian crosswalks. More specifically, the speed reduction effects varied from 1.89km/h to 4.41km/h with an average of 3.79km/h. The reduction in the 85th percentile speed varied from 0.81km/h to 5.34km/h with an average of 4.19km/h. Odds ratios (OR) showed that the parallelogram-shaped pavement markings had effects of a 7.1% reduction in the mean speed and a 6.9% reduction in the 85th percentile speed at the pedestrian crosswalks. The reduction of proportion of drivers exceeding the speed limit varied from 8.64% to 14.15% with an average of 11.03%. The results of the crash data analysis suggested that the use of parallelogram-shaped pavement markings reduced both the frequency and severity of crashes at pedestrian crosswalks. The parallelogram-shaped pavement markings had a significant effect on reducing the vehicle-pedestrian crashes. Two crash prediction models were developed for vehicle-pedestrian crashes and rear-end crashes. According to the crash models, the presence of parallelogram-shaped pavement markings reduced vehicle-pedestrian crashes at pedestrian crosswalks by 24.87% with a 95% confidence interval of [10.06-30.78%]. However, the model results also showed that the presence of parallelogram-shaped pavement markings increased rear-end crashes at pedestrian crosswalks by 5.4% with a 95% confidence interval of [0-11.2%]. Copyright © 2015 Elsevier Ltd. All rights reserved.

Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole-lesion diffusion-weighted imaging histogram analysis.

PubMed

Hao, Yonghong; Pan, Chu; Chen, WeiWei; Li, Tao; Zhu, WenZhen; Qi, JianPin

2016-12-01

To explore the usefulness of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) derived from reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) in differentiating malignant and benign thyroid nodules and stratifying papillary thyroid cancer (PTC) with aggressive histological features. This Institutional Review Board-approved, retrospective study included 93 patients with 101 pathologically proven thyroid nodules. All patients underwent preoperative r-FOV DWI at 3T. The whole-lesion ADC assessments were performed for each patient. Histogram-derived ADC parameters between different subgroups (pathologic type, extrathyroidal extension, lymph node metastasis) were compared. Receiver operating characteristic curve analysis was used to determine optimal histogram parameters in differentiating benign and malignant nodules and predicting aggressiveness of PTC. Mean ADC, median ADC, 5 th percentile ADC, 25 th percentile ADC, 75 th percentile ADC, 95 th percentile ADC (all P < 0.001), and kurtosis (P = 0.001) were significantly lower in malignant thyroid nodules, and mean ADC achieved the highest AUC (0.919) with a cutoff value of 1842.78 × 10 -6 mm 2 /s in differentiating malignant and benign nodules. Compared to the PTCs without extrathyroidal extension, PTCs with extrathyroidal extension showed significantly lower median ADC, 5 th percentile ADC, and 25 th percentile ADC. The 5 th percentile ADC achieved the highest AUC (0.757) with cutoff value of 911.5 × 10 -6 mm 2 /s for differentiating between PTCs with and without extrathyroidal extension. Whole-lesion ADC histogram analysis might help to differentiate malignant nodules from benign ones and show the PTCs with extrathyroidal extension. J. Magn. Reson. Imaging 2016;44:1546-1555. © 2016 International Society for Magnetic Resonance in Medicine.

The relationship between dietary patterns, body mass index percentile, and household food security in young urban children.

PubMed

Trapp, Christine M; Burke, Georgine; Gorin, Amy A; Wiley, James F; Hernandez, Dominica; Crowell, Rebecca E; Grant, Autherene; Beaulieu, Annamarie; Cloutier, Michelle M

2015-04-01

The relationship between food insecurity and child obesity is unclear. Few studies have examined dietary patterns in children with regard to household food security and weight status. The aim of this study was to examine the association between household food security, dietary intake, and BMI percentile in low-income, preschool children. Low-income caregivers (n=222) with children ages 2-4 years were enrolled in a primary-care-based obesity prevention/reversal study (Steps to Growing Up Healthy) between October 2010 and December 2011. At baseline, demographic data, household food security status (US Household Food Security Instrument) and dietary intake (Children's Dietary Questionnaire; CDQ) were collected. BMI percentile was calculated from anthropometric data. Participating children were primarily Hispanic (90%), Medicaid insured (95%), 50% female, 35±8.7 months of age (mean±standard deviation), 19% overweight (BMI 85th-94th percentile), and 29% obese (≥95th percentile). Thirty-eight percent of interviews were conducted in Spanish. Twenty-five percent of households reported food insecurity. There was no association between household food insecurity and child BMI percentile. Dietary patterns of the children based on the CDQ did not differ by household food security status. Food group subscale scores (fruit and vegetable, fat from dairy, sweetened beverages, and noncore foods) on the CDQ did not differ between normal weight and overweight/obese children. Maternal depression and stress did not mediate the relationship between household food insecurity and child weight status. Hispanic children were more likely to be overweight or obese in both food-secure and food-insecure households. Household food insecurity was not associated with child BMI percentile in this study. Dietary intake patterns of children from food-insecure households were not different compared to those from food-secure households.

Identifying mild and severe preeclampsia in asymptomatic pregnant women by levels of cell-free fetal DNA.

PubMed

Jakobsen, Tanja Roien; Clausen, Frederik Banch; Rode, Line; Dziegiel, Morten Hanefeld; Tabor, Ann

2013-09-01

The objective was to investigate whether women who develop preeclampsia can be identified in a routine analysis when determining fetal RHD status at 25 weeks' gestation in combination with PAPP-A levels at the first-trimester combined risk assessment for Trisomy 21. D- women participating in the routine antenatal RHD screening program in the capital region of Denmark were retrospectively studied. We used a standard dilution curve to quantify the amounts of cell-free fetal DNA (cffDNA) and divided women into groups according to cffDNA levels. PAPP-A was measured at 11 to 14 weeks. Information about pregnancy outcome and complications was obtained from the National Fetal Medicine Database, medical charts, and discharge letters. The odds ratio (OR) of developing severe preeclampsia given a cffDNA level above the 90th percentile compared to cffDNA below the 90th percentile was 8.1 (95% confidence interval [CI], 2.6-25.5). The OR of developing mild preeclampsia given a cffDNA level below the 5th percentile compared to cffDNA levels above the 5th percentile was 3.6 (95% CI, 1.1-11.7). PAPP-A levels below the 5th percentile were associated with mild preeclampsia, but adding it to the analysis did not increase the detection rate (DR). Women with cffDNA levels below the 5th percentile and above the 90th percentile quantified at 25 weeks' gestation are at increased risk of developing preeclampsia. Adding PAPP-A levels to the analysis did not increase the DR of preeclampsia. © 2013 American Association of Blood Banks.

Food Security and Weight Status in Children: Interactions With Food Assistance Programs.

PubMed

Nguyen, Binh T; Ford, Christopher N; Yaroch, Amy L; Shuval, Kerem; Drope, Jeffrey

2017-02-01

It is unclear whether Supplemental Nutrition Assistance Program (SNAP) or National School Lunch Program (NSLP) participation modifies the relationship between food insecurity and obesity in children. Data were included for 4,719 children aged 9-17 years who participated in the National Health and Nutrition Survey between 2003-2004 and 2011-2012. Linear regression was used to examine the relationship between household food security (full, marginal, low, and very low) and BMI percentile. Adjusted models were also stratified by SNAP and NSLP participation. There was no significant overall relationship between household food security and BMI percentile. In SNAP non-participants, there was no apparent overall relationship between BMI percentile and household food security. However, BMI percentile in children from households with low food security was significantly higher than that of children from fully food-secure households (risk difference [RD]=5.95, 95% CI=1.11, 10.80). Among SNAP participants, there was no significant relationship between household food security and BMI percentile. By NSLP participation category, there was a non-significant trend toward increasing BMI percentile with decreasing household food security in those reporting two or fewer (RD=1.75, 95% CI= -0.79, 4.29) and two to three (RD=1.07; 95% CI= -1.74, 3.89) lunches/week. There was no apparent relationship between household food security and BMI percentile in those reporting four or more lunches/week. Although the overall relationship between household food security and weight status in school-aged children was not statistically significant, there was some evidence that the relationship may differ by SNAP or NSLP participation, suggesting the need for more research. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Elevated blood pressure among primary school children in Dar es salaam, Tanzania: prevalence and risk factors.

PubMed

Muhihi, Alfa J; Njelekela, Marina A; Mpembeni, Rose N M; Muhihi, Bikolimana G; Anaeli, Amani; Chillo, Omary; Kubhoja, Sulende; Lujani, Benjamin; Maghembe, Mwanamkuu; Ngarashi, Davis

2018-02-13

Whilst the burden of non-communicable diseases is increasing in developing countries, little data is available on blood pressure among Tanzanian children. This study aimed at determining the blood pressure profiles and risk factors associated with elevated blood pressure among primary school children in Dar es Salaam, Tanzania. We conducted a cross sectional survey among 446 children aged 6-17 years from 9 randomly selected primary schools in Dar es Salaam. We measured blood pressure using a standardized digital blood pressure measuring machine (Omron Digital HEM-907, Tokyo, Japan). We used an average of the three blood pressure readings for analysis. Elevated blood pressure was defined as average systolic or diastolic blood pressure ≥ 90th percentile for age, gender and height. The proportion of children with elevated blood pressure was 15.2% (pre-hypertension 4.4% and hypertension 10.8%). No significant gender differences were observed in the prevalence of elevated BP. Increasing age and overweight/obese children were significantly associated with elevated BP (p = 0.0029 and p < 0.0001) respectively. Similar associations were observed for age and overweight/obesity with hypertension. (p = 0.0506 and p < 0.0001) respectively. In multivariate analysis, age above 10 years (adjusted RR = 3.63, 95% CI = 1.03-7.82) was significantly and independently associated with elevated BP in this population of school age children. We observed a higher proportion of elevated BP in this population of school age children. Older age and overweight/obesity were associated with elevated BP. Assessment of BP and BMI should be incorporated in school health program in Tanzania to identify those at risk so that appropriate interventions can be instituted before development of associated complications.

Stand-Biased Versus Seated Classrooms and Childhood Obesity: A Randomized Experiment in Texas

PubMed Central

Wendel, Monica L.; Zhao, Hongwei; Jeffrey, Christina

2016-01-01

Objectives. To measure changes in body mass index (BMI) percentiles among third- and fourth-grade students in stand-biased classrooms and traditional seated classrooms in 3 Texas elementary schools. Methods. Research staff recorded the height and weight of 380 students in 24 classrooms across the 3 schools at the beginning (2011–2012) and end (2012–2013) of the 2-year study. Results. After adjustment for grade, race/ethnicity, and gender, there was a statistically significant decrease in BMI percentile in the group that used stand-biased desks for 2 consecutive years relative to the group that used standard desks during both years. Mean BMI increased by 0.1 and 0.4 kilograms per meter squared in the treatment and control groups, respectively. The between-group difference in BMI percentile change was 5.24 (SE = 2.50; P = .037). No other covariates had a statistically significant impact on BMI percentile changes. Conclusions. Changing a classroom to a stand-biased environment had a significant effect on students’ BMI percentile, indicating the need to redesign traditional classroom environments. PMID:27552276

[Dynamic evaluation on body weight gain in premature infants and its significance].

PubMed

Ru, Xi-fang; Feng, Qi; Wang, Ying; Zhang, Xin; Li, Xing; Meng, Jing-wen; Guo, Zai-chen

2010-09-01

To investigate the incidence of intra- and extrauterine growth retardation (EUGR) and growth restriction in premature infants, and to illustrate the growth pattern of them in postnatal and infantile period. All premature infants were admitted to our neonatal intensive care unit (NICU) during the recent 7 years. The criteria for enrollment were (1) gestational age < 37 weeks; (2) single fetus; (3) admitted within the first 24 hours of life; (4) hospitalization period ≥ 14 days; (5) clinical follow-up persisted till ≥ 3 months of corrected gestational age. Intrauterine growth restriction (IUGR), EUGR and growth restriction were defined as having a measured growth value (weight) that was ≤ 10(th) percentile of Chinese infants' growth curve in corrected age on admission, discharge and follow-up period. Results were analyzed by using SPSS 12.0 statistical software package by chi-square test, rank-sum test, and t test. Two hundred and thirty nine infants were involved, 134 were boys and 105 girls. The incidence of IUGR and EUGR assessed by weight was 25.5% and 40.6%, respectively. The lower the birth weight was, the higher the incidence of IUGR and EUGR was. The percentile of body weight in the growth curve at discharge was lower than that at birth (Z = -7.784, P = 0.000). The incidence of growth restriction assessed by weight was 20.5%, 15.0%, 8.8%, 17.0%, 10.4%, 10.1%, 11.9%, 7.0% at corrected gestational age of 38 - 40 weeks, corrected age of 28 d, 61 d, 91 d, 122 d, 152 d, 183 d, and 274 d, respectively. The incidences of growth restriction were stable when the corrected age was older than 91 days. The incidence of growth restriction in female premature infants at 183 days' corrected age was higher than that in male children (χ(2) = 6.181, P = 0.017), the incidence was 19.3% and 3.8% respectively. During the follow-up period, most of the average body weight of premature infants whose gestational age was < 32 weeks or birth weight ≤ 1500 g were lower than the 50(th) percentile of the growth curve except the average body weight of boys whose gestational age < 32 weeks at corrected age of 2 and 4 months. Premature and/or low birth weight infants are at high risk of growth restriction, especially very low birth weight infants. The incidence of growth restriction decreased with growth. Long-term prognosis requires further investigation.

Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study.

PubMed

Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

2015-11-21

Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15-24; 69 of 352 fetuses) for selective ultrasonography and 57% (51-62; 199 of 352 fetuses) for universal ultrasonography (relative sensitivity 2·9, 95% CI 2·4-3·5, p<0·0001). Of the 3977 fetuses, 562 (14·1%) were identified by universal ultrasonography with an estimated fetal weight of less than the 10th percentile and were at an increased risk of neonatal morbidity (relative risk [RR] 1·60, 95% CI 1·22-2·09, p=0·0012). However, estimated fetal weight of less than the 10th percentile was only associated with the risk of neonatal morbidity (pinteraction=0·005) if the fetal abdominal circumference growth velocity was in the lowest decile (RR 3·9, 95% CI 1·9-8·1, p=0·0001). 172 (4%) of 3977 pregnancies had both an estimated fetal weight of less than the 10th percentile and abdominal circumference growth velocity in the lowest decile, and had a relative risk of delivering an SGA infant with neonatal morbidity of 17·6 (9·2-34·0, p<0·0001). Screening of nulliparous women with universal third trimester fetal biometry roughly tripled detection of SGA infants. Combined analysis of fetal biometry and fetal growth velocity identified a subset of SGA fetuses that were at increased risk of neonatal morbidity. National Institute for Health Research, Medical Research Council, Sands, and GE Healthcare. Copyright © 2015 Sovio et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Monitoring of ovarian activity by measurement of urinary excretion rates of estrone glucuronide and pregnanediol glucuronide using the Ovarian Monitor, Part II: reliability of home testing.

PubMed

Blackwell, Leonard F; Vigil, Pilar; Gross, Barbara; d'Arcangues, Catherine; Cooke, Delwyn G; Brown, James B

2012-02-01

The UNDP/WHO/World Bank/Special Programme of Research, Development and Research Training in Human Reproduction (Geneva) set up a study to determine whether it is feasible for women to monitor their ovarian activity reliably by home testing. Daily self-monitoring of urinary hormone metabolites for menstrual cycle assessment was evaluated by comparison of results obtained with the Home Ovarian Monitor by untrained users both at home and in study centres. Women collected daily data for urinary estrone glucuronide (E1G) and pregnanediol glucuronide (PdG) for two cycles, then the procedure was repeated in the women's local centre (in Chile, Australia or New Zealand) giving a total of 113 duplicate cycles. The tests were performed without the benefit of replicates or quality controls. The home and centre cycles were normalized and compared to identify assay errors, and the resulting home and centre menstrual cycle profiles were averaged. Reliable mean cycle profiles were obtained with the home and centre excretion rates agreeing to within 36 ± 21 nmol/24 h for E1G and 0.77 ± 0.28 µmol/24 h for baseline PdG values (1-5 µmol/24 h). The cycles had a mean length of 28.1 ± 3.1 days (n = 112; 5th and 95th percentiles: 24 and 35 days, respectively), a mean follicular phase of 14.8 ± 3.1 days (n = 107; 5th and 95th percentiles: 11 and 21 days) and a mean luteal phase length of 13.3 ± 1.5 days (n = 106; 5th and 95th percentiles: 11 and 17 days), calculated from the day of the LH peak. The study confirmed that the Ovarian Monitor pre-coated assay tubes worked well even in the hands of lay users, without standard curves, quality controls or replicates. Point-of-care monitoring to give reliable fertility data is feasible.

Dynamic kinematic responses of female volunteers in rear impacts and comparison to previous male volunteer tests.

PubMed

Carlsson, Anna; Linder, Astrid; Davidsson, Johan; Hell, Wolfram; Schick, Sylvia; Svensson, Mats

2011-08-01

The objective was to quantify dynamic responses of 50th percentile females in rear impacts and compare to those from similar tests with males. The results will serve as a basis for future work with models, criteria, and safety systems. A rear impact sled test series with 8 female volunteers was performed at velocity changes of 5 and 7 km/h. The following dynamic response corridors were generated for the head, T1 (first thoracic vertebra) and head relative to T1: (1) accelerations in posterior-anterior direction, (2) horizontal and vertical displacements, (3) angular displacements for 6 females close to the 50th percentile in size. Additionally, the head-to-head restraint distance and contact time and neck injury criterion (NIC) were extracted from the data set. These data were compared to results from previously performed male volunteer tests, representing the 50th percentile male, in equivalent test conditions. T-tests were performed with the statistical significance level of .05 to quantify the significance of the parameter value differences for the males and females. At 7 km/h, the females showed 29 percent earlier head-to-head restraint contact time (p = .0072); 27 percent shorter horizontal rearward head displacement (p = .0017); 36 percent narrower head extension angle (p = .0281); and 52 percent lower NIC value (p = .0239) than the males in previous tests. This was mainly due to 35 percent shorter initial head-to-head restraint distance for the females (p = .0125). The peak head acceleration in the posterior-anterior direction was higher and occurred earlier for the females. The overall result indicated differences in the dynamic response for the female and male volunteers. The results could be used in developing and evaluating a mechanical and/or mathematical average-sized female dummy model for rear impact safety assessment. These models can be used as a tool in the design of protective systems and for further development and evaluation of injury criteria.

The ASVAB (Armed Services Vocational Aptitude Battery) Score Scales. 1980 and World War II

DTIC Science & Technology

1986-07-01

TABLE B-3 ASVAB 14 (A, B, & C) MECHANICAL & CRAFTS (MC) COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males Total Standard Grade...COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males Total Standard Grade Grade Standard Score 11th 12th nth 12th nth 12th Score 24 24...Standard Scores. B-8 TABLE B-3 ASVAB 14 (A. B,&C) ELECTRONIC & ELECTRICAL (EE) COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males

Growth Charts (For Parents)

MedlinePlus

... say about a child's health. Why Do Doctors Use Growth Charts? Growth charts are a standard part ... chart, they see which percentile line those measurements land on. The higher the percentile number, the bigger ...

Total and inorganic arsenic in fish, seafood and seaweeds--exposure assessment.

PubMed

Mania, Monika; Rebeniak, Małgorzata; Szynal, Tomasz; Wojciechowska-Mazurek, Maria; Starska, Krystyna; Ledzion, Ewa; Postupolski, Jacek

2015-01-01

According to the European Food Safety Authority (EFSA), fish, seafood and seaweeds are foodstuffs that significantly contribute to dietary arsenic intake. With the exception of some algal species, the dominant compounds of arsenic in such food products are the less toxic organic forms. Both the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and EFSA recommend that speciation studies be performed to determine the different chemical forms in which arsenic is present in food due to the differences in their toxicity. Knowing such compositions can thus enable a complete exposure assessment to be made. Determination of total and inorganic arsenic contents in fish, their products, seafood and seaweeds present on the Polish market. This was then followed by an exposure assessment of consumers to inorganic arsenic in these foodstuffs. Total and inorganic arsenic was determined in 55 samples of fish, their products, seafood as well as seaweeds available on the market. The analytical method was hydride generation atomic absorption spectrometry (HGAAS), after dry ashing of samples and reduction of arsenic to arsenic hydride using sodium borohydride. In order to isolate only the inorganic forms of arsenic prior to mineralisation, samples were subjected to concentrated HCl hydrolysis, followed by reduction with hydrobromic acid and hydrazine sulphate after which triple chloroform extractions and triple 1M HCl re-extractions were performed. Exposure of adults was estimated in relation to the Benchmark Dose Lower Confidence Limit (BMDL0.5) as set by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) that resulted in a 0.5% increase in lung cancer (3.0 μg/kg body weight (b.w.) per day). Mean total arsenic content from all investigated fish samples was 0.46 mg/kg (90th percentile 0.94 mg/kg), whilst the inorganic arsenic content never exceeded the detection limit of the analytical method used (0.025 mg/kg). In fish products, mean total arsenic concentration was 1.48 mg/kg (90th percentile: 2.42 mg/kg), whilst in seafood they were 0.87 mg/ kg (90th percentile: 2.23 mg/kg), for inorganic arsenic contamination at the 90th percentile was 0.043 mg/kg with most results however being less than 0.025 mg/kg. The highest inorganic arsenic levels were determined in the Hijiki algal species samples (102.7 mg/kg), whereas the other algal samples gave a mean inorganic concentration of 0.41 mg/kg (90th percentile 0.86 mg/kg). The estimated average adults exposure to inorganic arsenic in fish, seafood and seaweeds was less than 0.5% of the lowest BMDL0.5 dose. Only for the Hijiki seaweed it was at 4.9% BMDL0.5. Results demonstrate that dietary arsenic intake from fish, seafood and seaweed along with all their products do not constitute a significant health threat to consumers apart from the seaweed species Hizikia fusiformis in which over 40% of all the inorganic arsenic compounds were found.

Algal community characteristics and response to nitrogen and phosphorus concentrations in streams in the Ozark Plateaus, Southern Missouri, 1993-95 and 2006-07

USGS Publications Warehouse

Femmer, Suzanne R.

2012-01-01

Nutrient and algae data were collected in the 1990s and 2000s by the U.S. Geological Survey for the National Water- Quality Assessment program in the Ozark Highlands, southern Missouri. These data were collected at sites of differing drainage area, land use, nutrient concentrations, and physiography. All samples were collected at sites with a riffle/pool structure and cobble/gravel bed material. A total of 60 samples from 45 sites were available for analyses to determine relations between nutrient concentrations and algal community structure in this region. This information can be used by the Missouri Department of Natural Resources to develop the State's nutrient criteria plan. Water samples collected for this study had total nitrogen concentrations ranging from 0.07 to 4.41 milligram per liter (mg/L) with a median of 0.26 mg/L, and total phosphorus concentrations ranging from 0.003 to 0.78 mg/L with a median of 0.007 mg/L. These nutrient concentrations were transformed into nutrient categories consisting of varying percentiles of data. Algal community data were entered into the U.S. Geological Survey's Algae Data Analysis System for the computation of more than 250 metrics. These metrics were correlated with nutrient categories, and four metrics with the strongest relation with the nutrient data were selected. These metrics were Organic Nitrogen Tolerance, Oxygen Tolerance, Bahls Pollution Class, and the Saprobien index with the 25th and 80th percentile nutrient categories. These data indicate that near the 80th percentile (Total Nitrogen = 0.84 mg/L, Total Phosphorus = 0.035 mg/L) the algae communities significantly changed from nitrogen-fixing species dominance to those species more tolerant of eutrophic conditions.

A simulation model for studying the role of pre-slaughter factors on the exposure of beef carcasses to human microbial hazards.

PubMed

Jordan, D; McEwen, S A; Lammerding, A M; McNab, W B; Wilson, J B

1999-06-29

A Monte Carlo simulation model was constructed for assessing the quantity of microbial hazards deposited on cattle carcasses under different pre-slaughter management regimens. The model permits comparison of industry-wide and abattoir-based mitigation strategies and is suitable for studying pathogens such as Escherichia coli O157:H7 and Salmonella spp. Simulations are based on a hierarchical model structure that mimics important aspects of the cattle population prior to slaughter. Stochastic inputs were included so that uncertainty about important input assumptions (such as prevalence of a human pathogen in the live cattle-population) would be reflected in model output. Control options were built into the model to assess the benefit of having prior knowledge of animal or herd-of-origin pathogen status (obtained from the use of a diagnostic test). Similarly, a facility was included for assessing the benefit of re-ordering the slaughter sequence based on the extent of external faecal contamination. Model outputs were designed to evaluate the performance of an abattoir in a 1-day period and included outcomes such as the proportion of carcasses contaminated with a pathogen, the daily mean and selected percentiles of pathogen counts per carcass, and the position of the first infected animal in the slaughter run. A measure of the time rate of introduction of pathogen into the abattoir was provided by assessing the median, 5th percentile, and 95th percentile cumulative pathogen counts at 10 equidistant points within the slaughter run. Outputs can be graphically displayed as frequency distributions, probability densities, cumulative distributions or x-y plots. The model shows promise as an inexpensive method for evaluating pathogen control strategies such as those forming part of a Hazard Analysis and Critical Control Point (HACCP) system.

Patient radiation doses in interventional cardiology in the U.S.: Advisory data sets and possible initial values for U.S. reference levels

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

Miller, Donald L.; Hilohi, C. Michael; Spelic, David C.

2012-10-15

Purpose: To determine patient radiation doses from interventional cardiology procedures in the U.S and to suggest possible initial values for U.S. benchmarks for patient radiation dose from selected interventional cardiology procedures [fluoroscopically guided diagnostic cardiac catheterization and percutaneous coronary intervention (PCI)]. Methods: Patient radiation dose metrics were derived from analysis of data from the 2008 to 2009 Nationwide Evaluation of X-ray Trends (NEXT) survey of cardiac catheterization. This analysis used deidentified data and did not require review by an IRB. Data from 171 facilities in 30 states were analyzed. The distributions (percentiles) of radiation dose metrics were determined for diagnosticmore » cardiac catheterizations, PCI, and combined diagnostic and PCI procedures. Confidence intervals for these dose distributions were determined using bootstrap resampling. Results: Percentile distributions (advisory data sets) and possible preliminary U.S. reference levels (based on the 75th percentile of the dose distributions) are provided for cumulative air kerma at the reference point (K{sub a,r}), cumulative air kerma-area product (P{sub KA}), fluoroscopy time, and number of cine runs. Dose distributions are sufficiently detailed to permit dose audits as described in National Council on Radiation Protection and Measurements Report No. 168. Fluoroscopy times are consistent with those observed in European studies, but P{sub KA} is higher in the U.S. Conclusions: Sufficient data exist to suggest possible initial benchmarks for patient radiation dose for certain interventional cardiology procedures in the U.S. Our data suggest that patient radiation dose in these procedures is not optimized in U.S. practice.« less

Associations between organochlorine pesticides and cognition in U.S. elders: National Health and Nutrition Examination Survey 1999-2002.

PubMed

Kim, Ki-Su; Lee, Yu-Mi; Lee, Ho-Won; Jacobs, David R; Lee, Duk-Hee

2015-02-01

There is limited evidence about whether background exposure to organochlorine pesticides is related to impairment of cognitive function in general populations. This study was performed to investigate cross-sectional associations between serum concentrations of organochlorine pesticides and cognitive function, a predictor of dementia, among U.S. elders without overt dementia. Study subjects were 644 elders aged 60-85, participating in the National Health and Nutrition Examination Survey 1999-2002. We selected 6 organochlorine pesticides (p,p'-dichlorodiphenyltrichloroethane (DDT), p,p'-dichlorodiphenyldichloroethylene (DDE), trans-nonachlor, oxychlordane, heptachlor epoxide, and β-hexachlorocyclohexane) which were commonly detected in current general population. Cognitive function was assessed with the Digit-Symbol Substitution Test. All 6 compounds showed statistically significant or marginally significant inverse associations with cognitive score after adjusting for covariates including education levels. The strongest association was observed with p,p'-DDT. With the outcome of low cognitive score defined as <25th percentile, elders in the highest quartile of p,p'-DDT, p,p'-DDE, and β-hexachlorocyclohexane had 2 to 3 times higher risks than those in the lowest quartile. In particular, when their concentrations were further divided with the cutoff points of 90th and 95th percentiles, p,p'-DDT in the highest 5th percentile showed 6.5 (95% confidence interval: 2.6-16.3) times higher risk of low cognitive score. On the other hand, non-persistent pesticides like organophosphates or pyrethroid showed little association with this cognitive score. The potential role of background exposure to organochlorine pesticides in the development of dementia should be explored in future prospective studies and in-vitro/in-vivo experimental studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Particulate Organic Matter Affects Soil Nitrogen Mineralization under Two Crop Rotation Systems

PubMed Central

Bu, Rongyan; Lu, Jianwei; Ren, Tao; Liu, Bo; Li, Xiaokun; Cong, Rihuan

2015-01-01

Changes in the quantity and/or quality of soil labile organic matter between and after different types of cultivation system could play a dominant role in soil nitrogen (N) mineralization. The quantity and quality of particulate organic matter (POM) and potentially mineralizable-N (PMN) contents were measured in soils from 16 paired rice-rapeseed (RR)/cotton-rapeseed (CR) rotations sites in Hubei province, central China. Then four paired soils encompassing low (10th percentile), intermediate (25th and 75th percentiles), and high (90th percentile) levels of soil PMN were selected to further study the effects of POM on soil N mineralization by quantifying the net N mineralization in original soils and soils from which POM was removed. Both soil POM carbon (POM-C) and N (POM-N) contents were 45.8% and 55.8% higher under the RR rotation compared to the CR rotation, respectively. The PMN contents were highly correlated with the POM contents. The PMN and microbial biomass N (MBN) contents concurrently and significantly decreased when POM was removed. The reduction rate of PMN was positively correlated with changes in MBN after the removal of POM. The reduction rates of PMN and MBN after POM removal are lower under RR rotations (38.0% and 16.3%, respectively) than CR rotations (45.6% and 19.5%, respectively). Furthermore, infrared spectroscopy indicated that compounds with low-bioavailability accumulated (e.g., aromatic recalcitrant materials) in the soil POM fraction under the RR rotation but not under the CR rotation. The results of the present study demonstrated that POM plays a vital role in soil N mineralization under different rotation systems. The discrepancy between POM content and composition resulting from different crop rotation systems caused differences in N mineralization in soils. PMID:26647157

Particulate Organic Matter Affects Soil Nitrogen Mineralization under Two Crop Rotation Systems.

PubMed

Bu, Rongyan; Lu, Jianwei; Ren, Tao; Liu, Bo; Li, Xiaokun; Cong, Rihuan

2015-01-01

Changes in the quantity and/or quality of soil labile organic matter between and after different types of cultivation system could play a dominant role in soil nitrogen (N) mineralization. The quantity and quality of particulate organic matter (POM) and potentially mineralizable-N (PMN) contents were measured in soils from 16 paired rice-rapeseed (RR)/cotton-rapeseed (CR) rotations sites in Hubei province, central China. Then four paired soils encompassing low (10th percentile), intermediate (25th and 75th percentiles), and high (90th percentile) levels of soil PMN were selected to further study the effects of POM on soil N mineralization by quantifying the net N mineralization in original soils and soils from which POM was removed. Both soil POM carbon (POM-C) and N (POM-N) contents were 45.8% and 55.8% higher under the RR rotation compared to the CR rotation, respectively. The PMN contents were highly correlated with the POM contents. The PMN and microbial biomass N (MBN) contents concurrently and significantly decreased when POM was removed. The reduction rate of PMN was positively correlated with changes in MBN after the removal of POM. The reduction rates of PMN and MBN after POM removal are lower under RR rotations (38.0% and 16.3%, respectively) than CR rotations (45.6% and 19.5%, respectively). Furthermore, infrared spectroscopy indicated that compounds with low-bioavailability accumulated (e.g., aromatic recalcitrant materials) in the soil POM fraction under the RR rotation but not under the CR rotation. The results of the present study demonstrated that POM plays a vital role in soil N mineralization under different rotation systems. The discrepancy between POM content and composition resulting from different crop rotation systems caused differences in N mineralization in soils.

Validation of equations and proposed reference values to estimate fat mass in Chilean university students.

PubMed

Gómez Campos, Rossana; Pacheco Carrillo, Jaime; Almonacid Fierro, Alejandro; Urra Albornoz, Camilo; Cossío-Bolaños, Marco

2018-03-01

(i) To propose regression equations based on anthropometric measures to estimate fat mass (FM) using dual energy X-ray absorptiometry (DXA) as reference method, and (ii)to establish population reference standards for equation-derived FM. A cross-sectional study on 6,713 university students (3,354 males and 3,359 females) from Chile aged 17.0 to 27.0years. Anthropometric measures (weight, height, waist circumference) were taken in all participants. Whole body DXA was performed in 683 subjects. A total of 478 subjects were selected to develop regression equations, and 205 for their cross-validation. Data from 6,030 participants were used to develop reference standards for FM. Equations were generated using stepwise multiple regression analysis. Percentiles were developed using the LMS method. Equations for men were: (i) FM=-35,997.486 +232.285 *Weight +432.216 *CC (R 2 =0.73, SEE=4.1); (ii)FM=-37,671.303 +309.539 *Weight +66,028.109 *ICE (R2=0.76, SEE=3.8), while equations for women were: (iii)FM=-13,216.917 +461,302 *Weight+91.898 *CC (R 2 =0.70, SEE=4.6), and (iv) FM=-14,144.220 +464.061 *Weight +16,189.297 *ICE (R 2 =0.70, SEE=4.6). Percentiles proposed included p10, p50, p85, and p95. The developed equations provide valid and accurate estimation of FM in both sexes. The values obtained using the equations may be analyzed from percentiles that allow for categorizing body fat levels by age and sex. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Application of wildfire simulation models for risk analysis

NASA Astrophysics Data System (ADS)

Ager, A.; Finney, M.

2009-04-01

Wildfire simulation models are being widely used by fire and fuels specialists in the U.S. to support tactical and strategic decisions related to the mitigation of wildfire risk. Much of this application has resulted from the development of a minimum travel time (MTT) fire spread algorithm (M. Finney) that makes it computationally feasible to simulate thousands of fires and generate burn probability and intensity maps over large areas (10,000 - 2,000,000 ha). The MTT algorithm is parallelized for multi-threaded processing and is imbedded in a number of research and applied fire modeling applications. High performance computers (e.g., 32-way 64 bit SMP) are typically used for MTT simulations, although the algorithm is also implemented in the 32 bit desktop FlamMap3 program (www.fire.org). Extensive testing has shown that this algorithm can replicate large fire boundaries in the heterogeneous landscapes that typify much of the wildlands in the western U.S. In this paper, we describe the application of the MTT algorithm to understand spatial patterns of burn probability (BP), and to analyze wildfire risk to key human and ecological values. The work is focused on a federally-managed 2,000,000 ha landscape in the central interior region of Oregon State, USA. The fire-prone study area encompasses a wide array of topography and fuel types and a number of highly valued resources that are susceptible to fire. We quantitatively defined risk as the product of the probability of a fire and the resulting consequence. Burn probabilities at specific intensity classes were estimated for each 100 x 100 m pixel by simulating 100,000 wildfires under burn conditions that replicated recent severe wildfire events that occurred under conditions where fire suppression was generally ineffective (97th percentile, August weather). We repeated the simulation under milder weather (70th percentile, August weather) to replicate a "wildland fire use scenario" where suppression is minimized to manage fires for fuel reduction. The average BP was calculated for these scenarios to examine variation within and among a number of key designated management units, including forest-urban interface, conservation areas, protected species habitat, municipal watersheds, recreation areas, and others. To quantify risk, we developed a number of loss-benefit functions using fire effects models that relate fire intensity to tree mortality and biomass consumption. We used these relationships to measure the change in highly-valued old forest, designated wildlife conservation areas, aboveground carbon, surface fuels, and other wildland values. The loss-benefit functions were then coupled with BP's for different intensity classes to estimate expected value change (risk) for each pixel. For a subset of the study area we also measured the change in risk from fuels management for selected resources. Estimates of BP, excluding non burnable fuels (water, rock), fro the simulations ranged from 0.00001 to 0.026 within the study area, with a mean value of 0.007. In comparison, the annual burn probability estimated from fire occurrence data within the study area (1910 - 2003) was 0.0022. The estimate from simulations represents the average probability of a random pixel burning from a single large fire that escapes suppression, hence some difference is expected. Variation in BP among designated conservation and fire protection units was relatively large and illustrated spatial differences in wildfire likelihood among highly values resources. For instance, among the 130 different forest-urban interface areas, average BP varied from 0.0001 to 0.02. Average BP for nesting sites used by the endangered Northern spotted owl averaged 0.04 and varied from 0.001 to 0.01. The marginal BP's for high fire intensities was higher for many of the conservation areas compared the surrounding managed forest. Conservation areas that were located on the lee side of non-burnable fuels such as lava flows and lakes showed markedly reduced BP. When wildfire probabilities were combined with habitat loss functions for the Northern spotted owl, we observed expected loss from a random wildfire event ranging from 0.0 to 9.4% with a mean value of 1.5%. Expected loss was strongly correlated with BP for owl habitat, apparently because fires at very low intensities caused understory mortality and reduced stand canopy closure below minimum levels. The effect of simulating strategic fuel treatments on a subunit of the area resulted in significant decrease in expected loss of owl habitat. The effect of changing weather from a severe to mild (97th to 70th) percentile weather resulted in a dramatic 8-fold drop in BP and reduced the average wildfire size. However, the reduction was not uniform with the departures well correlated with specific fuel models. In total, this work demonstrated the application of wildfire spread models to quantitative risk assessment for fuels management on federally-managed lands in the U.S. The analyses revealed spatial variation in BP that is useful in prioritizing fuels treatments and guiding other wildfire mitigation activities. The work also illuminated the conflict between biodiversity conservation efforts on federally-managed lands and the high wildfire risk on fire-prone landscapes.

Quantifying uncertainty in future floods and drought conditions in the Northeastern United States using regionally downscaled climate projections

NASA Astrophysics Data System (ADS)

Siddique, R.; Wu, C.; Karmalkar, A.; Bradley, R. S.; Palmer, R. N.

2017-12-01

Northeastern region (NER) of the United States (US) has been projected to be a place where climate change can have the most severe impacts. These impacts include, but are not limited to, increases in the following: extreme precipitation events, temperature, flood magnitudes, flood frequencies, droughts, and sea level rise. In this study, we estimate the frequency of hydrological extremes under different climate change scenarios using regionally downscaled climate projections from a limited number of selected models from the fifth phase of Coupled Model Intercomparison Project (CMIP5). The models are chosen to minimize the loss of key climate information relevant to the NER. Precipitation and temperature from the selected models are forced into a distributed hydrological model called Hydrology Laboratory - Research Distributed Hydrological Model (HL-RDHM) to obtain streamflows for two different time regimes, near-term (20-50 years out) and long-term (50-80 years out). For this, two climate emission scenarios will be considered: RCP 4.5 and RCP 8.5. The impacts of the climate projections on the streamflows are then evaluated across different watershed scales in the NER. Among different metrics, we employ: 1) Flood Events - return period of 1 year, 10 year, 20 year, 50 year, and 100 year flood events and 2) Drought Events -low flow events associated with the 7-day 10 year low flow, number of days per month that will be below the historic monthly average, number of days per month that will be below the 25 percentile monthly historic average, changes in the 30-day and 60-day cumulative summer flows, and the timing and magnitude of spring run-off. For estimates of the climate impacts on low and high flows, only the unregulated watersheds are taken into consideration. Ensembles of streamflows obtained by forcing different climate projections are used to quantify and account for the associated uncertainties. Thus, the outcomes of this study are expected to guide regional decision makers on potential impacts of climate change on hydrological extreme events and water resources across different spatial scales within NER of the US.

Long-term changes in the statistical distribution of Dobson total ozone in selected Northern Hemisphere geographical regions

NASA Technical Reports Server (NTRS)

Krzyscin, Janusz W.

1994-01-01

The daily averages of total column amount of ozone taken in the period 1964-1988 at a network of 24 Dobson stations have been analyzed. Year-round data as well as summer data (May - Aug.) and winter data (Dec. - March) have been examined in the following regions: latitude bands (30 deg N - 39 deg N, 40 deg N - 52 deg N, 30 deg N - 60 deg N), North America, Europe, and Japan. To find year-to-year changes in the shape of the annual statistical distribution of total ozone (ASDTO) for these regions, we analyze trends in the following statistic characteristics of ASDTO: mean, standard deviation, median, and 10 and 90 percentiles. Time series of the statistical characteristics for the selected regions have been combined by averaging the individual stations values of these characteristics. The trends have been calculated by the multiple regression model adjusted for: the 11-year solar cycle, the Southern Oscillations effects, and for serial correlations. We have found that: a) in all regions (excluding Japan, North America), the shape of ASDTO has been drifting towards low ozone values. The drift seems to be not accompanied with a transformation in the shape of ASDTO. The drift speed (the rate of decrease in the annual means of total ozone) is of order 1-3 percent per decade (in the period 1970-1988). b) In Japan, the interannual changes in the shape of ASDTO have not been revealed. c) In North America, the drift of the year-round ASDTO (the year-round ASDTO comprises all the daily means of total ozone in a given year) has been accompanied with a transformation in the shape. The shape of the year round ASDTO becomes narrower. d) In all regions, except Japan and the band 30 deg - 39 deg N, the winter ASDTO (the winter ASDTO comprises the data taken in the period December in a given year through March next year) moves faster towards low ozone values than the summer ASDTO (the summer ASDTO comprises the data taken in the period May through August in a given year).

Anthropometric indices among schoolchildren from a municipality in Southern Brazil: a descriptive analysis using the LMS method☆

PubMed Central

Barbosa, Valter Cordeiro; Lopes, Adair da Silva; Fagundes, Ricardo Rosa; de Campos, Wagner

2014-01-01

OBJECTIVE: To describe the percentile values for body mass index (BMI), waist circumference (WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them with data of children from other countries. METHODS: This was a cross-sectional study with a random sample of 2,035 children aged 6-11 years. Age- and sex-specific smoothed percentiles curves for BMI, WC and WHtR were created using the LMS method. Values of 10th, 50th and 90th percentiles from Brazilian children were compared with data from other countries. RESULTS: There was a trend of increasing BMI and WC with age in both sexes. WHtR remained constant with advancing age in boys and girls. Comparison of the growth pattern among countries showed clear differences. Southern Brazil boys and girls had elevated 90th percentile values for BMI, which was similar to German children and higher than the North American and World Health Organization percentile values. However, children from this study had intermediate values for WC and WHtR in comparison to children from other countries. CONCLUSIONS: Elevated BMI values were observed among southern Brazilian children, but WC and WHtR percentile values were lower in southern Brazilian children than in children from other countries. Interventions at different levels should be made to avoid a probable increase of nutritional disorders (especially general obesity) in the next years. PMID:25510997

Improving nutritional status in a pediatric cystic fibrosis center.

PubMed

Ramírez, Ixsy; Filbrun, Amy; Hasan, Aws; Kidwell, Kelley M; Nasr, Samya Z

2015-06-01

The nutritional status of patients with cystic fibrosis (CF) is strongly associated with pulmonary function, respiratory status and survival. Malnutrition could result from a discrepancy between energy needs and food intake while malabsorption results from pancreatic insufficiency which occurs in 85% of people with CF. A quality improvement (QI) project was designed to improve the nutritional status of patients with CF with low Body Mass Index (BMI) between 3 and 19 years of age. An algorithm was developed which included clinic-based assessments of patients' nutritional status and periodic assessment by a dietitian, social worker and/or psychologist during the project. Gastrostomy tube placement and feeding was offered as a last resort to improve caloric intake. 173 patients seen during January-June, 2010, were included in this project. They were classified into four BMI groups and data were collected quarterly through June, 2012. The project target population (BMI percentile ≤ 24) had a median BMI percentile at the start of the project of 11.8. At the end of the project median BMI percentile was 22 (46% improvement). Improving nutrition and BMI for patients with CF is achievable. There must be a motivated, multi-disciplinary team that includes patients and families. A patient-specific combination of interventions must be used. These interventions could be quite basic for patients with BMI percentile ≥ 25, yet more elaborate for patients with BMI percentile <25. Clinic-based algorithms such as ours can successfully improve the BMI percentile in patients with CF. © 2014 Wiley Periodicals, Inc.

Association of third-trimester abdominal circumference with provider-initiated preterm delivery

PubMed Central

Hawkins, Leah K.; Schnettler, William T.; Modest, Anna M.; Hacker, Michele R.; Rodriguez, Diana

2016-01-01

Objective Evaluate the association of a small third-trimester abdominal circumference (AC < 10th percentile) in the setting of a normal estimated fetal weight (EFW ≥ 10th percentile) with gestational age at delivery, indication for delivery and neonatal outcomes. Methods Retrospective cohort study at an academic hospital of women with singleton pregnancy seen for ultrasound from 28+0-33+6 weeks of gestation during 2009-2011. Outcomes were compared between two groups: normal AC (AC and EFW ≥ 10th percentile) and small AC (AC < 10th percentile and EFW ≥ 10th percentile). Results Among 592 pregnancies, fetuses in the small AC group (n = 55) experienced a higher incidence of overall preterm delivery (RR: 2.2, 95% Cl: 1.3–3.7) and provider-initiated preterm delivery (RR: 3.7, Cl: 1.8–7.5) compared to those in the normal AC group (n = 537). Neonates in the small AC group had a lower median birth weight whether delivered at term (p < 0.001) or preterm (p = 0.04), but were not more likely to experience intensive care unit admission or respiratory distress syndrome (all p ≥ 0.35). Conclusions Small AC, even in the setting of an EFW ≥ 10th percentile, was associated with a higher incidence of overall and provider-initiated preterm delivery despite similar neonatal outcomes. Further investigation is warranted to determine whether these preterm deliveries could be prevented. PMID:24102316

Arm anthropometry indices in Turkish children and adolescents: changes over a three-year period.

PubMed

Çiçek, Betül; Öztürk, Ahmet; Mazıcıoğlu, Mustafa Mümtaz; Kurtoğlu, Selim

2014-12-01

Time-related changes and comparisons for mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), arm fat area (AFA) are lacking for Turkish children and adolescents. To determine the arm anthropometry indices (MUAC, TSF, AFA) in children and adolescents and to also assess the changes in these indices over a 3-year time period. The data of the Anthropometry of Turkish Children Aged 0-6 Years (ATCA-06) study and the Second Study of Determination of the Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA-II) were used to calculate the arm anthropometry percentiles in a total group of 6982 children and adolescents aged 28 days to 17 years. The 3rd-97th percentiles were computed by the LMS method. In girls, 50th percentile MUAC values linearly increased with age. In boys, 50th percentile TSF values linearly increased until 10 years of age and decreased after age 11 years, while in girls, TSF values increased linearly with age. 50th percentile values for AFA showed a linear increase in both genders with age. Significant differences were found between the 5th, 50th and 95th percentile values for MUAC and AFA obtained in the two studies (DAMTCA-II and DAMTCA-I) in both boys and girls. The prominent finding was the significant and alarming increase in arm anthropometry indices in both genders within as short period of time as three years.

Motor Skills of Obese and Severely Obese Children and Adolescents - A CIRCUIT Study.

PubMed

Häcker, Anna-Luisa; Bigras, Jean-Luc; Henderson, Mélanie; Barnett, Tracie A; Mathieu, Marie-Eve

2017-11-27

During childhood, excessive weight is negatively associated with the development of motor skills, with children with overweight or obesity having poorer motor skills compared to children with normal weight. The objectives of the current study are to identify the differences in motor skills between children and adolescent with obesity and severe obesity and the extent of this difference. To do so, we examined cross-sectionally 165 subjects. Physical fitness was analyzed in both participants with obesity (>97-99.9 BMI percentile) and severe obesity (>99.9 BMI percentile) using eight standardized tests: sit-and-reach, grip force, sit-ups, push-ups, balance, hand-eye coordination, standing long jump and 5-meter shuttle run. Poorer performance were observed in participants with severe obesity in sit-ups (children: 59%; 18.6±17.0 percentile value vs. 29.5±23.2 percentile value, p=0.008), balance (adolescent: 59%; 12.1±12.2 sec. v. 19.3±13.9 sec., p=0.034) and in the 5-meter shuttle run (children: 49%; 14.0±13.9 percentile value vs. 20.8 ± 19.4 percentile value, p=0.046; adolescents: 11%; 13.2±2.2 sec. vs. 11.8±1.6 sec., p=0.008) compared to obese counterparts. In conclusion, while physical performance was found to be similar between the different obesity levels for the majority of tests, youth with severe obesity demonstrated impairments ranging from 11 to 59% in specific tests.

Savings needed to fund health insurance and health care expenses in retirement: findings from a simulation model.

PubMed

Fronstin, Paul; Salisbury, Dallas; VanDerhei, Jack

2008-05-01

MODELING RETIREE HEALTH COSTS: This Issue Brief examines the uncertainty of health care expenses in retirement by using a Monte Carlo simulation model to estimate the amount of savings needed to cover health insurance premiums and out-of-pocket health care expenses. This type of simulation is able to account for the uncertainty related to individual mortality and rates of return, and computes the present value of the savings needed to cover health insurance premiums and out-of-pocket expenses in retirement. These observations were used to determine asset targets for having adequate savings to cover retiree health costs 50, 75, and 90 percent of the time. NOT ENOUGH SAVINGS: Many individuals will need more money than the amounts reported in this Issue Brief because this analysis does not factor in the savings needed to cover long-term care expenses, nor does it take into account the fact that many individuals retire prior to becoming eligible for Medicare. However, some workers will need to save less than what is reported if they keep working in retirement and receive health benefits as active workers. WHO HAS RETIREE HEALTH BENEFITS BEYOND MEDICARE?: About 12 percent of private-sector employers report offering any Medicare supplemental health insurance. This increases to about 40 percent among large employers. Overall, nearly 22 percent of retirees age 65 and older had retiree health benefits in 2005 to supplement Medicare coverage. As recently as 2006, 53 percent of retirees age 65 and older were covered by Medicare Part D, 24 percent had outpatient prescription drug coverage through an employment-based plan. Only 10 percent had no prescription drug coverage. INDIVIDUALLY PURCHASED MEDICARE SUPPLEMENTS, 2008: Among those who purchase Medigap and Medicare Part D prescription drug coverage at age 65 in 2008, men would need between $79,000 and $159,000 with median prescription drug expenses (50th percentile and 90th percentiles, respectively), and between $156,000 and $331,000 with prescription spending that is at the 90th percentile. Women would need between $108,000 and $184,000 with median prescription drug expenses (50th and 90th percentiles, respectively), and between $217,000 and $390,000 with prescription spending that is at the 90th percentile. The savings needed for couples would range from $194,000 at the 50th percentile to $635,000 at the 90th percentile. EMPLOYMENT-BASED BENEFITS, 2008: Among those who have employment-based retiree health benefits to supplement Medicare, but who must pay their own premiums, men would need between $102,000 and $196,000 in current savings (50th and 90th percentiles, respectively) to cover health care costs in retirement. Women would need between $137,000 and $224,000, respectively, due to their greater longevity. The savings needed for couples would range from $154,000 to $376,000. INDIVIDUALLY PURCHASED MEDICARE SUPPLEMENTS, 2018: Among those who purchase Medigap and Medicare Part D prescription drug coverage at age 65 in 2018 (currently age 55), men would need between $132,000 and $266,000 with median prescription drug expenses (50th and 90th percentiles, respectively), and between $261,000 and $555,000 with prescription spending that is at the 90th percentile. Women would need between $181,000 and S308,000 with median prescription drug expenses (50th and 90th percentiles), and between S364,000 and $654,000 with prescription spending that is at the 90th percentile. The savings needed for couples would range from $325,000 at the 50th percentile to S1,064,000 at the 90th percentile. RETIREE HEALTH MAY BE DRIVING LONGER TIME IN THE WORK FORCE: The declining availability of retiree health benefits may partly explain the rising labor force participation rate among individuals ages 55-64. Between 1996 and 2006, the labor force participation rate increased from 67 percent to 69.6 percent for men and from 49.6 percent to 58.2 percent for women.

2014 annual summary of the lower Gunnison River Basin Selenium Management Program water-quality monitoring, Colorado

USGS Publications Warehouse

Henneberg, Mark F.

2016-08-10

Dissolved-selenium loading analyses of data collected at 18 water-quality sites in the lower Gunnison River Basin in Colorado were completed through water year (WY) 2014. A WY is defined as October 1–September 30. Selenium is a trace element that bioaccumulates in aquatic food chains and can cause reproductive failure, deformities, and other harmful effects. This report presents information on the dissolved-selenium loads at 18 sites in the lower Gunnison River Basin for WYs 2011–2014. Annual dissolved-selenium loads were calculated at 5 sites with continuous U.S. Geological Survey (USGS) streamflow gages, whereas instantaneous dissolved-selenium loads were calculated for the remaining 13 sites using water-quality samples that had been collected periodically during WYs 2011–2014. Annual dissolved-selenium loads for WY 2014 ranged from 336 pounds (lb) at Uncompahgre River at Colona to 13,300 lb at Gunnison River near Grand Junction (Whitewater). Most sites in the basin had a median instantaneous dissolved-selenium load of less than 20.0 lb per day. In general, dissolved-selenium loads at Gunnison River main-stem sites showed an increase from upstream to downstream.The State of Colorado water-quality standard for dissolved selenium of 4.6 micrograms per liter (µg/L) was compared to the 85th percentiles for dissolved selenium at selected water-quality sites. Annual 85th percentiles for dissolved selenium were calculated for the five core USGS sites having streamflow gages using estimated dissolved-selenium concentrations from linear regression models. These annual 85th percentiles in WY 2014 ranged from 0.97 µg/L at Uncompahgre River at Colona to 16.7 µg/L at Uncompahgre River at Delta. Uncompahgre River at Delta and Whitewater were the only core sites where water samples exceeded the State of Colorado water-quality standard for dissolved selenium of 4.6 µg/L.Instantaneous 85th percentiles for dissolved selenium were calculated for sites with sufficient data using water-quality samples collected during WYs 2011–2014. The instantaneous 85th percentiles for samples for WY 2014 ranged from 1.1 µg/L at Uncompahgre River at Colona to 125 µg/L at Loutzenhizer Arroyo at North River Road.A trend analysis was completed for Whitewater to determine if dissolved-selenium loads are increasing or decreasing. The trend analysis indicates a decrease of 8,000 lb from WY 1986 to WY 2014, a 34.8 percent reduction during the time period, and an additional 6.2 percent reduction from a reported 28.6 percent reduction during WYs 1986–2008. The trend analysis for WY 1992 to WY 2014 indicates a decrease of 5,800 lb per year, or 27.9 percent.

PERSONAL MEASURES OF POWER-FREQUENCY MAGNETIC FIELD EXPOSURE AMONG MEN FROM AN INFERTILITY CLINIC: DISTRIBUTION, TEMPORAL VARIABILITY AND CORRELATION WITH THEIR FEMALE PARTNERS' EXPOSURE

PubMed Central

Lewis, Ryan C.; Hauser, Russ; Maynard, Andrew D.; Neitzel, Richard L.; Wang, Lu; Kavet, Robert; Morey, Patricia; Ford, Jennifer B.; Meeker, John D.

2016-01-01

Power-frequency magnetic field exposure science as it relates to men and couples have not been explored despite the advantage of this information in the design and interpretation of reproductive health epidemiology studies. This analysis examined the distribution and temporal variability of exposures in men, and the correlation of exposures within couples using data from a longitudinal study of 25 men and their female partners recruited from an infertility clinic. The average and 90th percentile demonstrated fair to good reproducibility, whereas the maximum showed poor reproducibility over repeated sampling days, each separated by a median of 4.6 weeks. Average magnetic field exposures were also strongly correlated within couples, suggesting that one partner's data could be used as a surrogate in the absence of data from the other for this metric. Environment was also an important effect modifier in these explored matters. These issues should be considered in future relevant epidemiology studies. PMID:26705359

Maternal hemodynamics, fetal biometry and Dopplers in pregnancies followed up for suspected fetal growth restriction.

PubMed

Roberts, Llinos A; Ling, Hua Zen; Poon, Liona; Nicolaides, Kypros H; Kametas, Nikos A

2018-04-01

To assess whether in a cohort of patients with small for gestational age (SGA) foetuses with estimated fetal weight ≤10 th percentile, maternal hemodynamics, fetal biometry and Dopplers at presentation, can predict the subsequent development of abnormal fetal Dopplers or delivery with birthweight <3 rd percentile. The study population comprised of 86 singleton pregnancies with SGA fetuses presenting at a median gestational age of 32 (range 26-35) weeks. We measured maternal cardiac function with a non-invasive transthoracic bioreactance monitor (NICOM, Cheetah), mean arterial pressure, fetal biometry, umbilical artery (UA), middle cerebral artery (MCA) and uterine artery (UT) pulsatility index (PI) and the deepest vertical pool (DVP) of amniotic fluid. Z-scores of these variables were calculated based on reported reference ranges and the values were compared between those with evidence of abnormal fetal Dopplers at presentation (group 1), those that developed abnormal Dopplers in subsequent visits (group 2) and those who did not develop abnormal Dopplers throughout pregnancy (group 3). Abnormal fetal Dopplers were defined as UAPI >95 th percentile, or MCA PI <5 th percentile. Differences in measured variables at presentation were also compared between pregnancies delivering a baby with birthweight <3 rd and ≥3 rd percentile. Multivariate logistic regression analysis was used to determine significant predictors of birthweight <3 rd percentile and evolution from normal fetal Dopplers to abnormal fetal Dopplers in groups 2 and 3. In the study population 14 (16%) cases were in group 1, 19 (22%) in group 2 and 53 (62%) in group 3. The birthweight was <3 rd percentile in 39 (45%) cases and ≥3 rd percentile in 47 (55%). In the study groups, compared to normal populations, there was decreased cardiac output and stroke volume and increased peripheral vascular resistance and mean arterial pressure (MAP) and the deviations from normal were most marked in group 1. Pregnancies with a birthweight <3 rd , compared to those ≥3 rd percentile, had higher deviations from normal in fetal biometry, maternal cardiac output, stroke volume, heart rate and peripheral vascular resistance and UT-PI. Multivariate logistic regression analysis demonstrated that in the prediction of birth weight ≤3 rd percentile, maternal hemodynamics provided significant improvement to the prediction provided by maternal demographics, fetal biometry and UT-PI, UA-PI and MCA-PI (difference between AUCs 0.18, 95% CI 0.06-0.29, p=0.002). In contrast, there was no significant independent contribution from maternal hemodynamics in the prediction of subsequent abnormal fetal Dopplers. In pregnancies with SGA fetuses there is decreased maternal cardiac output and stroke volume and increased peripheral vascular resistance and MAP and the deviations from normal are most marked in cases of redistribution in the fetal circulation and reduced amniotic fluid volume. This article is protected by copyright. All rights reserved.

The effect of customization and use of a fetal growth standard on the association between birthweight percentile and adverse perinatal outcome.

PubMed

Sovio, Ulla; Smith, Gordon C S

2018-02-01

It has been proposed that correction of offspring weight percentiles (customization) might improve the prediction of adverse pregnancy outcome; however, the approach is not accepted universally. A complication in the interpretation of the data is that the main method for calculation of customized percentiles uses a fetal growth standard, and multiple analyses have compared the results with birthweight-based standards. First, we aimed to determine whether women who deliver small-for-gestational-age infants using a customized standard differed from other women. Second, we aimed to compare the association between birthweight percentile and adverse outcome using 3 different methods for percentile calculation: (1) a noncustomized actual birthweight standard, (2) a noncustomized fetal growth standard, and (3) a fully customized fetal growth standard. We analyzed data from the Pregnancy Outcome Prediction study, a prospective cohort study of nulliparous women who delivered in Cambridge, UK, between 2008 and 2013. We used a composite adverse outcome, namely, perinatal morbidity or preeclampsia. Receiver operating characteristic curve analysis was used to compare the 3 methods of calculating birthweight percentiles in relation to the composite adverse outcome. We confirmed previous observations that delivering an infant who was small for gestational age (<10th percentile) with the use of a fully customized fetal growth standard but who was appropriate for gestational age with the use of a noncustomized actual birthweight standard was associated with higher rates of adverse outcomes. However, we also observed that the mothers of these infants were 3-4 times more likely to be obese and to deliver preterm. When we compared the risk of adverse outcome from logistic regression models that were fitted to the birthweight percentiles that were derived by each of the 3 predefined methods, the areas under the receiver operating characteristic curves were similar for all 3 methods: 0.56 (95% confidence interval, 0.54-0.59) fully customized, 0.56 (95% confidence interval, 0.53-0.59) noncustomized fetal weight standard, and 0.55 (95% confidence interval, 0.53-0.58) noncustomized actual birthweight standard. When we classified the top 5% of predicted risk as high risk, the methods that used a fetal growth standard showed attenuation after adjustment for gestational age, whereas the birthweight standard did not. Further adjustment for the maternal characteristics, which included weight, attenuated the association with the customized standard, but not the other 2 methods. The associations after full adjustment were similar when we compared the 3 approaches. The independent association between birthweight percentile and adverse outcome was similar when we compared actual birthweight standards and fetal growth standards and compared customized and noncustomized standards. Use of fetal weight standards and customized percentiles for maternal characteristics could lead to stronger associations with adverse outcome through confounding by preterm birth and maternal obesity. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of Perinatal Dioxin Exposure on Infant Growth: A Cross-Sectional and Longitudinal Studies in Dioxin-Contaminated Areas in Vietnam

PubMed Central

Nishijo, Muneko; Tai, Pham The; Nakagawa, Hideaki; Maruzeni, Shoko; Anh, Nguyen Thi Nguyet; Van Luong, Hoang; Anh, Tran Hai; Honda, Ryumon; Morikawa, Yuko; Kido, Teruhiko; Nishijo, Hisao

2012-01-01

Dioxin exposure levels remain elevated in residents living around former US Air Force bases in Vietnam, indicating potential adverse impacts on infant growth. In this study, 210 mother–infant pairs in dioxin-contaminated areas in Vietnam were recruited at the infants’ birth and followed up for 4 months. Perinatal dioxin exposure levels were estimated by measurement of polychlorinated dibenzo-p-dioxins/furans toxic equivalent (PCDDs/Fs-TEQ) in breast milk. The infants’ size was measured at birth and 1 and 4 months after birth, and neurodevelopment was evaluated using the Bayley Scales III at 4 months of age. Among 4 dioxin groups (<25, 25–50, 50–75, ≥75 percentile of PCDDs/Fs-TEQ), cross-sectional comparisons of body size and neurodevelopment scales and comparisons of longitudinally assessed body size were performed respectively. At birth, head circumference of girls in the ≥75 percentile group was significantly larger than those in the <25 and 50–75 percentile groups. At 4 months of age, the weight and body mass index (BMI) of boys in the ≥75 percentile group were significantly lower than those in the other groups. Increase in weight was significantly lower in the ≥75 percentile group in both sexes from birth to 1 month but only in boys at 1–4 months of age. Estimated marginal mean values in a mixed model of weight and BMI during the first 4 months of life were significantly lower in the ≥75 percentile group in boys. In girls, marginal mean values for head circumference were increased with increase in dioxin levels. Only in boys, cognitive, language, and fine motor scores in the ≥75 percentile group were significantly lower than those in the other groups. These results suggested a considerable impact of perinatal dioxin exposure on infant growth, particularly in boys exposed to dioxins at high level of PCDDs/Fs-TEQ. PMID:22815734

Impact of perinatal dioxin exposure on infant growth: a cross-sectional and longitudinal studies in dioxin-contaminated areas in Vietnam.

PubMed

Nishijo, Muneko; Tai, Pham The; Nakagawa, Hideaki; Maruzeni, Shoko; Anh, Nguyen Thi Nguyet; Luong, Hoang Van; Anh, Tran Hai; Honda, Ryumon; Morikawa, Yuko; Kido, Teruhiko; Nishijo, Hisao

2012-01-01

Dioxin exposure levels remain elevated in residents living around former US Air Force bases in Vietnam, indicating potential adverse impacts on infant growth. In this study, 210 mother-infant pairs in dioxin-contaminated areas in Vietnam were recruited at the infants' birth and followed up for 4 months. Perinatal dioxin exposure levels were estimated by measurement of polychlorinated dibenzo-p-dioxins/furans toxic equivalent (PCDDs/Fs-TEQ) in breast milk. The infants' size was measured at birth and 1 and 4 months after birth, and neurodevelopment was evaluated using the Bayley Scales III at 4 months of age. Among 4 dioxin groups (<25, 25-50, 50-75, ≥75 percentile of PCDDs/Fs-TEQ), cross-sectional comparisons of body size and neurodevelopment scales and comparisons of longitudinally assessed body size were performed respectively. At birth, head circumference of girls in the ≥75 percentile group was significantly larger than those in the <25 and 50-75 percentile groups. At 4 months of age, the weight and body mass index (BMI) of boys in the ≥75 percentile group were significantly lower than those in the other groups. Increase in weight was significantly lower in the ≥75 percentile group in both sexes from birth to 1 month but only in boys at 1-4 months of age. Estimated marginal mean values in a mixed model of weight and BMI during the first 4 months of life were significantly lower in the ≥75 percentile group in boys. In girls, marginal mean values for head circumference were increased with increase in dioxin levels. Only in boys, cognitive, language, and fine motor scores in the ≥75 percentile group were significantly lower than those in the other groups. These results suggested a considerable impact of perinatal dioxin exposure on infant growth, particularly in boys exposed to dioxins at high level of PCDDs/Fs-TEQ.

Prognostic Importance of Sex-Specific Cardiac Troponin T 99(th) Percentiles in Suspected Acute Coronary Syndrome.

PubMed

Eggers, Kai M; Jernberg, Tomas; Lindahl, Bertil

2016-08-01

Cardiac troponin levels differ between the sexes, with higher values commonly seen in men. The use of sex-specific troponin thresholds is, thus, subject of an ongoing debate. We assessed whether sex-specific cardiac troponin T (cTnT) 99(th) percentiles would improve risk prediction in patients admitted to Swedish coronary care units due to suspected acute coronary syndrome. In this retrospective register-based study (48,250 patients), we investigated the prediction of all-cause mortality and the composite of cardiovascular death or nonfatal myocardial infarction within 1 year using the single 99(th) cTnT percentile (>14 ng/L) or sex-specific cTnT 99(th) percentiles (>16/9 ng/L). A total of 1078 men (3.0%) with cTnT 15-16 ng/L and 1854 women (8.4%) with cTnT 10-14 ng/L would have been reclassified regarding their cTnT status by the means of sex-specific 99(th) percentiles. The prevalence of cardiovascular risk factors and crude event rates increased across higher cTnT strata in both men and women. Multivariable-adjusted Cox models, however, did not demonstrate better risk prediction by sex-specific 99(th) percentiles. Assessing cTnT as a continuous variable demonstrated an increase in multivariable-adjusted risk starting at levels around 10-12 ng/L in both men and women. We found no evidence supporting the use of sex-specific cTnT 99(th) percentiles in men and women admitted because of suspected acute coronary syndrome. This likely depends on sex-specific differences in disease mechanisms associated with small cTnT elevations. From a pragmatic perspective, a single cTnT cutoff slightly below 14 ng/L seems to be preferable as a threshold for medical decision-making. Copyright © 2016 Elsevier Inc. All rights reserved.

Cerebrospinal Fluid Glucose and Lactate: Age-Specific Reference Values and Implications for Clinical Practice

PubMed Central

Leen, Wilhelmina G.; Willemsen, Michèl A.; Wevers, Ron A.; Verbeek, Marcel M.

2012-01-01

Cerebrospinal fluid (CSF) analysis is an important tool in the diagnostic work-up of many neurological disorders, but reference ranges for CSF glucose, CSF/plasma glucose ratio and CSF lactate based on studies with large numbers of CSF samples are not available. Our aim was to define age-specific reference values. In 1993 The Nijmegen Observational CSF Study was started. Results of all CSF samples that were analyzed between 1993 and 2008 at our laboratory were systematically collected and stored in our computerized database. After exclusion of CSF samples with an unknown or elevated erythrocyte count, an elevated leucocyte count, elevated concentrations of bilirubin, free hemoglobin, or total protein 9,036 CSF samples were further studied for CSF glucose (n = 8,871), CSF/plasma glucose ratio (n = 4,516) and CSF lactate values (n = 7,614). CSF glucose, CSF/plasma glucose ratio and CSF lactate were age-, but not sex dependent. Age-specific reference ranges were defined as 5–95th percentile ranges. CSF glucose 5th percentile values ranged from 1.8 to 2.9 mmol/L and 95th percentile values from 3.8 to 5.6 mmol/L. CSF/plasma glucose ratio 5th percentile values ranged from 0.41 to 0.53 and 95th percentile values from 0.82 to 1.19. CSF lactate 5th percentile values ranged from 0.88 to 1.41 mmol/L and 95th percentile values from 2.00 to 2.71 mmol/L. Reference ranges for all three parameters were widest in neonates and narrowest in toddlers, with lower and upper limits increasing with age. These reference values allow a reliable interpretation of CSF results in everyday clinical practice. Furthermore, hypoglycemia was associated with an increased CSF/plasma glucose ratio, whereas hyperglycemia did not affect the CSF/plasma glucose ratio. PMID:22880096

Impact of a park-based afterschool program replicated over five years on modifiable cardiovascular disease risk factors.

PubMed

Messiah, Sarah E; Vidot, Denise; Hansen, Eric; Kardys, Jack; Sunil Matthew, M; Nardi, Maria; Arheart, Kristopher L

2017-02-01

Major challenges to the current childhood obesity epidemic include availability of prevention and/or treatment programs that are affordable and acc5essible. We evaluated the change in several modifiable, obesity-related cardiovascular disease risk factors after participation in Fit2Play™, a structured afterschool program housed in a large urban county parks system. Children ages 6-14 who participated in Fit2Play™ in one of 34 parks for one school year during a five-year period (2010-2015) had height, weight, 4-site skinfold thicknesses, systolic/diastolic blood pressure (SBP/DBP), fitness tests, and a health/wellness behavior/knowledge test collected at the beginning and end of the school year. Comparison of pre/post outcome measures were assessed via general linear mixed models for normal weight, overweight, and obese participants and both aggregate and cohort/year-specific results were generated. Aggregate (N=1546, 51% Hispanic, 44% NHB) results showed after one year of participation (U.S. Department of Health and Human Services, 2016) both the obese and overweight groups significantly decreased their mean body mass index (BMI) percentile (98th to 95th percentile, p<0.001; 91st percentile to 89th percentile, p<0.001, respectively); (Ogden et al. 2015) the normal weight group maintained a healthy BMI percentile (54.6th); (Ogden et al., 2014) mean SBP and DBP significantly decreased (3.6 percentile and 6 percentile points, respectively, p<0.001 for both). Mean number of sit-ups, push-ups, 400meter run time, and nutrition knowledge scores improved in all participants (p<0.001 for all). These findings suggest that parks-based afterschool health/wellness programs can be a low-cost, high value tool in both preventing and treating the current childhood obesity epidemic and among high-risk groups in particular. Copyright © 2016 Elsevier Inc. All rights reserved.

Nationwide singleton birth weight percentiles by gestational age in Taiwan, 1998-2002.

PubMed

Hsieh, Wu-Shiun; Wu, Hui-Chen; Jeng, Suh-Fang; Liao, Hua-Fang; Su, Yi-Ning; Lin, Shio-Jean; Hsieh, Chia-Jung; Chen, Pau-Chung

2006-01-01

There are limited nationwide population-based data about birth weight percentiles by gestational age in Taiwan. The purpose of this study was to develop updated intrauterine growth charts that are population based and contain the information of birth weight percentiles by gestational age for singleton newborns in Taiwan. We abstracted and analyzed the birth registration database from the Ministry of the Interior in Taiwan during the period of 1998-2002 that consisted of over one million singleton births. Percentiles of birth weight for each increment of gestational week from 21 to 44 weeks were estimated using smoothed means and standard deviations. The analyses revealed that birth weight rose with advancing gestational age, with greater slopes during the third trimester and then leveled off beyond 40 weeks of gestational age. The male to female ratio ranged from 1.088 to 1.096. The mean birth weights during the period of 1998-2002 were higher than those previously reported for the period of 1945-1967; while the birth weight distribution and percentile during the period of 1998-2002 were similar to those reported for the period of 1979-1989. The 10th, 50th, and 90th percentiles of birth weigh at 40th gestational age among the male newborns were 2914, 3374, and 3890 g respectively; and for the female newborns 2816, 3250, and 3747 g. At the gestational age of 37 weeks, the 10th, 50th, and 90th percentiles of birth weigh among the male newborns were 2499, 2941, and 3433 g respectively; and for the female newborns 2391, 2832, and 3334 g. From 1998 to 2002, there was a gradual increase in the prevalence of low birth weight and preterm birth together with the percentage of infants born to foreign-born mothers. This study provides the first nationwide singleton intrauterine growth charts in Taiwan that are population-based and gender-specific. The normative data are particularly useful for the investigation of predictors and outcomes of altered fetal growth.

Assessing gross motor development of Brazilian infants.

PubMed

Gontijo, Ana Paula Bensemann; de Castro Magalhães, Lívia; Guerra, Miriam Queiroz Faria

2014-01-01

To determine whether the Alberta Infant Motor Scale (AIMS) requires reference values specific for Brazilian infants. A total of 660 (330 girls) healthy full-term infants from Belo Horizonte were assessed using the AIMS. Scores and percentile curves were compared with the Canadian reference values. Differences were found in the 5th percentile (9-<10 and 10-<11 months) and the 10th percentile (4-<5, 9-<10, and 10-<11 months) curves. No significant differences were found between sexes on the basis of the economic classification or the criteria of the Human Development Index. Primarily because of the corrections made to the 5th and 10th percentile curves, we recommend the use of the Brazilian infant data curves reported here for further studies conducted in Brazil. Because the Human Development Index of Belo Horizonte is similar to that for Brazil as a whole, the results of this study should be relevant for clinicians throughout Brazil.

Estimation of a monotone percentile residual life function under random censorship.

PubMed

Franco-Pereira, Alba M; de Uña-Álvarez, Jacobo

2013-01-01

In this paper, we introduce a new estimator of a percentile residual life function with censored data under a monotonicity constraint. Specifically, it is assumed that the percentile residual life is a decreasing function. This assumption is useful when estimating the percentile residual life of units, which degenerate with age. We establish a law of the iterated logarithm for the proposed estimator, and its n-equivalence to the unrestricted estimator. The asymptotic normal distribution of the estimator and its strong approximation to a Gaussian process are also established. We investigate the finite sample performance of the monotone estimator in an extensive simulation study. Finally, data from a clinical trial in primary biliary cirrhosis of the liver are analyzed with the proposed methods. One of the conclusions of our work is that the restricted estimator may be much more efficient than the unrestricted one. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Serum neurofilament as a predictor of disease worsening and brain and spinal cord atrophy in multiple sclerosis.

PubMed

Barro, Christian; Benkert, Pascal; Disanto, Giulio; Tsagkas, Charidimos; Amann, Michael; Naegelin, Yvonne; Leppert, David; Gobbi, Claudio; Granziera, Cristina; Yaldizli, Özgür; Michalak, Zuzanna; Wuerfel, Jens; Kappos, Ludwig; Parmar, Katrin; Kuhle, Jens

2018-05-30

Neuro-axonal injury is a key factor in the development of permanent disability in multiple sclerosis. Neurofilament light chain in peripheral blood has recently emerged as a biofluid marker reflecting neuro-axonal damage in this disease. We aimed at comparing serum neurofilament light chain levels in multiple sclerosis and healthy controls, to determine their association with measures of disease activity and their ability to predict future clinical worsening as well as brain and spinal cord volume loss. Neurofilament light chain was measured by single molecule array assay in 2183 serum samples collected as part of an ongoing cohort study from 259 patients with multiple sclerosis (189 relapsing and 70 progressive) and 259 healthy control subjects. Clinical assessment, serum sampling and MRI were done annually; median follow-up time was 6.5 years. Brain volumes were quantified by structural image evaluation using normalization of atrophy, and structural image evaluation using normalization of atrophy, cross-sectional, cervical spinal cord volumes using spinal cord image analyser (cordial). Results were analysed using ordinary linear regression models and generalized estimating equation modelling. Serum neurofilament light chain was higher in patients with a clinically isolated syndrome or relapsing remitting multiple sclerosis as well as in patients with secondary or primary progressive multiple sclerosis than in healthy controls (age adjusted P < 0.001 for both). Serum neurofilament light chain above the 90th percentile of healthy controls values was an independent predictor of Expanded Disability Status Scale worsening in the subsequent year (P < 0.001). The probability of Expanded Disability Status Scale worsening gradually increased by higher serum neurofilament light chain percentile category. Contrast enhancing and new/enlarging lesions were independently associated with increased serum neurofilament light chain (17.8% and 4.9% increase per lesion respectively; P < 0.001). The higher the serum neurofilament light chain percentile level, the more pronounced was future brain and cervical spinal volume loss: serum neurofilament light chain above the 97.5th percentile was associated with an additional average loss in brain volume of 1.5% (P < 0.001) and spinal cord volume of 2.5% over 5 years (P = 0.009). Serum neurofilament light chain correlated with concurrent and future clinical and MRI measures of disease activity and severity. High serum neurofilament light chain levels were associated with both brain and spinal cord volume loss. Neurofilament light chain levels are a real-time, easy to measure marker of neuro-axonal injury that is conceptually more comprehensive than brain MRI.

'Outbreak Gold Standard' selection to provide optimized threshold for infectious diseases early-alert based on China Infectious Disease Automated-alert and Response System.

PubMed

Wang, Rui-Ping; Jiang, Yong-Gen; Zhao, Gen-Ming; Guo, Xiao-Qin; Michael, Engelgau

2017-12-01

The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008. The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China. In the CIDARS, thresholds are determined using the "Mean+2SD‟ in the early stage which have limitations. This study compared the performance of optimized thresholds defined using the "Mean +2SD‟ method to the performance of 5 novel algorithms to select optimal "Outbreak Gold Standard (OGS)‟ and corresponding thresholds for outbreak detection. Data for infectious disease were organized by calendar week and year. The "Mean+2SD‟, C1, C2, moving average (MA), seasonal model (SM), and cumulative sum (CUSUM) algorithms were applied. Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window. When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week, this Px was then defined as the optimized threshold for that algorithm. In this study, six infectious diseases were selected and classified into TYPE A (chickenpox and mumps), TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever]. Optimized thresholds for chickenpox (P 55 ), mumps (P 50 ), influenza (P 40 , P 55 , and P 75 ), rubella (P 45 and P 75 ), HFMD (P 65 and P 70 ), and scarlet fever (P 75 and P 80 ) were identified. The C1, C2, CUSUM, SM, and MA algorithms were appropriate for TYPE A. All 6 algorithms were appropriate for TYPE B. C1 and CUSUM algorithms were appropriate for TYPE C. It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

A Winter Distribution Model for Bicknell’s Thrush (Catharus bicknelli), a Conservation Tool for a Threatened Migratory Songbird

PubMed Central

McFarland, Kent P.; Rimmer, Christopher C.; Goetz, James E.; Aubry, Yves; Wunderle, Joseph M.; Sutton, Anne; Townsend, Jason M.; Sosa, Alejandro Llanes; Kirkconnell, Arturo

2013-01-01

Conservation planning and implementation require identifying pertinent habitats and locations where protection and management may improve viability of targeted species. The winter range of Bicknell’s Thrush (Catharus bicknelli), a threatened Nearctic-Neotropical migratory songbird, is restricted to the Greater Antilles. We analyzed winter records from the mid-1970s to 2009 to quantitatively evaluate winter distribution and habitat selection. Additionally, we conducted targeted surveys in Jamaica (n = 433), Cuba (n = 363), Dominican Republic (n = 1,000), Haiti (n = 131) and Puerto Rico (n = 242) yielding 179 sites with thrush presence. We modeled Bicknell’s Thrush winter habitat selection and distribution in the Greater Antilles in Maxent version 3.3.1. using environmental predictors represented in 30 arc second study area rasters. These included nine landform, land cover and climatic variables that were thought a priori to have potentially high predictive power. We used the average training gain from ten model runs to select the best subset of predictors. Total winter precipitation, aspect and land cover, particularly broadleaf forests, emerged as important variables. A five-variable model that contained land cover, winter precipitation, aspect, slope, and elevation was the most parsimonious and not significantly different than the models with more variables. We used the best fitting model to depict potential winter habitat. Using the 10 percentile threshold (>0.25), we estimated winter habitat to cover 33,170 km2, nearly 10% of the study area. The Dominican Republic contained half of all potential habitat (51%), followed by Cuba (15.1%), Jamaica (13.5%), Haiti (10.6%), and Puerto Rico (9.9%). Nearly one-third of the range was found to be in protected areas. By providing the first detailed predictive map of Bicknell’s Thrush winter distribution, our study provides a useful tool to prioritize and direct conservation planning for this and other wet, broadleaf forest specialists in the Greater Antilles. PMID:23326554

Dynamics of social behaviour at parturition in a gregarious ungulate.

PubMed

Pérez-Barbería, F J; Walker, D M

2018-05-01

Group living is the behavioural response that results when individuals assess the costs vs benefits of sociality, and these trade-offs vary across an animal's life. Here we quantitatively assess how periparturient condition (mother/non-mother) and births affect the dynamics of social interactions of a gregarious ungulate, and how such can help to explain evolutionary hypotheses of the mother-offspring bond. To achieve this we used data of the individual movement of a group of Scottish blackface sheep (Ovis aries) marked with GPS collars and properties of mathematical graphs (networks). Euclidean pair-wise distance between sheep were threshold at different percentiles to determine network links, and these thresholds have a profound effect on the connectivity of the resulting network. Births increased the average pair-wise distance between mothers, and between mothers and non-mothers, with less effect on the distance between non-mothers. Mothers occupied peripheral positions within the flock, more evident following births. Associations between individuals (i.e. network community change) were highly dynamic, though mothers were less likely to change community than non-mothers, especially after births. Births hampered individual communication within the flock (assessed via network closeness centrality), especially in mothers. Overall leadership (lead positioning relative to flock movement) was not associated to reproductive condition, and individual leadership rank was not affected by births. A ten minute GPS acquisition time was adequate to capture complex social dynamics in sheep movement. The results on mother's isolation behaviour support the hypotheses of selection for maternal imprint facilitation, reducing risks to nursing alien offspring, and group/multilevel selection on group formation. Copyright © 2018 Elsevier B.V. All rights reserved.

The Impact of Early Life Stress on Growth and Cardiovascular Risk: A Possible Example for Autonomic Imprinting?

PubMed

Buchhorn, Reiner; Meint, Sebastian; Willaschek, Christian

2016-01-01

Early life stress is imprinting regulatory properties with life-long consequences. We investigated heart rate variability in a group of small children with height below the third percentile, who experienced an episode of early life stress due to heart failure or intra uterine growth retardation. These children appear to develop autonomic dysfunction in later life. Compared to the healthy control group heart rate variability (HRV) is reduced on average in a group of 101 children with short stature. Low HRV correlates to groups of children born small for gestational age (SGA), children with cardiac growth failure and children with congenital syndromes, but not to those with constitutional growth delay (CGD), who had normal HRV. Reduced HRV indicated by lower RMSSD and High Frequency (HF)-Power is indicating reduced vagal activity as a sign of autonomic imbalance. It is not short stature itself, but rather the underlying diseases that are the cause for reduced HRV in children with height below the third percentile. These high risk children-allocated in the groups with an adverse autonomic imprinting in utero or infancy (SGA, congenital heart disease and congenital syndromes)-have the highest risk for 'stress diseases' such as cardiovascular disease in later life. The incidence of attention deficit disorder is remarkably high in our group of short children.

The Impact of Early Life Stress on Growth and Cardiovascular Risk: A Possible Example for Autonomic Imprinting?

PubMed Central

Buchhorn, Reiner; Meint, Sebastian

2016-01-01

Introduction Early life stress is imprinting regulatory properties with life-long consequences. We investigated heart rate variability in a group of small children with height below the third percentile, who experienced an episode of early life stress due to heart failure or intra uterine growth retardation. These children appear to develop autonomic dysfunction in later life. Results Compared to the healthy control group heart rate variability (HRV) is reduced on average in a group of 101 children with short stature. Low HRV correlates to groups of children born small for gestational age (SGA), children with cardiac growth failure and children with congenital syndromes, but not to those with constitutional growth delay (CGD), who had normal HRV. Reduced HRV indicated by lower RMSSD and High Frequency (HF)-Power is indicating reduced vagal activity as a sign of autonomic imbalance. Conclusion It is not short stature itself, but rather the underlying diseases that are the cause for reduced HRV in children with height below the third percentile. These high risk children—allocated in the groups with an adverse autonomic imprinting in utero or infancy (SGA, congenital heart disease and congenital syndromes)—have the highest risk for ‘stress diseases’ such as cardiovascular disease in later life. The incidence of attention deficit disorder is remarkably high in our group of short children. PMID:27861527

Refined assessment of associations between drinking water residence time and emergency department visits for gastrointestinal illness in Metro Atlanta, Georgia.

PubMed

Levy, Karen; Klein, Mitchel; Sarnat, Stefanie Ebelt; Panwhar, Samina; Huttinger, Alexandra; Tolbert, Paige; Moe, Christine

2016-08-01

Recent outbreak investigations suggest that a substantial proportion of waterborne disease outbreaks are attributable to water distribution system issues. In this analysis, we examine the relationship between modeled water residence time (WRT), a proxy for probability of microorganism intrusion into the distribution system, and emergency department visits for gastrointestinal (GI) illness for two water utilities in Metro Atlanta, USA during 1993-2004. We also examine the association between proximity to the nearest distribution system node, based on patients' residential address, and GI illness using logistic regression models. Comparing long (≥90th percentile) with intermediate WRTs (11th to 89th percentile), we observed a modestly increased risk for GI illness for Utility 1 (OR = 1.07, 95% CI: 1.02-1.13), which had substantially higher average WRT than Utility 2, for which we found no increased risk (OR = 0.98, 95% CI: 0.94-1.02). Examining finer, 12-hour increments of WRT, we found that exposures >48 h were associated with increased risk of GI illness, and exposures of >96 h had the strongest associations, although none of these associations was statistically significant. Our results suggest that utilities might consider reducing WRTs to <2-3 days or adding booster disinfection in areas with longer WRT, to minimize risk of GI illness from water consumption.

Childhood family wealth and mental health in a national cohort of young adults.

PubMed

Lê-Scherban, Félice; Brenner, Allison B; Schoeni, Robert F

2016-12-01

Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. We used prospectively collected data from 2060 young adults aged 18-27 in 2005-2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale) and childhood average household wealth during ages 0-18 years (net worth in 2010 dollars). In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to below-median wealth, prevalence ratio (PR) = 0.56 (0.36-0.87) for 3 rd quartile and PR = 0.46 (0.29-0.73) for 4 th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness.

Refined Assessment of Associations between Drinking Water Residence Time and Emergency Department Visits for Gastrointestinal Illness in Metro Atlanta, Georgia

PubMed Central

Levy, Karen; Klein, Mitchell; Sarnat, Stefanie Ebelt; Panwhar, Samina; Huttinger, Alexandra; Tolbert, Paige; Moe, Christine

2017-01-01

Recent outbreak investigations suggest that a substantial proportion of waterborne disease outbreaks are attributable to water distribution system issues. In this analysis, we examine the relationship between modeled water residence time (WRT), a proxy for probability of microorganism intrusion into the distribution system, and emergency department visits for gastrointestinal (GI) illness for two water utilities in Metro Atlanta, USA during 1993–2004. We also examine the association between proximity to the nearest distribution system node, based on patients' residential address, and GI illness using logistic regression models. Comparing long (≥90th percentile) to intermediate WRTs (11th to 89th percentile), we observed a modestly increased risk for GI illness for Utility 1 (OR=1.07, 95% CI: 1.02–1.13), which had substantially higher average WRT than Utility 2, for which we found no increased risk (OR=0.98, 95% CI: 0.94–1.02). Examining finer, 12-hour increments of WRT, we found that exposures >48 hrs were associated with increased risk of GI illness, and exposures of >96 hrs had the strongest associations, although none of these associations were statistically significant. Our results suggest that utilities might consider reducing WRTs to <2–3 days or add booster disinfection in areas with longer WRT, to minimize risk of GI illness from water consumption. PMID:27441862

24-hour aortic blood pressure variability showed a stronger association with carotid damage than 24-hour brachial blood pressure variability: The SAFAR study.

PubMed

Yu, Shikai; Chi, Chen; Protogerou, Athanase D; Safar, Michel E; Blacher, Jacques; Argyris, Antonis A; Nasothimiou, Efthimia G; Sfikakis, Petros P; Papaioannou, Theodore G; Xu, Henry; Zhang, Yi; Xu, Yawei

2018-03-01

We aim to compare 24-hour aortic blood pressure variability (BPV) with brachial BPV in relation to carotid damage as estimated by carotid intima-media thickness (CIMT) and cross-sectional area (CCSA). Four hundred and forty five individuals received brachial and aortic 24-hour ambulatory BP monitoring with a validated device (Mobil-O-Graph). Systolic BPV was estimated by average real variability (ARV) and time-weighted standard deviation (wSD). In multiple logistic regression analysis, CIMT > 900 μm was significantly and independently associated with aortic ARV (OR = 1.38; 95% CI: 1.04-1.84), aortic wSD (OR = 1.65; 95% CI: 1.19-2.29) and brachial ARV (OR = 1.53; 95% CI: 1.07-2.18), but not with brachial wSD. CCSA > 90th percentile was significantly and independently associated with aortic ARV (OR = 1.50; 95% CI: 1.07-2.10) and wSD (OR = 1.70; 95% CI: 1.12-2.56), but not with brachial BPVs. In receiver operator characteristics curve analysis, aortic wSD identified CCSA > 90th percentile better than brachial wSD (AUC: 0.73 vs 0.68, P < .01). In conclusion, aortic 24-hour systolic BPV showed a slightly stronger association with carotid damage than brachial BPV. ©2018 Wiley Periodicals, Inc.

The burden of ambient temperature on years of life lost in Guangzhou, China

NASA Astrophysics Data System (ADS)

Yang, Jun; Ou, Chun-Quan; Guo, Yuming; Li, Li; Guo, Cui; Chen, Ping-Yan; Lin, Hua-Liang; Liu, Qi-Yong

2015-08-01

Limited evidence is available on the association between temperature and years of life lost (YLL). We applied distributed lag non-linear model to assess the nonlinear and delayed effects of temperature on YLL due to cause-/age-/education-specific mortality in Guangzhou, China. We found that hot effects appeared immediately, while cold effects were more delayed and lasted for 14 days. On average, 1 °C decrease from 25th to 1st percentile of temperature was associated with an increase of 31.15 (95%CI: 20.57, 41.74), 12.86 (8.05, 17.68) and 6.64 (3.68, 9.61) YLL along lag 0-14 days for non-accidental, cardiovascular and respiratory diseases, respectively. The corresponding estimate of cumulative hot effects (1 °C increase from 75th to 99th percentile of temperature) was 12.71 (-2.80, 28.23), 4.81 (-2.25, 11.88) and 2.81 (-1.54, 7.16). Effect estimates of cold and hot temperatures-related YLL were higher in people aged up to 75 years and persons with low education level than the elderly and those with high education level, respectively. The mortality risks associated with cold and hot temperatures were greater on the elderly and persons with low education level. This study highlights that YLL provides a complementary method for assessing the death burden of temperature.

Variation of quantitative emphysema measurements from CT scans

NASA Astrophysics Data System (ADS)

Keller, Brad M.; Reeves, Anthony P.; Henschke, Claudia I.; Barr, R. Graham; Yankelevitz, David F.

2008-03-01

Emphysema is a lung disease characterized by destruction of the alveolar air sacs and is associated with long-term respiratory dysfunction. CT scans allow for imaging of the anatomical basis of emphysema, and several measures have been introduced for the quantification of the extent of disease. In this paper we compare these measures for repeatability over time. The measures of interest in this study are emphysema index, mean lung density, histogram percentile, and the fractal dimension. To allow for direct comparisons, the measures were normalized to a 0-100 scale. These measures have been computed for a set of 2,027 scan pairs in which the mean interval between scans was 1.15 years (σ: 93 days). These independent pairs were considered with respect to three different scanning conditions (a) 223 pairs where both were scanned with a 5 mm slice thickness protocol, (b) 695 with the first scanned with the 5 mm protocol and the second with a 1.25 mm protocol, and (c) 1109 pairs scanned both times using a 1.25 mm protocol. We found that average normalized emphysema index and histogram percentiles scores increased by 5.9 and 11 points respectively, while the fractal dimension showed stability with a mean difference of 1.2. We also found, a 7 point bias introduced for emphysema index under condition (b), and that the fractal dimension measure is least affected by scanner parameter changes.

Trends in Middle East climate extreme indices from 1950 to 2003

NASA Astrophysics Data System (ADS)

Zhang, Xuebin; Aguilar, Enric; Sensoy, Serhat; Melkonyan, Hamlet; Tagiyeva, Umayra; Ahmed, Nader; Kutaladze, Nato; Rahimzadeh, Fatemeh; Taghipour, Afsaneh; Hantosh, T. H.; Albert, Pinhas; Semawi, Mohammed; Karam Ali, Mohammad; Said Al-Shabibi, Mansoor Halal; Al-Oulan, Zaid; Zatari, Taha; Al Dean Khelet, Imad; Hamoud, Saleh; Sagir, Ramazan; Demircan, Mesut; Eken, Mehmet; Adiguzel, Mustafa; Alexander, Lisa; Peterson, Thomas C.; Wallis, Trevor

2005-11-01

A climate change workshop for the Middle East brought together scientists and data for the region to produce the first area-wide analysis of climate extremes for the region. This paper reports trends in extreme precipitation and temperature indices that were computed during the workshop and additional indices data that became available after the workshop. Trends in these indices were examined for 1950-2003 at 52 stations covering 15 countries, including Armenia, Azerbaijan, Bahrain, Cyprus, Georgia, Iran, Iraq, Israel, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Syria, and Turkey. Results indicate that there have been statistically significant, spatially coherent trends in temperature indices that are related to temperature increases in the region. Significant, increasing trends have been found in the annual maximum of daily maximum and minimum temperature, the annual minimum of daily maximum and minimum temperature, the number of summer nights, and the number of days where daily temperature has exceeded its 90th percentile. Significant negative trends have been found in the number of days when daily temperature is below its 10th percentile and daily temperature range. Trends in precipitation indices, including the number of days with precipitation, the average precipitation intensity, and maximum daily precipitation events, are weak in general and do not show spatial coherence. The workshop attendees have generously made the indices data available for the international research community.

Does the bathing water classification depend on sampling strategy? A bootstrap approach for bathing water quality assessment, according to Directive 2006/7/EC requirements.

PubMed

López, Iago; Alvarez, César; Gil, José L; Revilla, José A

2012-11-30

Data on the 95th and 90th percentiles of bacteriological quality indicators are used to classify bathing waters in Europe, according to the requirements of Directive 2006/7/EC. However, percentile values and consequently, classification of bathing waters depend both on sampling effort and sample-size, which may undermine an appropriate assessment of bathing water classification. To analyse the influence of sampling effort and sample size on water classification, a bootstrap approach was applied to 55 bacteriological quality datasets of several beaches in the Balearic Islands (Spain). Our results show that the probability of failing the regulatory standards of the Directive is high when sample size is low, due to a higher variability in percentile values. In this way, 49% of the bathing waters reaching an "Excellent" classification (95th percentile of Escherichia coli under 250 cfu/100 ml) can fail the "Excellent" regulatory standard due to sampling strategy, when 23 samples per season are considered. This percentage increases to 81% when 4 samples per season are considered. "Good" regulatory standards can also be failed in bathing waters with an "Excellent" classification as a result of these sampling strategies. The variability in percentile values may affect bathing water classification and is critical for the appropriate design and implementation of bathing water Quality Monitoring and Assessment Programs. Hence, variability of percentile values should be taken into account by authorities if an adequate management of these areas is to be achieved. Copyright © 2012 Elsevier Ltd. All rights reserved.

Both low and high temperature may increase the risk of stroke mortality

PubMed Central

Chen, Renjie; Wang, Cuicui; Meng, Xia; Chen, Honglei; Thach, Thuan Quoc; Wong, Chit-Ming

2013-01-01

Objective: To examine temperature in relation to stroke mortality in a multicity time series study in China. Methods: We obtained data on daily temperature and mortality from 8 large cities in China. We used quasi-Poisson generalized additive models and distributed lag nonlinear models to estimate the accumulative effects of temperature on stroke mortality across multiple days, adjusting for long-term and seasonal trends, day of the week, air pollution, and relative humidity. We applied the Bayesian hierarchical model to pool city-specific effect estimates. Results: Both cold and hot temperatures were associated with increased risk of stroke mortality. The potential effect of cold temperature might last more than 2 weeks. The pooled relative risks of extreme cold (first percentile of temperature) and cold (10th percentile of temperature) temperatures over lags 0–14 days were 1.39 (95% posterior intervals [PI] 1.18–1.64) and 1.11 (95% PI 1.06–1.17), compared with the 25th percentile of temperature. In contrast, the effect of hot temperature was more immediate. The relative risks of stroke mortality over lags 0–3 days were 1.06 (95% PI 1.02–1.10) for extreme hot temperature (99th percentile of temperature) and 1.14 (95% PI 1.05–1.24) for hot temperature (90th percentile of temperature), compared with the 75th percentile of temperature. Conclusions: This study showed that both cold and hot temperatures were associated with increased risk of stroke mortality in China. Our findings may have important implications for stroke prevention in China. PMID:23946311

Both low and high temperature may increase the risk of stroke mortality.

PubMed

Chen, Renjie; Wang, Cuicui; Meng, Xia; Chen, Honglei; Thach, Thuan Quoc; Wong, Chit-Ming; Kan, Haidong

2013-09-17

To examine temperature in relation to stroke mortality in a multicity time series study in China. We obtained data on daily temperature and mortality from 8 large cities in China. We used quasi-Poisson generalized additive models and distributed lag nonlinear models to estimate the accumulative effects of temperature on stroke mortality across multiple days, adjusting for long-term and seasonal trends, day of the week, air pollution, and relative humidity. We applied the Bayesian hierarchical model to pool city-specific effect estimates. Both cold and hot temperatures were associated with increased risk of stroke mortality. The potential effect of cold temperature might last more than 2 weeks. The pooled relative risks of extreme cold (first percentile of temperature) and cold (10th percentile of temperature) temperatures over lags 0-14 days were 1.39 (95% posterior intervals [PI] 1.18-1.64) and 1.11 (95% PI 1.06-1.17), compared with the 25th percentile of temperature. In contrast, the effect of hot temperature was more immediate. The relative risks of stroke mortality over lags 0-3 days were 1.06 (95% PI 1.02-1.10) for extreme hot temperature (99th percentile of temperature) and 1.14 (95% PI 1.05-1.24) for hot temperature (90th percentile of temperature), compared with the 75th percentile of temperature. This study showed that both cold and hot temperatures were associated with increased risk of stroke mortality in China. Our findings may have important implications for stroke prevention in China.

The association of weight percentile and motor vehicle crash injury among 3 to 8 year old children.

PubMed

Zonfrillo, Mark R; Nelson, Kyle A; Durbin, Dennis R; Kallan, Michael J

2010-01-01

The use of age-appropriate child restraint systems significantly reduces injury and death associated with motor vehicle crashes (MVCs). Pediatric obesity has become a global epidemic. Although recent evidence suggests a possible association between pediatric obesity and MVC-related injury, there are potential misclassifications of body mass index from under-estimated height in younger children. Given this limitation, age- and sex-specific weight percentiles can be used as a proxy of weight status. The specific aim of this study was to determine the association between weight percentile and the risk of significant injury for children 3-8 years in MVCs. This was a cross-sectional study of children aged 3-8 years in MVCs in 16 US states, with data collected via insurance claims records and a telephone survey from 12/1/98-11/30/07. Parent-reported injuries with an abbreviated Injury Scale (AIS) score of 2+ indicated a clinically significant injury. Age- and sex-specific weight percentiles were calculated using pediatric norms. The study sample included 9,327 children aged 3-8 years (weighted to represent 157,878 children), of which 0.96% sustained clinically significant injuries. There was no association between weight percentiles and overall injury when adjusting for restraint type (p=0.71). However, increasing weight percentiles were associated with lower extremity injuries at a level that approached significance (p=0.053). Further research is necessary to describe mechanisms for weight-related differences in injury risk. Parents should continue to properly restrain their children in accordance with published guidelines.

Searching for the definition of macrosomia through an outcome-based approach.

PubMed

Ye, Jiangfeng; Zhang, Lin; Chen, Yan; Fang, Fang; Luo, ZhongCheng; Zhang, Jun

2014-01-01

Macrosomia has been defined in various ways by obstetricians and researchers. The purpose of the present study was to search for a definition of macrosomia through an outcome-based approach. In a study of 30,831,694 singleton term live births and 38,053 stillbirths in the U.S. Linked Birth-Infant Death Cohort datasets (1995-2004), we compared the occurrence of stillbirth, neonatal death, and 5-min Apgar score less than four in subgroups of birthweight (4000-4099 g, 4100-4199 g, 4200-4299 g, 4300-4399 g, 4400-4499 g, 4500-4999 g vs. reference group 3500-4000 g) and birthweight percentile for gestational age (90th-94th percentile, 95th-96th, and ≥ 97th percentile, vs. reference group 75th-90th percentile). There was no significant increase in adverse perinatal outcomes until birthweight exceeded the 97th percentile. Weight-specific odds ratios (ORs) elevated substantially to 2 when birthweight exceeded 4500 g in Whites. In Blacks and Hispanics, the aORs exceeded 2 for 5-min Apgar less than four when birthweight exceeded 4300 g. For vaginal deliveries, the aORs of perinatal morbidity and mortality were larger for most of the subgroups, but the patterns remained the same. A birthweight greater than 4500 g in Whites, or 4300 g in Blacks and Hispanics regardless of gestational age is the optimal threshold to define macrosomia. A birthweight greater than the 97th percentile for a given gestational age, irrespective of race is also reasonable to define macrosomia. The former may be more clinically useful and simpler to apply.

Relation between birth weight and weight and height at the age of 2 in children born preterm.

PubMed

Olson, Gayle; Weiner, Steven J; Rouse, Dwight J; Reddy, Uma M; Mercer, Brian M; Varner, Michael W; Leveno, Kenneth J; Iams, Jay D; Wapner, Ronald J; Ramin, Susan M; Malone, Fergal D; Carpenter, Marshall W; O'Sullivan, Mary J; Dinsmoor, Mara J; Hankins, Gary D V; Caritis, Steve N

2015-05-01

The aim of the study was to evaluate associations between fetal growth and weight at 2 years in infants born preterm using a customized approach for birth weight. This is a secondary analysis of a multicenter trial that included a 2-year follow-up of children born prematurely. Customized birth weight percentiles were calculated using the Gardosi model for a U.S. population, and the relation between customized percentile and weight and height at 2 years (adjusted for gender using z-score) was determined using regression analysis and by comparing z-scores for children with birth weight <10th versus ≥10th percentile. Weight z-score at 2 years was significantly lower in the <10th than in the ≥10th percentile group (median [interquartile range, IQR]: -0.66 [-1.58, -0.01] vs. -0.23 [-1.05, 0.55]; p < 0.001), and remained after adjusting for maternal education (p < 0.001). A similar relationship was noted for height z-score between groups (median [IQR]: -0.56 [-1.29, 0.19] vs. -0.24 [-0.99, 0.37]; p < 0.001). Positive relationships between customized birth weight percentile and weight and height at 2 years were noted (p < 0.001 for both), but were not strong (R (2) = 0.04 and 0.02, respectively). Customized birth weight percentile is a minor determinant of weight at 2 years among children born preterm. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Development and validation of a prediction model for measurement variability of lung nodule volumetry in patients with pulmonary metastases.

PubMed

Hwang, Eui Jin; Goo, Jin Mo; Kim, Jihye; Park, Sang Joon; Ahn, Soyeon; Park, Chang Min; Shin, Yeong-Gil

2017-08-01

To develop a prediction model for the variability range of lung nodule volumetry and validate the model in detecting nodule growth. For model development, 50 patients with metastatic nodules were prospectively included. Two consecutive CT scans were performed to assess volumetry for 1,586 nodules. Nodule volume, surface voxel proportion (SVP), attachment proportion (AP) and absolute percentage error (APE) were calculated for each nodule and quantile regression analyses were performed to model the 95% percentile of APE. For validation, 41 patients who underwent metastasectomy were included. After volumetry of resected nodules, sensitivity and specificity for diagnosis of metastatic nodules were compared between two different thresholds of nodule growth determination: uniform 25% volume change threshold and individualized threshold calculated from the model (estimated 95% percentile APE). SVP and AP were included in the final model: Estimated 95% percentile APE = 37.82 · SVP + 48.60 · AP-10.87. In the validation session, the individualized threshold showed significantly higher sensitivity for diagnosis of metastatic nodules than the uniform 25% threshold (75.0% vs. 66.0%, P = 0.004) CONCLUSION: Estimated 95% percentile APE as an individualized threshold of nodule growth showed greater sensitivity in diagnosing metastatic nodules than a global 25% threshold. • The 95 % percentile APE of a particular nodule can be predicted. • Estimated 95 % percentile APE can be utilized as an individualized threshold. • More sensitive diagnosis of metastasis can be made with an individualized threshold. • Tailored nodule management can be provided during nodule growth follow-up.

Examining the Predictive Validity of NIH Peer Review Scores

PubMed Central

Lindner, Mark D.; Nakamura, Richard K.

2015-01-01

The predictive validity of peer review at the National Institutes of Health (NIH) has not yet been demonstrated empirically. It might be assumed that the most efficient and expedient test of the predictive validity of NIH peer review would be an examination of the correlation between percentile scores from peer review and bibliometric indices of the publications produced from funded projects. The present study used a large dataset to examine the rationale for such a study, to determine if it would satisfy the requirements for a test of predictive validity. The results show significant restriction of range in the applications selected for funding. Furthermore, those few applications that are funded with slightly worse peer review scores are not selected at random or representative of other applications in the same range. The funding institutes also negotiate with applicants to address issues identified during peer review. Therefore, the peer review scores assigned to the submitted applications, especially for those few funded applications with slightly worse peer review scores, do not reflect the changed and improved projects that are eventually funded. In addition, citation metrics by themselves are not valid or appropriate measures of scientific impact. The use of bibliometric indices on their own to measure scientific impact would likely increase the inefficiencies and problems with replicability already largely attributed to the current over-emphasis on bibliometric indices. Therefore, retrospective analyses of the correlation between percentile scores from peer review and bibliometric indices of the publications resulting from funded grant applications are not valid tests of the predictive validity of peer review at the NIH. PMID:26039440

How to select a proper early warning threshold to detect infectious disease outbreaks based on the China infectious disease automated alert and response system (CIDARS).

PubMed

Wang, Ruiping; Jiang, Yonggen; Michael, Engelgau; Zhao, Genming

2017-06-12

China Centre for Diseases Control and Prevention (CDC) developed the China Infectious Disease Automated Alert and Response System (CIDARS) in 2005. The CIDARS was used to strengthen infectious disease surveillance and aid in the early warning of outbreak. The CIDARS has been integrated into the routine outbreak monitoring efforts of the CDC at all levels in China. Early warning threshold is crucial for outbreak detection in the CIDARS, but CDCs at all level are currently using thresholds recommended by the China CDC, and these recommended thresholds have recognized limitations. Our study therefore seeks to explore an operational method to select the proper early warning threshold according to the epidemic features of local infectious diseases. The data used in this study were extracted from the web-based Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), and data for infectious disease cases were organized by calendar week (1-52) and year (2009-2015) in Excel format; Px was calculated using a percentile-based moving window (moving window [5 week*5 year], x), where x represents one of 12 centiles (0.40, 0.45, 0.50….0.95). Outbreak signals for the 12 Px were calculated using the moving percentile method (MPM) based on data from the CIDARS. When the outbreak signals generated by the 'mean + 2SD' gold standard were in line with a Px generated outbreak signal for each week during the year of 2014, this Px was then defined as the proper threshold for the infectious disease. Finally, the performance of new selected thresholds for each infectious disease was evaluated by simulated outbreak signals based on 2015 data. Six infectious diseases were selected in this study (chickenpox, mumps, hand foot and mouth diseases (HFMD), scarlet fever, influenza and rubella). Proper thresholds for chickenpox (P75), mumps (P80), influenza (P75), rubella (P45), HFMD (P75), and scarlet fever (P80) were identified. The selected proper thresholds for these 6 infectious diseases could detect almost all simulated outbreaks within a shorter time period compared to thresholds recommended by the China CDC. It is beneficial to select the proper early warning threshold to detect infectious disease aberrations based on characteristics and epidemic features of local diseases in the CIDARS.

Metabolic Syndrome (For Parents)

MedlinePlus

... at or above the 90th percentile for a child's age and sex would be considered a risk factor. Blood pressure. ... at or above the 90th percentile for a child's age and sex, it is considered a risk factor. Blood tests , ...

Short-term effects of air temperature on mortality and effect modification by air pollution in three cities of Bavaria, Germany: a time-series analysis.

PubMed

Breitner, Susanne; Wolf, Kathrin; Devlin, Robert B; Diaz-Sanchez, David; Peters, Annette; Schneider, Alexandra

2014-07-01

Air temperature has been shown to be associated with mortality; however, only very few studies have been conducted in Germany. This study examined the association between daily air temperature and cause-specific mortality in Bavaria, Southern Germany. Moreover, we investigated effect modification by age and ambient air pollution. We obtained data from Munich, Nuremberg as well as Augsburg, Germany, for the period 1990 to 2006. Data included daily cause-specific death counts, mean daily meteorology and air pollution concentrations (particulate matter with a diameter<10 μm [PM10] and maximum 8-h ozone). We used Poisson regression models combined with distributed lag non-linear models adjusting for long-term trend, calendar effects, and meteorological factors. Air pollutant concentrations were categorized into three levels, and an interaction term was included to quantify potential effect modification of the air temperature effects. The temperature-mortality relationships were non-linear for all cause-specific mortality categories showing U- or J-shaped curves. An increase from the 90th (20.0 °C) to the 99th percentile (24.8 °C) of 2-day average temperature led to an increase in non-accidental mortality by 11.4% (95% CI: 7.6%-15.3%), whereas a decrease from the 10th (-1.0 °C) to the 1st percentile (-7.5 °C) in the 15-day average temperature resulted in an increase of 6.2% (95% CI: 1.8%-10.8%). The very old were found to be most susceptible to heat effects. Results also suggested some effect modification by ozone, but not for PM10. Results indicate that both very low and very high air temperature increase cause-specific mortality in Bavaria. Results also pointed to the importance of considering effect modification by age and ozone in assessing temperature effects on mortality. Copyright © 2014 Elsevier B.V. All rights reserved.

Ambient air pollution, adipokines, and glucose homeostasis: The Framingham Heart Study.

PubMed

Li, Wenyuan; Dorans, Kirsten S; Wilker, Elissa H; Rice, Mary B; Kloog, Itai; Schwartz, Joel D; Koutrakis, Petros; Coull, Brent A; Gold, Diane R; Meigs, James B; Fox, Caroline S; Mittleman, Murray A

2018-02-01

To examine associations of proximity to major roadways, sustained exposure to fine particulate matter (PM 2.5 ), and acute exposure to ambient air pollutants with adipokines and measures of glucose homeostasis among participants living in the northeastern United States. We included 5958 participants from the Framingham Offspring cohort examination cycle 7 (1998-2001) and 8 (2005-2008) and Third Generation cohort examination cycle 1 (2002-2005) and 2 (2008-2011), who did not have type 2 diabetes at the time of examination visit. We calculated 2003 annual average PM 2.5 at participants' home address, residential distance to the nearest major roadway, and daily PM 2.5 , black carbon (BC), sulfate, nitrogen oxides (NO x ), and ozone concentrations. We used linear mixed effects models for fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) which were measured up to twice, and used linear regression models for adiponectin, resistin, leptin, and hemoglobin A1c (HbA1c) which were measured only once, adjusting for demographics, socioeconomic position, lifestyle, time, and seasonality. The mean age was 51years and 55% were women. Participants who lived 64m (25th percentile) from a major roadway had 0.28% (95% CI: 0.05%, 0.51%) higher fasting plasma glucose than participants who lived 413m (75th percentile) away, and the association appeared to be driven by participants who lived within 50m from a major roadway. Higher exposures to 3- to 7-day moving averages of BC and NO x were associated with higher glucose whereas the associations for ozone were negative. The associations otherwise were generally null and did not differ by median age, sex, educational attainment, obesity status, or prediabetes status. Living closer to a major roadway or acute exposure to traffic-related air pollutants were associated with dysregulated glucose homeostasis but not with adipokines among participants from the Framingham Offspring and Third Generation cohorts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder.

PubMed

Doney, Robyn; Lucas, Barbara R; Watkins, Rochelle E; Tsang, Tracey W; Sauer, Kay; Howat, Peter; Latimer, Jane; Fitzpatrick, James P; Oscar, June; Carter, Maureen; Elliott, Elizabeth J

2016-08-01

Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits. VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5-9.6 years, n=108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established. Mean VMI scores were 'below average' (M=87.8±9.6), and visual perception scores were 'average' (M=97.6±12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M=87.9±12.5; 66.7%) than children without PAE (M=95.1±10.7; 23.3%) and PAE (no FASD) (M=96.1±10.9; 15.4%). Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Heat and health in Antwerp under climate change: Projected impacts and implications for prevention.

PubMed

Martinez, Gerardo Sanchez; Diaz, Julio; Hooyberghs, Hans; Lauwaet, Dirk; De Ridder, Koen; Linares, Cristina; Carmona, Rocio; Ortiz, Cristina; Kendrovski, Vladimir; Aerts, Raf; Van Nieuwenhuyse, An; Dunbar, Maria Bekker-Nielsen

2018-02-01

Excessive summer heat is a serious environmental health problem in several European cities. Heat-related mortality and morbidity is likely to increase under climate change scenarios without adequate prevention based on locally relevant evidence. We modelled the urban climate of Antwerp for the summer season during the period 1986-2015, and projected summer daily temperatures for two periods, one in the near (2026-2045) and one in the far future (2081-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the relationship between temperature and mortality, as well as with hospital admissions for the period 2009-2013, and estimated the projected mortality in the near future and far future periods under changing climate and population, assuming alternatively no acclimatization and acclimatization based on a constant threshold percentile temperature. During the sample period 2009-2013 we observed an increase in daily mortality from a maximum daily temperature of 26°C, or the 89th percentile of the maximum daily temperature series. The annual average heat-related mortality in this period was 13.4 persons (95% CI: 3.8-23.4). No effect of heat was observed in the case of hospital admissions due to cardiorespiratory causes. Under a no acclimatization scenario, annual average heat-related mortality is multiplied by a factor of 1.7 in the near future (24.1deaths/year CI 95%: 6.78-41.94) and by a factor of 4.5 in the far future (60.38deaths/year CI 95%: 17.00-105.11). Under a heat acclimatization scenario, mortality does not increase significantly in the near or in the far future. These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate, and the calibration of existing prevention activities in light of locally relevant evidence. Copyright © 2017. Published by Elsevier Ltd.

Stanford GEMS phase 2 obesity prevention trial for low-income African-American girls: design and sample baseline characteristics.

PubMed

Robinson, Thomas N; Kraemer, Helena C; Matheson, Donna M; Obarzanek, Eva; Wilson, Darrell M; Haskell, William L; Pruitt, Leslie A; Thompson, Nikko S; Haydel, K Farish; Fujimoto, Michelle; Varady, Ann; McCarthy, Sally; Watanabe, Connie; Killen, Joel D

2008-01-01

African-American girls and women are at high risk of obesity and its associated morbidities. Few studies have tested obesity prevention strategies specifically designed for African-American girls. This report describes the design and baseline findings of the Stanford GEMS (Girls health Enrichment Multi-site Studies) trial to test the effect of a two-year community- and family-based intervention to reduce weight gain in low-income, pre-adolescent African-American girls. Randomized controlled trial with measurements scheduled in girls' homes at baseline, 6, 12, 18 and 24 month post-randomization. Low-income areas of Oakland, CA. Eight, nine and ten year old African-American girls and their parents/caregivers. Girls are randomized to a culturally-tailored after-school dance program and a home/family-based intervention to reduce screen media use versus an information-based community health education Active-Placebo Comparison intervention. Interventions last for 2 years for each participant. Change in body mass index over the two-year study. Recruitment and enrollment successfully produced a predominately low-socioeconomic status sample. Two-hundred sixty one (261) families were randomized. One girl per family is randomly chosen for the analysis sample. Randomization produced comparable experimental groups with only a few statistically significant differences. The sample had a mean body mass index (BMI) at the 74 th percentile on the 2000 CDC BMI reference, and one-third of the analysis sample had a BMI at the 95th percentile or above. Average fasting total cholesterol and LDL cholesterol were above NCEP thresholds for borderline high classifications. Girls averaged low levels of moderate to vigorous physical activity, more than 3 h per day of screen media use, and diets high in energy from fat. The Stanford GEMS trial is testing the benefits of culturally-tailored after-school dance and screen-time reduction interventions for obesity prevention in low-income, pre-adolescent African-American girls.

3D fluoroscopic image estimation using patient-specific 4DCBCT-based motion models

PubMed Central

Dhou, Salam; Hurwitz, Martina; Mishra, Pankaj; Cai, Weixing; Rottmann, Joerg; Li, Ruijiang; Williams, Christopher; Wagar, Matthew; Berbeco, Ross; Ionascu, Dan; Lewis, John H.

2015-01-01

3D fluoroscopic images represent volumetric patient anatomy during treatment with high spatial and temporal resolution. 3D fluoroscopic images estimated using motion models built using 4DCT images, taken days or weeks prior to treatment, do not reliably represent patient anatomy during treatment. In this study we develop and perform initial evaluation of techniques to develop patient-specific motion models from 4D cone-beam CT (4DCBCT) images, taken immediately before treatment, and use these models to estimate 3D fluoroscopic images based on 2D kV projections captured during treatment. We evaluate the accuracy of 3D fluoroscopic images by comparing to ground truth digital and physical phantom images. The performance of 4DCBCT- and 4DCT- based motion models are compared in simulated clinical situations representing tumor baseline shift or initial patient positioning errors. The results of this study demonstrate the ability for 4DCBCT imaging to generate motion models that can account for changes that cannot be accounted for with 4DCT-based motion models. When simulating tumor baseline shift and patient positioning errors of up to 5 mm, the average tumor localization error and the 95th percentile error in six datasets were 1.20 and 2.2 mm, respectively, for 4DCBCT-based motion models. 4DCT-based motion models applied to the same six datasets resulted in average tumor localization error and the 95th percentile error of 4.18 and 5.4 mm, respectively. Analysis of voxel-wise intensity differences was also conducted for all experiments. In summary, this study demonstrates the feasibility of 4DCBCT-based 3D fluoroscopic image generation in digital and physical phantoms, and shows the potential advantage of 4DCBCT-based 3D fluoroscopic image estimation when there are changes in anatomy between the time of 4DCT imaging and the time of treatment delivery. PMID:25905722

Closing the N-use efficiency gap to achieve food and environmental security.

PubMed

Cui, Zhenling; Wang, Guiliang; Yue, Shanchao; Wu, Liang; Zhang, Weifeng; Zhang, Fusuo; Chen, Xinping

2014-05-20

To achieve food and environmental security, closing the gap between actual and attainable N-use efficiency should be as important as closing yield gaps. Using a meta-analysis of 205 published studies from 317 study sites, including 1332 observations from rice, wheat, and maize system in China, reactive N (Nr) losses, and total N2O emissions from N fertilization both increased exponentially with increasing N application rate. On the basis of the N loss response curves from the literature meta-analysis, the direct N2O emission, NH3 volatilization, N leaching, and N runoff, and total N2O emission (direct + indirect) were calculated using information from the survey of farmers. The PFP-N (kilogram of harvested product per kilogram of N applied (kg (kg of N)(-1))) for 6259 farmers were relative low with only 37, 23, and 32 kg (kg of N)(-1) for rice, wheat, and maize systems, respectively. In comparison, the PFP-N for highest yield and PFP-N group (refers to fields where the PFP-N was within the 80-100th percentile among those fields that achieved yields within the 80-100th percentile) averaged 62, 42, and 53 kg (kg of N)(-1) for rice, wheat, and maize systems, respectively. The corresponding grain yield would increase by 1.6-2.3 Mg ha(-1), while the N application rate would be reduced by 56-100 kg of N ha(-1) from average farmer field to highest yield and PFP-N group. In return, the Nr loss intensity (4-11 kg of N (Mg of grain)(-1)) and total N2O emission intensity (0.15-0.29 kg of N (Mg of grain)(-1)) would both be reduced significantly as compared to current agricultural practices. In many circumstances, closing the PFP-N gap in intensive cropping systems is compatible with increased crop productivity and reductions in both Nr losses and total N2O emissions.

Normal probabilities for Vandenberg AFB wind components - monthly reference periods for all flight azimuths, 0- to 70-km altitudes

NASA Technical Reports Server (NTRS)

Falls, L. W.

1975-01-01

Vandenberg Air Force Base (AFB), California, wind component statistics are presented to be used for aerospace engineering applications that require component wind probabilities for various flight azimuths and selected altitudes. The normal (Gaussian) distribution is presented as a statistical model to represent component winds at Vandenberg AFB. Head tail, and crosswind components are tabulated for all flight azimuths for altitudes from 0 to 70 km by monthly reference periods. Wind components are given for 11 selected percentiles ranging from 0.135 percent to 99.865 percent for each month. The results of statistical goodness-of-fit tests are presented to verify the use of the Gaussian distribution as an adequate model to represent component winds at Vandenberg AFB.

Normal probabilities for Cape Kennedy wind components: Monthly reference periods for all flight azimuths. Altitudes 0 to 70 kilometers

NASA Technical Reports Server (NTRS)

Falls, L. W.

1973-01-01

This document replaces Cape Kennedy empirical wind component statistics which are presently being used for aerospace engineering applications that require component wind probabilities for various flight azimuths and selected altitudes. The normal (Gaussian) distribution is presented as an adequate statistical model to represent component winds at Cape Kennedy. Head-, tail-, and crosswind components are tabulated for all flight azimuths for altitudes from 0 to 70 km by monthly reference periods. Wind components are given for 11 selected percentiles ranging from 0.135 percent to 99,865 percent for each month. Results of statistical goodness-of-fit tests are presented to verify the use of the Gaussian distribution as an adequate model to represent component winds at Cape Kennedy, Florida.

Empirical, dimensionless, cumulative-rainfall hyetographs developed from 1959-86 storm data for selected small watersheds in Texas

USGS Publications Warehouse

Williams-Sether, Tara; Asquith, William H.; Thompson, David B.; Cleveland, Theodore G.; Fang, Xing

2004-01-01

A database of incremental cumulative-rainfall values for storms that occurred in small urban and rural watersheds in north and south central Texas during the period from 1959 to 1986 was used to develop empirical, dimensionless, cumulative-rainfall hyetographs. Storm-quartile classifications were determined from the cumulative-rainfall values, which were divided into data groups on the basis of storm-quartile classification (first, second, third, fourth, and first through fourth combined), storm duration (0 to 6, 6 to 12, 12 to 24, 24 to 72, and 0 to 72 hours), and rainfall amount (1 inch or more). Removal of long leading tails, in effect, shortened the storm duration and, in some cases, affected the storm-quartile classification. Therefore, two storm groups, untrimmed and trimmed, were used for analysis. The trimmed storms generally are preferred for interpretation. For a 12-hour or less trimmed storm duration, approximately 49 percent of the storms are first quartile. For trimmed storm durations of 12 to 24 and 24 to 72 hours, 47 and 38 percent, respectively, of the storms are first quartile. For a trimmed storm duration of 0 to 72 hours, the first-, second-, third-, and fourth-quartile storms accounted for 46, 21, 20, and 13 percent of all storms, respectively. The 90th-percentile curve for first-quartile storms indicated about 90 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. The 10th-percentile curve for first-quartile storms indicated about 30 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. The 90th-percentile curve for fourth-quartile storms indicated about 33 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. The 10th-percentile curve for fourth-quartile storms indicated less than 5 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. Statistics for the empirical, dimensionless, cumulative-rainfall hyetographs are presented in the report along with hyetograph curves and tables. The curves and tables presented do not present exact mathematical relations but can be used to estimate distributions of rainfall with time for small drainage areas of less than about 160 square miles in urban and small rural watersheds in north and south central Texas.

Multi-year objective analyses of warm season ground-level ozone and PM2.5 over North America using real-time observations and Canadian operational air quality models

NASA Astrophysics Data System (ADS)

Robichaud, A.; Ménard, R.

2013-05-01

We present multi-year objective analyses (OA) on a high spatio-temporal resolution (15 or 21 km, every hour) for the warm season period (1 May-31 October) for ground-level ozone (2002-2012) and for fine particulate matter (diameter less than 2.5 microns (PM2.5)) (2004-2012). The OA used here combines the Canadian Air Quality forecast suite with US and Canadian surface air quality monitoring sites. The analysis is based on an optimal interpolation with capabilities for adaptive error statistics for ozone and PM2.5 and an explicit bias correction scheme for the PM2.5 analyses. The estimation of error statistics has been computed using a modified version of the Hollingsworth-Lönnberg's (H-L) method. Various quality controls (gross error check, sudden jump test and background check) have been applied to the observations to remove outliers. An additional quality control is applied to check the consistency of the error statistics estimation model at each observing station and for each hour. The error statistics are further tuned "on the fly" using a χ2 (chi-square) diagnostic, a procedure which verifies significantly better than without tuning. Successful cross-validation experiments were performed with an OA set-up using 90% of observations to build the objective analysis and with the remainder left out as an independent set of data for verification purposes. Furthermore, comparisons with other external sources of information (global models and PM2.5 satellite surface derived measurements) show reasonable agreement. The multi-year analyses obtained provide relatively high precision with an absolute yearly averaged systematic error of less than 0.6 ppbv (parts per billion by volume) and 0.7 μg m-3 (micrograms per cubic meter) for ozone and PM2.5 respectively and a random error generally less than 9 ppbv for ozone and under 12 μg m-3 for PM2.5. In this paper, we focus on two applications: (1) presenting long term averages of objective analysis and analysis increments as a form of summer climatology and (2) analyzing long term (decadal) trends and inter-annual fluctuations using OA outputs. Our results show that high percentiles of ozone and PM2.5 are both following a decreasing trend overall in North America with the eastern part of United States (US) presenting the highest decrease likely due to more effective pollution controls. Some locations, however, exhibited an increasing trend in the mean ozone and PM2.5 such as the northwestern part of North America (northwest US and Alberta). The low percentiles are generally rising for ozone which may be linked to increasing emissions from emerging countries and the resulting pollution brought by the intercontinental transport. After removing the decadal trend, we demonstrate that the inter-annual fluctuations of the high percentiles are significantly correlated with temperature fluctuations for ozone and precipitation fluctuations for PM2.5. We also show that there was a moderately significant correlation between the inter-annual fluctuations of the high percentiles of ozone and PM2.5 with economic indices such as the Industrial Dow Jones and/or the US gross domestic product growth rate.

Statistical methods for estimating normal blood chemistry ranges and variance in rainbow trout (Salmo gairdneri), Shasta Strain

USGS Publications Warehouse

Wedemeyer, Gary A.; Nelson, Nancy C.

1975-01-01

Gaussian and nonparametric (percentile estimate and tolerance interval) statistical methods were used to estimate normal ranges for blood chemistry (bicarbonate, bilirubin, calcium, hematocrit, hemoglobin, magnesium, mean cell hemoglobin concentration, osmolality, inorganic phosphorus, and pH for juvenile rainbow (Salmo gairdneri, Shasta strain) trout held under defined environmental conditions. The percentile estimate and Gaussian methods gave similar normal ranges, whereas the tolerance interval method gave consistently wider ranges for all blood variables except hemoglobin. If the underlying frequency distribution is unknown, the percentile estimate procedure would be the method of choice.

Value of MR histogram analyses for prediction of microvascular invasion of hepatocellular carcinoma.

PubMed

Huang, Ya-Qin; Liang, He-Yue; Yang, Zhao-Xia; Ding, Ying; Zeng, Meng-Su; Rao, Sheng-Xiang

2016-06-01

The objective is to explore the value of preoperative magnetic resonance (MR) histogram analyses in predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Fifty-one patients with histologically confirmed HCC who underwent diffusion-weighted and contrast-enhanced MR imaging were included. Histogram analyses were performed and mean, variance, skewness, kurtosis, 1th, 10th, 50th, 90th, and 99th percentiles were derived. Quantitative histogram parameters were compared between HCCs with and without MVI. Receiver operating characteristics (ROC) analyses were generated to compare the diagnostic performance of tumor size, histogram analyses of apparent diffusion coefficient (ADC) maps, and MR enhancement.The mean, 1th, 10th, and 50th percentiles of ADC maps, and the mean, variance. 1th, 10th, 50th, 90th, and 99th percentiles of the portal venous phase (PVP) images were significantly different between the groups with and without MVI (P <0.05), with area under the ROC curves (AUCs) of 0.66 to 0.74 for ADC and 0.76 to 0.88 for PVP. The largest AUC of PVP (1th percentile) showed significantly higher accuracy compared with that of arterial phase (AP) or tumor size (P <0.001).MR histogram analyses-in particular for 1th percentile for PVP images-held promise for prediction of MVI of HCC.