Sodium-glucose co-transporter 2 inhibitors in addition to insulin therapy for management of type 2 diabetes mellitus: A meta-analysis of randomized controlled trials.

PubMed

Tang, Huilin; Cui, Wei; Li, Dandan; Wang, Tiansheng; Zhang, Jingjing; Zhai, Suodi; Song, Yiqing

2017-01-01

Given inconsistent trial results of sodium-glucose cotransporter 2 (SGLT2) inhibitors in addition to insulin therapy for treating type 2 diabetes mellitus (T2DM), a meta-analysis was performed to evaluate the efficacy and safety of this combination for T2DM by searching available randomized trials from PubMed, Embase, CENTRAL and ClinicalTrials.gov. Our meta-analysis included seven eligible placebo-controlled trials involving 4235 patients. Compared with placebo, SGLT2 inhibitor treatment was significantly associated with a mean reduction in HbA1c of -0.56%, fasting plasma glucose of -0.95 mmol/L, body weight of -2.63 kg and insulin dose of -8.79 IU, but an increased risk of drug-related adverse events by 36%, urinary tract infections by 29% and genital infections by 357%. No significant increase was observed in risk of overall adverse events [risk ratio (RR), 1.00], serious adverse events (RR, 0.90), adverse events leading to discontinuation (RR, 1.16), hypoglycaemia events (RR, 1.07) and severe hypoglycaemia events (RR, 1.24). No diabetic ketoacidosis events were reported. Further studies are needed to establish optimal combination type and dose. © 2016 John Wiley & Sons Ltd.

Detection and analysis of microseismic events using a Matched Filtering Algorithm (MFA)

NASA Astrophysics Data System (ADS)

Caffagni, Enrico; Eaton, David W.; Jones, Joshua P.; van der Baan, Mirko

2016-07-01

A new Matched Filtering Algorithm (MFA) is proposed for detecting and analysing microseismic events recorded by downhole monitoring of hydraulic fracturing. This method requires a set of well-located template (`parent') events, which are obtained using conventional microseismic processing and selected on the basis of high signal-to-noise (S/N) ratio and representative spatial distribution of the recorded microseismicity. Detection and extraction of `child' events are based on stacked, multichannel cross-correlation of the continuous waveform data, using the parent events as reference signals. The location of a child event relative to its parent is determined using an automated process, by rotation of the multicomponent waveforms into the ray-centred co-ordinates of the parent and maximizing the energy of the stacked amplitude envelope within a search volume around the parent's hypocentre. After correction for geometrical spreading and attenuation, the relative magnitude of the child event is obtained automatically using the ratio of stacked envelope peak with respect to its parent. Since only a small number of parent events require interactive analysis such as picking P- and S-wave arrivals, the MFA approach offers the potential for significant reduction in effort for downhole microseismic processing. Our algorithm also facilitates the analysis of single-phase child events, that is, microseismic events for which only one of the S- or P-wave arrivals is evident due to unfavourable S/N conditions. A real-data example using microseismic monitoring data from four stages of an open-hole slickwater hydraulic fracture treatment in western Canada demonstrates that a sparse set of parents (in this case, 4.6 per cent of the originally located events) yields a significant (more than fourfold increase) in the number of located events compared with the original catalogue. Moreover, analysis of the new MFA catalogue suggests that this approach leads to more robust interpretation of the induced microseismicity and novel insights into dynamic rupture processes based on the average temporal (foreshock-aftershock) relationship of child events to parents.

Total Thrombus-formation Analysis System Predicts Periprocedural Bleeding Events in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention.

PubMed

Oimatsu, Yu; Kaikita, Koichi; Ishii, Masanobu; Mitsuse, Tatsuro; Ito, Miwa; Arima, Yuichiro; Sueta, Daisuke; Takahashi, Aya; Iwashita, Satomi; Yamamoto, Eiichiro; Kojima, Sunao; Hokimoto, Seiji; Tsujita, Kenichi

2017-04-24

Periprocedural bleeding events are common after percutaneous coronary intervention. We evaluated the association of periprocedural bleeding events with thrombogenicity, which was measured quantitatively by the Total Thrombus-formation Analysis System equipped with microchips and thrombogenic surfaces (collagen, platelet chip [PL]; collagen plus tissue factor, atheroma chip [AR]). Between August 2013 and March 2016, 313 consecutive patients with coronary artery disease undergoing elective percutaneous coronary intervention were enrolled. They were divided into those with or without periprocedural bleeding events. We determined the bleeding events as composites of major bleeding events defined by the International Society on Thrombosis and Hemostasis and minor bleeding events (eg, minor hematoma, arteriovenous shunt and pseudoaneurysm). Blood samples obtained at percutaneous coronary intervention were analyzed for thrombus formation area under the curve (PL 24 -AUC 10 for PL chip; AR 10 -AUC 30 for AR chip) by the Total Thrombus-formation Analysis System and P2Y12 reaction unit by the VerifyNow system. Periprocedural bleeding events occurred in 37 patients. PL 24 -AUC 10 levels were significantly lower in patients with such events than those without ( P =0.002). Multiple logistic regression analyses showed association between low PL 24 -AUC 10 levels and periprocedural bleeding events (odds ratio, 2.71 [1.22-5.99]; P =0.01) and association between PL 24 -AUC 10 and periprocedural bleeding events in 176 patients of the femoral approach group (odds ratio, 2.88 [1.11-7.49]; P =0.03). However, PL 24 -AUC 10 levels in 127 patients of the radial approach group were not significantly different in patients with or without periprocedural bleeding events. PL 24 -AUC 10 measured by the Total Thrombus-formation Analysis System is a potentially useful predictor of periprocedural bleeding events in coronary artery disease patients undergoing elective percutaneous coronary intervention. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis.

PubMed

Kraan, Tamar; Velthorst, Eva; Smit, Filip; de Haan, Lieuwe; van der Gaag, Mark

2015-02-01

Childhood trauma and recent life-events have been related to psychotic disorders. The aim of the present study was to examine whether childhood trauma and recent life-events are significantly more prevalent in patients at Ultra High Risk (UHR) of developing a psychotic disorder compared to healthy controls. A search of PsychInfo and Embase was conducted, relevant papers were reviewed, and three random-effects meta-analyses were performed. One meta-analysis assessed the prevalence rate of childhood trauma in UHR subjects and two meta-analyses were conducted to compare UHR subjects and healthy control subjects on the experience of childhood trauma and recent life-events. We found 12 studies on the prevalence of (childhood) trauma in UHR populations and 4 studies on recent life-events in UHR populations. We performed a meta-analysis on 6 studies (of which trauma prevalence rates were available) on childhood trauma in UHR populations, yielding a mean prevalence rate of 86.8% (95% CI 77%-93%). Childhood trauma was significantly more prevalent in UHR subjects compared to healthy control groups (Random effects Hedges' g=1.09; Z=4.60, p<.001). In contrast to our hypothesis, life-event rates were significantly lower in UHR subjects compared to healthy controls (Random effects Hedges' g=-0.53; Z=-2.36, p<.02). Our meta-analytic results illustrate that childhood trauma is highly prevalent among UHR subjects and that childhood trauma is related to UHR status. These results are in line with studies on childhood trauma in psychotic populations. In contrast to studies on recent life-events in psychotic populations, our results show that recent life-events are not associated with UHR status. Copyright © 2014 Elsevier B.V. All rights reserved.

Predicting Pilot Performance in Off-Nominal Conditions: A Meta-Analysis and Model Validation

NASA Technical Reports Server (NTRS)

Wickens, C.D.; Hooey, B.L.; Gore, B.F.; Sebok, A.; Koenecke, C.; Salud, E.

2009-01-01

Pilot response to off-nominal (very rare) events represents a critical component to understanding the safety of next generation airspace technology and procedures. We describe a meta-analysis designed to integrate the existing data regarding pilot accuracy of detecting rare, unexpected events such as runway incursions in realistic flight simulations. Thirty-five studies were identified and pilot responses were categorized by expectancy, event location, and whether the pilot was flying with a highway-in-the-sky display. All three dichotomies produced large, significant effects on event miss rate. A model of human attention and noticing, N-SEEV, was then used to predict event noticing performance as a function of event salience and expectancy, and retinal eccentricity. Eccentricity is predicted from steady state scanning by the SEEV model of attention allocation. The model was used to predict miss rates for the expectancy, location and highway-in-the-sky (HITS) effects identified in the meta-analysis. The correlation between model-predicted results and data from the meta-analysis was 0.72.

Association between Use of Exogenous Testosterone Therapy and Risk of Venous Thrombotic Events among Exogenous Testosterone Treated and Untreated Men with Hypogonadism.

PubMed

Li, Hu; Benoit, Karin; Wang, Wei; Motsko, Stephen

2016-04-01

Limited information exists about whether exogenous testosterone therapy is associated with a risk of venous thrombotic events. We investigated via cohort and nested case-control analyses whether exogenous testosterone therapy is associated with the risk of venous thrombotic events in men with hypogonadism. Databases were reviewed to identify men prescribed exogenous testosterone therapy and/or men with a hypogonadism diagnosis. Propensity score 1:1 matching was used to select patients for cohort analysis. Cases (men with venous thrombotic events) were matched 1:4 with controls (men without venous thrombotic events) for the nested case-control analysis. Primary outcome was defined as incident idiopathic venous thrombotic events. Cox regression and conditional logistic regression were used to assess HRs and ORs, respectively. Sensitivity analyses were also performed. A total of 102,650 exogenous testosterone treated and 102,650 untreated patients were included in cohort analysis after matching, and 2,785 cases and 11,119 controls were included in case-control analysis. Cohort analysis revealed a HR of 1.08 for all testosterone treated patients (95% CI 0.91, 1.27, p = 0.378). Case-control analysis resulted in an OR of 1.02 (95% CI 0.92, 1.13, p = 0.702) for current exogenous testosterone therapy exposure and an OR of 0.92 (95% CI 0.82, 1.03, p = 0.145) for past exogenous testosterone therapy exposure. These results remained nonstatistically significant after stratifying by exogenous testosterone therapy administration route and age category. Most sensitivity analyses yielded consistent results. No significant association was found between exogenous testosterone therapy and incidents of idiopathic or overall venous thrombotic events in men with hypogonadism. However, some discrepant findings exist for the association between injectable formulations and the risk of overall venous thrombotic events. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Philosophy of ATHEANA

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

Bley, D.C.; Cooper, S.E.; Forester, J.A.

ATHEANA, a second-generation Human Reliability Analysis (HRA) method integrates advances in psychology with engineering, human factors, and Probabilistic Risk Analysis (PRA) disciplines to provide an HRA quantification process and PRA modeling interface that can accommodate and represent human performance in real nuclear power plant events. The method uses the characteristics of serious accidents identified through retrospective analysis of serious operational events to set priorities in a search process for significant human failure events, unsafe acts, and error-forcing context (unfavorable plant conditions combined with negative performance-shaping factors). ATHEANA has been tested in a demonstration project at an operating pressurized water reactor.

Comparative tolerability of treatments for acute migraine: A network meta-analysis.

PubMed

Thorlund, Kristian; Toor, Kabirraaj; Wu, Ping; Chan, Keith; Druyts, Eric; Ramos, Elodie; Bhambri, Rahul; Donnet, Anne; Stark, Richard; Goadsby, Peter J

2017-09-01

Introduction Migraine headache is a neurological disorder whose attacks are associated with nausea, vomiting, photophobia and phonophobia. Treatments for migraine aim to either prevent attacks before they have started or relieve attacks (abort) after onset of symptoms and range from complementary therapies to pharmacological interventions. A number of treatment-related adverse events such as somnolence, fatigue, and chest discomfort have previously been reported in association with triptans. The comparative tolerability of available agents for the abortive treatment of migraine attacks has not yet been systematically reviewed and quantified. Methods We performed a systematic literature review and Bayesian network meta-analysis for comparative tolerability of treatments for migraine. The literature search targeted all randomized controlled trials evaluating oral abortive treatments for acute migraine over a range of available doses in adults. The primary outcomes of interest were any adverse event, treatment-related adverse events, and serious adverse events. Secondary outcomes were fatigue, dizziness, chest discomfort, somnolence, nausea, and vomiting. Results Our search yielded 141 trials covering 15 distinct treatments. Of the triptans, sumatriptan, eletriptan, rizatriptan, zolmitriptan, and the combination treatment of sumatriptan and naproxen were associated with a statistically significant increase in odds of any adverse event or a treatment-related adverse event occurring compared with placebo. Of the non-triptans, only acetaminophen was associated with a statistically significant increase in odds of an adverse event occurring when compared with placebo. Overall, triptans were not associated with increased odds of serious adverse events occurring and the same was the case for non-triptans. For the secondary outcomes, with the exception of vomiting, all triptans except for almotriptan and frovatriptan were significantly associated with increased risk for all outcomes. Almotriptan was significantly associated with an increased risk of vomiting, whereas all other triptans yielded non-significant lower odds compared with placebo. Generally, the non-triptans were not associated with decreased tolerability for the secondary outcomes. Discussion In summary, triptans were associated with higher odds of any adverse event or a treatment-related adverse event occurring when compared to placebo and non-triptans. Non-significant results for non-triptans indicate that these treatments are comparable with one another and placebo regarding tolerability outcomes.

The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events From 2010 to 2015.

PubMed

Goldberg, Scott A; Maggin, Jeremy; Molloy, Michael S; Baker, Olesya; Sarin, Ritu; Kelleher, Michael; Mont, Kevin; Fajana, Adedeji; Goralnick, Eric

2018-03-19

Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness. A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015. We examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts. Rates were 10 presentations and 1.6 transports per 10,000 attendees with a non-significant trend towards increased rates in postseason National Football League games. Concerts had significantly higher rates of presentation and transport than all other event types. Presenting concern varied significantly by event type and gender, and transport rate increased predictably with age. For cold weather events, transport rates increased at colder temperatures. Overall, on-site physicians did not impact rates. At a single venue hosting a variety of events across a 6-year period, we demonstrated significant variations in presentation and transport rates. Weather, gender, event type, and age all play important roles. Our analysis, while representative only of our specific venue, may be useful in developing response plans and staffing models for similar mass gathering venues. (Disaster Med Public Health Preparedness. 2018;page 1 of 7).

P2Y12 Polymorphisms and the Risk of Adverse Clinical Events in Patients Treated with Clopidogrel: A Meta-Analysis.

PubMed

Zhao, Kun; Yang, Ming; Lu, Yanxia; Sun, Shusen; Li, Wei; Li, Xingang; Zhao, Zhigang

2018-05-23

Some studies have reported an association between P2Y12 gene polymorphisms and clopidogrel adverse outcomes with inconsistent results. We aimed to explore the relationship between P2Y12 polymorphisms and the risk of adverse clinical events in patients treated with clopidogrel through a meta-analysis. A systematic search of PubMed, Web of Science and the Cochrane Library was conducted. Retrieved articles were comprehensively reviewed and eligible studies were included, and the relevant data was extracted for this meta-analysis. All statistical tests were performed by the Review Manager 5.3 software. A total of 14 studies involving 8,698 patients were included. In the Han Chinese population, ischemic events were associated with P2Y12 T744C polymorphism in the CC vs TT+CT genetic model (OR=3.32, 95%CI=1.62-6.82, P =0.001), and the events were associated with P2Y12 C34T polymorphism in the TT+TC vs CC genetic model (OR=1.70, 95%CI=1.22-2.36, P =0.002). However, ischemic events were not related to P2Y12 G52T polymorphism (TT+TG vs GG: OR=1.13, 95%CI=0.76-1.68, P =0.56; TT vs GG+TG: OR=2.02, 95%CI=0.65-6.28, P =0.22). The associations between the P2Y12 polymorphism and ischemic events were not significant in T744C, G52T and C34T genotype for another subgroup of the Caucasian population ( P >0.05). Only two studies referring to bleeding events were included in this analysis of C34T polymorphism, and no significant association was found (TT+TC vs CC: OR=1.07, 95%CI=0.37-3.15, P =0.90). In the Caucasian population, P2Y12 gene polymorphisms are not associated with clinical events. However, in the Chinese Han population, P2Y12 T744C and C34T polymorphisms are significantly associated with adverse clinical events. © Georg Thieme Verlag KG Stuttgart · New York.

Adverse events with bismuth salts for Helicobacter pylori eradication: Systematic review and meta-analysis

PubMed Central

Ford, Alexander C; Malfertheiner, Peter; Giguère, Monique; Santana, José; Khan, Mostafizur; Moayyedi, Paul

2008-01-01

AIM: To assess the safety of bismuth used in Helicobacter pylori (H pylori) eradication therapy regimens. METHODS: We conducted a systematic review and meta-analysis. MEDLINE and EMBASE were searched (up to October 2007) to identify randomised controlled trials comparing bismuth with placebo or no treatment, or bismuth salts in combination with antibiotics as part of eradication therapy with the same dose and duration of antibiotics alone or, in combination, with acid suppression. Total numbers of adverse events were recorded. Data were pooled and expressed as relative risks with 95% confidence intervals (CI). RESULTS: We identified 35 randomised controlled trials containing 4763 patients. There were no serious adverse events occurring with bismuth therapy. There was no statistically significant difference detected in total adverse events with bismuth [relative risk (RR) = 1.01; 95% CI: 0.87-1.16], specific individual adverse events, with the exception of dark stools (RR = 5.06; 95% CI: 1.59-16.12), or adverse events leading to withdrawal of therapy (RR = 0.86; 95% CI: 0.54-1.37). CONCLUSION: Bismuth for the treatment of H pylori is safe and well-tolerated. The only adverse event occurring significantly more commonly was dark stools. PMID:19109870

Adverse cardiac events in 56,000 orthopaedic trauma patients: Does anatomic area make a difference?

PubMed

Lee, Adam K; Dodd, Ashley C; Lakomkin, Nikita; Yarlagadda, Mahesh; Jahangir, A Alex; Collinge, Cory A; Sethi, Manish K

2016-08-01

Postoperative cardiac events in orthopaedic trauma patients constitute severe morbidity and mortality. It is therefore increasingly important to determine patient risk factors that are predictive of postoperative myocardial infarctions and cardiac arrests. This study sought to assess if there is an association between anatomic area and cardiac complications in the orthopaedic trauma patient. From 2006-2013, a total of 361,402 orthopaedic patients were identified in the NSQIP database using Current Procedural Terminology (CPT) codes. Of these, 56,336 (15.6%) patients were identified as orthopaedic trauma patients broken down by anatomic region: 11,905 (21.1%) upper extremity patients (UE), 29,009 (51.5%) hip/pelvis patients (HP), and 15,422 (27.4%) lower extremity patients (LE) using CPT codes. Patients were defined as having adverse cardiac events if they developed myocardial infarctions or cardiac arrests within 30days after surgery. Chi-squared analysis was used to determine if there was an association between anatomic area and rates of cardiac events. Multivariate logistical analysis was used with over 40 patient characteristics including age, gender, history of cardiac disease, and anatomic region as independent predictors to determine whether anatomic area significantly predicted the development of cardiac complications. There were significant differences in baseline demographics among the three groups: HP patients had the greatest average age (77.6 years) compared to 54.8 years for UE patients and 54.1 years in LE patients (p<0.001). HP patients also had the highest average ASA score (3.0) (p<0.001). There was a significant difference in adverse cardiac events based on anatomic area: 0.27% (32/11,905) UE patients developed cardiac complications compared to 2.15% (623/29,009) HP patients and 0.61% (94/15,422) LE patients. After multivariate analysis, HP patients were significantly more likely to develop cardiac complications compared to both UE patients (OR: 6.377, p=0.014) and LE patients (OR: 2.766, p=0.009). There is a significant difference in adverse cardiac events following orthopaedic trauma based on anatomic region. Hip/Pelvis surgery appeared to be a significant risk factor in developing an adverse cardiac event. Further studies should investigate why hip/pelvic patients are at a higher risk of adverse cardiac events. Copyright © 2016 Elsevier Ltd. All rights reserved.

Alcohol intoxication in the context of major public holidays, sporting and social events: a time-series analysis in Melbourne, Australia, 2000-2009.

PubMed

Lloyd, Belinda; Matthews, Sharon; Livingston, Michael; Jayasekara, Harindra; Smith, Karen

2013-04-01

To assess the relationship between ambulance attendances, emergency department (ED) presentations and hospital admissions for acute alcohol intoxication and the timing of public holidays, sporting and social events. Time-series analysis was used to explore trends in intoxication in the context of major events. Population of Melbourne, Victoria, Australia between 2000 and 2009. All patients attended by ambulance, presenting to hospital EDs, or admitted to hospital who were classified as acutely alcohol intoxicated. Analysis of daily numbers of presentations for acute alcohol intoxication associated with major events were undertaken, including lead and lag effects. Analyses controlled for day of week and month of year to address temporal and seasonal variations. Alcohol intoxication presentations were significantly elevated the day before all public holidays, with intoxication cases on the day of public holidays only higher on New Year's Day (ambulance 6.57, 95% confidence intervals (CI): 3.4-9.74; ED 3.34, 95% CI: 1.28-5.4) and ANZAC Day (ambulance 3.71, 95% CI: 0.68-6.75). The Australian Football League (AFL) Grand Final (ED 2.37, 95% CI: 0.55-4.19), Commonwealth Games (ED 2.45, 95% CI: 0.6-4.3) and Melbourne Cup Day (ambulance 6.14, 95% CI: 2.42-9.85) represented the sporting events with significant elevations in acute intoxication requiring medical attention. The last working day before Christmas was the only social event where a significant increase in acute intoxication occurred (ambulance 8.98, 95% CI: 6.8-11.15). Acute alcohol intoxication cases requiring ambulance, emergency department and hospital in-patient treatment increase substantially on the day preceding public holidays and other major social events. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Study of the peculiarities of multiparticle production via event-by-event analysis in asymmetric nucleus-nucleus interactions

NASA Astrophysics Data System (ADS)

Fedosimova, Anastasiya; Gaitinov, Adigam; Grushevskaya, Ekaterina; Lebedev, Igor

2017-06-01

In this work the study on the peculiarities of multiparticle production in interactions of asymmetric nuclei to search for unusual features of such interactions, is performed. A research of long-range and short-range multiparticle correlations in the pseudorapidity distribution of secondary particles on the basis of analysis of individual interactions of nuclei of 197 Au at energy 10.7 AGeV with photoemulsion nuclei, is carried out. Events with long-range multiparticle correlations (LC), short-range multiparticle correlations (SC) and mixed type (MT) in pseudorapidity distribution of secondary particles, are selected by the Hurst method in accordance with Hurst curve behavior. These types have significantly different characteristics. At first, they have different fragmentation parameters. Events of LC type are processes of full destruction of the projectile nucleus, in which multicharge fragments are absent. In events of mixed type several multicharge fragments of projectile nucleus are discovered. Secondly, these two types have significantly different multiplicity distribution. The mean multiplicity of LC type events is significantly more than in mixed type events. On the basis of research of the dependence of multiplicity versus target-nuclei fragments number for events of various types it is revealed, that the most considerable multiparticle correlations are observed in interactions of the mixed type, which correspond to the central collisions of gold nuclei and nuclei of CNO-group, i.e. nuclei with strongly asymmetric volume, nuclear mass, charge, etc. Such events are characterised by full destruction of the target-nucleus and the disintegration of the projectile-nucleus on several multi-charged fragments.

The added predictive value of biphasic events in ST analysis of the fetal electrocardiogram for intrapartum fetal monitoring.

PubMed

Becker, Jeroen H; Krikhaar, Anniek; Schuit, Ewoud; Mårtendal, Annika; Maršál, Karel; Kwee, Anneke; Visser, Gerard H A; Amer-Wåhlin, Isis

2015-02-01

To study the predictive value of biphasic ST-events for interventions for suspected fetal distress and adverse neonatal outcome, when using ST-analysis of the fetal electrocardiogram (FECG) for intrapartum fetal monitoring. Prospective cohort study. Three academic hospitals in Sweden. Women in labor with a high-risk singleton fetus in cephalic position beyond 36 weeks of gestation. In women in labor who were monitored with conventional cardiotocography, ST-waveform analysis was recorded and concealed. Traces with biphasic ST-events of the FECG (index) were compared with traces without biphasic events of the FECG. The ability of biphasic events to predict interventions for suspected fetal distress and adverse outcome was assessed using univariable and multivariable logistic regression analyses. Interventions for suspected fetal distress and adverse outcome (defined as presence of metabolic acidosis (i.e. umbilical cord pH <7.05 and base deficit in extracellular fluid >12 mmol), umbilical cord pH <7.00, 5-min Apgar score <7, admittance to neonatal intensive care unit or perinatal death). Although the presence of biphasic events of the FECG was associated with more interventions for fetal distress and an increased risk of adverse outcome compared with cases with no biphasic events, the presence of significant (i.e. intervention advised according to cardiotocography interpretation) biphasic events showed no independent association with interventions for fetal distress [odds ratio (OR) 1.71, 95% confidence interval (CI) 0.65-4.50] or adverse outcome (OR 1.96, 95% CI 0.74-5.24). The presence of significant biphasic events did not discriminate in the prediction of interventions for fetal distress or adverse outcome. Therefore, biphasic events in relation to ST-analysis monitoring during birth should be omitted if future studies confirm our findings. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Routine perioperative ketorolac administration is not associated with hemorrhage in pediatric neurosurgery patients.

PubMed

Richardson, Marlin Dustin; Palmeri, Nicholas O; Williams, Sarah A; Torok, Michelle R; O'Neill, Brent R; Handler, Michael H; Hankinson, Todd C

2016-01-01

OBJECT NSAIDs are effective perioperative analgesics. Many surgeons are reluctant to use NSAIDs perioperatively because of a theoretical increase in the risk for bleeding events. The authors assessed the effect of routine perioperative ketorolac use on intracranial hemorrhage in children undergoing a wide range of neurosurgical procedures. METHODS A retrospective single-institution analysis of 1451 neurosurgical cases was performed. Data included demographics, type of surgery, and perioperative ketorolac use. Outcomes included bleeding events requiring return to the operating room, bleeding seen on postoperative imaging, and the development of renal failure or gastrointestinal tract injury. Variables associated with both the exposure and outcomes (p < 0.20) were evaluated as potential confounders for bleeding on postoperative imaging, and multivariable logistic regression was performed. Bivariable analysis was performed for bleeding events. Odds ratios and 95% CIs were estimated. RESULTS Of the 1451 patients, 955 received ketorolac. Multivariate regression analysis demonstrated no significant association between clinically significant bleeding events (OR 0.69; 95% CI 0.15-3.1) or radiographic hemorrhage (OR 0.81; 95% CI 0.43-1.51) and the perioperative administration of ketorolac. Treatment with a medication that creates a known bleeding risk (OR 3.11; 95% CI 1.01-9.57), surgical procedure (OR 2.35; 95% CI 1.11-4.94), and craniotomy/craniectomy (OR 2.43; 95% CI 1.19-4.94) were associated with a significantly elevated risk for radiographically identified hemorrhage. CONCLUSIONS Short-term ketorolac therapy does not appear to be associated with a statistically significant increase in the risk of bleeding documented on postoperative imaging in pediatric neurosurgical patients and may be considered as part of a perioperative analgesic regimen. Although no association was found between ketorolac and clinically significant bleeding events, a larger study needs to be conducted to control for confounding factors, because of the rarity of these events.

A computer aided treatment event recognition system in radiation therapy.

PubMed

Xia, Junyi; Mart, Christopher; Bayouth, John

2014-01-01

To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012-November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors' clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when executed on either a desktop computer or a mobile device. CATERS offers an effective tool to detect and report treatment events. Automation and rapid processing enables electronic record interrogation daily, alerting the medical physicist of deviations potentially days prior to performing weekly check. The output of CATERS could also be utilized as an important input to failure mode and effects analysis.

An analysis of post-event processing in social anxiety disorder.

PubMed

Brozovich, Faith; Heimberg, Richard G

2008-07-01

Research has demonstrated that self-focused thoughts and negative affect have a reciprocal relationship [Mor, N., Winquist, J. (2002). Self-focused attention and negative affect: A meta-analysis. Psychological Bulletin, 128, 638-662]. In the anxiety disorder literature, post-event processing has emerged as a specific construction of repetitive self-focused thoughts that pertain to social anxiety disorder. Post-event processing can be defined as an individual's repeated consideration and potential reconstruction of his performance following a social situation. Post-event processing can also occur when an individual anticipates a social or performance event and begins to brood about other, past social experiences. The present review examined the post-event processing literature in an attempt to organize and highlight the significant results. The methodologies employed to study post-event processing have included self-report measures, daily diaries, social or performance situations created in the laboratory, and experimental manipulations of post-event processing or anticipation of an upcoming event. Directions for future research on post-event processing are discussed.

New FIGO and Swedish intrapartum cardiotocography classification systems incorporated in the fetal ECG ST analysis (STAN) interpretation algorithm: agreements and discrepancies in cardiotocography classification and evaluation of significant ST events.

PubMed

Olofsson, Per; Norén, Håkan; Carlsson, Ann

2018-02-01

The updated intrapartum cardiotocography (CTG) classification system by FIGO in 2015 (FIGO2015) and the FIGO2015-approached classification by the Swedish Society of Obstetricians and Gynecologist in 2017 (SSOG2017) are not harmonized with the fetal ECG ST analysis (STAN) algorithm from 2007 (STAN2007). The study aimed to reveal homogeneity and agreement between the systems in classifying CTG and ST events, and relate them to maternal and perinatal outcomes. Among CTG traces with ST events, 100 traces originally classified as normal, 100 as suspicious and 100 as pathological were randomly selected from a STAN database and classified by two experts in consensus. Homogeneity and agreement statistics between the CTG classifications were performed. Maternal and perinatal outcomes were evaluated in cases with clinically hidden ST data (n = 151). A two-tailed p < 0.05 was regarded as significant. For CTG classes, the heterogeneity was significant between the old and new systems, and agreements were moderate to strong (proportion of agreement, kappa index 0.70-0.86). Between the new classifications, heterogeneity was significant and agreements strong (0.90, 0.92). For significant ST events, heterogeneities were significant and agreements moderate to almost perfect (STAN2007 vs. FIGO2015 0.86, 0.72; STAN2007 vs. SSOG2017 0.92, 0.84; FIGO2015 vs. SSOG2017 0.94, 0.87). Significant ST events occurred more often combined with STAN2007 than with FIGO2015 classification, but not with SSOG2017; correct identification of adverse outcomes was not significantly different between the systems. There are discrepancies in the classification of CTG patterns and significant ST events between the old and new systems. The clinical relevance of the findings remains to be shown. © 2017 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Asthma exacerbations in children immediately following stressful life events: a Cox's hierarchical regression.

PubMed

Sandberg, S; Järvenpää, S; Penttinen, A; Paton, J Y; McCann, D C

2004-12-01

A recent prospective study of children with asthma employing a within subject, over time analysis using dynamic logistic regression showed that severely negative life events significantly increased the risk of an acute exacerbation during the subsequent 6 week period. The timing of the maximum risk depended on the degree of chronic psychosocial stress also present. A hierarchical Cox regression analysis was undertaken to examine whether there were any immediate effects of negative life events in children without a background of high chronic stress. Sixty children with verified chronic asthma were followed prospectively for 18 months with continuous monitoring of asthma by daily symptom diaries and peak flow measurements, accompanied by repeated interview assessments of life events. The key outcome measures were asthma exacerbations and severely negative life events. An immediate effect evident within the first 2 days following a severely negative life event increased the risk of a new asthma attack by a factor of 4.69, 95% confidence interval 2.33 to 9.44 (p<0.001) [corrected] In the period 3-10 days after a severe event there was no increased risk of an asthma attack (p = 0.5). In addition to the immediate effect, an increased risk of 1.81 (95% confidence interval 1.24 to 2.65) [corrected] was found 5-7 weeks after a severe event (p = 0.002). This is consistent with earlier findings. There was a statistically significant variation due to unobserved factors in the incidence of asthma attacks between the children. The use of statistical methods capable of investigating short time lags showed that stressful life events significantly increase the risk of a new asthma attack immediately after the event; a more delayed increase in risk was also evident 5-7 weeks later.

Sources of Infrasound events listed in IDC Reviewed Event Bulletin

NASA Astrophysics Data System (ADS)

Bittner, Paulina; Polich, Paul; Gore, Jane; Ali, Sherif; Medinskaya, Tatiana; Mialle, Pierrick

2017-04-01

Until 2003 two waveform technologies, i.e. seismic and hydroacoustic were used to detect and locate events included in the International Data Centre (IDC) Reviewed Event Bulletin (REB). The first atmospheric event was published in the REB in 2003, however automatic processing required significant improvements to reduce the number of false events. In the beginning of 2010 the infrasound technology was reintroduced to the IDC operations and has contributed to both automatic and reviewed IDC bulletins. The primary contribution of infrasound technology is to detect atmospheric events. These events may also be observed at seismic stations, which will significantly improve event location. Examples sources of REB events, which were detected by the International Monitoring System (IMS) infrasound network were fireballs (e.g. Bangkok fireball, 2015), volcanic eruptions (e.g. Calbuco, Chile 2015) and large surface explosions (e.g. Tjanjin, China 2015). Query blasts (e.g. Zheleznogorsk) and large earthquakes (e.g. Italy 2016) belong to events primarily recorded at seismic stations of the IMS network but often detected at the infrasound stations. In case of earthquakes analysis of infrasound signals may help to estimate the area affected by ground vibration. Infrasound associations to query blast events may help to obtain better source location. The role of IDC analysts is to verify and improve location of events detected by the automatic system and to add events which were missed in the automatic process. Open source materials may help to identify nature of some events. Well recorded examples may be added to the Reference Infrasound Event Database to help in analysis process. This presentation will provide examples of events generated by different sources which were included in the IDC bulletins.

Event shape analysis of deep inelastic scattering events with a large rapidity gap at HERA

NASA Astrophysics Data System (ADS)

ZEUS Collaboration; Breitweg, J.; Derrick, M.; Krakauer, D.; Magill, S.; Mikunas, D.; Musgrave, B.; Repond, J.; Stanek, R.; Talaga, R. L.; Yoshida, R.; Zhang, H.; Mattingly, M. C. K.; Anselmo, F.; Antonioli, P.; Bari, G.; Basile, M.; Bellagamba, L.; Boscherini, D.; Bruni, A.; Bruni, G.; Cara Romeo, G.; Castellini, G.; Cifarelli, L.; Cindolo, F.; Contin, A.; Corradi, M.; de Pasquale, S.; Gialas, I.; Giusti, P.; Iacobucci, G.; Laurenti, G.; Levi, G.; Margotti, A.; Massam, T.; Nania, R.; Palmonari, F.; Pesci, A.; Polini, A.; Ricci, F.; Sartorelli, G.; Zamora Garcia, Y.; Zichichi, A.; Amelung, C.; Bornheim, A.; Brock, I.; Coböken, K.; Crittenden, J.; Deffner, R.; Eckert, M.; Grothe, M.; Hartmann, H.; Heinloth, K.; Heinz, L.; Hilger, E.; Jakob, H.-P.; Katz, U. F.; Kerger, R.; Paul, E.; Pfeiffer, M.; Rembser, Ch.; Stamm, J.; Wedemeyer, R.; Wieber, H.; Bailey, D. S.; Campbell-Robson, S.; Cottingham, W. N.; Foster, B.; Hall-Wilton, R.; Hayes, M. E.; Heath, G. P.; Heath, H. F.; McFall, J. D.; Piccioni, D.; Roff, D. G.; Tapper, R. J.; Arneodo, M.; Ayad, R.; Capua, M.; Garfagnini, A.; Iannotti, L.; Schioppa, M.; Susinno, G.; Kim, J. Y.; Lee, J. H.; Lim, I. T.; Pac, M. Y.; Caldwell, A.; Cartiglia, N.; Jing, Z.; Liu, W.; Mellado, B.; Parsons, J. A.; Ritz, S.; Sampson, S.; Sciulli, F.; Straub, P. B.; Zhu, Q.; Borzemski, P.; Chwastowski, J.; Eskreys, A.; Figiel, J.; Klimek, K.; Przybycień , M. B.; Zawiejski, L.; Adamczyk, L.; Bednarek, B.; Bukowy, M.; Jeleń , K.; Kisielewska, D.; Kowalski, T.; Przybycień , M.; Rulikowska-Zarȩ Bska, E.; Suszycki, L.; Zaja C, J.; Duliń Ski, Z.; Kotań Ski, A.; Abbiendi, G.; Bauerdick, L. A. T.; Behrens, U.; Beier, H.; Bienlein, J. K.; Cases, G.; Deppe, O.; Desler, K.; Drews, G.; Fricke, U.; Gilkinson, D. J.; Glasman, C.; Göttlicher, P.; Haas, T.; Hain, W.; Hasell, D.; Johnson, K. F.; Kasemann, M.; Koch, W.; Kötz, U.; Kowalski, H.; Labs, J.; Lindemann, L.; Löhr, B.; Löwe, M.; Mań Czak, O.; Milewski, J.; Monteiro, T.; Ng, J. S. T.; Notz, D.; Ohrenberg, K.; Park, I. H.; Pellegrino, A.; Pelucchi, F.; Piotrzkowski, K.; Roco, M.; Rohde, M.; Roldán, J.; Ryan, J. J.; Savin, A. A.; Schneekloth, U.; Selonke, F.; Surrow, B.; Tassi, E.; Voß, T.; Westphal, D.; Wolf, G.; Wollmer, U.; Youngman, C.; Zsolararnecki, A. F.; Zeuner, W.; Burow, B. D.; Grabosch, H. J.; Meyer, A.; Schlenstedt, S.; Barbagli, G.; Gallo, E.; Pelfer, P.; Maccarrone, G.; Votano, L.; Bamberger, A.; Eisenhardt, S.; Markun, P.; Trefzger, T.; Wölfle, S.; Bromley, J. T.; Brook, N. H.; Bussey, P. J.; Doyle, A. T.; MacDonald, N.; Saxon, D. H.; Sinclair, L. E.; Strickland, E.; Waugh, R.; Bohnet, I.; Gendner, N.; Holm, U.; Meyer-Larsen, A.; Salehi, H.; Wick, K.; Gladilin, L. K.; Horstmann, D.; Kçira, D.; Klanner, R.; Lohrmann, E.; Poelz, G.; Schott, W.; Zetsche, F.; Bacon, T. C.; Butterworth, I.; Cole, J. E.; Howell, G.; Hung, B. H. Y.; Lamberti, L.; Long, K. R.; Miller, D. B.; Pavel, N.; Prinias, A.; Sedgbeer, J. K.; Sideris, D.; Walker, R.; Mallik, U.; Wang, S. M.; Wu, J. T.; Cloth, P.; Filges, D.; Fleck, J. I.; Ishii, T.; Kuze, M.; Suzuki, I.; Tokushuku, K.; Yamada, S.; Yamauchi, K.; Yamazaki, Y.; Hong, S. J.; Lee, S. B.; Nam, S. W.; Park, S. K.; Barreiro, F.; Fernández, J. P.; García, G.; Graciani, R.; Hernández, J. M.; Hervás, L.; Labarga, L.; Martínez, M.; del Peso, J.; Puga, J.; Terrón, J.; de Trocóniz, J. F.; Corriveau, F.; Hanna, D. S.; Hartmann, J.; Hung, L. W.; Murray, W. N.; Ochs, A.; Riveline, M.; Stairs, D. G.; St-Laurent, M.; Ullmann, R.; Tsurugai, T.; Bashkirov, V.; Dolgoshein, B. A.; Stifutkin, A.; Bashindzhagyan, G. L.; Ermolov, P. F.; Golubkov, Yu. A.; Khein, L. A.; Korotkova, N. A.; Korzhavina, I. A.; Kuzmin, V. A.; Lukina, O. Yu.; Proskuryakov, A. S.; Shcheglova, L. M.; Solomin, A. N.; Zotkin, S. A.; Bokel, C.; Botje, M.; Brümmer, N.; Chlebana, F.; Engelen, J.; Koffeman, E.; Kooijman, P.; van Sighem, A.; Tiecke, H.; Tuning, N.; Verkerke, W.; Vossebeld, J.; Vreeswijk, M.; Wiggers, L.; de Wolf, E.; Acosta, D.; Bylsma, B.; Durkin, L. S.; Gilmore, J.; Ginsburg, C. M.; Kim, C. L.; Ling, T. Y.; Nylander, P.; Romanowski, T. A.; Blaikley, H. E.; Cashmore, R. J.; Cooper-Sarkar, A. M.; Devenish, R. C. E.; Edmonds, J. K.; Große-Knetter, J.; Harnew, N.; Nath, C.; Noyes, V. A.; Quadt, A.; Ruske, O.; Tickner, J. R.; Uijterwaal, H.; Walczak, R.; Waters, D. S.; Bertolin, A.; Brugnera, R.; Carlin, R.; dal Corso, F.; Dosselli, U.; Limentani, S.; Morandin, M.; Posocco, M.; Stanco, L.; Stroili, R.; Voci, C.; Bulmahn, J.; Oh, B. Y.; Okrasiń Ski, J. R.; Toothacker, W. S.; Whitmore, J. J.; Iga, Y.; D'Agostini, G.; Marini, G.; Nigro, A.; Raso, M.; Hart, J. C.; McCubbin, N. A.; Shah, T. P.; Epperson, D.; Heusch, C.; Rahn, J. T.; Sadrozinski, H. F.-W.; Seiden, A.; Wichmann, R.; Williams, D. C.; Schwarzer, O.; Walenta, A. H.; Abramowicz, H.; Briskin, G.; Dagan, S.; Kananov, S.; Levy, A.; Abe, T.; Fusayasu, T.; Inuzuka, M.; Nagano, K.; Umemori, K.; Yamashita, T.; Hamatsu, R.; Hirose, T.; Homma, K.; Kitamura, S.; Matsushita, T.; Cirio, R.; Costa, M.; Ferrero, M. I.; Maselli, S.; Monaco, V.; Peroni, C.; Petrucci, M. C.; Ruspa, M.; Sacchi, R.; Solano, A.; Staiano, A.; Dardo, M.; Bailey, D. C.; Fagerstroem, C.-P.; Galea, R.; Hartner, G. F.; Joo, K. K.; Levman, G. M.; Martin, J. F.; Orr, R. S.; Polenz, S.; Sabetfakhri, A.; Simmons, D.; Teuscher, R. J.; Butterworth, J. M.; Catterall, C. D.; Jones, T. W.; Lane, J. B.; Saunders, R. L.; Sutton, M. R.; Wing, M.; Ciborowski, J.; Grzelak, G.; Kasprzak, M.; Muchorowski, K.; Nowak, R. J.; Pawlak, J. M.; Pawlak, R.; Tymieniecka, T.; Wróblewski, A. K.; Zakrzewski, J. A.; Adamus, M.; Coldewey, C.; Eisenberg, Y.; Hochman, D.; Karshon, U.; Badgett, W. F.; Chapin, D.; Cross, R.; Dasu, S.; Foudas, C.; Loveless, R. J.; Mattingly, S.; Reeder, D. D.; Smith, W. H.; Vaiciulis, A.; Wodarczyk, M.; Deshpande, A.; Dhawan, S.; Hughes, V. W.; Bhadra, S.; Frisken, W. R.; Khakzad, M.; Schmidke, W. B.

1998-03-01

A global event shape analysis of the multihadronic final states observed in neutral current deep inelastic scattering events with a large rapidity gap with respect to the proton direction is presented. The analysis is performed in the range 5<=Q2<=185 GeV2 and 160<=W<=250 GeV, where Q2 is the virtuality of the photon and W is the virtual-photon proton centre of mass energy. Particular emphasis is placed on the dependence of the shape variables, measured in the γ*-pomeron rest frame, on the mass of the hadronic final state, MX. With increasing MX the multihadronic final state becomes more collimated and planar. The experimental results are compared with several models which attempt to describe diffractive events. The broadening effects exhibited by the data require in these models a significant gluon component of the pomeron.

Negated bio-events: analysis and identification

PubMed Central

2013-01-01

Background Negation occurs frequently in scientific literature, especially in biomedical literature. It has previously been reported that around 13% of sentences found in biomedical research articles contain negation. Historically, the main motivation for identifying negated events has been to ensure their exclusion from lists of extracted interactions. However, recently, there has been a growing interest in negative results, which has resulted in negation detection being identified as a key challenge in biomedical relation extraction. In this article, we focus on the problem of identifying negated bio-events, given gold standard event annotations. Results We have conducted a detailed analysis of three open access bio-event corpora containing negation information (i.e., GENIA Event, BioInfer and BioNLP’09 ST), and have identified the main types of negated bio-events. We have analysed the key aspects of a machine learning solution to the problem of detecting negated events, including selection of negation cues, feature engineering and the choice of learning algorithm. Combining the best solutions for each aspect of the problem, we propose a novel framework for the identification of negated bio-events. We have evaluated our system on each of the three open access corpora mentioned above. The performance of the system significantly surpasses the best results previously reported on the BioNLP’09 ST corpus, and achieves even better results on the GENIA Event and BioInfer corpora, both of which contain more varied and complex events. Conclusions Recently, in the field of biomedical text mining, the development and enhancement of event-based systems has received significant interest. The ability to identify negated events is a key performance element for these systems. We have conducted the first detailed study on the analysis and identification of negated bio-events. Our proposed framework can be integrated with state-of-the-art event extraction systems. The resulting systems will be able to extract bio-events with attached polarities from textual documents, which can serve as the foundation for more elaborate systems that are able to detect mutually contradicting bio-events. PMID:23323936

Development and testing of an assessment instrument for the formative peer review of significant event analyses.

PubMed

McKay, J; Murphy, D J; Bowie, P; Schmuck, M-L; Lough, M; Eva, K W

2007-04-01

To establish the content validity and specific aspects of reliability for an assessment instrument designed to provide formative feedback to general practitioners (GPs) on the quality of their written analysis of a significant event. Content validity was quantified by application of a content validity index. Reliability testing involved a nested design, with 5 cells, each containing 4 assessors, rating 20 unique significant event analysis (SEA) reports (10 each from experienced GPs and GPs in training) using the assessment instrument. The variance attributable to each identified variable in the study was established by analysis of variance. Generalisability theory was then used to investigate the instrument's ability to discriminate among SEA reports. Content validity was demonstrated with at least 8 of 10 experts endorsing all 10 items of the assessment instrument. The overall G coefficient for the instrument was moderate to good (G>0.70), indicating that the instrument can provide consistent information on the standard achieved by the SEA report. There was moderate inter-rater reliability (G>0.60) when four raters were used to judge the quality of the SEA. This study provides the first steps towards validating an instrument that can provide educational feedback to GPs on their analysis of significant events. The key area identified to improve instrument reliability is variation among peer assessors in their assessment of SEA reports. Further validity and reliability testing should be carried out to provide GPs, their appraisers and contractual bodies with a validated feedback instrument on this aspect of the general practice quality agenda.

Forecasting Significant Societal Events Using The Embers Streaming Predictive Analytics System

PubMed Central

Katz, Graham; Summers, Kristen; Ackermann, Chris; Zavorin, Ilya; Lim, Zunsik; Muthiah, Sathappan; Butler, Patrick; Self, Nathan; Zhao, Liang; Lu, Chang-Tien; Khandpur, Rupinder Paul; Fayed, Youssef; Ramakrishnan, Naren

2014-01-01

Abstract Developed under the Intelligence Advanced Research Project Activity Open Source Indicators program, Early Model Based Event Recognition using Surrogates (EMBERS) is a large-scale big data analytics system for forecasting significant societal events, such as civil unrest events on the basis of continuous, automated analysis of large volumes of publicly available data. It has been operational since November 2012 and delivers approximately 50 predictions each day for countries of Latin America. EMBERS is built on a streaming, scalable, loosely coupled, shared-nothing architecture using ZeroMQ as its messaging backbone and JSON as its wire data format. It is deployed on Amazon Web Services using an entirely automated deployment process. We describe the architecture of the system, some of the design tradeoffs encountered during development, and specifics of the machine learning models underlying EMBERS. We also present a detailed prospective evaluation of EMBERS in forecasting significant societal events in the past 2 years. PMID:25553271

Forecasting Significant Societal Events Using The Embers Streaming Predictive Analytics System.

PubMed

Doyle, Andy; Katz, Graham; Summers, Kristen; Ackermann, Chris; Zavorin, Ilya; Lim, Zunsik; Muthiah, Sathappan; Butler, Patrick; Self, Nathan; Zhao, Liang; Lu, Chang-Tien; Khandpur, Rupinder Paul; Fayed, Youssef; Ramakrishnan, Naren

2014-12-01

Developed under the Intelligence Advanced Research Project Activity Open Source Indicators program, Early Model Based Event Recognition using Surrogates (EMBERS) is a large-scale big data analytics system for forecasting significant societal events, such as civil unrest events on the basis of continuous, automated analysis of large volumes of publicly available data. It has been operational since November 2012 and delivers approximately 50 predictions each day for countries of Latin America. EMBERS is built on a streaming, scalable, loosely coupled, shared-nothing architecture using ZeroMQ as its messaging backbone and JSON as its wire data format. It is deployed on Amazon Web Services using an entirely automated deployment process. We describe the architecture of the system, some of the design tradeoffs encountered during development, and specifics of the machine learning models underlying EMBERS. We also present a detailed prospective evaluation of EMBERS in forecasting significant societal events in the past 2 years.

A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events

PubMed Central

Erskine, Nathaniel; Tran, Hoang; Levin, Leonard; Ulbricht, Christine; Fingeroth, Joyce; Kiefe, Catarina; Singh, Sonal

2017-01-01

Background Patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. We systematically reviewed the published literature to determine the association between herpes zoster and its subtypes with the occurrence of cerebrovascular and cardiac events. Methods/Results Systematic searches of PubMed (MEDLINE), SCOPUS (Embase) and Google Scholar were performed in December 2016. Eligible studies were cohort, case-control, and self-controlled case-series examining the association between herpes zoster or subtypes of herpes zoster with the occurrence of cerebrovascular and cardiac events including stroke, transient ischemic attack, coronary heart disease, and myocardial infarction. Data on the occurrence of the examined events were abstracted. Odds ratios and their accompanying confidence intervals were estimated using random and fixed effects models with statistical heterogeneity estimated with the I2 statistic. Twelve studies examining 7.9 million patients up to 28 years after the onset of herpes zoster met our pre-defined eligibility criteria. Random and fixed effects meta-analyses showed that herpes zoster, type unspecified, and herpes zoster ophthalmicus were associated with a significantly increased risk of cerebrovascular events, without any evidence of statistical heterogeneity. Our meta-analysis also found a significantly increased risk of cardiac events associated with herpes zoster, type unspecified. Conclusions Our results are consistent with the accumulating body of evidence that herpes zoster and herpes zoster ophthalmicus are significantly associated with cerebrovascular and cardiovascular events. PMID:28749981

A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events.

PubMed

Erskine, Nathaniel; Tran, Hoang; Levin, Leonard; Ulbricht, Christine; Fingeroth, Joyce; Kiefe, Catarina; Goldberg, Robert J; Singh, Sonal

2017-01-01

Patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. We systematically reviewed the published literature to determine the association between herpes zoster and its subtypes with the occurrence of cerebrovascular and cardiac events. Systematic searches of PubMed (MEDLINE), SCOPUS (Embase) and Google Scholar were performed in December 2016. Eligible studies were cohort, case-control, and self-controlled case-series examining the association between herpes zoster or subtypes of herpes zoster with the occurrence of cerebrovascular and cardiac events including stroke, transient ischemic attack, coronary heart disease, and myocardial infarction. Data on the occurrence of the examined events were abstracted. Odds ratios and their accompanying confidence intervals were estimated using random and fixed effects models with statistical heterogeneity estimated with the I2 statistic. Twelve studies examining 7.9 million patients up to 28 years after the onset of herpes zoster met our pre-defined eligibility criteria. Random and fixed effects meta-analyses showed that herpes zoster, type unspecified, and herpes zoster ophthalmicus were associated with a significantly increased risk of cerebrovascular events, without any evidence of statistical heterogeneity. Our meta-analysis also found a significantly increased risk of cardiac events associated with herpes zoster, type unspecified. Our results are consistent with the accumulating body of evidence that herpes zoster and herpes zoster ophthalmicus are significantly associated with cerebrovascular and cardiovascular events.

An extreme event of sea-level rise along the Northeast Coast of North America in 2009-2010.

PubMed

Goddard, Paul B; Yin, Jianjun; Griffies, Stephen M; Zhang, Shaoqing

2015-02-24

The coastal sea levels along the Northeast Coast of North America show significant year-to-year fluctuations in a general upward trend. The analysis of long-term tide gauge records identified an extreme sea-level rise (SLR) event during 2009-10. Within this 2-year period, the coastal sea level north of New York City jumped by 128 mm. This magnitude of interannual SLR is unprecedented (a 1-in-850 year event) during the entire history of the tide gauge records. Here we show that this extreme SLR event is a combined effect of two factors: an observed 30% downturn of the Atlantic meridional overturning circulation during 2009-10, and a significant negative North Atlantic Oscillation index. The extreme nature of the 2009-10 SLR event suggests that such a significant downturn of the Atlantic overturning circulation is very unusual. During the twenty-first century, climate models project an increase in magnitude and frequency of extreme interannual SLR events along this densely populated coast.

Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis

PubMed Central

Niu, Peng-Peng; Guo, Zhen-Ni; Jin, Hang; Xing, Ying-Qi; Yang, Yi

2016-01-01

Objective To examine the comparative efficacy and safety of different antiplatelet regimens in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Design Systematic review and network meta-analysis. Data sources As on 31 March 2015, all randomised controlled trials that investigated the effects of antiplatelet agents in the long-term (≥3 months) secondary prevention of non-cardioembolic transient ischaemic attack or ischaemic stroke were searched and identified. Outcome measures The primary outcome measure of efficacy was serious vascular events (non-fatal stroke, non-fatal myocardial infarction and vascular death). The outcome measure of safety was any bleeding. Results A total of 36 randomised controlled trials (82 144 patients) were included. Network meta-analysis showed that cilostazol was significantly more effective than clopidogrel (OR 0.77, 95% credible interval 0.60–0.98) and low-dose (75–162 mg daily) aspirin (0.69, 0.55–0.86) in the prevention of serious vascular events. Aspirin (50 mg daily) plus dipyridamole (400 mg daily) and clopidogrel reduced the risk of serious vascular events compared with low-dose aspirin; however, the difference was not statistically significant. Furthermore, low-dose aspirin was as effective as higher daily doses. Cilostazol was associated with a significantly lower bleeding risk than most of the other regimens. Moreover, aspirin plus clopidogrel was associated with significantly more haemorrhagic events than other regimens. Direct comparisons showed similar results as the network meta-analysis. Conclusions Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75–162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups. PMID:26988347

An evaluation of various forms of VAS retrievals in the analysis of a preconvective environment

NASA Technical Reports Server (NTRS)

Petersen, R. A.; Keyser, D. A.

1987-01-01

VISSR Atmospheric Sounder (VAS) radiance data obtained over the continental United States on July 20, 1981 are used to evaluate a variety of VAS retrieval procedures and parameters in the qualitative analysis and forecasting of severe weather events. The particular case analyzed contains two significantly different mesoscale convective events in the central plains. Retrievals of temperature, dewpoint temperature, equivalent potential temperature, total column precipitable water, and lifted index are shown to be physically consistent in space and time and to compare well with available radiosonde data. The analysis of the VAS retrievals identified significant spatial gradients and temporal changes in the thermal and moisture fields, including times and locations between radiosonde observations.

Element analysis: a wavelet-based method for analysing time-localized events in noisy time series.

PubMed

Lilly, Jonathan M

2017-04-01

A method is derived for the quantitative analysis of signals that are composed of superpositions of isolated, time-localized 'events'. Here, these events are taken to be well represented as rescaled and phase-rotated versions of generalized Morse wavelets, a broad family of continuous analytic functions. Analysing a signal composed of replicates of such a function using another Morse wavelet allows one to directly estimate the properties of events from the values of the wavelet transform at its own maxima. The distribution of events in general power-law noise is determined in order to establish significance based on an expected false detection rate. Finally, an expression for an event's 'region of influence' within the wavelet transform permits the formation of a criterion for rejecting spurious maxima due to numerical artefacts or other unsuitable events. Signals can then be reconstructed based on a small number of isolated points on the time/scale plane. This method, termed element analysis , is applied to the identification of long-lived eddy structures in ocean currents as observed by along-track measurements of sea surface elevation from satellite altimetry.

Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and Trial Sequential Analysis.

PubMed

Jakobsen, Janus Christian; Katakam, Kiran Kumar; Schou, Anne; Hellmuth, Signe Gade; Stallknecht, Sandra Elkjær; Leth-Møller, Katja; Iversen, Maria; Banke, Marianne Bjørnø; Petersen, Iggiannguaq Juhl; Klingenberg, Sarah Louise; Krogh, Jesper; Ebert, Sebastian Elgaard; Timm, Anne; Lindschou, Jane; Gluud, Christian

2017-02-08

The evidence on selective serotonin reuptake inhibitors (SSRIs) for major depressive disorder is unclear. Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo, 'active' placebo, or no intervention in adult participants with major depressive disorder. We searched for eligible randomised clinical trials in The Cochrane Library's CENTRAL, PubMed, EMBASE, PsycLIT, PsycINFO, Science Citation Index Expanded, clinical trial registers of Europe and USA, websites of pharmaceutical companies, the U.S. Food and Drug Administration (FDA), and the European Medicines Agency until January 2016. All data were extracted by at least two independent investigators. We used Cochrane systematic review methodology, Trial Sequential Analysis, and calculation of Bayes factor. An eight-step procedure was followed to assess if thresholds for statistical and clinical significance were crossed. Primary outcomes were reduction of depressive symptoms, remission, and adverse events. Secondary outcomes were suicides, suicide attempts, suicide ideation, and quality of life. A total of 131 randomised placebo-controlled trials enrolling a total of 27,422 participants were included. None of the trials used 'active' placebo or no intervention as control intervention. All trials had high risk of bias. SSRIs significantly reduced the Hamilton Depression Rating Scale (HDRS) at end of treatment (mean difference -1.94 HDRS points; 95% CI -2.50 to -1.37; P < 0.00001; 49 trials; Trial Sequential Analysis-adjusted CI -2.70 to -1.18); Bayes factor below predefined threshold (2.01*10 -23 ). The effect estimate, however, was below our predefined threshold for clinical significance of 3 HDRS points. SSRIs significantly decreased the risk of no remission (RR 0.88; 95% CI 0.84 to 0.91; P < 0.00001; 34 trials; Trial Sequential Analysis adjusted CI 0.83 to 0.92); Bayes factor (1426.81) did not confirm the effect). SSRIs significantly increased the risks of serious adverse events (OR 1.37; 95% CI 1.08 to 1.75; P = 0.009; 44 trials; Trial Sequential Analysis-adjusted CI 1.03 to 1.89). This corresponds to 31/1000 SSRI participants will experience a serious adverse event compared with 22/1000 control participants. SSRIs also significantly increased the number of non-serious adverse events. There were almost no data on suicidal behaviour, quality of life, and long-term effects. SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects. PROSPERO CRD42013004420.

Effects of Marijuana on Ictal and Interictal EEG Activities in Idiopathic Generalized Epilepsy.

PubMed

Sivakumar, Sanjeev; Zutshi, Deepti; Seraji-Bozorgzad, Navid; Shah, Aashit K

2017-01-01

Marijuana-based treatment for refractory epilepsy shows promise in surveys, case series, and clinical trials. However, literature on their EEG effects is sparse. Our objective is to analyze the effect of marijuana on EEG in a 24-year-old patient with idiopathic generalized epilepsy treated with cannabis. We blindly reviewed 3 long-term EEGs-a 24-hour study while only on antiepileptic drugs, a 72-hour EEG with Cannabis indica smoked on days 1 and 3 in addition to antiepileptic drugs, and a 48-hour EEG with combination C indica/sativa smoked on day 1 plus antiepileptic drugs. Generalized spike-wave discharges and diffuse paroxysmal fast activity were categorized as interictal and ictal, based on duration of less than 10 seconds or greater, respectively. Data from three studies concatenated into contiguous time series, with usage of marijuana modeled as time-dependent discrete variable while interictal and ictal events constituted dependent variables. Analysis of variance as initial test for significance followed by time series analysis using Generalized Autoregressive Conditional Heteroscedasticity model was performed. Statistical significance for lower interictal events (analysis of variance P = 0.001) was seen during C indica use, but not for C indica/sativa mixture (P = 0.629) or ictal events (P = 0.087). However, time series analysis revealed a significant inverse correlation between marijuana use, with interictal (P < 0.0004) and ictal (P = 0.002) event rates. Using a novel approach to EEG data, we demonstrate a decrease in interictal and ictal electrographic events during marijuana use. Larger samples of patients and EEG, with standardized cannabinoid formulation and dosing, are needed to validate our findings.

Safety and tolerability of atomoxetine in treatment of attention deficit hyperactivity disorder in adult patients: an integrated analysis of 15 clinical trials.

PubMed

Camporeale, Angelo; Porsdal, Vibeke; De Bruyckere, Katrien; Tanaka, Yoko; Upadhyaya, Himanshu; Deix, Claudia; Deberdt, Walter

2015-01-01

The safety profile of atomoxetine in the treatment of attention deficit hyperactivity disorder has been studied in many clinical trials. We performed an integrated safety analysis of 15 clinical trials in adults with attention deficit hyperactivity disorder. The analysis pooled patient data into three groups: acute placebo-controlled trials; long-term placebo-controlled trials; all trials. In total, 4829 adults (18-77 years, median: 36 years) were exposed to atomoxetine. Statistically significantly more atomoxetine-treated than placebo-treated patients experienced treatment-emergent adverse events (81.3% vs. 68.3% acute; 90.6% vs. 76.8% long term) and discontinued due to adverse events (8.9% vs. 4.0% acute; 17.9% vs. 6.3% long term). No statistically significant differences were observed in the proportion of patients experiencing serious adverse events. No previously unknown adverse events were identified. The most common adverse events included nausea, dry mouth, decreased appetite, insomnia and erectile dysfunction. Mean increases in heart rate (+5.2 beats per min) and blood pressure (systolic +2 mmHg, diastolic +1.9 mmHg) were modest. The proportion of patients experiencing clinically significant increases in blood pressure and heart rate at any time was statistically significantly higher with atomoxetine (systolic blood pressure 13-17%, diastolic blood pressure 37-40%, heart rate 42-43%) compared to placebo (systolic blood pressure 8-13%, diastolic blood pressure 29-34%, heart rate 21-26%). There was no increased risk of suicidal ideation or behaviour. Our findings confirm atomoxetine's known safety profile. From a safety perspective, atomoxetine is a useful treatment option for adults with attention deficit hyperactivity disorder. © The Author(s) 2014.

External events analysis for the Savannah River Site K reactor

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

Brandyberry, M.D.; Wingo, H.E.

1990-01-01

The probabilistic external events analysis performed for the Savannah River Site K-reactor PRA considered many different events which are generally perceived to be external'' to the reactor and its systems, such as fires, floods, seismic events, and transportation accidents (as well as many others). Events which have been shown to be significant contributors to risk include seismic events, tornados, a crane failure scenario, fires and dam failures. The total contribution to the core melt frequency from external initiators has been found to be 2.2 {times} 10{sup {minus}4} per year, from which seismic events are the major contributor (1.2 {times} 10{supmore » {minus}4} per year). Fire initiated events contribute 1.4 {times} 10{sup {minus}7} per year, tornados 5.8 {times} 10{sup {minus}7} per year, dam failures 1.5 {times} 10{sup {minus}6} per year and the crane failure scenario less than 10{sup {minus}4} per year to the core melt frequency. 8 refs., 3 figs., 5 tabs.« less

A case-crossover analysis of forest fire haze events and mortality in Malaysia

NASA Astrophysics Data System (ADS)

Sahani, Mazrura; Zainon, Nurul Ashikin; Wan Mahiyuddin, Wan Rozita; Latif, Mohd Talib; Hod, Rozita; Khan, Md Firoz; Tahir, Norhayati Mohd; Chan, Chang-Chuan

2014-10-01

The Southeast Asian (SEA) haze events due to forest fires are recurrent and affect Malaysia, particularly the Klang Valley region. The aim of this study is to examine the risk of haze days due to biomass burning in Southeast Asia on daily mortality in the Klang Valley region between 2000 and 2007. We used a case-crossover study design to model the effect of haze based on PM10 concentration to the daily mortality. The time-stratified control sampling approach was used, adjusted for particulate matter (PM10) concentrations, time trends and meteorological influences. Based on time series analysis of PM10 and backward trajectory analysis, haze days were defined when daily PM10 concentration exceeded 100 μg/m3. The results showed a total of 88 haze days were identified in the Klang Valley region during the study period. A total of 126,822 cases of death were recorded for natural mortality where respiratory mortality represented 8.56% (N = 10,854). Haze events were found to be significantly associated with natural and respiratory mortality at various lags. For natural mortality, haze events at lagged 2 showed significant association with children less than 14 years old (Odd Ratio (OR) = 1.41; 95% Confidence Interval (CI) = 1.01-1.99). Respiratory mortality was significantly associated with haze events for all ages at lagged 0 (OR = 1.19; 95% CI = 1.02-1.40). Age-and-gender-specific analysis showed an incremental risk of respiratory mortality among all males and elderly males above 60 years old at lagged 0 (OR = 1.34; 95% CI = 1.09-1.64 and OR = 1.41; 95% CI = 1.09-1.84 respectively). Adult females aged 15-59 years old were found to be at highest risk of respiratory mortality at lagged 5 (OR = 1.66; 95% CI = 1.03-1.99). This study clearly indicates that exposure to haze events showed immediate and delayed effects on mortality.

Meta-analysis of transcatheter closure versus medical therapy for patent foramen ovale in prevention of recurrent neurological events after presumed paradoxical embolism.

PubMed

Agarwal, Shikhar; Bajaj, Navkaranbir Singh; Kumbhani, Dharam J; Tuzcu, E Murat; Kapadia, Samir R

2012-07-01

In this study, a meta-analysis of observational studies was performed to compare the rate of recurrent neurological events (RNE) between transcatheter closure and medical management of patients with cryptogenic stroke/transient ischemic attack (TIA) and concomitant patent foramen ovale (PFO). A significant controversy surrounds the optimal strategy for treatment of cryptogenic stroke/TIA and coexistent PFO. We conducted a MEDLINE search with standard search terms to determine eligible studies. Adjusted incidence rates of RNE were 0.8 (95% confidence interval [CI]: 0.5 to 1.1) events and 5.0 (95% CI: 3.6 to 6.9) events/100 person-years (PY) in the transcatheter closure and medical management arms, respectively. Meta-analysis of the limited number of comparative studies and meta-regression analysis suggested that the transcatheter closure might be superior to the medical therapy in prevention of RNE after cryptogenic stroke. Comparison of the anticoagulation and antiplatelet therapy subgroups of the medical arm yielded a significantly lower risk of RNE within patients treated with anticoagulants. Device-related complications were encountered at the rate of 4.1 (95% CI: 3.2 to 5.0) events/100 PY, with atrial arrhythmias being the most frequent complication. After transcatheter closure, RNE did not seem to be related to the pre-treatment shunt size or the presence of residual shunting in the follow-up period. Significant benefit of transcatheter PFO closure was apparent in elderly patients, patients with concomitant atrial septal aneurysm, and patients with thrombophilia. Rates of RNE with transcatheter closure and medical therapy in patients presenting with cryptogenic stroke or TIA were estimated at 0.8 and 5.0 events/100 PY. Further randomized controlled trials are needed to conclusively compare these 2 management strategies. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The unique contribution of the IDC Reviewed Event Bulletin to global seismicity catalogues

NASA Astrophysics Data System (ADS)

Koch, Karl; Kebede, Fekadu

2010-05-01

For monitoring the Comprehensive Nuclear-Test-Ban Treaty (CTBT) the International Monitoring System (IMS) network is currently being established that will eventually consists of 241 seismic, hydroacoustic and infrasound stations. The final result of processing and analysis of seismological and other waveform technology data from these stations is the Reviewed Event Bulletin (REB), which has been issued by the International Data Center (IDC) under provisional operation since February 2000 on a daily basis, except for a total of 28 days. The nearly 300,000 events produced since then correspond to more than 25,000 events per year. As an accompanying effort to the bulletin production at the IDC, quality assurance work has been carried out for the REB for the years from 2000 to 2008 through comparisons to similar bulletins of global seismicity, issued by the ISC and the National Earthquake Information Center (NEIC) of the United States Geological Survey. The comparisons with the NEIC bulletin concentrate on a timely identification of larger events that were either missed during interactive analysis at the IDC or which have been significantly mislocated. For the scope of this study the comparisons with the ISC bulletin are the focus, as this bulletin provides the most complete reference to global seismicity, even though it becomes available only after about two years of event occurrence. In our quality assessments we aimed at evaluating the consistency of event locations for common events, i.e. found in both the REB and the ISC bulletin having been relocated by ISC; the degree and the geospatial location of the events only produced in the REB and verified not being bogus, and those ISC relocated events not contained in the REB and which were missed during IDC analysis. Even though the seismic component of the IMS network with its maximum 170 seismometer stations is a sparse teleseismic network, locations differences of less than 1° (0.5° ) are observed, on average, for about 94% (85%) of the common events, as obtained from the ISC bulletin comparisons for the years 2000 to 2006. On the other hand, only 0.25% of such events were located more than 5° apart by the IDC and the ISC. The number of events of significant magnitude missed by the IDC is small and related predominantly to lack of sufficient number of observed arrivals to define an event. The unique contribution of the REB to global seismicity catalogues is expressed by the significant number of REB events that are solely reported in the ISC bulletin. Over the most recent years 2004-2006 the REB and ISC bulletin include about 20,000 common events which were reprocessed by the ISC. This compares to a steadily rising number of solely contributed REB events from more than 5,000 events in 2004 to nearly 7,500 events in 2006, i.e. a quarter to a third events more. These unique IDC events are mainly in remote and oceanic areas. A more important aspect, however, is the number of unique IDC events at depth. Below a depth of about 300 km there are nearly any ISC events not detected by the IMS network, while the number of events at larger depths and only detected by the IMS is significant. As conclusion it is found that the IDC REB is a valuable source for studies of deep seismicity occurring within the global subduction zones.

Defining Human Failure Events for Petroleum Risk Analysis

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

Ronald L. Boring; Knut Øien

2014-06-01

In this paper, an identification and description of barriers and human failure events (HFEs) for human reliability analysis (HRA) is performed. The barriers, called target systems, are identified from risk significant accident scenarios represented as defined situations of hazard and accident (DSHAs). This report serves as the foundation for further work to develop petroleum HFEs compatible with the SPAR-H method and intended for reuse in future HRAs.

Comparison of the Long-Term Outcomes of Mechanical and Bioprosthetic Aortic Valves　- A Propensity Score Analysis.

PubMed

Minakata, Kenji; Tanaka, Shiro; Tamura, Nobushige; Yanagi, Shigeki; Ohkawa, Yohei; Okonogi, Shuichi; Kaneko, Tatsuo; Usui, Akihiko; Abe, Tomonobu; Shimamoto, Mitsuomi; Takahara, Yoshiharu; Yamanaka, Kazuo; Yaku, Hitoshi; Sakata, Ryuzo

2017-07-25

The aim of this study was to assess the long-term outcomes of aortic valve replacement (AVR) with either mechanical or bioprosthetic valves according to age at operation.Methods and Results:A total of 1,002 patients (527 mechanical valves and 475 bioprosthetic valves) undergoing first-time AVR were categorized according to age at operation: group Y, age <60 years; group M, age 60-69 years; and group O, age ≥70 years). Outcomes were compared on propensity score analysis (adjusted for 28 variables). Hazard ratio (HR) was calculated using the Cox regression model with adjustment for propensity score with bioprosthetic valve as a reference (HR=1). There were no significant differences in overall mortality between mechanical and bioprosthetic valves for all age groups. Valve-related mortality was significantly higher for mechanical valves in group O (HR, 2.53; P=0.02). Reoperation rate was significantly lower for mechanical valves in group Y (HR, 0.16; P<0.01) and group M (no events for mechanical valves). Although the rate of thromboembolic events was higher in mechanical valves in group Y (no events for tissue valves) and group M (HR, 9.05; P=0.03), there were no significant differences in bleeding events between all age groups. The type of prosthetic valve used in AVR does not significantly influence overall mortality.

Video analysis of motor events in REM sleep behavior disorder.

PubMed

Frauscher, Birgit; Gschliesser, Viola; Brandauer, Elisabeth; Ulmer, Hanno; Peralta, Cecilia M; Müller, Jörg; Poewe, Werner; Högl, Birgit

2007-07-30

In REM sleep behavior disorder (RBD), several studies focused on electromyographic characterization of motor activity, whereas video analysis has remained more general. The aim of this study was to undertake a detailed and systematic video analysis. Nine polysomnographic records from 5 Parkinson patients with RBD were analyzed and compared with sex- and age-matched controls. Each motor event in the video during REM sleep was classified according to duration, type of movement, and topographical distribution. In RBD, a mean of 54 +/- 23.2 events/10 minutes of REM sleep (total 1392) were identified and visually analyzed. Seventy-five percent of all motor events lasted <2 seconds. Of these events, 1,155 (83.0%) were classified as elementary, 188 (13.5%) as complex behaviors, 50 (3.6%) as violent, and 146 (10.5%) as vocalizations. In the control group, 3.6 +/- 2.3 events/10 minutes (total 264) of predominantly elementary simple character (n = 240, 90.9%) were identified. Number and types of motor events differed significantly between patients and controls (P < 0.05). This study shows a very high number and great variety of motor events during REM sleep in symptomatic RBD. However, most motor events are minor, and violent episodes represent only a small fraction. Copyright 2007 Movement Disorder Society

EVENT-LEVEL ANALYSIS OF ANAL SEX ROLES AND SEX DRUG USE AMONG GAY AND BISEXUAL MEN IN VANCOUVER, BRITISH COLUMBIA, CANADA

PubMed Central

Rich, Ashleigh J; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Lal, Allan; Moore, David M; Hogg, Robert S; Roth, Eric A

2015-01-01

This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and so-called “sex drugs”, i.e. erectile dysfunction drugs (EDD), poppers and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n=2,514) as the unit of analysis tested four hypotheses: 1) EDD are significantly associated with insertive anal sex roles, 2) poppers are significantly associated with receptive anal sex, 3) both poppers and EDD are significantly associated with anal sexual versatility and, 4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis. PMID:26525571

Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada.

PubMed

Rich, Ashleigh J; Lachowsky, Nathan J; Cui, Zishan; Sereda, Paul; Lal, Allan; Moore, David M; Hogg, Robert S; Roth, Eric A

2016-08-01

This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and the so-called "sex drugs," i.e., erectile dysfunction drugs (EDD), poppers, and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n = 2514) as the unit of analysis tested four hypotheses: (1) EDD are significantly associated with insertive anal sex roles, (2) poppers are significantly associated with receptive anal sex, (3) both poppers and EDD are significantly associated with anal sexual versatility, and (4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis.

Cardiovascular disease in live related renal transplantation.

PubMed

Kaul, A; Sharm, R K; Gupta, A; Sinha, N; Singh, U

2011-11-01

Cardiovascular disease has become the leading cause of morbidity and mortality in renal transplant recipients, although its pathogenesis and treatment are poorly understood. Modifiable cardiovascular risk factors and graft dysfunction both play an important role in development of post transplant cardiovascular events. Prevalence of cardiovascular disease was studied in stable kidney transplant patients on cyclosporine based triple immunosuppression in relation to the various risk factors and post transplant cardiovascular events. Analysis of 562 post transplant patients with stable graft function for 6 months, the patients were evaluated for cardiovascular events in post transplant period. Pre and post transplant risk factors were analyzed using the COX proportional hazard model. 174 patients had undergone pre transplant coronary angiography, 15 of these patients underwent coronary revascularization (angioplasty in 12, CABG in 3). The prevalence of CAD was 7.2% in transplant recipients. Of 42 patients with CAD 31 (73.8%) had cardiovascular event in post transplant period. Age > or = 40 yrs, male sex, graft dysfunction, diabetes as primary renal disease, pre transplant cardiovascular event, chronic rejection showed significant correlation in univariate analysis and there was significant between age > or = 40 years (OR = 2.16 with 95% CI, 0.977-4.78) S creatinine > or = 1.4 mg % (OR = 2.40 with 95% CI, 1.20 - 4.82), diabetes as primary disease (OR with 95% CI 3.67, 3.2-14.82), PTDM (OR 3.67, 95% CI 1.45-9.40), pre-transplant cardiovascular disease (OR 4.14, 95% CI .38-13.15) with post transplant cardiovascular event on multivariate analysis. There was poor patient and graft survival among those who suffered post transplant cardiovascular event. The incidence of cardiovascular disease continues to be high after renal transplantation and modifiable risk factors should be identified to prevent occurrence of events in post transplant period.

Manned space flight nuclear system safety. Volume 3: Reactor system preliminary nuclear safety analysis. Part 2: Accident Model Document (AMD)

NASA Technical Reports Server (NTRS)

1972-01-01

The Accident Model Document is one of three documents of the Preliminary Safety Analysis Report (PSAR) - Reactor System as applied to a Space Base Program. Potential terrestrial nuclear hazards involving the zirconium hydride reactor-Brayton power module are identified for all phases of the Space Base program. The accidents/events that give rise to the hazards are defined and abort sequence trees are developed to determine the sequence of events leading to the hazard and the associated probabilities of occurence. Source terms are calculated to determine the magnitude of the hazards. The above data is used in the mission accident analysis to determine the most probable and significant accidents/events in each mission phase. The only significant hazards during the prelaunch and launch ascent phases of the mission are those which arise form criticality accidents. Fission product inventories during this time period were found to be very low due to very limited low power acceptance testing.

An Updated Earthquake Relocation Catalog for the Island of Hawaíi from 2009 to 2016

NASA Astrophysics Data System (ADS)

Lin, G.; Okubo, P.; Shearer, P. M.; Matoza, R. S.

2017-12-01

We present an updated catalog of Hawaiian seismicity, systematically relocated from a starting catalog compiled by the Hawaiian Volcano Observatory (HVO). This is a continuation of our collaboration that began with relocating Hawaiian seismicity from 1992 through April 2009 and subsequently added 1986 through 1991, all initially processed with HVO's Caltech-USGS Seismic Processing systems. Our current efforts are initially focused on extending waveform cross-correlation analyses to significantly greater numbers of candidate event pairs of earthquakes recorded since 2009, after HVO migrated to its ANSS Quake Management Software (AQMS) systems. In its roughly 8 years of AQMS processing, HVO has cataloged over 170,000 events. Particular challenges with this more recent dataset relate to field network upgrades that introduced numerous broadband sensors to replace short-period instruments and significantly increased numbers of event triggers. A relatively low percentage of interactively-reviewed events compared to the pre-2009 catalogs also presents a significant challenge to our analysis. We start by ray tracing through a previously developed three-dimensional (3-D) seismic velocity model to relocate all the earthquakes with phase arrivals. We then use these 3-D relocated events, with improved absolute locations, as reference events to perform similar-event cluster analysis and differential-time relative relocation to all the available events in the data set. The resulting catalog of relocated, well-constrained hypocenters is an extension of our previous studies. Combined with earlier products of our systematic catalog relocations, the increased numbers of relocated earthquakes from more than 30 years of seismic monitoring offer enhanced opportunities for study and interpretation of seismic and volcanic processes spanning the entire 1986-2016 interval.

Psychoanalytic reflections through the prism of September 11, 2001.

PubMed

Nunberg, Henry; Dahl, Kirsten; Herschkowitz, Samuel; Kantrowitz, Judy L; Neubauer, Peter; Orgel, Shelly; Basch, Samuel; Fogelman, Eva

2011-01-01

An important area for psychoanalytic study is the significance for intrapsychic life of important events taking place in the community of which analyst and analysand are a part. September 11, 2001 provides a vantage point for examination of questions that arise from looking at the interrelationship between current environment and intrapsychic life. Two cases are presented as a focus for discussing the interaction of the memorialized past and occurrences in present reality, the significance for an analysis of analyst and patient sharing the same experience, instigations to progress that a current event may provide and the ways in which communal experience influences intrapsychic life. As a part of the discussion, we ask as well in what ways a common experience may be shared, and the significance of radically different meanings that the same event may have for analyst and analysand. We also pose the question whether the differences and similarities, each in their own way, may serve as progressive forces in the analysis.

Correlation of treatment-emergent adverse events and clinical response to endocrine therapy in early breast cancer: a retrospective analysis of the German cohort of TEAM.

PubMed

Hadji, P; Kieback, D G; Tams, J; Hasenburg, A; Ziller, M

2012-10-01

Previous studies have suggested a correlation between the occurrence of vasomotor or joint symptoms during tamoxifen or aromatase inhibitor treatment and improved clinical response. A retrospective analysis of the German cohort of the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial was carried out to assess disease-free survival (DFS) and overall survival (OS) in patients with and without arthralgia/myalgia and/or menopausal symptoms during adjuvant endocrine treatment. A total of 1502 patients were included; 739 patients received tamoxifen followed by exemestane and 763 received exemestane. Patients reporting arthralgia/myalgia and patients reporting menopausal symptoms during endocrine treatment had significantly longer OS and DFS than those not reporting these events. The effect on OS was irrespective of treatment. DFS was significantly improved in exemestane-treated patients reporting arthralgia/myalgia or those reporting menopausal symptoms versus those not reporting these events. This effect on DFS was not observed in patients receiving sequential treatment. A combined analysis of patients reporting either menopausal symptoms or arthralgia/myalgia showed that OS and DFS were significantly improved in patients reporting one of these symptoms versus those not reporting either symptom. The occurrence of arthralgia/myalgia or menopausal symptoms during endocrine treatment is associated with significantly improved OS.

Frequency and Character of Extreme Aerosol Events in the Southwestern United States: A Case Study Analysis in Arizona

PubMed Central

Lopez, David H.; Rabbani, Michael R.; Crosbie, Ewan; Raman, Aishwarya; Arellano, Avelino F.; Sorooshian, Armin

2016-01-01

This study uses more than a decade’s worth of data across Arizona to characterize the spatiotemporal distribution, frequency, and source of extreme aerosol events, defined as when the concentration of a species on a particular day exceeds that of the average plus two standard deviations for that given month. Depending on which of eight sites studied, between 5% and 7% of the total days exhibited an extreme aerosol event due to either extreme levels of PM10, PM2.5, and/or fine soil. Grand Canyon exhibited the most extreme event days (120, i.e., 7% of its total days). Fine soil is the pollutant type that most frequently impacted multiple sites at once at an extreme level. PM10, PM2.5, fine soil, non-Asian dust, and Elemental Carbon extreme events occurred most frequently in August. Nearly all Asian dust extreme events occurred between March and June. Extreme Elemental Carbon events have decreased as a function of time with statistical significance, while other pollutant categories did not show any significant change. Extreme events were most frequent for the various pollutant categories on either Wednesday or Thursday, but there was no statistically significant difference in the number of events on any particular day or on weekends versus weekdays. PMID:27088005

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals.

PubMed

Aung, Theingi; Halsey, Jim; Kromhout, Daan; Gerstein, Hertzel C; Marchioli, Roberto; Tavazzi, Luigi; Geleijnse, Johanna M; Rauch, Bernhard; Ness, Andrew; Galan, Pilar; Chew, Emily Y; Bosch, Jackie; Collins, Rory; Lewington, Sarah; Armitage, Jane; Clarke, Robert

2018-03-01

Current guidelines advocate the use of marine-derived omega-3 fatty acids supplements for the prevention of coronary heart disease and major vascular events in people with prior coronary heart disease, but large trials of omega-3 fatty acids have produced conflicting results. To conduct a meta-analysis of all large trials assessing the associations of omega-3 fatty acid supplements with the risk of fatal and nonfatal coronary heart disease and major vascular events in the full study population and prespecified subgroups. This meta-analysis included randomized trials that involved at least 500 participants and a treatment duration of at least 1 year and that assessed associations of omega-3 fatty acids with the risk of vascular events. Aggregated study-level data were obtained from 10 large randomized clinical trials. Rate ratios for each trial were synthesized using observed minus expected statistics and variances. Summary rate ratios were estimated by a fixed-effects meta-analysis using 95% confidence intervals for major diseases and 99% confidence intervals for all subgroups. The main outcomes included fatal coronary heart disease, nonfatal myocardial infarction, stroke, major vascular events, and all-cause mortality, as well as major vascular events in study population subgroups. Of the 77 917 high-risk individuals participating in the 10 trials, 47 803 (61.4%) were men, and the mean age at entry was 64.0 years; the trials lasted a mean of 4.4 years. The associations of treatment with outcomes were assessed on 6273 coronary heart disease events (2695 coronary heart disease deaths and 2276 nonfatal myocardial infarctions) and 12 001 major vascular events. Randomization to omega-3 fatty acid supplementation (eicosapentaenoic acid dose range, 226-1800 mg/d) had no significant associations with coronary heart disease death (rate ratio [RR], 0.93; 99% CI, 0.83-1.03; P = .05), nonfatal myocardial infarction (RR, 0.97; 99% CI, 0.87-1.08; P = .43) or any coronary heart disease events (RR, 0.96; 95% CI, 0.90-1.01; P = .12). Neither did randomization to omega-3 fatty acid supplementation have any significant associations with major vascular events (RR, 0.97; 95% CI, 0.93-1.01; P = .10), overall or in any subgroups, including subgroups composed of persons with prior coronary heart disease, diabetes, lipid levels greater than a given cutoff level, or statin use. This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease.

Clinical changes in terminally ill cancer patients and death within 48 h: when should we refer patients to a separate room?

PubMed

Hwang, In Cheol; Ahn, Hong Yup; Park, Sang Min; Shim, Jae Yong; Kim, Kyoung Kon

2013-03-01

There is scant research concerning the prediction of imminent death, and current studies simply list events "that have already occurred" around 48 h of the death. We sought to determine what events herald the onset of dying process using the length of time from "any change" to death. This is a prospective observational study with chart audit. Inclusion criteria were terminal cancer patients who passed away in a palliative care unit. The analysis was limited to 181 patients who had medical records for their final week. Commonly observed events in the terminally ill were determined and their significant changes were defined beforehand. We selected the statistically significant changes by multiple logistic regression analysis and evaluated their predictive values for "death within 48 h." The median age was 67 years and there were 103 male patients. After adjusting for age, sex, primary cancer site, metastatic site, and cancer treatment, multiple logistic regression analyses for association between the events and "death within 48 h" revealed some significant changes: confused mental state, decreased blood pressure, increased pulse pressure, low oxygen saturation, death rattle, and decreased conscious level. The events that had higher predictability for death within 48 h were decreased blood pressure and low oxygen saturation, and the positive and negative predictive values of their combination were 95.0 and 81.4%, respectively. The most reliable events to predict impending death were decreased blood pressure and low oxygen saturation.

Interpreting aCGH-defined karyotypic changes in gliomas using copy number status, loss of heterozygosity and allelic ratios

PubMed Central

Cowell, John K; Lo, Ken C; Luce, Jesse; Hawthorn, Lesleyann

2009-01-01

We have used SNP mapping arrays to simultaneously record copy number changes, loss of heterozygosity and allele ratios (ploidy) in a series of 13 gliomas. This combined analysis has defined novel amplification events in this tumor type involving chr1:241544532-243005121 and chr18:54716681-54917277 which contain the AKT3 and ZNF532 genes respectively. The high resolution of this analysis has also identified homozygous deletions involving chr17:25600031-26490848 and Chr19:53883612-55061878. Throughout the karyotypes of these tumors, the combined analysis revealed counter intuitive relationships between copy number and LOH that requires reinterpretation of the significance of copy number gains and losses. It was not uncommon to observe copy number gains that were associated with loss of heterozygosity as well as copy number losses that were not. These events appeared to be related to ploidy status in the tumors as determined using allelic ratio calculations. Overall, this analysis of gliomas provides evidence for the need to perform more comprehensive interpretation of the CGH data beyond copy number analysis alone to evaluate the significance of individual events in the karyotypes. PMID:19818351

Search for Electronic Recoil Event Rate Modulation with 4 Years of XENON100 Data

NASA Astrophysics Data System (ADS)

Aprile, E.; Aalbers, J.; Agostini, F.; Alfonsi, M.; Amaro, F. D.; Anthony, M.; Arneodo, F.; Barrow, P.; Baudis, L.; Bauermeister, B.; Benabderrahmane, M. L.; Berger, T.; Breur, P. A.; Brown, A.; Brown, E.; Bruenner, S.; Bruno, G.; Budnik, R.; Bütikofer, L.; Calvén, J.; Cardoso, J. M. R.; Cervantes, M.; Cichon, D.; Coderre, D.; Colijn, A. P.; Conrad, J.; Cussonneau, J. P.; Decowski, M. P.; de Perio, P.; di Gangi, P.; di Giovanni, A.; Diglio, S.; Eurin, G.; Fei, J.; Ferella, A. D.; Fieguth, A.; Franco, D.; Fulgione, W.; Gallo Rosso, A.; Galloway, M.; Gao, F.; Garbini, M.; Geis, C.; Goetzke, L. W.; Greene, Z.; Grignon, C.; Hasterok, C.; Hogenbirk, E.; Itay, R.; Kaminsky, B.; Kessler, G.; Kish, A.; Landsman, H.; Lang, R. F.; Lellouch, D.; Levinson, L.; Lin, Q.; Lindemann, S.; Lindner, M.; Lopes, J. A. M.; Manfredini, A.; Maris, I.; Marrodán Undagoitia, T.; Masbou, J.; Massoli, F. V.; Masson, D.; Mayani, D.; Messina, M.; Micheneau, K.; Miguez, B.; Molinario, A.; Murra, M.; Naganoma, J.; Ni, K.; Oberlack, U.; Pakarha, P.; Pelssers, B.; Persiani, R.; Piastra, F.; Pienaar, J.; Pizzella, V.; Piro, M.-C.; Plante, G.; Priel, N.; Rauch, L.; Reichard, S.; Reuter, C.; Rizzo, A.; Rosendahl, S.; Rupp, N.; Dos Santos, J. M. F.; Sartorelli, G.; Scheibelhut, M.; Schindler, S.; Schreiner, J.; Schumann, M.; Scotto Lavina, L.; Selvi, M.; Shagin, P.; Silva, M.; Simgen, H.; Sivers, M. V.; Stein, A.; Thers, D.; Tiseni, A.; Trinchero, G.; Tunnell, C.; Wang, H.; Wei, Y.; Weinheimer, C.; Wulf, J.; Ye, J.; Zhang, Y.; Xenon Collaboration

2017-03-01

We report on a search for electronic recoil event rate modulation signatures in the XENON100 data accumulated over a period of 4 yr, from January 2010 to January 2014. A profile likelihood method, which incorporates the stability of the XENON100 detector and the known electronic recoil background model, is used to quantify the significance of periodicity in the time distribution of events. There is a weak modulation signature at a period of 43 1-14+16 day in the low energy region of (2.0-5.8) keV in the single scatter event sample, with a global significance of 1.9 σ ; however, no other more significant modulation is observed. The significance of an annual modulation signature drops from 2.8 σ , from a previous analysis of a subset of this data, to 1.8 σ with all data combined. Single scatter events in the low energy region are thus used to exclude the DAMA/LIBRA annual modulation as being due to dark matter electron interactions via axial vector coupling at 5.7 σ .

Add-on lacosamide: a retrospective study on the relationship between serum concentration, dosage, and adverse events.

PubMed

Hillenbrand, Barbara; Wisniewski, Ilona; Jürges, Uta; Steinhoff, Bernhard J

2011-11-01

We performed a retrospective study in patients with poorly controlled epilepsy treated with add-on lacosamide (LCM) to investigate the relationship of LCM-related adverse events with LCM serum concentration and weight-dependent dosage. We collected serum concentrations, weight-related dosages, and occurrences of the seven most frequent adverse events according to the randomized double-blind, placebo-controlled trials. Seventy of 131 patients could be sufficiently evaluated. LCM serum concentrations and weight-related dosages in patients with and without typical adverse events did not differ significantly. Closer analysis of the data suggested that dizziness as the leading adverse event occurred significantly more often if LCM was combined with classic sodium channel blockers. There was a significant correlation between LCM serum concentrations and co-medication, so there is still evidence for dependent variables that might have a relevant impact in individual cases. However, our data do not allow definition of a safety range for LCM. Copyright © 2011 Elsevier Inc. All rights reserved.

Total cosine R-to-T for predicting ventricular arrhythmic and mortality outcomes: A systematic review and meta-analysis.

PubMed

Tse, Gary; Gong, Mengqi; Wong, Cheuk Wai; Chan, Cynthia; Georgopoulos, Stamatis; Chan, Yat Sun; Yan, Bryan P; Li, Guangping; Whittaker, Paula; Ciobanu, Ana; Ali-Hasan-Al-Saegh, Sadeq; Wong, Sunny H; Wu, William K K; Bazoukis, George; Lampropoulos, Konstantinos; Wong, Wing Tak; Tse, Lap Ah; Baranchuk, Adrian M; Letsas, Konstantinos P; Liu, Tong

2018-03-01

The total cosine R-to-T (TCRT), a vectorcardiographic marker reflecting the spatial difference between the depolarization and repolarization wavefronts, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death (SCD) in different clinical settings. However, its prognostic value has been controversial. This systematic review and meta-analysis evaluated the significance of TRCT in predicting arrhythmic and/or mortality endpoints. PubMed and Embase databases were searched through December 31, 2016. Of the 890 studies identified initially, 13 observational studies were included in our meta-analysis. A total of 11,528 patients, mean age 47 years old, 72% male, were followed for 43 ± 6 months. Data from five studies demonstrated lower TCRT values in myocardial infarction patients with adverse events (syncope, ventricular arrhythmias, or sudden cardiac death) compared to those without these events (mean difference = -0.36 ± 0.05, p < .001; I 2  = 48%). By contrast, only two studies analyzed outcomes in heart failure, and pooled meta-analysis did not demonstrate significant difference in TCRT between event-positive and event-negative patients (mean difference = -0.01 ± 0.10, p > .05; I 2  = 80%). TCRT is lower in MI patients at high risk of adverse events when compared to those free from such events. It can provide additional risk stratification beyond the use of clinical parameters and traditional electrocardiogram markers. Its value in other diseases such as heart failure requires further studies. © 2017 Wiley Periodicals, Inc.

Most and Least Helpful Events in Three Supervision Modalities

ERIC Educational Resources Information Center

Fickling, Melissa J.; Borders, L. DiAnne; Mobley, Keith A.; Wester, Kelly

2017-01-01

The authors conducted a content analysis of supervisors' (n = 10) and supervisees' (n = 31) descriptions (n = 707) of most and least helpful significant events in individual, group, and triadic supervision across 1 semester. Categories by group for each modality and areas of agreement and disagreement are highlighted.

Extreme seismicity and disaster risks: Hazard versus vulnerability (Invited)

NASA Astrophysics Data System (ADS)

Ismail-Zadeh, A.

2013-12-01

Although the extreme nature of earthquakes has been known for millennia due to the resultant devastation from many of them, the vulnerability of our civilization to extreme seismic events is still growing. It is partly because of the increase in the number of high-risk objects and clustering of populations and infrastructure in the areas prone to seismic hazards. Today an earthquake may affect several hundreds thousand lives and cause significant damage up to hundred billion dollars; it can trigger an ecological catastrophe if occurs in close vicinity to a nuclear power plant. Two types of extreme natural events can be distinguished: (i) large magnitude low probability events, and (ii) the events leading to disasters. Although the first-type events may affect earthquake-prone countries directly or indirectly (as tsunamis, landslides etc.), the second-type events occur mainly in economically less-developed countries where the vulnerability is high and the resilience is low. Although earthquake hazards cannot be reduced, vulnerability to extreme events can be diminished by monitoring human systems and by relevant laws preventing an increase in vulnerability. Significant new knowledge should be gained on extreme seismicity through observations, monitoring, analysis, modeling, comprehensive hazard assessment, prediction, and interpretations to assist in disaster risk analysis. The advanced disaster risk communication skill should be developed to link scientists, emergency management authorities, and the public. Natural, social, economic, and political reasons leading to disasters due to earthquakes will be discussed.

Negative Life Events and Antenatal Depression among Pregnant Women in Rural China: The Role of Negative Automatic Thoughts.

PubMed

Wang, Yang; Wang, Xiaohua; Liu, Fangnan; Jiang, Xiaoning; Xiao, Yun; Dong, Xuehan; Kong, Xianglei; Yang, Xuemei; Tian, Donghua; Qu, Zhiyong

2016-01-01

Few studies have looked at the relationship between psychological and the mental health status of pregnant women in rural China. The current study aims to explore the potential mediating effect of negative automatic thoughts between negative life events and antenatal depression. Data were collected in June 2012 and October 2012. 495 rural pregnant women were interviewed. Depressive symptoms were measured by the Edinburgh postnatal depression scale, stresses of pregnancy were measured by the pregnancy pressure scale, negative automatic thoughts were measured by the automatic thoughts questionnaire, and negative life events were measured by the life events scale for pregnant women. We used logistic regression and path analysis to test the mediating effect. The prevalence of antenatal depression was 13.7%. In the logistic regression, the only socio-demographic and health behavior factor significantly related to antenatal depression was sleep quality. Negative life events were not associated with depression in the fully adjusted model. Path analysis showed that the eventual direct and general effects of negative automatic thoughts were 0.39 and 0.51, which were larger than the effects of negative life events. This study suggested that there was a potentially significant mediating effect of negative automatic thoughts. Pregnant women who had lower scores of negative automatic thoughts were more likely to suffer less from negative life events which might lead to antenatal depression.

Comparison of mesalazine and balsalazide in induction and maintenance of remission in patients with ulcerative colitis: a meta-analysis.

PubMed

Rahimi, Roja; Nikfar, Shekoufeh; Rezaie, Ali; Abdollahi, Mohammad

2009-04-01

5-Aminosalicylates are the standard treatment for induction and maintenance of remission in mild-to-moderate ulcerative colitis. In recent years, the 5-aminosalicylic acid-containing pro-drug balsalazide has been the focus of attention. To compare the efficacy and tolerance of balsalazide and mesalazine by meta-analysis. Pubmed, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for studies comparing the efficacy and/or tolerance of balsalazide with mesalazine in the management of UC. The search terms were: "mesalazine" or "5-aminosalicylic acid" and "balsalazide" and "ulcerative colitis." Data were collected from 1966 to 2007 (up to February). There was no language restriction. "Symptomatic remission," "complete remission," "relapse rate," "total adverse events," and "withdrawals because of adverse events" were the key outcomes of interest. Six randomized placebo-controlled clinical trials met our criteria and were included in the meta-analysis. In these "symptomatic remission," "complete remission," "relapse rate," "total adverse events," and "withdrawals because of adverse events" were evaluated in three, three, two, five, and six of the trials, respectively. They included 653 patients consisting of 55.4% men and 44.6% women randomized to receive either balsalazide or mesalazine. Pooling of three trials for symptomatic remission yielded a significant relative risk (RR) of 1.23 (95% confidence interval of 1.03-1.47, P = 0.02). The summary RR for complete remission in three trials was 1.3 (95% CI of 1.002-1.68, P = 0.048). Pooling of two trials for the outcome of relapse yielded a non-significant RR of 0.77 (95% CI of 0.56-1.07, P = 0.12). Pooling five studies from which data for any adverse events were extracted, yielded a non-significant RR of 0.87 (95% CI of 0.75-1.001, P = 0.53). The summary RR for withdrawals because of adverse events in six trials was 0.69, a non-significant RR (95% CI of 0.37-1.29, P = 0.24). Balsalazide is more effective than mesalazine in induction of remission, but balsalazide has no benefit compared with mesalazine in preventing relapse in the population selected. The number of patients with any adverse events and withdrawals because of severe adverse events is similar for mesalazine and balsalazide.

Periodic Impact Cratering and Extinction Events Over the Last 260 Million Years

NASA Technical Reports Server (NTRS)

Rampino, Michael R.; Caldeira, Ken

2015-01-01

The claims of periodicity in impact cratering and biological extinction events are controversial. Anewly revised record of dated impact craters has been analyzed for periodicity, and compared with the record of extinctions over the past 260 Myr. A digital circular spectral analysis of 37 crater ages (ranging in age from 15 to 254 Myr ago) yielded evidence for a significant 25.8 +/- 0.6 Myr cycle. Using the same method, we found a significant 27.0 +/- 0.7 Myr cycle in the dates of the eight recognized marine extinction events over the same period. The cycles detected in impacts and extinctions have a similar phase. The impact crater dataset shows 11 apparent peaks in the last 260 Myr, at least 5 of which correlate closely with significant extinction peaks. These results suggest that the hypothesis of periodic impacts and extinction events is still viable.

What drives high flow events in the Swiss Alps? Recent developments in wavelet spectral analysis and their application to hydrology

NASA Astrophysics Data System (ADS)

Schaefli, B.; Maraun, D.; Holschneider, M.

2007-12-01

Extreme hydrological events are often triggered by exceptional co-variations of the relevant hydrometeorological processes and in particular by exceptional co-oscillations at various temporal scales. Wavelet and cross wavelet spectral analysis offers promising time-scale resolved analysis methods to detect and analyze such exceptional co-oscillations. This paper presents the state-of-the-art methods of wavelet spectral analysis, discusses related subtleties, potential pitfalls and recently developed solutions to overcome them and shows how wavelet spectral analysis, if combined to a rigorous significance test, can lead to reliable new insights into hydrometeorological processes for real-world applications. The presented methods are applied to detect potentially flood triggering situations in a high Alpine catchment for which a recent re-estimation of design floods encountered significant problems simulating the observed high flows. For this case study, wavelet spectral analysis of precipitation, temperature and discharge offers a powerful tool to help detecting potentially flood producing meteorological situations and to distinguish between different types of floods with respect to the prevailing critical hydrometeorological conditions. This opens very new perspectives for the analysis of model performances focusing on the occurrence and non-occurrence of different types of high flow events. Based on the obtained results, the paper summarizes important recommendations for future applications of wavelet spectral analysis in hydrology.

Centre of pressure patterns in the golf swing: individual-based analysis.

PubMed

Ball, Kevin; Best, Russell

2012-06-01

Weight transfer has been identified as important in group-based analyses. The aim of this study was to extend this work by examining the importance of weight transfer in the golf swing on an individual basis. Five professional and amateur golfers performed 50 swings with the driver, hitting a ball into a net. The golfer's centre of pressure position and velocity, parallel with the line of shot, were measured by two force plates at eight swing events that were identified from high-speed video. The relationships between these parameters and club head velocity at ball contact were examined using regression statistics. The results did support the use of group-based analysis, with all golfers returning significant relationships. However, results were also individual-specific, with golfers returning different combinations of significant factors. Furthermore, factors not identified in group-based analysis were significant on an individual basis. The most consistent relationship was a larger weight transfer range associated with a larger club head velocity (p < 0.05). All golfers also returned at least one significant relationship with rate of weight transfer at swing events (p < 0.01). Individual-based analysis should form part of performance-based biomechanical analysis of sporting skills.

Incidence and risk factors of intraoperative adverse events during donor lobectomy for living-donor liver transplantation: a retrospective analysis.

PubMed

Araz, Coskun; Pirat, Arash; Unlukaplan, Aytekin; Torgay, Adnan; Karakayali, Hamdi; Arslan, Gulnaz; Moray, Gokhan; Haberal, Mehmet

2012-04-01

To evaluate the frequency, type, and predictors of intraoperative adverse events during donor hepatectomy for living-donor liver transplant. Retrospective analyses of the data from 182 consecutive living-donor liver transplant donors between May 2002 and September 2008. Ninety-one patients (50%) had at least 1 intraoperative adverse event including hypothermia (39%), hypotension (26%), need for transfusions (17%), and hypertension (7%). Patients with an adverse event were older (P = .001), had a larger graft weight (P = .023), more frequently underwent a right hepatectomy (P = .019), and were more frequently classified as American Society of Anesthesiologists physical status class II (P = .027) than those who did not have these adverse events. Logistic regression analysis revealed that only age (95% confidence interval 1.018-1.099; P = .001) was a risk factor for intraoperative adverse events. Patients with these adverse events more frequently required admission to the intensive care unit and were hospitalized longer postoperatively. A before and after analysis showed that after introduction of in-line fluid warmers and more frequent use of acute normovolemic hemodilution, the frequency of intraoperative adverse events was significantly lower (80% vs 29%; P < .001). Intraoperative adverse events such as hypothermia and hypotension were common in living-donor liver transplant donors, and older age was associated with an increased risk of these adverse events. However, the effect of these adverse events on postoperative recovery is not clear.

Corrective interpersonal experience in psychodrama group therapy: a comprehensive process analysis of significant therapeutic events.

PubMed

McVea, Charmaine S; Gow, Kathryn; Lowe, Roger

2011-07-01

This study investigated the process of resolving painful emotional experience during psychodrama group therapy, by examining significant therapeutic events within seven psychodrama enactments. A comprehensive process analysis of four resolved and three not-resolved cases identified five meta-processes which were linked to in-session resolution. One was a readiness to engage in the therapeutic process, which was influenced by client characteristics and the client's experience of the group; and four were therapeutic events: (1) re-experiencing with insight; (2) activating resourcefulness; (3) social atom repair with emotional release; and (4) integration. A corrective interpersonal experience (social atom repair) healed the sense of fragmentation and interpersonal disconnection associated with unresolved emotional pain, and emotional release was therapeutically helpful when located within the enactment of this new role relationship. Protagonists who experienced resolution reported important improvements in interpersonal functioning and sense of self which they attributed to this experience.

Breast cancer, psychological distress and life events among young women

PubMed Central

Peled, Ronit; Carmil, Devora; Siboni-Samocha, Orly; Shoham-Vardi, Ilana

2008-01-01

Since 1983, studies have suggested an interaction between the severe life events, psychological distress and the etiology of Cancer. However, these associations are still under dispute. The aim of the present study was to examine the relationship between life events, psychological distress and Breast Cancer (BC) among young women. Methods A case control study. The study population included 622 women, under the age of 45 years. 255 were diagnosed for BC, and 367 were healthy women. A validated Brief Symptom Inventory (BSI) and Life Event Questionnaire were used. Results The cases presented significantly higher scores of depression compared to the controls and significant lower scores of happiness and optimism. A significant difference was found when comparing the groups according to the cumulative number of life events (two or more events). A multivariate analysis suggest that exposure to more than one life event is positively associated with BC [Odds Ratio(OR) :1.62 95% Confidence Interval (CI): 1.09–2.40], and that a general feeling of happiness and optimism has a "protective effect" on the etiology of BC. (OR-0.75, 95% CI:0.64–0.86). Conclusion Young women who were exposed to a number of life events, should be considered as a risk group for BC and treated accordingly. PMID:18721454

Empagliflozin and Cerebrovascular Events in Patients With Type 2 Diabetes Mellitus at High Cardiovascular Risk

PubMed Central

Inzucchi, Silvio E.; Lachin, John M.; Wanner, Christoph; Fitchett, David; Kohler, Sven; Mattheus, Michaela; Woerle, Hans J.; Broedl, Uli C.; Johansen, Odd Erik; Albers, Gregory W.; Diener, Hans Christoph

2017-01-01

Background and Purpose— In the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), empagliflozin added to standard of care in patients with type 2 diabetes mellitus and high cardiovascular risk reduced the risk of 3-point major adverse cardiovascular events, driven by a reduction in cardiovascular mortality, with no significant difference between empagliflozin and placebo in risk of myocardial infarction or stroke. In a modified intent-to-treat analysis, the hazard ratio for stroke was 1.18 (95% confidence interval, 0.89–1.56; P=0.26). We further investigated cerebrovascular events. Methods— Patients were randomized to empagliflozin 10 mg, empagliflozin 25 mg, or placebo; 7020 patients were treated. Median observation time was 3.1 years. Results— The numeric difference in stroke between empagliflozin and placebo in the modified intent-to-treat analysis was primarily because of 18 patients in the empagliflozin group with a first event >90 days after last intake of study drug (versus 3 on placebo). In a sensitivity analysis based on events during treatment or ≤90 days after last dose of drug, the hazard ratio for stroke with empagliflozin versus placebo was 1.08 (95% confidence interval, 0.81–1.45; P=0.60). There were no differences in risk of recurrent, fatal, or disabling strokes, or transient ischemic attack, with empagliflozin versus placebo. Patients with the largest increases in hematocrit or largest decreases in systolic blood pressure did not have an increased risk of stroke. Conclusions— In patients with type 2 diabetes mellitus and high cardiovascular risk, there was no significant difference in the risk of cerebrovascular events with empagliflozin versus placebo. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01131676. PMID:28386035

Empagliflozin and Cerebrovascular Events in Patients With Type 2 Diabetes Mellitus at High Cardiovascular Risk.

PubMed

Zinman, Bernard; Inzucchi, Silvio E; Lachin, John M; Wanner, Christoph; Fitchett, David; Kohler, Sven; Mattheus, Michaela; Woerle, Hans J; Broedl, Uli C; Johansen, Odd Erik; Albers, Gregory W; Diener, Hans Christoph

2017-05-01

In the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), empagliflozin added to standard of care in patients with type 2 diabetes mellitus and high cardiovascular risk reduced the risk of 3-point major adverse cardiovascular events, driven by a reduction in cardiovascular mortality, with no significant difference between empagliflozin and placebo in risk of myocardial infarction or stroke. In a modified intent-to-treat analysis, the hazard ratio for stroke was 1.18 (95% confidence interval, 0.89-1.56; P =0.26). We further investigated cerebrovascular events. Patients were randomized to empagliflozin 10 mg, empagliflozin 25 mg, or placebo; 7020 patients were treated. Median observation time was 3.1 years. The numeric difference in stroke between empagliflozin and placebo in the modified intent-to-treat analysis was primarily because of 18 patients in the empagliflozin group with a first event >90 days after last intake of study drug (versus 3 on placebo). In a sensitivity analysis based on events during treatment or ≤90 days after last dose of drug, the hazard ratio for stroke with empagliflozin versus placebo was 1.08 (95% confidence interval, 0.81-1.45; P =0.60). There were no differences in risk of recurrent, fatal, or disabling strokes, or transient ischemic attack, with empagliflozin versus placebo. Patients with the largest increases in hematocrit or largest decreases in systolic blood pressure did not have an increased risk of stroke. In patients with type 2 diabetes mellitus and high cardiovascular risk, there was no significant difference in the risk of cerebrovascular events with empagliflozin versus placebo. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01131676. © 2017 The Authors.

Transforming the Morbidity and Mortality Conference to Promote Safety and Quality in a PICU.

PubMed

Cifra, Christina L; Bembea, Melania M; Fackler, James C; Miller, Marlene R

2016-01-01

Determine the effectiveness of a structured systems-oriented morbidity and mortality conference in improving the process of reviewing and responding to adverse events in a PICU. Prospective time series analysis before and after implementation of a systems-oriented morbidity and mortality conference. Single tertiary referral PICU in Baltimore, MD. Thirty-three patients discussed before and 31 patients after implementation of a systems-oriented morbidity and mortality conference over a total of 20 morbidity and mortality conferences, from April 2013 to March 2014. Systems-oriented morbidity and mortality conference incorporating elements of medical incident analysis. There was a significant increase in meeting attendance (mean, 12 vs 31 attendees per morbidity and mortality conference; p < 0.001) after the systems-oriented morbidity and mortality conference was instituted. There was no significant difference in the mean number of cases suggested (4.2 vs 4.6) or discussed (3.3 vs 3.1) per morbidity and mortality conference. There was also no significant difference in the mean number of adverse events identified per morbidity and mortality conference (3.4 vs 4.3). However, there was an increase in the proportion of cases discussed using a standard case review tool, but this did not reach statistical significance (27% vs 45%; p = 0.231). Nevertheless, we observed a significant increase in the mean number of quality improvement interventions suggested (2.4 vs 5.6; p < 0.001) and implemented (1.7 vs 4.4; p < 0.001) per morbidity and mortality conference. All adverse event categories identified had corresponding interventions suggested after the systems-oriented morbidity and mortality conference was instituted compared with before (80% vs 100%). Intervention-to-adverse event ratios per category were also higher (mean, 0.6 vs 1.5). A structured systems-oriented PICU morbidity and mortality conference incorporating elements of medical incident analysis improves the process of reviewing and responding to adverse events by significantly increasing quality improvement interventions suggested and implemented. Future work would involve testing locally adapted versions of the systems-oriented morbidity and mortality conference in multiple inpatient settings.

A probability index for surface zonda wind occurrence at Mendoza city through vertical sounding principal components analysis

NASA Astrophysics Data System (ADS)

Otero, Federico; Norte, Federico; Araneo, Diego

2018-01-01

The aim of this work is to obtain an index for predicting the probability of occurrence of zonda event at surface level from sounding data at Mendoza city, Argentine. To accomplish this goal, surface zonda wind events were previously found with an objective classification method (OCM) only considering the surface station values. Once obtained the dates and the onset time of each event, the prior closest sounding for each event was taken to realize a principal component analysis (PCA) that is used to identify the leading patterns of the vertical structure of the atmosphere previously to a zonda wind event. These components were used to construct the index model. For the PCA an entry matrix of temperature ( T) and dew point temperature (Td) anomalies for the standard levels between 850 and 300 hPa was build. The analysis yielded six significant components with a 94 % of the variance explained and the leading patterns of favorable weather conditions for the development of the phenomenon were obtained. A zonda/non-zonda indicator c can be estimated by a logistic multiple regressions depending on the PCA component loadings, determining a zonda probability index \\widehat{c} calculable from T and Td profiles and it depends on the climatological features of the region. The index showed 74.7 % efficiency. The same analysis was performed by adding surface values of T and Td from Mendoza Aero station increasing the index efficiency to 87.8 %. The results revealed four significantly correlated PCs with a major improvement in differentiating zonda cases and a reducing of the uncertainty interval.

Association between vascular calcification assessed by simple radiography and non-fatal cardiovascular events in hemodialysis patients.

PubMed

Petrauskiene, Vaida; Vaiciuniene, Ruta; Bumblyte, Inga Arune; Kuzminskis, Vytautas; Ziginskiene, Edita; Grazulis, Saulius; Jonaitiene, Egle

2016-12-01

Vascular calcification (VC) is one of the factors associated with cardiovascular mortality in hemodialysis (HD) patients. Recommendations concerning screening for VC differ. Possible ability to prevent and reversibility of VC are major subjects on debate whether screening for VC could improve outcomes of renal patients. The objective of the study was to evaluate the significance of simple vascular calcification score (SVCS) based on plane radiographic films and to test its association with non-fatal cardiovascular events in patients on chronic HD. A study population consisted of 95 prevalent HD patients in the HD unit of Hospital of Lithuanian University of Health sciences Kaunas Clinics. Clinical data and laboratory tests information were collected from medical records. SVCS was evaluated as it is described by Adragao et al. After measurement of VC, HD patients were observed for novel non-fatal cardiovascular events. Patients were divided into two groups: SVCS≥3 (57 patients [60%]) and <3 (38 patients [40%]). The Kaplan-Meier survival curves show a significant difference in non-fatal cardiovascular events in the group with SVCS≥3 vs. <3 group (26.3% vs. 7.8%; log rank 5,49; P=0.018). Multivariate Cox regression analysis confirmed a negative impact of VC, hyperphosphatemia, and lower ejection fraction on cardiovascular events. No statistically significant differences were observed comparing parameters of Ca-P metabolism disorders between groups with different SVCS. On separate analysis, the presence of VC in hands was also associated with higher rate of novel cardiovascular events (score 0 goup-5 events [10.6%] vs. score≥1 group-13 events [27%], log rank P=0.035). VC assessed by simple and inexpensive radiological method was an independent predictor of novel non-fatal cardiovascular events in HD patients. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Temporal and spatial characteristics of extreme precipitation events in the Midwest of Jilin Province based on multifractal detrended fluctuation analysis method and copula functions

NASA Astrophysics Data System (ADS)

Guo, Enliang; Zhang, Jiquan; Si, Ha; Dong, Zhenhua; Cao, Tiehua; Lan, Wu

2017-10-01

Environmental changes have brought about significant changes and challenges to water resources and management in the world; these include increasing climate variability, land use change, intensive agriculture, and rapid urbanization and industrial development, especially much more frequency extreme precipitation events. All of which greatly affect water resource and the development of social economy. In this study, we take extreme precipitation events in the Midwest of Jilin Province as an example; daily precipitation data during 1960-2014 are used. The threshold of extreme precipitation events is defined by multifractal detrended fluctuation analysis (MF-DFA) method. Extreme precipitation (EP), extreme precipitation ratio (EPR), and intensity of extreme precipitation (EPI) are selected as the extreme precipitation indicators, and then the Kolmogorov-Smirnov (K-S) test is employed to determine the optimal probability distribution function of extreme precipitation indicators. On this basis, copulas connect nonparametric estimation method and the Akaike Information Criterion (AIC) method is adopted to determine the bivariate copula function. Finally, we analyze the characteristics of single variable extremum and bivariate joint probability distribution of the extreme precipitation events. The results show that the threshold of extreme precipitation events in semi-arid areas is far less than that in subhumid areas. The extreme precipitation frequency shows a significant decline while the extreme precipitation intensity shows a trend of growth; there are significant differences in spatiotemporal of extreme precipitation events. The spatial variation trend of the joint return period gets shorter from the west to the east. The spatial distribution of co-occurrence return period takes on contrary changes and it is longer than the joint return period.

Using Wavelet Analysis To Assist in Identification of Significant Events in Molecular Dynamics Simulations.

PubMed

Heidari, Zahra; Roe, Daniel R; Galindo-Murillo, Rodrigo; Ghasemi, Jahan B; Cheatham, Thomas E

2016-07-25

Long time scale molecular dynamics (MD) simulations of biological systems are becoming increasingly commonplace due to the availability of both large-scale computational resources and significant advances in the underlying simulation methodologies. Therefore, it is useful to investigate and develop data mining and analysis techniques to quickly and efficiently extract the biologically relevant information from the incredible amount of generated data. Wavelet analysis (WA) is a technique that can quickly reveal significant motions during an MD simulation. Here, the application of WA on well-converged long time scale (tens of μs) simulations of a DNA helix is described. We show how WA combined with a simple clustering method can be used to identify both the physical and temporal locations of events with significant motion in MD trajectories. We also show that WA can not only distinguish and quantify the locations and time scales of significant motions, but by changing the maximum time scale of WA a more complete characterization of these motions can be obtained. This allows motions of different time scales to be identified or ignored as desired.

Extended Duration Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Peripheral Arterial Disease: A Meta-Analysis.

PubMed

Ling, Hua; Andrews, Ebony; Ombengi, David; Li, Fang

2018-06-01

Patients with peripheral arterial disease (PAD) undergoing percutaneous coronary intervention (PCI) are at elevated risk of ischemic and bleeding events. However, the optimal duration of dual antiplatelet therapy (DAPT) after PCI in patients with PAD remains unclear. A systematic literature search was performed through June 2017 using PubMed, EMBASE and Cochrane databases with the following key terms: "dual antiplatelet therapy", "P2Y12 inhibitor", "myocardial infarction", "percutaneous coronary intervention", "stent", "peripheral arterial disease", and "ankle-brachial index". The analysis was restricted to randomized trials published in English in patients with PAD receiving extended DAPT (> 12-month) after PCI. Overall analysis was performed using Review Manager 5.3 with the Mantel-Haenszel method. Two randomized controlled trials involving 895 patients were included in this review. Compared to the placebo group, there was no statistical significance in the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in patients receiving extended DAPT (odds ratio (OR) 0.76, 95% confidence interval (CI) 0.37 - 1.57; P = 0.46). The results were associated with substantial heterogeneity (I 2 = 71%, P = 0.07). Extended DAPT was not significantly associated with increased moderate/severe bleeding events (OR 1.63, 95% CI 0.84 - 3.18; P = 0.15; I 2 = 0%, P = 0.59). The extended DAPT was associated with 82% relative risk reduction in the events of definite/probably stent thrombosis. Among patients with PAD, extended DAPT after PCI resulted in a non-significant difference in ischemic and bleeding events compared to placebo, respectively. The routine use of extended DAPT in this cohort should be carefully evaluated.

Analysis of the daily rainfall events over India using a new long period (1901-2010) high resolution (0.25° × 0.25°) gridded rainfall data set

NASA Astrophysics Data System (ADS)

Pai, D. S.; Sridhar, Latha; Badwaik, M. R.; Rajeevan, M.

2015-08-01

In this study, analysis of the long term climatology, variability and trends in the daily rainfall events of ≥5 mm [or daily rainfall (DR) events] during the southwest monsoon season (June-September) over four regions of India; south central India (SCI), north central India (NCI), northeast India (NEI) and west coast (WC) have been presented. For this purpose, a new high spatial resolution (0.25° × 0.25°) daily gridded rainfall data set covering 110 years (1901-2010) over the Indian main land has been used. The association of monsoon low pressure systems (LPSs) with the DR events of various intensities has also been examined. Major portion of the rainfall over these regions during the season was received in the form of medium rainfall (≥5-100 mm) or moderate rainfall (MR) events. The mean seasonal cycle of the daily frequency of heavy rainfall (HR) (≥100-150 mm) or HR events and very heavy rainfall (VHR) (≥150 mm) or VHR events over each of the four regions showed peak at different parts of the season. The peak in the mean daily HR and VHR events occurred during middle of July to middle of August over SCI, during late part of June to early part of July over NCI, during middle of June to early July over NEI, and during late June to middle July over WC. Significant long term trends in the frequency and intensity of the DR events were observed in all the four geographical regions. Whereas the intensity of the DR events over all the four regions showed significant positive trends during the second half and the total period, the signs and magnitude of the long term trends in the frequency of the various categories of DR events during the total period and its two halves differed from the region to the region. The trend analysis revealed increased disaster potential for instant flooding over SCI and NCI during the recent years due to significant increasing trends in the frequency (areal coverage) and intensity of the HR and VHR events during the recent half of the data period. However, there is increased disaster potential over NEI and WC due to the increasing trends in the intensity of the rainfall events. There is strong association between the LPS days and the DR events in both the spatial and temporal scales. In all the four regions, the contributions to the total MR events by the LPS days were nearly equal. On the other hand, there was relatively large regional difference in the number of combined HR and VHR events associated with LPS days particularly that associated with monsoon depression (LPS stronger than monsoon depression) days. The possible reasons for the same have also been discussed. The increasing trend in the monsoon low (low pressure) days post 1970s is the primary reason for the observed significant increasing trends in the HR and VHR events over SCI and NCI and decreasing trend in HR events over NEI during the recent half (1956-2010). This is in spite of the decreasing trend in the MD days.

Season ending events, a matter of perspective

Treesearch

Laurie L. Kurth

2010-01-01

Agency managers are often faced with making difficult wildland fire management decisions based on collating a significant amount of information regarding a fire. Supporting the decisions is understanding how long an incident may persist, especially if the fire has potential for resource benefits. Analysis of historical season ending events has occurred since the mid-...

Adenosine Diphosphate-Induced Platelet-Fibrin Clot Strength: A New Thrombelastographic Indicator of Long-Term Post-Stenting Ischemic Events

PubMed Central

Gurbel, Paul A.; Bliden, Kevin P.; Navickas, Irene A.; Mahla, Elizabeth; Dichiara, Joseph; Suarez, Thomas A.; Antonino, Mark J.; Tantry, Udaya S.; Cohen, Eli

2010-01-01

Background Post-stenting ischemic events occur despite dual antiplatelet therapy suggesting that a “one size fits all” antithrombotic strategy has significant limitations. Ex vivo platelet function measurements may facilitate risk stratification and personalized antiplatelet therapy. Methods We investigated the prognostic utility of the strength of ADP-induced (MAADP) and thrombin-induced (MATHROMBIN) platelet-fibrin clots measured by thrombelastography and ADP-induced light transmittance aggregation (LTAADP) in 225 serial patients following elective stenting treated with aspirin and clopidogrel. Ischemic and bleeding events were assessed over three-years. Results Overall, 59 (26 %) first ischemic events occurred. Patients with ischemic events had higher MAADP, MATHROMBIN, and LTAADP (p<0.0001 for all comparisons). By receiver operating characteristic curve analysis, MAADP > 47mm had the best predictive value of long-term ischemic events compared to other measurements (p<0.0001) with an area under the curve = 0.84 [95% CI 0.78 – 0.89, p < 0.0001]. The univariate Cox proportional hazards model identified MAADP >47mm, MATHROMBIN >69mm, and LTA ADP >34% as significant independent predictors of first ischemic events at the three-year time point, with hazard ratios of 10.3 (p<0.0001), 3.8 (p<0.0001), and 4.8 (p<0.0001) respectively. Fifteen bleeding events occurred. Receiver operator characteristic curve and quartile analysis suggest MAADP ≤ 31 as a predictive value for bleeding. Conclusion This study is the first demonstration of the prognostic utility of MAADP in predicting long term event occurrence following stenting. The quantitative assessment of ADP-stimulated platelet-fibrin clot strength measured by thrombelastography can serve as a future tool in investigations of personalized antiplatelet treatment designed to reduce ischemic events and bleeding. PMID:20691842

Adenosine diphosphate-induced platelet-fibrin clot strength: a new thrombelastographic indicator of long-term poststenting ischemic events.

PubMed

Gurbel, Paul A; Bliden, Kevin P; Navickas, Irene A; Mahla, Elizabeth; Dichiara, Joseph; Suarez, Thomas A; Antonino, Mark J; Tantry, Udaya S; Cohen, Eli

2010-08-01

Poststenting ischemic events occur despite dual-antiplatelet therapy, suggesting that a "one size fits all" antithrombotic strategy has significant limitations. Ex vivo platelet function measurements may facilitate risk stratification and personalized antiplatelet therapy. We investigated the prognostic utility of the strength of adenosine diphosphate (ADP)-induced (MA(ADP)) and thrombin-induced (MA(THROMBIN)) platelet-fibrin clots measured by thrombelastography and ADP-induced light transmittance aggregation (LTA(ADP)) in 225 serial patients after elective stenting treated with aspirin and clopidogrel. Ischemic and bleeding events were assessed over 3 years. Overall, 59 (26%) first ischemic events occurred. Patients with ischemic events had higher MA(ADP), MA(THROMBIN), and LTA(ADP) (P < .0001 for all comparisons). By receiver operating characteristic curve analysis, MA(ADP) >47 mm had the best predictive value of long-term ischemic events compared with other measurements (P < .0001), with an area under the curve = 0.84 (95% CI 0.78-0.89, P < .0001). The univariate Cox proportional hazards model identified MA(ADP) >47 mm, MA(THROMBIN) >69 mm, and LTA(ADP) >34% as significant independent predictors of first ischemic events at the 3-year time point, with hazard ratios of 10.3 (P < .0001), 3.8 (P < .0001), and 4.8 (P < .0001), respectively. Fifteen bleeding events occurred. Receiver operating characteristic curve and quartile analysis suggests MA(ADP)

FHR patterns that become significant in connection with ST waveform changes and metabolic acidosis at birth.

PubMed

Rosén, Karl G; Norén, Håkan; Carlsson, Ann

2018-04-18

Recent developments have produced new CTG classification systems and the question is to what extent these may affect the model of FHR + ST interpretation? The two new systems (FIGO2015 and SSOG2017) classify FHR + ST events differently from the current CTG classification system used in the STAN interpretation algorithm (STAN2007). Identify the predominant FHR patterns in connection with ST events in cases of cord artery metabolic acidosis missed by the different CTG classification systems. Indicate to what extent STAN clinical guidelines could be modified enhancing the sensitivity. Provide a pathophysiological rationale. Forty-four cases with umbilical cord artery metabolic acidosis were retrieved from a European multicenter database. Significant FHR + ST events were evaluated post hoc in consensus by an expert panel. Eighteen cases were not identified as in need of intervention and regarded as negative in the sensitivity analysis. In 12 cases, ST changes occurred but the CTG was regarded as reassuring. Visual analysis of the FHR + ST tracings revealed specific FHR patterns: Conclusion: These findings indicate FHR + ST analysis may be undertaken regardless of CTG classification system provided there is a more physiologically oriented approach to FHR assessment in connection with an ST event.

Analysis of Loss-of-Offsite-Power Events 1997-2015

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

Johnson, Nancy Ellen; Schroeder, John Alton

2016-07-01

Loss of offsite power (LOOP) can have a major negative impact on a power plant’s ability to achieve and maintain safe shutdown conditions. LOOP event frequencies and times required for subsequent restoration of offsite power are important inputs to plant probabilistic risk assessments. This report presents a statistical and engineering analysis of LOOP frequencies and durations at U.S. commercial nuclear power plants. The data used in this study are based on the operating experience during calendar years 1997 through 2015. LOOP events during critical operation that do not result in a reactor trip, are not included. Frequencies and durations weremore » determined for four event categories: plant-centered, switchyard-centered, grid-related, and weather-related. Emergency diesel generator reliability is also considered (failure to start, failure to load and run, and failure to run more than 1 hour). There is an adverse trend in LOOP durations. The previously reported adverse trend in LOOP frequency was not statistically significant for 2006-2015. Grid-related LOOPs happen predominantly in the summer. Switchyard-centered LOOPs happen predominantly in winter and spring. Plant-centered and weather-related LOOPs do not show statistically significant seasonality. The engineering analysis of LOOP data shows that human errors have been much less frequent since 1997 than in the 1986 -1996 time period.« less

Pesticide leaching via subsurface drains in different hydrologic situations

NASA Astrophysics Data System (ADS)

Zajíček, Antonín; Fučík, Petr; Liška, Marek; Dobiáš, Jakub

2017-04-01

esticides and their degradates in tile drainage waters were studied in two small, predominantly agricultural, tile-drained subcatchments in the Bohemian-Moravian Highlands, Czech Republic. The goal was to evaluate their occurence and the dymamics of their concentrations in drainage waters in different hydrologic situations using discharge and concentration monitoring together with 18O and 2H isotope analysis for Mean Residence Time (MRT) estimation and hydrograph separations during rainfall - runoff (R-R) events. The drainage and stream discharges were measured continuously at the closing outlets of three drainage groups and one small stream. During periods of prevailing base and interflow, samples were collected manually in two-week intervals for isotope analysis and during the spraying period (March to October) also for pesticide analysis. During R-R events, samples were taken by automatic samplers in intervals varying from 20 min (summer) to 1 hour (winter). To enable isotopic analysis, precipitation was sampled both manually at two-week intervals and also using an automatic rainfall sampler which collected samples of precipitation during the R-R events at 20-min. intervals. The isotopic analysis showed, that MRT of drainage base flow and interflow varies from 2,2 to 3,3 years, while MRT of base flow and interflow in surface stream is several months. During R-R events, the proportion of event water varied from 0 to 60 % in both drainage and surface runoff. The occurrence of pesticides and their degradates in drainage waters is strongly dependent on the hydrologic situation. While degradates were permanently present in drainage waters in high but varying concentrations according to instantaneous runoff composition, parent matters were detected almost exclusively during R-R events. In periods with prevailing base flow and interflow (grab samples), especially ESA forms of chloracetanilide degradates occured in high concentrations in all samples. Average sum of degradates varried between 1 730 - 5 760 ng/l. During R-R events, pesticide concentration varried according to runoff composition and time between sprayng and event. Event with no protortiom of event water in drainage runoff were typical by incereas in degradates concentrations (up to 20 000ng/l) and none or low occurence of parent matters. Events with significant event water proportion in drainage runoff were characterised by decrease in degradates concentrations and (when event happened soon affter spraying) by presence of paternal pesticides in drinage runoff. Instanteous concentrations of paren matters can be extremely high in that causes, up to 23 000 ng/l in drainage waters and up to 40 000 ng/l in small stream. Above results suggest that drainage systems could act as significant source of pesticide leaching. When parent compounds leaches via tile drainage systems, there are some border conditions that must exist together such as the occurence of R-R event soon after the pests application and the presence of event water (or water with short residence time in the catchment) in the drainage runoff.

Clinical predictors of colectomy in patients with ulcerative colitis: systematic review and meta-analysis of cohort studies.

PubMed

Dias, Cláudia Camila; Rodrigues, Pedro Pereira; da Costa-Pereira, Altamiro; Magro, Fernando

2015-02-01

Colectomy is a major event that may significantly affect the outcome of ulcerative colitis (UC) in terms of both quality of life and mortality. This paper aims to identify clinical prognostic factors that may be significantly associated with this event. PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigating the association between clinical factors in adult patients with UC and studied events.The clinical factors evaluated in this meta-analysis were gender, smoking habits, disease extent,use of corticosteroids, and episodes of hospitalization. Of the 3753 initially selected papers, 20 were included. The analysis showed a significantly lower risk of colectomy for female patients (odds ratio [OR] 0.78 [95% CI 0.68, 0.90]) and for smoking patients (OR 0.55 [0.33, 0.91]), and a higher risk for patients with extensive disease (OR 3.68 [2.39,5.69]), for patients who took corticosteroids at least once (OR 2.10 [1.05, 4.22]), and for patients who were hospitalized (OR 4.13 [3.23, 5.27]). Gender, smoking habits, disease extent, need for corticosteroids, and hospitalization were all significantly associated with UC prognosis. These results may clarify the relative influences of these and other prognostic factors in the natural course of the disease and therefore help improve the management approach, thus improving the follow-up of patients.

Performance Analysis: Work Control Events Identified January - August 2010

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

De Grange, C E; Freeman, J W; Kerr, C E

2011-01-14

This performance analysis evaluated 24 events that occurred at LLNL from January through August 2010. The analysis identified areas of potential work control process and/or implementation weaknesses and several common underlying causes. Human performance improvement and safety culture factors were part of the causal analysis of each event and were analyzed. The collective significance of all events in 2010, as measured by the occurrence reporting significance category and by the proportion of events that have been reported to the DOE ORPS under the ''management concerns'' reporting criteria, does not appear to have increased in 2010. The frequency of reporting inmore » each of the significance categories has not changed in 2010 compared to the previous four years. There is no change indicating a trend in the significance category and there has been no increase in the proportion of occurrences reported in the higher significance category. Also, the frequency of events, 42 events reported through August 2010, is not greater than in previous years and is below the average of 63 occurrences per year at LLNL since 2006. Over the previous four years, an average of 43% of the LLNL's reported occurrences have been reported as either ''management concerns'' or ''near misses.'' In 2010, 29% of the occurrences have been reported as ''management concerns'' or ''near misses.'' This rate indicates that LLNL is now reporting fewer ''management concern'' and ''near miss'' occurrences compared to the previous four years. From 2008 to the present, LLNL senior management has undertaken a series of initiatives to strengthen the work planning and control system with the primary objective to improve worker safety. In 2008, the LLNL Deputy Director established the Work Control Integrated Project Team to develop the core requirements and graded elements of an institutional work planning and control system. By the end of that year this system was documented and implementation had begun. In 2009, training of the workforce began and as of the time of this report more than 50% of authorized Integration Work Sheets (IWS) use the activity-based planning process. In 2010, LSO independently reviewed the work planning and control process and confirmed to the Laboratory that the Integrated Safety Management (ISM) System was implemented. LLNL conducted a cross-directorate management self-assessment of work planning and control and is developing actions to respond to the issues identified. Ongoing efforts to strengthen the work planning and control process and to improve the quality of LLNL work packages are in progress: completion of remaining actions in response to the 2009 DOE Office of Health, Safety, and Security (HSS) evaluation of LLNL's ISM System; scheduling more than 14 work planning and control self-assessments in FY11; continuing to align subcontractor work control with the Institutional work planning and control system; and continuing to maintain the electronic IWS application. The 24 events included in this analysis were caused by errors in the first four of the five ISMS functions. The most frequent cause was errors in analyzing the hazards (Function 2). The second most frequent cause was errors occurring when defining the work (Function 1), followed by errors during the performance of work (Function 4). Interestingly, very few errors in developing controls (Function 3) resulted in events. This leads one to conclude that if improvements are made to defining the scope of work and analyzing the potential hazards, LLNL may reduce the frequency or severity of events. Analysis of the 24 events resulted in the identification of ten common causes. Some events had multiple causes, resulting in the mention of 39 causes being identified for the 24 events. The most frequent cause was workers, supervisors, or experts believing they understood the work and the hazards but their understanding was incomplete. The second most frequent cause was unclear, incomplete or confusing documents directing the work. Together, these two causes were mentioned 17 times and contributed to 13 of the events. All of the events with the cause of ''workers, supervisors, or experts believing they understood the work and the hazards but their understanding was incomplete'' had this error in the first two ISMS functions: define the work and analyze the hazard. This means that these causes result in the scope of work being ill-defined or the hazard(s) improperly analyzed. Incomplete implementation of these functional steps leads to the hazards not being controlled. The causes are then manifested in events when the work is conducted. The process to operate safely relies on accurately defining the scope of work. This review has identified a number of examples of latent organizational weakness in the execution of work control processes.« less

Idaho National Laboratory Quarterly Performance Analysis

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

Mitchell, Lisbeth

2014-11-01

This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 60 reportable events (23 from the 4th Qtr FY14 and 37 from the prior three reporting quarters) as well as 58 other issue reports (including not reportable events and Significant Category A and B conditions) identified at INLmore » from July 2013 through October 2014. Battelle Energy Alliance (BEA) operates the INL under contract DE AC07 051D14517.« less

Idaho National Laboratory Quarterly Occurrence Analysis - 3rd Quarter FY-2016

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

Mitchell, Lisbeth Ann

This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 73 reportable events (23 from the 3rd Qtr FY-16 and 50 from the prior three reporting quarters), as well as 45 other issue reports (including events found to be not reportable and Significant Category A and B conditions)more » identified at INL during the past 12 months (16 from this quarter and 29 from the prior three quarters).« less

Idaho National Laboratory Quarterly Occurrence Analysis - 1st Quarter FY 2016

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

Mitchell, Lisbeth Ann

This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 74 reportable events (16 from the 1st Qtr FY-16 and 58 from the prior three reporting quarters), as well as 35 other issue reports (including events found to be not reportable and Significant Category A and B conditions)more » identified at INL during the past 12 months (15 from this quarter and 20 from the prior three quarters).« less

Idaho National Laboratory Quarterly Occurrence Analysis 4th Quarter FY 2016

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

Mitchell, Lisbeth Ann

This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System, as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 84 reportable events (29 from the 4th quarter fiscal year 2016 and 55 from the prior three reporting quarters), as well as 39 other issue reports (including events found to be not reportable and Significant Category A and Bmore » conditions) identified at INL during the past 12 months (two from this quarter and 37 from the prior three quarters).« less

Idaho National Laboratory Quarterly Occurrence Analysis

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

Mitchell, Lisbeth Ann

This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 85 reportable events (18 from the 4th Qtr FY-15 and 67 from the prior three reporting quarters), as well as 25 other issue reports (including events found to be not reportable and Significant Category A and B conditions)more » identified at INL during the past 12 months (8 from this quarter and 17 from the prior three quarters).« less

Effect of probiotics on inducing remission and maintaining therapy in ulcerative colitis, Crohn's disease, and pouchitis: meta-analysis of randomized controlled trials.

PubMed

Shen, Jun; Zuo, Zhi-Xiang; Mao, Ai-Ping

2014-01-01

Whether probiotics are beneficial at all stages of treatment in inflammatory bowel disease or superior to placebo remains controversial. Two reviewers independently selected randomized controlled trials comparing probiotics with controls in inflammatory bowel disease and extracted data related to remission/response rates, relapse rates, and adverse events. Subanalyses were also performed. Twenty-three randomized controlled trials with a total of 1763 participants met the inclusion criteria. From the meta-analysis, probiotics significantly increase the remission rates in patients with active ulcerative colitis (UC) (P = 0.01, risk ratio [RR] = 1.51). The remission rates were significantly higher in patients with active UC treated with probiotics than placebo (P < 0.0001, RR = 1.80). Unfortunately, subgroup analysis found that only VSL#3 significantly increased the remission rates compared with controls in patients with active UC (P = 0.004, RR = 1.74). Interestingly, VSL#3 (P < 0.00001, RR = 0.18) also significantly reduced the clinical relapse rates for maintaining remission in patients with pouchitis. No significantly different adverse events were detected between probiotics and controls in the treatment of UC (P = 0.94, RR = 0.99) or CD (P = 0.33, RR = 0.87). Administration of probiotics results in additional benefit in inducing remission of patients with UC. VSL#3 are beneficial for maintaining remission in patients with pouchitis. And, probiotics can provide the similar effect as 5-aminosalicylic acid on maintaining remission of UC, although no additional adverse events presented.

The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis.

PubMed

Branas, Charles C; Kastanaki, Anastasia E; Michalodimitrakis, Manolis; Tzougas, John; Kranioti, Elena F; Theodorakis, Pavlos N; Carr, Brendan G; Wiebe, Douglas J

2015-02-02

To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. Greece from 1 January 1983 to 31 December 2012. A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (-27.1%, p<0.05). This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis

PubMed Central

Branas, Charles C; Kastanaki, Anastasia E; Michalodimitrakis, Manolis; Tzougas, John; Kranioti, Elena F; Theodorakis, Pavlos N; Carr, Brendan G; Wiebe, Douglas J

2015-01-01

Objectives To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. Setting Greece from 1 January 1983 to 31 December 2012. Participants A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. Primary and secondary outcomes National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. Results In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (−27.1%, p<0.05). Conclusions This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events. PMID:25643700

Reduction in Total Cardiovascular Events With Ezetimibe/Simvastatin Post-Acute Coronary Syndrome: The IMPROVE-IT Trial.

PubMed

Murphy, Sabina A; Cannon, Christopher P; Blazing, Michael A; Giugliano, Robert P; White, Jennifer A; Lokhnygina, Yuliya; Reist, Craig; Im, KyungAh; Bohula, Erin A; Isaza, Daniel; Lopez-Sendon, Jose; Dellborg, Mikael; Kher, Uma; Tershakovec, Andrew M; Braunwald, Eugene

2016-02-02

Intensive low-density lipoprotein cholesterol therapy with ezetimibe/simvastatin in IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) significantly reduced the first primary endpoint (PEP) in patients post-acute coronary syndrome (ACS) compared to placebo/simvastatin. This analysis tested the hypothesis that total events, including those beyond the first event, would also be reduced with ezetimibe/simvastatin therapy. All PEP events (cardiovascular [CV] death, myocardial infarction [MI], stroke, unstable angina [UA] leading to hospitalization, coronary revascularization ≥30 days post-randomization) during a median 6-year follow-up were analyzed in patients randomized to receive ezetimibe/simvastatin or placebo/simvastatin in IMPROVE-IT. Negative binomial regression was used for the primary analysis. Among 18,144 patients, there were 9,545 total PEP events (56% were first events and 44% subsequent events). Total PEP events were significantly reduced by 9% with ezetimibe/simvastatin vs placebo/simvastatin (incidence-rate ratio [RR]: 0.91; 95% confidence interval [CI]: 0.85 to 0.97; p = 0.007), as were the 3 pre-specified secondary composite endpoints and the exploratory composite endpoint of CV death, MI, or stroke (RR: 0.88; 95% CI: 0.81 to 0.96; p = 0.002). The reduction in total events was driven by decreases in total nonfatal MI (RR: 0.87; 95% CI: 0.79 to 0.96; p = 0.004) and total NF stroke (RR: 0.77; 95% CI: 0.65 to 0.93; p = 0.005). Lipid-lowering therapy with ezetimibe plus simvastatin improved clinical outcomes. Reductions in total PEP events, driven by reductions in MI and stroke, more than doubled the number of events prevented compared with examining only the first event. These data support continuation of intensive combination lipid-lowering therapy after an initial CV event. (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial [IMPROVE-IT]; NCT00202878). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Ontology-aided feature correlation for multi-modal urban sensing

NASA Astrophysics Data System (ADS)

Misra, Archan; Lantra, Zaman; Jayarajah, Kasthuri

2016-05-01

The paper explores the use of correlation across features extracted from different sensing channels to help in urban situational understanding. We use real-world datasets to show how such correlation can improve the accuracy of detection of city-wide events by combining metadata analysis with image analysis of Instagram content. We demonstrate this through a case study on the Singapore Haze. We show that simple ontological relationships and reasoning can significantly help in automating such correlation-based understanding of transient urban events.

The Integration of Emotions in Memories: Cognitive-Emotional Distinctiveness and Posttraumatic Stress Disorder

PubMed Central

Boals, Adriel; Rubin, David C.

2013-01-01

The current study examined cognitive-emotional distinctiveness (CED), the extent to which emotions are linked with event information, in memories associated with PTSD. Participants either with PTSD (n=68) or without PTSD (n=40) completed a modified multidimensional scaling technique to measure CED for their most negative and most positive events. The results revealed that participants in the PTSD group evidenced significantly lower levels of CED. This group difference remained significant when we limited the analysis to traumatic events that led to a PTSD diagnosis (n=33) in comparison to control participants who nominated a traumatic event that did not result in PTSD (n=32). Replicating previous findings, CED levels were higher in memories of negative events, in comparison to positive events. These results provide empirical evidence that memories associated with PTSD do contain special organizational features with respect to the links between emotions and memory. Implications for understanding and treating PTSD are discussed. PMID:23436960

Efficacy and adverse events of cold vs hot polypectomy: A meta-analysis.

PubMed

Fujiya, Mikihiro; Sato, Hiroki; Ueno, Nobuhiro; Sakatani, Aki; Tanaka, Kazuyuki; Dokoshi, Tatsuya; Fujibayashi, Shugo; Nomura, Yoshiki; Kashima, Shin; Gotoh, Takuma; Sasajima, Junpei; Moriichi, Kentaro; Watari, Jiro; Kohgo, Yutaka

2016-06-21

To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events. A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords "cold polypectomy". RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients' demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias. Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size (less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group. Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.

Normal saline solution versus other viscous solutions for submucosal injection during endoscopic mucosal resection: a systematic review and meta-analysis.

PubMed

Yandrapu, Harathi; Desai, Madhav; Siddique, Sameer; Vennalganti, Prashanth; Vennalaganti, Sreekar; Parasa, Sravanthi; Rai, Tarun; Kanakadandi, Vijay; Bansal, Ajay; Titi, Mohammad; Repici, Alessandro; Bechtold, Matthew L; Sharma, Prateek; Choudhary, Abhishek

2017-04-01

EMR is being increasingly practiced for the removal of large colorectal polyps. A variety of solutions such as normal saline solution (NS) and other viscous and hypertonic solutions (VS) have been used as submucosal injections for EMR. A systematic review and meta-analysis is presented comparing the efficacy and adverse events of EMR performed using NS versus VS. Two independent reviewers conducted a search of all databases for human, randomized controlled trials that compared NS with VS for EMR of colorectal polyps. Data on complete en bloc resection, presence of residual lesions, and adverse events were extracted using a standardized protocol. Pooled odds ratio (OR) estimates along with 95% confidence intervals (CI) were calculated using fixed effect or random effects models. Five prospective, randomized controlled trials (504 patients) met the inclusion criteria. The mean polyp sizes were 20.84 mm with NS and 21.44 mm with VS. On pooled analysis, a significant increase in en bloc resection (OR, 1.91; 95% CI, 1.11-3.29; P = .02; I 2  = 0%) and decrease in residual lesions (OR, 0.54; 95% CI, 0.32-0.91; P = .02; I 2  = 0%) were noted in VS compared with NS. There was no significant difference in the rate of overall adverse events between the 2 groups. Use of VS during EMR leads to higher rates of en bloc resection and lower rates of residual lesions compared with NS, without any significant difference in adverse events. Endoscopists could consider using VS for EMR of large colorectal polyps and NS for smaller polyps because there is no significant difference in the outcomes with lesions <2 cm. Published by Elsevier Inc.

The Impact of Urbanization on Temporal Changes in Sediment Transport in a Gravel Bed Channel in Southern Ontario, Canada

NASA Astrophysics Data System (ADS)

Plumb, B. D.; Annable, W. K.; Thompson, P. J.; Hassan, M. A.

2017-10-01

A field investigation has been undertaken to characterize the event-based bed load transport dynamics of a highly urbanized gravel bed stream. A combination of direct bed load and tracer particle measurements were taken over a 3 year period during which time approximately 30 sediment mobilizing events occurred. Sediment transport measurements were used to calibrate a fractional bed load transport model and combined with hydrometric data which represent four different land use conditions (ranging from rural to highly urbanized) to analyze the differences in discharge magnitude and frequency and its impact on sediment transport. Fractional transport analysis of the bed load measurements indicates that frequent intermediate discharge events can mobilize sand and fine gravel to an approximate equally mobile condition, however, the transport rates at these discharges exhibit greater variability than at discharges above the bankfull discharge. Path lengths of the coarse fraction, measured using tracer clasts, are insensitive to peak discharge, and instead transport at distances less than those reported in other gravel bed channels, which is attributed to the shorter duration discharge events common to urban streams. The magnitude-frequency analysis reveals that the frequency, time, and volume of competent sediment mobilizing events are increasing with urbanization. Variability in effective discharges suggests that a range of discharges, spanning between frequent, low magnitude events to less frequent, high magnitude events are geomorphically significant. However, trends in the different land use scenarios suggest that urbanization is shifting the geomorphic significance toward more frequent, lower magnitude events.

Are Stressful Life Events (SLEs) Associated with the Utilization of Substance Use Treatment-Related Services?

PubMed

Cruz-Feliciano, Miguel A; Ferraro, Aimee; Witt Prehn, Angela

2017-03-01

This study described herein explored the association of stressful life events with the utilization of substance use treatment-related services among substance users living in Puerto Rico. A secondary data analysis was conducted using data collected by a research project entitled Puerto Rico Drug Abuse Research Development Program II (PRDARDP II). The study population consisted of 378 individuals from 18 to 35 years of age who were residents of the San Juan metropolitan area and who presented evidence of substance use in the 30 days prior to the interview. The analysis considered demographic data, information on patterns of substance use, substance use treatment history, stressful events, and depression and anxiety symptomatology. As the number of stressful life events increased, substance users were more likely to report having utilized substance use treatment-related services (OR = 1.11, 95% CI [1.06, 1.17], p < 0.001). Relapsing, the inability to afford drugs, and poor working conditions were statistically significant stressful life events associated with the utilization of substance use treatment-related services. Despite the structural limitations associated with access to and with the quality of the services in the substance use treatment-related system of Puerto Rico, findings suggest that stressful life events play a significant role in the utilization of those services. Researchers and clinicians should consider screening for stressful life events in outreach and engagement strategies. At the same time, the assessment of stressful life events should be integrated into the treatment planning stage to support the recovery process of people with substance use disorders.

Changes in Large-Scale Atmospheric Circulation Associated with Increased Extreme Precipitation Events in the Northeast United States

NASA Astrophysics Data System (ADS)

Collow, A.; Bosilovich, M. G.; Koster, R. D.

2016-12-01

Over the past two decades a statistically significant increase in the frequency of summertime extreme precipitation events has been observed over the northeastern United States - the largest such increase in the US in terms of area and magnitude. In an effort to characterize synoptic scale patterns and changes to the atmospheric circulation associated with extreme precipitation events in this region, atmospheric fields from the Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2) are composited on days that exceed the 90th percentile of precipitation from the CPC-Unified daily gauge-based precipitation observations. Changes over time in composites of sea level pressure, 500 hPa height, and the vertical profile of equivalent potential temperature indicate that the observed increase in extreme precipitation events is associated with extratropical cyclones, including cut off low pressure and frontal systems. Analysis of the Eady maximum growth rate, an indicator for storm tracks, shows that storms tracks in recent years have shifted southward. In addition, mean summertime transient meridional winds have decreased over time, slowing baroclinic systems and causing stationary systems to become more frequent, in agreement with previous studies examining blocking due to high pressure systems. The Atlantic Ocean provides a significant supply of moisture that converges over the region when a cyclonic circulation is situated to the south, and the statistically significant increase in Eady maximum growth rate over time there provides an increasingly improved thermodynamic environment for extreme precipitation events.

Safety of Medical Abortion Provided Through Telemedicine Compared With In Person.

PubMed

Grossman, Daniel; Grindlay, Kate

2017-10-01

To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service. We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided α=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year. During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients [95% CI 0.23-0.45%]). The difference in adverse event prevalence was 0.13% (95% CI -0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion. Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant adverse events.

Data Albums: An Event Driven Search, Aggregation and Curation Tool for Earth Science

NASA Technical Reports Server (NTRS)

Ramachandran, Rahul; Kulkarni, Ajinkya; Maskey, Manil; Bakare, Rohan; Basyal, Sabin; Li, Xiang; Flynn, Shannon

2014-01-01

Approaches used in Earth science research such as case study analysis and climatology studies involve discovering and gathering diverse data sets and information to support the research goals. To gather relevant data and information for case studies and climatology analysis is both tedious and time consuming. Current Earth science data systems are designed with the assumption that researchers access data primarily by instrument or geophysical parameter. In cases where researchers are interested in studying a significant event, they have to manually assemble a variety of datasets relevant to it by searching the different distributed data systems. This paper presents a specialized search, aggregation and curation tool for Earth science to address these challenges. The search rool automatically creates curated 'Data Albums', aggregated collections of information related to a specific event, containing links to relevant data files [granules] from different instruments, tools and services for visualization and analysis, and information about the event contained in news reports, images or videos to supplement research analysis. Curation in the tool is driven via an ontology based relevancy ranking algorithm to filter out non relevant information and data.

NEOS Data and the Origin of the 5 MeV Bump in the Reactor Antineutrino Spectrum

NASA Astrophysics Data System (ADS)

Huber, Patrick

2017-01-01

We perform a combined analysis of recent NEOS and Daya Bay data on the reactor antineutrino spectrum. This analysis includes approximately 1.5 million antineutrino events, which is the largest neutrino event sample analyzed to date. We use a double ratio which cancels flux model dependence and related uncertainties as well as the effects of the detector response model. We find at 3-4 standard deviation significance level, that plutonium-239 and plutonium-241 are disfavored as the single source for the so-called 5 MeV bump. This analysis method has general applicability and, in particular, with higher statistics data sets, will be able to shed significant light on the issue of the bump. With some caveats, this should also allow us to improve the sensitivity for sterile neutrino searches in NEOS.

Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis.

PubMed

HaiBo, Tan; Xin, Kang; ShiHeng, Lu; Lin, Liu

2015-01-01

To compare the efficacy and safety of Ahmed glaucoma valve implantation (AGV) with trabeculectomy in the management of glaucoma patients. A comprehensive literature search (PubMed, Embase, Google, and the Cochrane library) was performed, including a systematic review with meta-analysis of controlled clinical trials comparing AGV versus trabeculectomy. Efficacy estimates were the weighted mean differences (WMDs) for the percentage intraocular pressure reduction (IOPR %) from baseline to end-point, the reduction in glaucoma medications, and the odds ratios (ORs) for complete and qualified success rates. Safety estimates were the relative risks (RRs) for adverse events. All outcomes were reported with a 95% confidence interval (CI). Statistical analysis was performed using the RevMan 5.0 software. Six controlled clinical trials were included in this meta-analysis. There was no significant difference between the AGV and trabeculectomy in the IOPR% (WMD = -3.04, 95% CI: -8.36- 2.26; P = 0.26). The pooled ORs comparing AGV with trabeculectomy were 0.46 (0.22, 0.99) for the complete success rate (P = 0.05) and 0.97 (0.78-1.20) for the quantified success rate (P = 0.76). No significant difference in the reduction in glaucoma medicines was observed (WMD = 0.24; 95% CI: -0.27-0.76; P = 0.35). AGV was found to be associated with a significantly lower frequency of all adverse events (RR = 0.71; 95%CI: 1.14-0.97; p = 0.001) than trabeculectomy, while the most common complications did not differ significantly (all p> 0.05). AGV was equivalent to trabeculectomy in reducing the IOP, the number of glaucoma medications, success rates, and rates of the most common complications. However, AGV was associated with a significantly lower frequency of overall adverse events.

Differences in Antipsychotic-Related Adverse Events in Adult, Pediatric, and Geriatric Populations.

PubMed

Sagreiya, Hersh; Chen, Yi-Ren; Kumarasamy, Narmadan A; Ponnusamy, Karthik; Chen, Doris; Das, Amar K

2017-02-26

In recent years, antipsychotic medications have increasingly been used in pediatric and geriatric populations, despite the fact that many of these drugs were approved based on clinical trials in adult patients only. Preliminary studies have shown that the "off-label" use of these drugs in pediatric and geriatric populations may result in adverse events not found in adults. In this study, we utilized the large-scale U.S. Food and Drug Administration (FDA) Adverse Events Reporting System (AERS) database to look at differences in adverse events from antipsychotics among adult, pediatric, and geriatric populations. We performed a systematic analysis of the FDA AERS database using MySQL by standardizing the database using structured terminologies and ontologies. We compared adverse event profiles of atypical versus typical antipsychotic medications among adult (18-65), pediatric (age < 18), and geriatric (> 65) populations. We found statistically significant differences between the number of adverse events in the pediatric versus adult populations with aripiprazole, clozapine, fluphenazine, haloperidol, olanzapine, quetiapine, risperidone, and thiothixene, and between the geriatric versus adult populations with aripiprazole, chlorpromazine, clozapine, fluphenazine, haloperidol, paliperidone, promazine, risperidone, thiothixene, and ziprasidone (p < 0.05, with adjustment for multiple comparisons). Furthermore, the particular types of adverse events reported also varied significantly between each population for aripiprazole, clozapine, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (Chi-square, p < 10 -6 ). Diabetes was the most commonly reported side effect in the adult population, compared to behavioral problems in the pediatric population and neurologic symptoms in the geriatric population. We also found discrepancies between the frequencies of reports in AERS and in the literature. Our analysis of the FDA AERS database shows that there are significant differences in both the numbers and types of adverse events among these age groups and between atypical and typical antipsychotics. It is important for clinicians to be mindful of these differences when prescribing antipsychotics, especially when prescribing medications off-label.

Rain-on-snow Events in Southwestern British Columbia: A Long-term Analysis of Meteorological Conditions and Snowpack Response

NASA Astrophysics Data System (ADS)

Trubilowicz, J. W.; Moore, D.

2015-12-01

Snowpack dynamics and runoff generation in coastal mountain regions are complicated by rain-on-snow (ROS) events. During major ROS events associated with warm, moist air and strong winds, turbulent heat fluxes can produce substantial melt to supplement rainfall, but previous studies suggest this may not be true for smaller, more frequent events. The internal temperature and water content of the snowpack are also expected to influence runoff generation during ROS events: a cold snowpack with no liquid water content will have the ability to store significant amounts of rainfall, whereas a 'ripe' snowpack may begin to melt and generate outflow with little rain input. However, it is not well understood how antecedent snowpack conditions and energy fluxes differ between ROS events that cause large runoff events and those that do not, in large part because major flood-producing ROS events occur infrequently, and thus are often not sampled during short-term research projects. To generate greater understanding of runoff generation over the spectrum of ROS magnitudes and frequencies, we analyzed data from Automated Snow Pillow (ASP) sites, which record hourly air temperature, precipitation and snowpack water equivalent and offer up to several decades of data at each site. We supplemented the ASP data with output from the North American Regional Reanalysis (NARR) product to support point scale snow modeling for 335 ROS event records from six ASP sites in southwestern BC from 2003 to 2013. Our analysis reconstructed the weather conditions, surface energy exchanges, internal mass and energy states of the snowpack, and generation of snow melt and water available for runoff (WAR) for each ROS event. Results indicate that WAR generation during large events is largely independent of the snowpack conditions, but for smaller events, the antecedent snow conditions play a significant role in either damping or enhancing WAR generation.

Association of a trait-like bias towards the perception of negative subjective life events with risk of developing premenstrual symptoms.

PubMed

Gonda, Xenia; Fountoulakis, Konstantinos N; Csukly, Gabor; Telek, Tamas; Pap, Dorottya; Rihmer, Zoltan; Bagdy, Gyorgy

2010-04-16

Premenstrual symptoms affect the majority of healthy women. Premenstrual symptomatology has earlier been linked to stress and a state-like alteration in the perception of life events in the late-luteal phase of the menstrual cycle. We hypothesised that there is also a trait-like negative bias in the perception of life events evident throughout the whole cycle which is associated with the likelihood to manifest more marked symptoms in the late-luteal phase of the cycle. 88 healthy women completed the PRISM calendar for three consecutive cycles and the Objective and Subjective Event Checklist during the follicular phase of the first cycle. Association between PRISM score change from the follicular through the late-luteal phase and life event variables was investigated by Generalized Linear Model Analysis (GENMOD). The PRISM score change showed a significant negative association with the ratio of positive subjective life events and a significant positive association with the ratio of negative subjective life events. There were no significant results in case of the objective life events. Our results indicate that women manifesting a more marked increase of symptoms from the late follicular through the late-luteal phase of the menstrual cycle are more likely to notice negative subjective life events and less likely to notice positive subjective life events. This suggest a trait-like negative bias in the perception of life events present throughout the whole reproductive cycle which may play an important role in the emergence of premenstrual symptoms. Copyright 2010 Elsevier Inc. All rights reserved.

Pre-2014 mudslides at Oso revealed by InSAR and multi-source DEM analysis

NASA Astrophysics Data System (ADS)

Kim, J. W.; Lu, Z.; QU, F.

2014-12-01

The landslide is a process that results in the downward and outward movement of slope-reshaping materials including rocks and soils and annually causes the loss of approximately $3.5 billion and tens of casualties in the United States. The 2014 Oso mudslide was an extreme event costing nearly 40 deaths and damaging civilian properties. Landslides are often unpredictable, but in many cases, catastrophic events are repetitive. Historic record in the Oso mudslide site indicates that there have been serial events in decades, though the extent of sliding events varied from time to time. In our study, the combination of multi-source DEMs, InSAR, and time-series InSAR analysis has enabled to characterize the Oso mudslide. InSAR results from ALOS PALSAR show that there was no significant deformation between mid-2006 and 2011. The combination of time-series InSAR analysis and old-dated DEM indicated revealed topographic changes associated the 2006 sliding event, which is confirmed by the difference of multiple LiDAR DEMs. Precipitation and discharge measurements before the 2006 and 2014 landslide events did not exhibit extremely anomalous records, suggesting the precipitation is not the controlling factor in determining the sliding events at Oso. The lack of surface deformation during 2006-2011 and weak correlation between the precipitation and the sliding event, suggest other factors (such as porosity) might play a critical role on the run-away events at this Oso and other similar landslides.

Adverse event reporting in cancer clinical trial publications.

PubMed

Sivendran, Shanthi; Latif, Asma; McBride, Russell B; Stensland, Kristian D; Wisnivesky, Juan; Haines, Lindsay; Oh, William K; Galsky, Matthew D

2014-01-10

Reporting adverse events is a critical element of a clinical trial publication. In 2003, the Consolidated Standards of Reporting Trials (CONSORT) group generated recommendations regarding the appropriate reporting of adverse events. The degree to which these recommendations are followed in oncology publications has not been comprehensively evaluated. A review of citations from PubMed, Medline, and Embase published between Jan 1, 2009 and December 31, 2011, identified eligible randomized, controlled phase III trials in metastatic solid malignancies. Publications were assessed for 14 adverse event-reporting elements derived from the CONSORT harms extension statement; a completeness score (range, 0 to 14) was calculated by adding the number of elements reported. Linear regression analysis identified which publication characteristics associated with reporting completeness. A total of 175 publications, with data for 96,125 patients, were included in the analysis. The median completeness score was eight (range, three to 12). Most publications (96%) reported only adverse events occurring above a threshold rate or severity, 37% did not specify the criteria used to select which adverse events were reported, and 88% grouped together adverse events of varying severity. Regression analysis revealed that trials without a stated funding source and with an earlier year of publication had significantly lower completeness scores. Reporting of adverse events in oncology publications of randomized trials is suboptimal and characterized by substantial selectivity and heterogeneity. The development of oncology-specific standards for adverse event reporting should be established to ensure consistency and provide critical information required for medical decision-making.

SAFE Software and FED Database to Uncover Protein-Protein Interactions using Gene Fusion Analysis.

PubMed

Tsagrasoulis, Dimosthenis; Danos, Vasilis; Kissa, Maria; Trimpalis, Philip; Koumandou, V Lila; Karagouni, Amalia D; Tsakalidis, Athanasios; Kossida, Sophia

2012-01-01

Domain Fusion Analysis takes advantage of the fact that certain proteins in a given proteome A, are found to have statistically significant similarity with two separate proteins in another proteome B. In other words, the result of a fusion event between two separate proteins in proteome B is a specific full-length protein in proteome A. In such a case, it can be safely concluded that the protein pair has a common biological function or even interacts physically. In this paper, we present the Fusion Events Database (FED), a database for the maintenance and retrieval of fusion data both in prokaryotic and eukaryotic organisms and the Software for the Analysis of Fusion Events (SAFE), a computational platform implemented for the automated detection, filtering and visualization of fusion events (both available at: http://www.bioacademy.gr/bioinformatics/projects/ProteinFusion/index.htm). Finally, we analyze the proteomes of three microorganisms using these tools in order to demonstrate their functionality.

SAFE Software and FED Database to Uncover Protein-Protein Interactions using Gene Fusion Analysis

PubMed Central

Tsagrasoulis, Dimosthenis; Danos, Vasilis; Kissa, Maria; Trimpalis, Philip; Koumandou, V. Lila; Karagouni, Amalia D.; Tsakalidis, Athanasios; Kossida, Sophia

2012-01-01

Domain Fusion Analysis takes advantage of the fact that certain proteins in a given proteome A, are found to have statistically significant similarity with two separate proteins in another proteome B. In other words, the result of a fusion event between two separate proteins in proteome B is a specific full-length protein in proteome A. In such a case, it can be safely concluded that the protein pair has a common biological function or even interacts physically. In this paper, we present the Fusion Events Database (FED), a database for the maintenance and retrieval of fusion data both in prokaryotic and eukaryotic organisms and the Software for the Analysis of Fusion Events (SAFE), a computational platform implemented for the automated detection, filtering and visualization of fusion events (both available at: http://www.bioacademy.gr/bioinformatics/projects/ProteinFusion/index.htm). Finally, we analyze the proteomes of three microorganisms using these tools in order to demonstrate their functionality. PMID:22267904

Maximum Likelihood Analysis of Low Energy CDMS II Germanium Data

DOE PAGES

Agnese, R.

2015-03-30

We report on the results of a search for a Weakly Interacting Massive Particle (WIMP) signal in low-energy data of the Cryogenic Dark Matter Search experiment using a maximum likelihood analysis. A background model is constructed using GEANT4 to simulate the surface-event background from Pb210decay-chain events, while using independent calibration data to model the gamma background. Fitting this background model to the data results in no statistically significant WIMP component. In addition, we also perform fits using an analytic ad hoc background model proposed by Collar and Fields, who claimed to find a large excess of signal-like events in ourmore » data. Finally, we confirm the strong preference for a signal hypothesis in their analysis under these assumptions, but excesses are observed in both single- and multiple-scatter events, which implies the signal is not caused by WIMPs, but rather reflects the inadequacy of their background model.« less

Network hydraulics inclusion in water quality event detection using multiple sensor stations data.

PubMed

Oliker, Nurit; Ostfeld, Avi

2015-09-01

Event detection is one of the current most challenging topics in water distribution systems analysis: how regular on-line hydraulic (e.g., pressure, flow) and water quality (e.g., pH, residual chlorine, turbidity) measurements at different network locations can be efficiently utilized to detect water quality contamination events. This study describes an integrated event detection model which combines multiple sensor stations data with network hydraulics. To date event detection modelling is likely limited to single sensor station location and dataset. Single sensor station models are detached from network hydraulics insights and as a result might be significantly exposed to false positive alarms. This work is aimed at decreasing this limitation through integrating local and spatial hydraulic data understanding into an event detection model. The spatial analysis complements the local event detection effort through discovering events with lower signatures by exploring the sensors mutual hydraulic influences. The unique contribution of this study is in incorporating hydraulic simulation information into the overall event detection process of spatially distributed sensors. The methodology is demonstrated on two example applications using base runs and sensitivity analyses. Results show a clear advantage of the suggested model over single-sensor event detection schemes. Copyright © 2015 Elsevier Ltd. All rights reserved.

An Overview of Recent Advances in Event-Triggered Consensus of Multiagent Systems.

PubMed

Ding, Lei; Han, Qing-Long; Ge, Xiaohua; Zhang, Xian-Ming

2018-04-01

Event-triggered consensus of multiagent systems (MASs) has attracted tremendous attention from both theoretical and practical perspectives due to the fact that it enables all agents eventually to reach an agreement upon a common quantity of interest while significantly alleviating utilization of communication and computation resources. This paper aims to provide an overview of recent advances in event-triggered consensus of MASs. First, a basic framework of multiagent event-triggered operational mechanisms is established. Second, representative results and methodologies reported in the literature are reviewed and some in-depth analysis is made on several event-triggered schemes, including event-based sampling schemes, model-based event-triggered schemes, sampled-data-based event-triggered schemes, and self-triggered sampling schemes. Third, two examples are outlined to show applicability of event-triggered consensus in power sharing of microgrids and formation control of multirobot systems, respectively. Finally, some challenging issues on event-triggered consensus are proposed for future research.

Life events and Tourette syndrome.

PubMed

Steinberg, Tamar; Shmuel-Baruch, Sharona; Horesh, Netta; Apter, Alan

2013-07-01

Tourette syndrome (TS) is a neuropsychiatric developmental disorder characterized by the presence of multiple motor tics and one or more vocal tics. Although TS is primarily biological in origin, stress-diatheses interactions most probably play a role in the course of the illness. The precise influence of the environment on this basically biological disorder is difficult to ascertain, particularly when TS is complicated by comorbidities. Among the many questions that remain unresolved are the differential impact of positive and negative events and specific subtypes of events, and the importance of major crucial events relative to minor daily ones to tic severity. To examine the relationships between life events, tic severity and comorbid disorders in Tourette Syndrome (TS), including OCD, ADHD, anxiety, depression and rage attacks. Life events were classified by quantity, quality (positive or negative) and classification types of events (family, friends etc.). Sixty patients aged 7-17 years with Tourette syndrome or a chronic tic disorder were recruited from Psychological Medicine Clinic in Schneider Children's Medical Center of Israel. Yale Global Tic Severity Scale; Children's Yale Brown Obsessive Compulsive Scale; Life Experiences Survey; Brief Adolescent Life Events Scale; Screen for Child Anxiety Related Emotional Disorders; Child Depression Inventory/Beck Depression Inventory; ADHD Rating Scale IV; Overt Aggression Scale. Regarding tics and minor life events, there was a weak but significant correlation between severity of motor tics and the quantity of negative events. No significant correlation was found between tic severity and quantity of positive events. Analysis of the BALES categories yielded a significant direct correlation between severity of vocal tics and quantity of negative events involving friends. Regarding comorbidities and minor life events, highly significant correlations were found with depression and anxiety. Regarding tics and major life events, significant correlation was found between the quantity of major life events and the severity of motor tics, but not vocal tics. Regarding comorbidities and major life events, significant correlation was found between the severity of compulsions, ADHD, and aggression and the subjects' personal evaluation of the effect of negative major life events on their lives. Minor life events appear to be correlated with tic severity and comorbidities in children and adolescents with Tourette syndrome. The lack of an association between major life events and tic severity further emphasizes the salient impact of minor life events that occur in temporal proximity to the assessment of tic severity. Clinically, the results match our impression from patient narratives wherein they "blamed" the exacerbations in tics on social interactions. The high correlation between negative life events and depression, anxiety and compulsions symptoms, were reported also in previous studies. In conclusion, These findings may have clinical implications for planning supportive psychotherapy or cognitive behavioral therapy for this patient population. Copyright © 2013 Elsevier Inc. All rights reserved.

A meta-analysis of the risk of total cardiovascular events of isosmolar iodixanol compared with low-osmolar contrast media.

PubMed

Zhang, Bu-Chun; Wu, Qiang; Wang, Cheng; Li, Dong-Ye; Wang, Zhi-Rong

2014-04-01

The iso-osmolar contrast agent iodixanol may be associated with a lower incidence of cardiac events than low-osmolar contrast media (LOCM), but previous trials have yielded mixed results. To compare the risk of total cardiovascular events of the iso-osmolar contrast medium, iodixanol, to LOCM. Medical literature databases were searched to identify comparisons between iodixanol and LOCM with cardiovascular events as a primary endpoint. A random-effects model was used to obtain pooled odds ratio (OR) for within-hospital and 30-day events. A total of 2 prospective cross-sectional studies and 11 randomized controlled trials (RCTs) (covering 6859 subjects) met our criteria. There was no significant difference in the incidence of within-hospital and 30-day cardiovascular events when iodixanol was compared with LOCM, with pooled OR of 0.72 (95%CI 0.49-1.06, p=0.09) and 1.19 (95%CI 0.70-2.02, p=0.53), respectively. Subgroup analysis showed no relative difference when iodixanol was compared with ioxaglate (OR=0.92, 95%CI 0.50-1.70, p=0.80) and iohexol (OR=0.75, 95%CI 0.48-1.17, p=0.21). However, a reduction in the within-hospital cardiovascular events was observed when iodixanol was compared with LOCM in the RCT subgroup (OR=0.65, 95%CI 0.44-0.96, p=0.03). Sensitivity analyses revealed that three studies had a strong impact on the association of within-hospital cardiovascular events between iodixanol and LOCM. Meta-regression analysis failed to account for heterogeneity. No publication bias was detected. This meta-analysis demonstrates that there is no conclusive evidence that iodixanol is superior to LOCM overall with regard to fewer cardiovascular events. Copyright © 2014. Published by Elsevier Ltd.

Analysis of brand personality to involve event involvement and loyalty: A case study of Jakarta Fashion Week 2017

NASA Astrophysics Data System (ADS)

Nasution, A. H.; Rachmawan, Y. A.

2018-04-01

Fashion trend in the world changed extremely fast. Fashion has become the one of people’s lifestyle in the world. Fashion week events in several areas can be a measurement of fahion trend nowadays. There was a fashion week event in Indonesia called Jakarta Fashion Week (JFW) aims to show fashion trend to people who want to improve their fashion style. People will join some events if the event has involvement to them, hence they will come to that event again and again. Annually and continuously event is really important to create loyalty among people who are involved in it, in order to increase positive development towards the organizer in organizing the next event. Saving a huge amount from the marketing budget, and creating a higher quality event. This study aims to know the effect of 5 brand personality dimension to event involvement and loyalty in Jakarta Fashion Week (JFW). This study use quantitative confirmative method with Structural Equation Model (SEM) analysis technique. The sample of this study is 150 respondents who became a participant of Jakarta Fashion Week 2017. Result show that there was significant effect of 5 brand personality dimension to 3 dimension of event involvement and loyalty. Meanwhile, there was one dimension of event involvement called personal self-expression that has not effect to loyalty.

Persistent landfalling atmospheric rivers over the west coast of North America

NASA Astrophysics Data System (ADS)

Payne, Ashley E.; Magnusdottir, Gudrun

2016-11-01

Landfalling atmospheric rivers (ARs) are linked to heavy precipitation and extreme flooding, and are well known along the western coast of North America. The hydrological impacts of ARs upon landfall are correlated with their duration and magnitude. In order to improve the forecast of these hydrologically significant landfalling events, a better understanding of how they differ from other landfalling events must be established through an investigation of the mechanisms leading to their development prior to landfall. A subset of persistent landfalling AR events between 30°N and 50°N is identified in 3-hourly Modern-Era Retrospective Analysis for Research and Applications reanalysis and validated against existing data sets. These events are identified as features in the low troposphere with high moisture transport and extended geometry that persist over a limited region of the coastline for longer than 63 h (85th percentile of AR duration). A composite analysis shows that persistent events have distinct thermodynamical and dynamical characteristics compared to all AR events. They are characterized by greater moisture content, suggestive of Pineapple Express-type events, a perturbed upper level jet and anticyclonic overturning of potential vorticity contours associated with anticyclonic Rossby wave breaking. Moreover, the location of the Rossby wave breaking is shifted inland compared to all AR events. Analogue analysis of the 500 hPa geopotential height anomalies is used to find nonpersistent events with similar dynamical characteristics to persistent events. Despite their similarity to persistent events, nonpersistent analogues show very little shift toward longer duration. A comparison of the development of persistent and nonpersistent analogues shows that persistent events have much greater moisture content.

Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: updated meta-analysis of randomized controlled trials.

PubMed

Kunutsor, S K; Seidu, S; Khunti, K

2017-03-01

To evaluate the benefits and harms of aspirin for the primary prevention of cardiovascular disease and all-cause mortality events in people with diabetes by conducting a systematic review and meta-analysis. Randomized controlled trials of aspirin compared with placebo (or no treatment) in people with diabetes with no history of cardiovascular disease were identified from MEDLINE, EMBASE, Web of Science, the Cochrane Library and a manual search of bibliographies to November 2015. Study-specific relative risks with 95% CIs were aggregated using random effects models. A total of 10 randomized trials were included in the review. There was a significant reduction in risk of major adverse cardiovascular events: relative risk of 0.90 (95% CI 0.81-0.99) in groups taking aspirin compared with placebo or no treatment. Limited subgroup analyses suggested that the effect of aspirin on major adverse cardiovascular events differed by baseline cardiovascular disease risk, medication compliance and sex (P for interaction for all > 0.05).There was no significant reduction in the risk of myocardial infarction, coronary heart disease, stroke, cardiovascular mortality or all-cause mortality. Aspirin significantly reduced the risk of myocardial infarction for a treatment duration of ≤ 5 years. There were differences in the effect of aspirin by dosage and treatment duration on overall stroke outcomes (P for interaction for all < 0.05). There was an increase in risk of major or gastrointestinal bleeding events, but estimates were imprecise and not significant. The emerging data do not clearly support guidelines that encourage the use of aspirin for the primary prevention of cardiovascular disease in adults with diabetes who are at increased cardiovascular disease risk. © 2016 Diabetes UK.

Event-related oscillations (EROs) and event-related potentials (ERPs) comparison in facial expression recognition.

PubMed

Balconi, Michela; Pozzoli, Uberto

2007-09-01

The study aims to explore the significance of event-related potentials (ERPs) and event-related brain oscillations (EROs) (delta, theta, alpha, beta, gamma power) in response to emotional (fear, happiness, sadness) when compared with neutral faces during 180-250 post-stimulus time interval. The ERP results demonstrated that the emotional face elicited a negative peak at approximately 230 ms (N2). Moreover, EEG measures showed that motivational significance of face (emotional vs. neutral) could modulate the amplitude of EROs, but only for some frequency bands (i.e. theta and gamma bands). In a second phase, we considered the resemblance of the two EEG measures by a regression analysis. It revealed that theta and gamma oscillations mainly effect as oscillation activity at the N2 latency. Finally, a posterior increased power of theta was found for emotional faces.

Pre-event quality of life and its influence on the post-event quality of life among patients with ST elevation and non-ST elevation myocardial infarctions of a premier province of Sri Lanka.

PubMed

Mahesh, P K B; Gunathunga, M W; Jayasinghe, Saroj; Arnold, S M; Haniffa, R; De Silva, A P

2017-08-01

Pre-event Quality of Life (QOL) reflects the true social circumstances in which people live prior to the onset of myocardial infarctions. It is believed to be a predictor of the post-event QOL. The aim of this study was to describe the pre-event QOL and its influence on the post-event Quality of Life among patients with ST elevation (STEMI) and Non-ST elevation myocardial infarctions (NSTEMI) using Short Form-36 (SF-36), a generic QOL tool with 8 domains. Documented literature is rare in this regard in Sri Lanka, which is a lower-middle-income country. A cross-sectional study with a 28-day post-discharge follow-up was carried out in 13 hospitals. Three hundred and forty-four patients who were diagnosed with STEMI or NSTEMI were recruited during the hospital stay. The pre-event QOL was measured using an interviewer-administered questionnaire which included the SF-36 QOL tool and medical details. Follow-up QOL was gathered using a questionnaire that was filled and posted back by participants. Of the recruited sample, 235 responded for the follow-up component. Analysis was conducted for associations between pre- and post-discharge QOL. Furthermore, comparisons were made between the STEMI and NSTEMI groups. Mann Whiney U test, Wilcoxon signed rank test and chi square test were used in the analysis. The post-event QOL was lower in seven out of eight domains than the pre-event QOL (p < 0.05). The NSTEMI group had more risk factors and a significantly lower pre-event QOL for seven domains (p < 0.05), when compared to the STEMI group. For seven domains, the post-discharge QOL was not significantly different (p > 0.05) between the STEMI and NSTEMI groups. Post-discharge general-health QOL domain score was higher than the pre-MI score (p = 0.028) and was higher in the STEMI group compared to the NSTEMI group (p = 0.042). Regression analysis showed a significant beta coefficient between pre- and post-QOL for five domains in STEMI and for all domains in NSTEMI groups when adjusted for the disease severity. The R square values ranged from 12.3 to 62.3% for STEMI and 7.3 to 64.8% for NSTEMI. Pre-event QOL is lower in the NSTEMI group compared to the STEMI group. Patients do not regain the previous QOL within one month post-discharge. Post-discharge QOL can be predicted by the pre-event QOL for most domains.

Associations Between Renal Duplex Parameters and Adverse Cardiovascular Events in the Elderly: A Prospective Cohort Study

PubMed Central

Pearce, Jeffrey D.; Craven, Timothy E.; Edwards, Matthew S.; Corriere, Matthew A.; Crutchley, Teresa A.; Fleming, Shawn H.; Hansen, Kimberley J.

2010-01-01

Background Atherosclerotic renovascular disease is associated with an increased risk of cardiovascular disease (CVD) events. This study examines associations between Doppler-derived parameters from the renal artery and renal parenchyma and all-cause mortality and fatal and nonfatal CVD events in a cohort of elderly Americans. Study Design Cohort study. Setting A subset of participants from the Cardiovascular Health Study (CHS). Through an ancillary study, 870 (70% recruitment) Forsyth County, NC, CHS participants consented to undergo renal duplex sonography to define the prevalence of renovascular disease in the elderly, resulting in 726 (36% men; mean age, 77 years) technically adequate complete studies included in this investigation. Predictor Renal duplex sonography–derived Doppler signals from the main renal arteries and renal parenchyma. Spectral analysis from Doppler-shifted frequencies and angle of insonation were used to estimate renal artery peak systolic and end diastolic velocity (both in meters per second). Color Doppler was used to identify the corticomedullary junction. Using a 3-mm Doppler sample, the parenchymal peak systolic and end diastolic frequency shift (both in kilohertz) were obtained. Resistive index was calculated as (1 – [end diastolic frequency shift/peak systolic frequency shift]) using Doppler samples from the hilar arteries of the left or right kidney with the higher main renal artery peak systolic velocity. Outcomes & Measurements Proportional hazard regression analysis was used to determine associations between renal duplex sonography–derived Doppler signals and CVD events and all-cause mortality adjusted for accepted cardiovascular risk factors. Index CVD outcomes were defined as coronary events (angina, myocardial infarction, and coronary artery bypass grafting/percutaneous coronary intervention), cerebrovascular events (stroke or transient ischemic attack), and any CVD event (angina, congestive heart failure, myocardial infarction, stroke, transient ischemic attack, and coronary artery bypass grafting [CABG]/percutaneous transluminal coronary intervention [PTCI]). Results During follow-up, 221 deaths (31%), 229 CVD events (32%), 122 coronary events (17%), and 92 cerebrovascular events (13%) were observed. Renal duplex sonography–derived Doppler signals from the renal parenchyma were associated independently with all-cause mortality and CVD outcomes. In particular, increased parenchymal end diastolic frequency shift was associated significantly with any CVD event (HR, 0.73; 95% CI, 0.62-0.87; P < 0.001). Marginally significant associations were observed between increases in parenchymal end diastolic frequency shift and decreased risk of death (HR, 0.86; 95% CI, 0.73-1.00; P = 0.06) and decreased risk of cerebrovascular events (HR, 0.78; 95% CI, 0.61-1.01; P = 0.06). Parenchymal end diastolic frequency shift was not significantly predictive of coronary events (HR, 0.84; 95% CI, 0.67-1.06; P = 0.1). Limitations CHS participants showed a “healthy cohort” effect that may underestimate the rate of CVD events in the general population. Conclusion Renal duplex sonographic Doppler signals from the renal parenchyma showed significant associations with subsequent CVD events after controlling for other significant risk factors. In particular, a standard deviation increase in parenchymal end diastolic frequency shift was associated with 27% risk reduction in any CVD event. PMID:20116688

Web Video Event Recognition by Semantic Analysis From Ubiquitous Documents.

PubMed

Yu, Litao; Yang, Yang; Huang, Zi; Wang, Peng; Song, Jingkuan; Shen, Heng Tao

2016-12-01

In recent years, the task of event recognition from videos has attracted increasing interest in multimedia area. While most of the existing research was mainly focused on exploring visual cues to handle relatively small-granular events, it is difficult to directly analyze video content without any prior knowledge. Therefore, synthesizing both the visual and semantic analysis is a natural way for video event understanding. In this paper, we study the problem of Web video event recognition, where Web videos often describe large-granular events and carry limited textual information. Key challenges include how to accurately represent event semantics from incomplete textual information and how to effectively explore the correlation between visual and textual cues for video event understanding. We propose a novel framework to perform complex event recognition from Web videos. In order to compensate the insufficient expressive power of visual cues, we construct an event knowledge base by deeply mining semantic information from ubiquitous Web documents. This event knowledge base is capable of describing each event with comprehensive semantics. By utilizing this base, the textual cues for a video can be significantly enriched. Furthermore, we introduce a two-view adaptive regression model, which explores the intrinsic correlation between the visual and textual cues of the videos to learn reliable classifiers. Extensive experiments on two real-world video data sets show the effectiveness of our proposed framework and prove that the event knowledge base indeed helps improve the performance of Web video event recognition.

Evaluation of thromboembolic events in cancer patients receiving bevacizumab according to the Japanese Adverse Drug Event Report database.

PubMed

Matsumura, Chikako; Chisaki, Yugo; Sakimoto, Satoko; Sakae, Honoka; Yano, Yoshitaka

2018-01-01

Purpose We aimed to examine the risk factors, time of onset, incidence rates, and outcomes of thromboembolic events induced by bevacizumab in patients with cancer using the Japanese Adverse Drug Event Report (JADER) database of the Pharmaceuticals and Medical Devices Agency. Methods Adverse event data recorded in the JADER database between January 2004 and January 2015 were used. After screening the data using the generic drug name bevacizumab, patient data were classified into two groups by age and five groups by cancer type. The histories of disorders were also categorized. Arterial thromboembolic event and venous thromboembolic event were classified as "favorable" or "unfavorable" outcomes. Results In total, 6076 patients were reported to have developed adverse events during the sample period, of which 233 and 453 developed arterial thromboembolic event and venous thromboembolic event, respectively. Logistic analysis suggested that the presence of cancer was a significant risk factor for both arterial thromboembolic event and venous thromboembolic event. Age (≥70 years), histories of either hypertension or diabetes mellitus were also risk factors for arterial thromboembolic event. Median cumulative times of onset for arterial thromboembolic event and venous thromboembolic event were 60 and 80 days, respectively, and were not significantly different by the log-rank test. By the chi-square test, the rate of unfavorable outcomes was found to be higher after developing arterial thromboembolic event than after venous thromboembolic event. Conclusion Thromboembolism is a leading cause of mortality in patients with cancer. Patients should be monitored for the symptoms of thromboembolic events right from the initial stages of bevacizumab treatment.

Measurement of neutrino oscillation with KamLAND: evidence of spectral distortion.

PubMed

Araki, T; Eguchi, K; Enomoto, S; Furuno, K; Ichimura, K; Ikeda, H; Inoue, K; Ishihara, K; Iwamoto, T; Kawashima, T; Kishimoto, Y; Koga, M; Koseki, Y; Maeda, T; Mitsui, T; Motoki, M; Nakajima, K; Ogawa, H; Owada, K; Ricol, J-S; Shimizu, I; Shirai, J; Suekane, F; Suzuki, A; Tada, K; Tajima, O; Tamae, K; Tsuda, Y; Watanabe, H; Busenitz, J; Classen, T; Djurcic, Z; Keefer, G; McKinny, K; Mei, D-M; Piepke, A; Yakushev, E; Berger, B E; Chan, Y D; Decowski, M P; Dwyer, D A; Freedman, S J; Fu, Y; Fujikawa, B K; Goldman, J; Gray, F; Heeger, K M; Lesko, K T; Luk, K-B; Murayama, H; Poon, A W P; Steiner, H M; Winslow, L A; Horton-Smith, G A; Mauger, C; McKeown, R D; Vogel, P; Lane, C E; Miletic, T; Gorham, P W; Guillian, G; Learned, J G; Maricic, J; Matsuno, S; Pakvasa, S; Dazeley, S; Hatakeyama, S; Rojas, A; Svoboda, R; Dieterle, B D; Detwiler, J; Gratta, G; Ishii, K; Tolich, N; Uchida, Y; Batygov, M; Bugg, W; Efremenko, Y; Kamyshkov, Y; Kozlov, A; Nakamura, Y; Gould, C R; Karwowski, H J; Markoff, D M; Messimore, J A; Nakamura, K; Rohm, R M; Tornow, W; Wendell, R; Young, A R; Chen, M-J; Wang, Y-F; Piquemal, F

2005-03-04

We present results of a study of neutrino oscillation based on a 766 ton/year exposure of KamLAND to reactor antineutrinos. We observe 258 nu (e) candidate events with energies above 3.4 MeV compared to 365.2+/-23.7 events expected in the absence of neutrino oscillation. Accounting for 17.8+/-7.3 expected background events, the statistical significance for reactor nu (e) disappearance is 99.998%. The observed energy spectrum disagrees with the expected spectral shape in the absence of neutrino oscillation at 99.6% significance and prefers the distortion expected from nu (e) oscillation effects. A two-neutrino oscillation analysis of the KamLAND data gives Deltam(2)=7.9(+0.6)(-0.5)x10(-5) eV(2). A global analysis of data from KamLAND and solar-neutrino experiments yields Deltam(2)=7.9(+0.6)(-0.5)x10(-5) eV(2) and tan((2)theta=0.40(+0.10)(-0.07), the most precise determination to date.

Report order and identification of multidimensional stimuli: a study of event-related brain potentials.

PubMed

Shieh, Kong-King; Shen, I-Hsuan

2004-06-01

An experiment was conducted to investigate the effect of order of report on multidimensional stimulus identification. Subjects were required to identify each two-dimensional symbol by pushing corresponding buttons on the keypad on which there were two columns representing the two dimensions. Order of report was manipulated for the dimension represented by the left or right column. Both behavioral data and event-related potentials were recorded from 14 college students. Behavioral data analysis showed that order of report had a significant effect on response times. Such results were consistent with those of previous studies. Analysis of event-related brain potentials showed significant differences in peak amplitude and mean amplitude at time windows of 120-250 msec. at Fz, F3, and F4 and of 350-750 msec. at Fz, F3, F4, Cz, and Pz. Data provided neurophysiological evidence that reporting dimensional values according to natural language habits was appropriate and less cognitively demanding.

Meta-Analysis of the Associations of p-Cresyl Sulfate (PCS) and Indoxyl Sulfate (IS) with Cardiovascular Events and All-Cause Mortality in Patients with Chronic Renal Failure.

PubMed

Lin, Cheng-Jui; Wu, Vincent; Wu, Pei-Chen; Wu, Chih-Jen

2015-01-01

Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are protein-bound uremic toxins that increase in the sera of patients with chronic kidney disease (CKD), and are not effectively removed by dialysis. The purpose of this meta-analysis was to investigate the relationships of PCS and IS with cardiovascular events and all-cause mortality in patients with CKD stage 3 and above. Medline, Cochrane, and EMBASE databases were searched until January 1, 2014 with combinations of the following keywords: chronic renal failure, end-stage kidney disease, uremic toxin, uremic retention, indoxyl sulfate, p-cresyl sulfate. Inclusion criteria were: 1) Patients with stage 1 to 5 CKD; 2) Prospective study; 3) Randomized controlled trial; 4) English language publication. The associations between serum levels of PCS and IS and the risks of all-cause mortality and cardiovascular events were the primary outcome measures. Of 155 articles initially identified, 10 prospective and one cross-sectional study with a total 1,572 patients were included. Free PCS was significantly associated with all-cause mortality among patients with chronic renal failure (pooled OR = 1.16, 95% CI = 1.03 to 1.30, P = 0.013). An elevated free IS level was also significantly associated with increased risk of all-cause mortality (pooled OR = 1.10, 95% CI = 1.03 to 1.17, P = 0.003). An elevated free PCS level was significantly associated with an increased risk of cardiovascular events among patients with chronic renal failure (pooled OR = 1.28, 95% CI = 1.10 to 1.50, P = 0.002), while free IS was not significantly associated with risk of cardiovascular events (pooled OR = 1.05, 95% CI = 0.98 to 1.13, P = 0.196). Elevated levels of PCS and IS are associated with increased mortality in patients with CKD, while PCS, but not IS, is associated with an increased risk of cardiovascular events.

Efficacy and Safety of Zoledronic Acid for Treatment of Postmenopausal Osteoporosis: A Meta-Analysis of Randomized Controlled Trials.

PubMed

Wang, Chao

We conducted a meta-analysis based on eligible studies to assess the efficacy and safety of zoledronic acid treatment for postmenopausal women with osteoporosis. PubMed, Web of Science, and Embase were searched for eligible studies that assessed the efficacy of zoledronic acid in the prevention of fractures among postmenopausal women with osteoporosis. The primary outcomes were new vertebral fracture, nonvertebral fracture, and hip fracture. Secondary outcomes were bone mineral density (BMD) and safety outcomes. A fixed-effect or random-effect model was used to pool the estimates according to the heterogeneity among the included studies. Eight randomized controlled trials, involving 13,335 patients, were included in this meta-analysis. Pooled results showed that treatment with zoledronic acid significantly reduced the incidences of nonvertebral fractures, vertebral fractures, and hip fractures, as compared with placebo. Zoledronic acid was also associated with significant improvement in BMD at lumbar spine, total hip, femoral neck, and trochanter. However, the incidence of any adverse events was higher in the zoledronic acid group than that in the control group, and serious adverse events were comparable between the 2 groups. This meta-analysis indicated that zoledronic acid could significantly reduce the fracture risk and increase BMD in postmenopausal women with osteoporosis. Furthermore, it would not result in serious adverse events. Zoledronic acid could be used as an effective and well-tolerated treatment for postmenopausal women with osteoporosis.

The relationship between organizational leadership for safety and learning from patient safety events.

PubMed

Ginsburg, Liane R; Chuang, You-Ta; Berta, Whitney Blair; Norton, Peter G; Ng, Peggy; Tregunno, Deborah; Richardson, Julia

2010-06-01

To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs). Forty-nine general acute care hospitals in Ontario, Canada. A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major near misses, (d) major event analysis, and (e) major event dissemination/communication. PCMs provided data on organizational leadership (formal and informal) for patient safety. Hospitals were the unit of analysis. Seemingly unrelated regression was used to examine the influence of formal and informal leadership for safety on the five types of learning from PSEs. The interaction between leadership and hospital size was also examined. Formal organizational leadership for patient safety is an important predictor of learning from minor, moderate, and major near-miss events, and major event dissemination. This relationship is significantly stronger for small hospitals (<100 beds). We find support for the relationship between patient safety leadership and patient safety behaviors such as learning from safety events. Formal leadership support for safety is of particular importance in small organizations where the economic burden of safety programs is disproportionately large and formal leadership is closer to the front lines.

Influence of risk factors and past events on flood resilience in coastal megacities: Comparative analysis of NYC and Shanghai.

PubMed

Xian, Siyuan; Yin, Jie; Lin, Ning; Oppenheimer, Michael

2018-01-01

Coastal flood protection measures have been widely implemented to improve flood resilience. However, protection levels vary among coastal megacities globally. This study compares the distinct flood protection standards for two coastal megacities, New York City and Shanghai, and investigates potential influences such as risk factors and past flood events. Extreme value analysis reveals that, compared to NYC, Shanghai faces a significantly higher flood hazard. Flood inundation analysis indicates that Shanghai has a higher exposure to extreme flooding. Meanwhile, Shanghai's urban development, population, and economy have increased much faster than NYC's over the last three decades. These risk factors provide part of the explanation for the implementation of a relatively high level of protection (e.g. reinforced concrete sea-wall designed for a 200-year flood return level) in Shanghai and low protection (e.g. vertical brick and stone walls and sand dunes) in NYC. However, individual extreme flood events (typhoons in 1962, 1974, and 1981) seem to have had a greater impact on flood protection decision-making in Shanghai, while NYC responded significantly less to past events (with the exception of Hurricane Sandy). Climate change, sea level rise, and ongoing coastal development are rapidly changing the hazard and risk calculus for both cities and both would benefit from a more systematic and dynamic approach to coastal protection. Copyright © 2017 Elsevier B.V. All rights reserved.

Multiresolution wavelet analysis for efficient analysis, compression and remote display of long-term physiological signals.

PubMed

Khuan, L Y; Bister, M; Blanchfield, P; Salleh, Y M; Ali, R A; Chan, T H

2006-06-01

Increased inter-equipment connectivity coupled with advances in Web technology allows ever escalating amounts of physiological data to be produced, far too much to be displayed adequately on a single computer screen. The consequence is that large quantities of insignificant data will be transmitted and reviewed. This carries an increased risk of overlooking vitally important transients. This paper describes a technique to provide an integrated solution based on a single algorithm for the efficient analysis, compression and remote display of long-term physiological signals with infrequent short duration, yet vital events, to effect a reduction in data transmission and display cluttering and to facilitate reliable data interpretation. The algorithm analyses data at the server end and flags significant events. It produces a compressed version of the signal at a lower resolution that can be satisfactorily viewed in a single screen width. This reduced set of data is initially transmitted together with a set of 'flags' indicating where significant events occur. Subsequent transmissions need only involve transmission of flagged data segments of interest at the required resolution. Efficient processing and code protection with decomposition alone is novel. The fixed transmission length method ensures clutter-less display, irrespective of the data length. The flagging of annotated events in arterial oxygen saturation, electroencephalogram and electrocardiogram illustrates the generic property of the algorithm. Data reduction of 87% to 99% and improved displays are demonstrated.

"It Should Have Been Happening to Me": The Psychosocial Issues Older Caregiving Mothers Experience

ERIC Educational Resources Information Center

Raveis, Victoria H.; Pretter, Sheindy; Carrero, Monique

2010-01-01

The occurrence of cancer is an event of significant importance to family functioning. The present analysis reports on an understudied group profoundly affected by this health event: older mothers caring for an adult child with cancer. As part of a study of breast cancer survivors and their family caregivers, a subsample (N = 13) of older…

Safety and acceptability of transcranial direct current stimulation for the acute treatment of major depressive episodes: Analysis of individual patient data.

PubMed

Moffa, Adriano H; Brunoni, André R; Fregni, Felipe; Palm, Ulrich; Padberg, Frank; Blumberger, Daniel M; Daskalakis, Zafiris J; Bennabi, Djamila; Haffen, Emmanuel; Alonzo, Angelo; Loo, Colleen K

2017-10-15

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation modality that has been increasingly used for major depressive disorder (MDD) treatment. Although studies in healthy volunteers showed that the technique is well-tolerated, tDCS safety and acceptability have not been sufficiently explored in patients with MDD. We collected individual patient data from 6 randomized clinical trials that had been previously identified in a systematic review and meta-analysis. Primary outcomes were safety (rate of adverse events) and acceptability (rate of dropouts). Secondary outcomes were clinical, demographic and treatment predictors of the primary outcomes. Dropout rates between active (8.8%) and sham (12%) groups were not significantly different (OR= 0.7, p=0.38). Adverse event rates between active (73.5%) and sham (68.3%) groups were not significantly different (OR= 1.4, p= 0.23). Higher current densities were associated with lower adverse event rates. Dropout reasons were not systematically reported and adverse events were not collected using questionnaires standardized across studies. Active tDCS is as acceptable and safe as sham tDCS, as found in randomized clinical trials of MDD. Copyright © 2017. Published by Elsevier B.V.

On the association between synoptic circulation and wildfires in the Eastern Mediterranean

NASA Astrophysics Data System (ADS)

Papadopoulos, A.; Paschalidou, A. K.; Kassomenos, P. A.; McGregor, G.

2014-02-01

In the present paper cluster analysis of 2-month air mass back-trajectories for three contrasting fire and non-fire events is conducted (high, low, and zero burnt area). The large fire event displays an air mass history dissimilar to other events whereby a 39-day period of warm and dry chiefly northerly anticyclonic conditions is evident, before a week of warmer predominantly southwesterly cyclonic activity, immediately prior to ignition. The pressure level of these anticyclonic air masses is above 800 hPa for more than 75 % of the trajectory length; this region is above the principal moisture transport regime of 800 hPa altitude. Analysis of variance on the mean rate of change of potential temperature identified weak statistically significant differences between two air mass pairs regarding the large fire: anticyclonic and cyclonic air masses in both cases ( p = 0.038 and p = 0.020). Such regularity of type and occurrence, approach pressure levels and statistically significant differences are not evident for the small and non-fire event air masses. Such understanding is expected to permit appropriate steps to be undertaken including superior prediction and improved suppression strategy.

Neural network approach in multichannel auditory event-related potential analysis.

PubMed

Wu, F Y; Slater, J D; Ramsay, R E

1994-04-01

Even though there are presently no clearly defined criteria for the assessment of P300 event-related potential (ERP) abnormality, it is strongly indicated through statistical analysis that such criteria exist for classifying control subjects and patients with diseases resulting in neuropsychological impairment such as multiple sclerosis (MS). We have demonstrated the feasibility of artificial neural network (ANN) methods in classifying ERP waveforms measured at a single channel (Cz) from control subjects and MS patients. In this paper, we report the results of multichannel ERP analysis and a modified network analysis methodology to enhance automation of the classification rule extraction process. The proposed methodology significantly reduces the work of statistical analysis. It also helps to standardize the criteria of P300 ERP assessment and facilitate the computer-aided analysis on neuropsychological functions.

Status and results from the OPERA experiment

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

Ariga, Tomoko

2011-10-06

The OPERA experiment is aiming at the first direct detection of neutrino oscillations in appearance mode through the study of the v{sub {mu}}{yields}v{tau} channel. The OPERA detector is placed in the CNGS long baseline v{sub {mu}} beam 730 km away from the neutrino source. The analysis of a sub-sample of the data taken in the 2008-2009 runs was completed After a brief description of the beam and the experimental setup, we report on event analysis and on a first candidate event, its background estimation and statistical significance.

Ontology-Based Combinatorial Comparative Analysis of Adverse Events Associated with Killed and Live Influenza Vaccines

PubMed Central

Sarntivijai, Sirarat; Xiang, Zuoshuang; Shedden, Kerby A.; Markel, Howard; Omenn, Gilbert S.; Athey, Brian D.; He, Yongqun

2012-01-01

Vaccine adverse events (VAEs) are adverse bodily changes occurring after vaccination. Understanding the adverse event (AE) profiles is a crucial step to identify serious AEs. Two different types of seasonal influenza vaccines have been used on the market: trivalent (killed) inactivated influenza vaccine (TIV) and trivalent live attenuated influenza vaccine (LAIV). Different adverse event profiles induced by these two groups of seasonal influenza vaccines were studied based on the data drawn from the CDC Vaccine Adverse Event Report System (VAERS). Extracted from VAERS were 37,621 AE reports for four TIVs (Afluria, Fluarix, Fluvirin, and Fluzone) and 3,707 AE reports for the only LAIV (FluMist). The AE report data were analyzed by a novel combinatorial, ontology-based detection of AE method (CODAE). CODAE detects AEs using Proportional Reporting Ratio (PRR), Chi-square significance test, and base level filtration, and groups identified AEs by ontology-based hierarchical classification. In total, 48 TIV-enriched and 68 LAIV-enriched AEs were identified (PRR>2, Chi-square score >4, and the number of cases >0.2% of total reports). These AE terms were classified using the Ontology of Adverse Events (OAE), MedDRA, and SNOMED-CT. The OAE method provided better classification results than the two other methods. Thirteen out of 48 TIV-enriched AEs were related to neurological and muscular processing such as paralysis, movement disorders, and muscular weakness. In contrast, 15 out of 68 LAIV-enriched AEs were associated with inflammatory response and respiratory system disorders. There were evidences of two severe adverse events (Guillain-Barre Syndrome and paralysis) present in TIV. Although these severe adverse events were at low incidence rate, they were found to be more significantly enriched in TIV-vaccinated patients than LAIV-vaccinated patients. Therefore, our novel combinatorial bioinformatics analysis discovered that LAIV had lower chance of inducing these two severe adverse events than TIV. In addition, our meta-analysis found that all previously reported positive correlation between GBS and influenza vaccine immunization were based on trivalent influenza vaccines instead of monovalent influenza vaccines. PMID:23209624

Prospective Association Between Negative Life Events and Initiation of Sexual Intercourse: The Influence of Family Structure and Family Income

PubMed Central

Oman, Roy F.; Vesely, Sara K.; Aspy, Cheryl B.; Tolma, Eleni L.; John, Robert

2015-01-01

Objectives. We examined the prospective association between negative life events and time to initiation of sexual intercourse and the influence of family structure and family income on this association. Methods. We followed up a randomly selected sample (n = 649) of ethnically diverse parents and their children aged 12 to 17 years over a 5-year period. We conducted Cox proportional hazards regression analysis to examine the relation between negative life events and time to initiation of sexual intercourse. Family structure and family income were assessed as confounders. Results. Negative life events were significant predictors of time to initiation of sexual intercourse in adolescents. After controlling for demographic variables, youths reporting 1 negative life event had a hazard of initiation of sexual intercourse 1.40 times greater and youths reporting 2 or more negative life events had a hazard of initiation of sexual intercourse 1.61 times greater compared with youths reporting no negative life events. Family structure and family income were not significant confounders of the relation between initiation of sexual intercourse and negative life events. Conclusions. Interventions to prevent initiation of sexual intercourse should focus on youths with recent negative life events, regardless of family income and structure. PMID:25602885

[The most common vital events in women 45-64 years of age. Repercussions as psychophysical stressors].

PubMed

Marín Torrens, R M; Sánchez Cánovas, J; Donat Colomer, F; Dupuy Layo, M J; Salas Trejo, M D

1996-05-15

To find what vital events middle-aged women in our society most often experience and their influence as stress factors on physical health and subjective psychological well-being. A multivariant transversal study. 5 primary care centres in Valencia and Alicante. 306 women chosen at random among those seen at these health centres. Frequency analysis of vital events. Correlation analysis with questionnaires on physical symptoms and diseases, psychological well-being, work situation, emotional behaviour, sexuality and relationships with their partner. ANOVA: dividing the sample into 2 groups based on mean adaptive effort. The most common events numbered 23. The ANOVA showed a significant association between greater adaptive effort and negative emotional behaviour, personal control, material well-being, relationship with the partner, and physical and psychological symptoms. The relevance of daily events as generators of stress was confirmed, as was the impact of these and major events on these women's physical and psychological health. The importance of attending women at this stage of their lives from an integrated and interdisciplinary perspective, which tackles the physiological, psychological and cultural features together, was shown.

Methods for evaluating temporal groundwater quality data and results of decadal-scale changes in chloride, dissolved solids, and nitrate concentrations in groundwater in the United States, 1988-2010

USGS Publications Warehouse

Lindsey, Bruce D.; Rupert, Michael G.

2012-01-01

Decadal-scale changes in groundwater quality were evaluated by the U.S. Geological Survey National Water-Quality Assessment (NAWQA) Program. Samples of groundwater collected from wells during 1988-2000 - a first sampling event representing the decade ending the 20th century - were compared on a pair-wise basis to samples from the same wells collected during 2001-2010 - a second sampling event representing the decade beginning the 21st century. The data set consists of samples from 1,236 wells in 56 well networks, representing major aquifers and urban and agricultural land-use areas, with analytical results for chloride, dissolved solids, and nitrate. Statistical analysis was done on a network basis rather than by individual wells. Although spanning slightly more or less than a 10-year period, the two-sample comparison between the first and second sampling events is referred to as an analysis of decadal-scale change based on a step-trend analysis. The 22 principal aquifers represented by these 56 networks account for nearly 80 percent of the estimated withdrawals of groundwater used for drinking-water supply in the Nation. Well networks where decadal-scale changes in concentrations were statistically significant were identified using the Wilcoxon-Pratt signed-rank test. For the statistical analysis of chloride, dissolved solids, and nitrate concentrations at the network level, more than half revealed no statistically significant change over the decadal period. However, for networks that had statistically significant changes, increased concentrations outnumbered decreased concentrations by a large margin. Statistically significant increases of chloride concentrations were identified for 43 percent of 56 networks. Dissolved solids concentrations increased significantly in 41 percent of the 54 networks with dissolved solids data, and nitrate concentrations increased significantly in 23 percent of 56 networks. At least one of the three - chloride, dissolved solids, or nitrate - had a statistically significant increase in concentration in 66 percent of the networks. Statistically significant decreases in concentrations were identified in 4 percent of the networks for chloride, 2 percent of the networks for dissolved solids, and 9 percent of the networks for nitrate. A larger percentage of urban land-use networks had statistically significant increases in chloride, dissolved solids, and nitrate concentrations than agricultural land-use networks. In order to assess the magnitude of statistically significant changes, the median of the differences between constituent concentrations from the first full-network sampling event and those from the second full-network sampling event was calculated using the Turnbull method. The largest median decadal increases in chloride concentrations were in networks in the Upper Illinois River Basin (67 mg/L) and in the New England Coastal Basins (34 mg/L), whereas the largest median decadal decrease in chloride concentrations was in the Upper Snake River Basin (1 mg/L). The largest median decadal increases in dissolved solids concentrations were in networks in the Rio Grande Valley (260 mg/L) and the Upper Illinois River Basin (160 mg/L). The largest median decadal decrease in dissolved solids concentrations was in the Apalachicola-Chattahoochee-Flint River Basin (6.0 mg/L). The largest median decadal increases in nitrate as nitrogen (N) concentrations were in networks in the South Platte River Basin (2.0 mg/L as N) and the San Joaquin-Tulare Basins (1.0 mg/L as N). The largest median decadal decrease in nitrate concentrations was in the Santee River Basin and Coastal Drainages (0.63 mg/L). The magnitude of change in networks with statistically significant increases typically was much larger than the magnitude of change in networks with statistically significant decreases. The magnitude of change was greatest for chloride in the urban land-use networks and greatest for dissolved solids and nitrate in the agricultural land-use networks. Analysis of data from all networks combined indicated statistically significant increases for chloride, dissolved solids, and nitrate. Although chloride, dissolved solids, and nitrate concentrations were typically less than the drinking-water standards and guidelines, a statistical test was used to determine whether or not the proportion of samples exceeding the drinking-water standard or guideline changed significantly between the first and second full-network sampling events. The proportion of samples exceeding the U.S. Environmental Protection Agency (USEPA) Secondary Maximum Contaminant Level for dissolved solids (500 milligrams per liter) increased significantly between the first and second full-network sampling events when evaluating all networks combined at the national level. Also, for all networks combined, the proportion of samples exceeding the USEPA Maximum Contaminant Level (MCL) of 10 mg/L as N for nitrate increased significantly. One network in the Delmarva Peninsula had a significant increase in the proportion of samples exceeding the MCL for nitrate. A subset of 261 wells was sampled every other year (biennially) to evaluate decadal-scale changes using a time-series analysis. The analysis of the biennial data set showed that changes were generally similar to the findings from the analysis of decadal-scale change that was based on a step-trend analysis. Because of the small number of wells in a network with biennial data (typically 4-5 wells), the time-series analysis is more useful for understanding water-quality responses to changes in site-specific conditions rather than as an indicator of the change for the entire network.

Effects of Recombinant Human Growth Hormone for Osteoporosis: Systematic Review and Meta-Analysis.

PubMed

Atkinson, Hayden F; Moyer, Rebecca F; Yacoub, Daniel; Coughlin, Dexter; Birmingham, Trevor B

2017-03-01

Our objective was to evaluate the efficacy of recombinant human growth hormone (GH) on bone mineral density (BMD) in persons age 50 and older, with normal pituitary function, with or at risk for developing osteoporosis. We systematically reviewed randomized clinical trials (RCTs), searching six databases, and conducted meta-analyses to examine GH effects on BMD of the lumbar spine and femoral neck. Data for fracture incidence, bone metabolism biomarkers, and adverse events were also extracted and analysed. Thirteen RCTs met the eligibility criteria. Pooled effect sizes suggested no significant GH effect on BMD. Pooled effect sizes were largest, but nonsignificant, when compared to placebo. GH had a significant effect on several bone metabolism biomarkers. A significantly higher rate of adverse events was observed in the GH groups. Meta-analysis of RCTs suggests that GH treatment for persons with or at risk for developing osteoporosis results in very small, nonsignificant increases in BMD.

Comparative hazard analysis of processes leading to remarkable flash floods (France, 1930-1999)

NASA Astrophysics Data System (ADS)

Boudou, M.; Lang, M.; Vinet, F.; Cœur, D.

2016-10-01

Flash flood events are responsible for large economic losses and lead to fatalities every year in France. This is especially the case in the Mediterranean and oversea territories/departments of France, characterized by extreme hydro-climatological features and with a large part of the population exposed to flood risks. The recurrence of remarkable flash flood events, associated with high hazard intensity, significant damage and socio-political consequences, therefore raises several issues for authorities and risk management policies. This study aims to improve our understanding of the hazard analysis process in the case of four remarkable flood events: March 1930, October 1940, January 1980 and November 1999. Firstly, we present the methodology used to define the remarkability score of a flood event. Then, to identify the factors leading to a remarkable flood event, we explore the main parameters of the hazard analysis process, such as the meteorological triggering conditions, the return period of the rainfall and peak discharge, as well as some additional factors (initial catchment state, flood chronology, cascade effects, etc.). The results contribute to understanding the complexity of the processes leading to flood hazard and highlight the importance for risk managers of taking additional factors into account.

Element analysis: a wavelet-based method for analysing time-localized events in noisy time series

PubMed Central

2017-01-01

A method is derived for the quantitative analysis of signals that are composed of superpositions of isolated, time-localized ‘events’. Here, these events are taken to be well represented as rescaled and phase-rotated versions of generalized Morse wavelets, a broad family of continuous analytic functions. Analysing a signal composed of replicates of such a function using another Morse wavelet allows one to directly estimate the properties of events from the values of the wavelet transform at its own maxima. The distribution of events in general power-law noise is determined in order to establish significance based on an expected false detection rate. Finally, an expression for an event’s ‘region of influence’ within the wavelet transform permits the formation of a criterion for rejecting spurious maxima due to numerical artefacts or other unsuitable events. Signals can then be reconstructed based on a small number of isolated points on the time/scale plane. This method, termed element analysis, is applied to the identification of long-lived eddy structures in ocean currents as observed by along-track measurements of sea surface elevation from satellite altimetry. PMID:28484325

Home advantage in the Winter Olympics (1908-1998).

PubMed

Balmer, N J; Nevill, A M; Williams, A M

2001-02-01

We obtained indices of home advantage, based on the medals won by competing nations, for each event held at the Winter Olympics from 1908 to 1998. These indices were designed to assess home advantage while controlling for nation strength, changes in the number of medals on offer and the performance of 'non-hosting' nations. Some evidence of home advantage was found in figure skating, freestyle skiing, ski jumping, alpine skiing and short track speed skating. In contrast, little or no home advantage was observed in ice hockey, Nordic combined, Nordic skiing, bobsled, luge, biathlon or speed skating. When all events were combined, a significant home advantage was observed (P = 0.029), although no significant differences in the extent of home advantage were found between events (P > 0.05). When events were grouped according to whether they were subjectively assessed by judges, significantly greater home advantage was observed in the subjectively assessed events (P = 0.037). This was a reflection of better home performances, suggesting that judges were scoring home competitors disproportionately higher than away competitors. Familiarity with local conditions was shown to have some effect, particularly in alpine skiing, although the bobsled and luge showed little or no advantage over other events. Regression analysis showed that the number of time zones and direction of travel produced no discernible trends or differences in performance.

Multi-hazard Assessment and Scenario Toolbox (MhAST): A Framework for Analyzing Compounding Effects of Multiple Hazards

NASA Astrophysics Data System (ADS)

Sadegh, M.; Moftakhari, H.; AghaKouchak, A.

2017-12-01

Many natural hazards are driven by multiple forcing variables, and concurrence/consecutive extreme events significantly increases risk of infrastructure/system failure. It is a common practice to use univariate analysis based upon a perceived ruling driver to estimate design quantiles and/or return periods of extreme events. A multivariate analysis, however, permits modeling simultaneous occurrence of multiple forcing variables. In this presentation, we introduce the Multi-hazard Assessment and Scenario Toolbox (MhAST) that comprehensively analyzes marginal and joint probability distributions of natural hazards. MhAST also offers a wide range of scenarios of return period and design levels and their likelihoods. Contribution of this study is four-fold: 1. comprehensive analysis of marginal and joint probability of multiple drivers through 17 continuous distributions and 26 copulas, 2. multiple scenario analysis of concurrent extremes based upon the most likely joint occurrence, one ruling variable, and weighted random sampling of joint occurrences with similar exceedance probabilities, 3. weighted average scenario analysis based on a expected event, and 4. uncertainty analysis of the most likely joint occurrence scenario using a Bayesian framework.

Simulation of a master-slave event set processor

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

Comfort, J.C.

1984-03-01

Event set manipulation may consume a considerable amount of the computation time spent in performing a discrete-event simulation. One way of minimizing this time is to allow event set processing to proceed in parallel with the remainder of the simulation computation. The paper describes a multiprocessor simulation computer, in which all non-event set processing is performed by the principal processor (called the host). Event set processing is coordinated by a front end processor (the master) and actually performed by several other functionally identical processors (the slaves). A trace-driven simulation program modeling this system was constructed, and was run with tracemore » output taken from two different simulation programs. Output from this simulation suggests that a significant reduction in run time may be realized by this approach. Sensitivity analysis was performed on the significant parameters to the system (number of slave processors, relative processor speeds, and interprocessor communication times). A comparison between actual and simulation run times for a one-processor system was used to assist in the validation of the simulation. 7 references.« less

Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm.

PubMed

Achuff, Barbara-Jo; Achuff, Jameson C; Park, Hwan H; Moffett, Brady; Acosta, Sebastian; Rusin, Craig G; Checchia, Paul A

2018-03-01

Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data. In all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (p<0.001), duration (p<0.001), and amplitude (p<0.001) compared with control data. This novel data collection and signal processing analysis showed a significant increase in frequency, duration, and magnitude of systolic blood pressure perturbations surrounding epinephrine syringe exchange events.

Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis.

PubMed

Jeitler, K; Horvath, K; Berghold, A; Gratzer, T W; Neeser, K; Pieber, T R; Siebenhofer, A

2008-06-01

We compared the effects of continuous subcutaneous insulin infusion (CSII) with those of multiple daily insulin (MDI) injections on glycaemic control, risk of hypoglycaemic episodes, insulin requirements and adverse events in type 1 and type 2 diabetes mellitus. The electronic databases MEDLINE, EMBASE and CENTRAL were systematically searched for randomised controlled trials up to March 2007. A systematic review and meta-analysis were performed. Overall, 22 studies were included (17 on type 1 diabetes mellitus, two on type 2 diabetes mellitus, three on children). With regard to adults with type 1 diabetes mellitus, our meta-analysis found a between-treatment difference of -0.4% HbA(1c) (six studies) in favour of CSII therapy. Available median rates of mild or overall hypoglycaemic events were comparable between the different interventions (1.9 [0.9-3.1] [CSII] vs 1.7 [1.1-3.3] [MDI] events per patient per week). Total daily insulin requirements were lower with CSII than with MDI therapy. In patients with type 2 diabetes mellitus, CSII and MDI treatment showed no statistically significant difference for HbA(1c). The incidence of mild hypoglycaemic events was comparable between the treatment groups. In adolescents with type 1 diabetes mellitus, glycated haemoglobin and insulin requirements were significantly lower in the CSII groups; no data were available on hypoglycaemic events. The only study performed in younger children did not provide enough data for conclusive inferences. No overall conclusions were possible for severe hypoglycaemia and adverse events for any of the different patient groups due to rareness of such events, different definitions and insufficient reporting. CSII therapy in adults and adolescents with type 1 diabetes mellitus resulted in a greater reduction of glycated haemoglobin, in adult patients without a higher rate of hypoglycaemia. No beneficial effect of CSII therapy could be detected for patients with type 2 diabetes mellitus.

Generic versus brand-name drugs used in cardiovascular diseases.

PubMed

Manzoli, Lamberto; Flacco, Maria Elena; Boccia, Stefania; D'Andrea, Elvira; Panic, Nikola; Marzuillo, Carolina; Siliquini, Roberta; Ricciardi, Walter; Villari, Paolo; Ioannidis, John P A

2016-04-01

This meta-analysis aimed to compare the efficacy and adverse events, either serious or mild/moderate, of all generic versus brand-name cardiovascular medicines. We searched randomized trials in MEDLINE, Scopus, EMBASE, Cochrane Controlled Clinical Trial Register, and ClinicalTrials.gov (last update December 1, 2014). Attempts were made to contact the investigators of all potentially eligible trials. Two investigators independently extracted and analyzed soft (including systolic blood pressure, LDL cholesterol, and others) and hard efficacy outcomes (including major cardiovascular adverse events and death), minor/moderate and serious adverse events. We included 74 randomized trials; 53 reported ≥1 efficacy outcome (overall sample 3051), 32 measured mild/moderate adverse events (n = 2407), and 51 evaluated serious adverse events (n = 2892). We included trials assessing ACE inhibitors (n = 12), anticoagulants (n = 5), antiplatelet agents (n = 17), beta-blockers (n = 11), calcium channel blockers (n = 7); diuretics (n = 13); statins (n = 6); and others (n = 3). For both soft and hard efficacy outcomes, 100 % of the trials showed non-significant differences between generic and brand-name drugs. The aggregate effect size was 0.01 (95 % CI -0.05; 0.08) for soft outcomes; -0.06 (-0.71; 0.59) for hard outcomes. All but two trials showed non-significant differences in mild/moderate adverse events, and aggregate effect size was 0.07 (-0.06; 0.20). Comparable results were observed for each drug class and in each stratified meta-analysis. Overall, 8 serious possibly drug-related adverse events were reported: 5/2074 subjects on generics; 3/2076 subjects on brand-name drugs (OR 1.69; 95 % CI 0.40-7.20). This meta-analysis strengthens the evidence for clinical equivalence between brand-name and generic cardiovascular drugs. Physicians could be reassured about prescribing generic cardiovascular drugs, and health care organization about endorsing their wider use.

Catchment process affecting drinking water quality, including the significance of rainfall events, using factor analysis and event mean concentrations.

PubMed

Cinque, Kathy; Jayasuriya, Niranjali

2010-12-01

To ensure the protection of drinking water an understanding of the catchment processes which can affect water quality is important as it enables targeted catchment management actions to be implemented. In this study factor analysis (FA) and comparing event mean concentrations (EMCs) with baseline values were techniques used to asses the relationships between water quality parameters and linking those parameters to processes within an agricultural drinking water catchment. FA found that 55% of the variance in the water quality data could be explained by the first factor, which was dominated by parameters usually associated with erosion. Inclusion of pathogenic indicators in an additional FA showed that Enterococcus and Clostridium perfringens (C. perfringens) were also related to the erosion factor. Analysis of the EMCs found that most parameters were significantly higher during periods of rainfall runoff. This study shows that the most dominant processes in an agricultural catchment are surface runoff and erosion. It also shows that it is these processes which mobilise pathogenic indicators and are therefore most likely to influence the transport of pathogens. Catchment management efforts need to focus on reducing the effect of these processes on water quality.

Heart dosimetric analysis of three types of cardiac toxicity in patients treated on dose-escalation trials for Stage III non-small-cell lung cancer.

PubMed

Wang, Kyle; Pearlstein, Kevin A; Patchett, Nicholas D; Deal, Allison M; Mavroidis, Panayiotis; Jensen, Brian C; Lipner, Matthew B; Zagar, Timothy M; Wang, Yue; Lee, Carrie B; Eblan, Michael J; Rosenman, Julian G; Socinski, Mark A; Stinchcombe, Thomas E; Marks, Lawrence B

2017-11-01

To assess associations between radiation dose/volume parameters for cardiac subvolumes and different types of cardiac events in patients treated on radiation dose-escalation trials. Patients with Stage III non-small-cell lung cancer received dose-escalated radiation (median 74 Gy) using 3D-conformal radiotherapy on six prospective trials from 1996 to 2009. Volumes analyzed included whole heart, left ventricle (LV), right atrium (RA), and left atrium (LA). Cardiac events were divided into three categories: pericardial (symptomatic effusion and pericarditis), ischemia (myocardial infarction and unstable angina), and arrhythmia. Univariable competing risks analysis was used. 112 patients were analyzed, with median follow-up 8.8 years for surviving patients. Nine patients had pericardial, seven patients had ischemic, and 12 patients had arrhythmic events. Pericardial events were correlated with whole heart, RA, and LA dose (eg, heart-V30 [p=0.024], RA-V30 [p=0.013], and LA-V30 [p=0.001]), but not LV dose. Ischemic events were correlated with LV and whole heart dose (eg, LV-V30 [p=0.012], heart-V30 [p=0.048]). Arrhythmic events showed borderline significant associations with RA, LA, and whole heart dose (eg, RA-V30 [p=0.082], LA-V30 [p=0.076], heart-V30 [p=0.051]). Cardiac events were associated with decreased survival on univariable analysis (p=0.008, HR 2.09), but only disease progression predicted for decreased survival on multivariable analysis. Cardiac events were heterogeneous and associated with distinct heart subvolume doses. These data support the hypothesis of distinct etiologies for different types of radiation-associated cardiotoxicity. Copyright © 2017 Elsevier B.V. All rights reserved.

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks

PubMed Central

Aung, Theingi; Halsey, Jim; Kromhout, Daan; Gerstein, Hertzel C.; Marchioli, Roberto; Tavazzi, Luigi; Geleijnse, Johanna M.; Rauch, Bernhard; Ness, Andrew; Galan, Pilar; Chew, Emily Y.; Bosch, Jackie; Collins, Rory; Lewington, Sarah; Armitage, Jane

2018-01-01

Importance Current guidelines advocate the use of marine-derived omega-3 fatty acids supplements for the prevention of coronary heart disease and major vascular events in people with prior coronary heart disease, but large trials of omega-3 fatty acids have produced conflicting results. Objective To conduct a meta-analysis of all large trials assessing the associations of omega-3 fatty acid supplements with the risk of fatal and nonfatal coronary heart disease and major vascular events in the full study population and prespecified subgroups. Data Sources and Study Selection This meta-analysis included randomized trials that involved at least 500 participants and a treatment duration of at least 1 year and that assessed associations of omega-3 fatty acids with the risk of vascular events. Data Extraction and Synthesis Aggregated study-level data were obtained from 10 large randomized clinical trials. Rate ratios for each trial were synthesized using observed minus expected statistics and variances. Summary rate ratios were estimated by a fixed-effects meta-analysis using 95% confidence intervals for major diseases and 99% confidence intervals for all subgroups. Main Outcomes and Measures The main outcomes included fatal coronary heart disease, nonfatal myocardial infarction, stroke, major vascular events, and all-cause mortality, as well as major vascular events in study population subgroups. Results Of the 77 917 high-risk individuals participating in the 10 trials, 47 803 (61.4%) were men, and the mean age at entry was 64.0 years; the trials lasted a mean of 4.4 years. The associations of treatment with outcomes were assessed on 6273 coronary heart disease events (2695 coronary heart disease deaths and 2276 nonfatal myocardial infarctions) and 12 001 major vascular events. Randomization to omega-3 fatty acid supplementation (eicosapentaenoic acid dose range, 226-1800 mg/d) had no significant associations with coronary heart disease death (rate ratio [RR], 0.93; 99% CI, 0.83-1.03; P = .05), nonfatal myocardial infarction (RR, 0.97; 99% CI, 0.87-1.08; P = .43) or any coronary heart disease events (RR, 0.96; 95% CI, 0.90-1.01; P = .12). Neither did randomization to omega-3 fatty acid supplementation have any significant associations with major vascular events (RR, 0.97; 95% CI, 0.93-1.01; P = .10), overall or in any subgroups, including subgroups composed of persons with prior coronary heart disease, diabetes, lipid levels greater than a given cutoff level, or statin use. Conclusions and Relevance This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease. PMID:29387889

Cardiovascular effects of urate-lowering therapies in patients with chronic gout: a systematic review and meta-analysis.

PubMed

Zhang, Tony; Pope, Janet E

2017-07-01

To determine if urate-lowering treatment (ULT) in gout can reduce cardiovascular (CV) outcomes. Randomized trials were searched for treatment with ULT in gout. Eligible trials had to report CV safety of a ULT. Potential medications included allopurinol, febuxostat, pegloticase, rasburicase, probenecid, benzbromarone, sulphinpyrazone, losartan, fenofibrate and sodium-glucose linked transporter 2 inhibitors. A total of 3084 citations were found, with 642 duplicates. After the primary screen, 35 studies were selected for review. Several trials did not report CV events. Six were not randomized controlled trials (RCTs). Four studies reported no events in either intervention arm while the other four had 40 events in the febuxostat group ( n = 3631) and 5 in allopurinol group ( n = 1154). Overall, the pooled analysis did not show a significant difference between the two [febuxostat vs allopurinol: relative risk (RR) 1.69 (95% CI 0.54, 5.34), P = 0.37]. CV events did not decrease over time. Comparing shorter studies (<52 weeks) to longer ones did not reveal any statistical differences. However, in long-term studies with febuxostat vs allopurinol, results were nearly significant, with more CVE occurring with febuxostat treatment. Comparing any ULT to placebo (eight studies, n = 2221 patients) did not demonstrate a significant difference in non-Anti-Platelet Trialists' Collaboration events [any ULT vs placebo: RR 1.47 (95% CI 0.49, 4.40), P = 0.49] or all-cause mortality [any ULT vs placebo: RR 1.45 (95% CI 0.35, 5.77), P = 0.60]. RCT data do not suggest differences in CV events among ULTs in gout. Trials had few events despite high-risk patients being enrolled and may have been too short to show CV reduction by controlling inflammatory attacks and lowering uric acid. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Parent-adolescent conflict and stress when parents are living with AIDS.

PubMed

Rotheram-Borus, M J; Robin, L; Reid, H M; Draimin, B H

1998-01-01

Parental perceptions of conflict and stress with their adolescent children are described, and their associations with demographic factors, physical health, and lifestyle are examined. Adolescent-parent conflicts, parenting stress, and parents' health, substance use, and sexual lifestyle were assessed among 151 parents living with AIDS. Parents living with AIDS reported a mean of 3.3 (SD = 1.3) areas of conflict with their adolescents and 1.5 (SD = 1.7) stressful parenting events over the previous 3 months. The parents were very ill, with many physical symptoms and diseases. Simultaneously, substance use was common (17% used daily), but not injection drug use (3.3%). Half had a sexual partner (63% protected their partners by using condoms consistently). Regression analysis revealed that parent-adolescent conflict was significantly associated with high parental drug use; stressful parenting events were significantly related to the lifestyle (high drug use and frequent sex acts) of Latino and African American parents, but not of white parents. Results of the analysis indicate that, in contrast to parents with other illnesses, parent-adolescent conflict and stressful parenting events were not influenced by parents' health status, but were significantly influenced by substance use and sexual lifestyles.

Influential factors of red-light running at signalized intersection and prediction using a rare events logistic regression model.

PubMed

Ren, Yilong; Wang, Yunpeng; Wu, Xinkai; Yu, Guizhen; Ding, Chuan

2016-10-01

Red light running (RLR) has become a major safety concern at signalized intersection. To prevent RLR related crashes, it is critical to identify the factors that significantly impact the drivers' behaviors of RLR, and to predict potential RLR in real time. In this research, 9-month's RLR events extracted from high-resolution traffic data collected by loop detectors from three signalized intersections were applied to identify the factors that significantly affect RLR behaviors. The data analysis indicated that occupancy time, time gap, used yellow time, time left to yellow start, whether the preceding vehicle runs through the intersection during yellow, and whether there is a vehicle passing through the intersection on the adjacent lane were significantly factors for RLR behaviors. Furthermore, due to the rare events nature of RLR, a modified rare events logistic regression model was developed for RLR prediction. The rare events logistic regression method has been applied in many fields for rare events studies and shows impressive performance, but so far none of previous research has applied this method to study RLR. The results showed that the rare events logistic regression model performed significantly better than the standard logistic regression model. More importantly, the proposed RLR prediction method is purely based on loop detector data collected from a single advance loop detector located 400 feet away from stop-bar. This brings great potential for future field applications of the proposed method since loops have been widely implemented in many intersections and can collect data in real time. This research is expected to contribute to the improvement of intersection safety significantly. Copyright © 2016 Elsevier Ltd. All rights reserved.

An analysis of high-impact, low-predictive skill severe weather events in the northeast U.S

NASA Astrophysics Data System (ADS)

Vaughan, Matthew T.

An objective evaluation of Storm Prediction Center slight risk convective outlooks, as well as a method to identify high-impact severe weather events with poor-predictive skill are presented in this study. The objectives are to assess severe weather forecast skill over the northeast U.S. relative to the continental U.S., build a climatology of high-impact, low-predictive skill events between 1980--2013, and investigate the dynamic and thermodynamic differences between severe weather events with low-predictive skill and high-predictive skill over the northeast U.S. Severe storm reports of hail, wind, and tornadoes are used to calculate skill scores including probability of detection (POD), false alarm ratio (FAR) and threat scores (TS) for each convective outlook. Low predictive skill events are binned into low POD (type 1) and high FAR (type 2) categories to assess temporal variability of low-predictive skill events. Type 1 events were found to occur in every year of the dataset with an average of 6 events per year. Type 2 events occur less frequently and are more common in the earlier half of the study period. An event-centered composite analysis is performed on the low-predictive skill database using the National Centers for Environmental Prediction Climate Forecast System Reanalysis 0.5° gridded dataset to analyze the dynamic and thermodynamic conditions prior to high-impact severe weather events with varying predictive skill. Deep-layer vertical shear between 1000--500 hPa is found to be a significant discriminator in slight risk forecast skill where high-impact events with less than 31-kt shear have lower threat scores than high-impact events with higher shear values. Case study analysis of type 1 events suggests the environment over which severe weather occurs is characterized by high downdraft convective available potential energy, steep low-level lapse rates, and high lifting condensation level heights that contribute to an elevated risk of severe wind.

Perioperative outcomes and adverse events of minimally invasive versus open posterior lumbar fusion: meta-analysis and systematic review.

PubMed

Goldstein, Christina L; Macwan, Kevin; Sundararajan, Kala; Rampersaud, Y Raja

2016-03-01

The objective of this study was to determine the clinical comparative effectiveness and adverse event rates of posterior minimally invasive surgery (MIS) compared with open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF). A systematic review of the Medline, EMBASE, PubMed, Web of Science, and Cochrane databases was performed. A hand search of reference lists was conducted. Studies were reviewed by 2 independent assessors to identify randomized controlled trials (RCTs) or comparative cohort studies including at least 10 patients undergoing MIS or open TLIF/PLIF for degenerative lumbar spinal disorders and reporting at least 1 of the following: clinical outcome measure, perioperative clinical or process measure, radiographic outcome, or adverse events. Study quality was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. When appropriate, a meta-analysis of outcomes data was conducted. The systematic review and reference list search identified 3301 articles, with 26 meeting study inclusion criteria. All studies, including 1 RCT, were of low or very low quality. No significant difference regarding age, sex, surgical levels, or diagnosis was identified between the 2 cohorts (856 patients in the MIS cohort, 806 patients in the open cohort). The meta-analysis revealed changes in the perioperative outcomes of mean estimated blood loss, time to ambulation, and length of stay favoring an MIS approach by 260 ml (p < 0.00001), 3.5 days (p = 0.0006), and 2.9 days (p < 0.00001), respectively. Operative time was not significantly different between the surgical techniques (p = 0.78). There was no significant difference in surgical adverse events (p = 0.97), but MIS cases were significantly less likely to experience medical adverse events (risk ratio [MIS vs open] = 0.39, 95% confidence interval 0.23-0.69, p = 0.001). No difference in nonunion (p = 0.97) or reoperation rates (p = 0.97) was observed. Mean Oswestry Disability Index scores were slightly better in the patients undergoing MIS (n = 346) versus open TLIF/PLIF (n = 346) at a median follow-up time of 24 months (mean difference [MIS - open] = 3.32, p = 0.001). The result of this quantitative systematic review of clinical comparative effectiveness research examining MIS versus open TLIF/PLIF for degenerative lumbar pathology suggests equipoise in patient-reported clinical outcomes. Furthermore, a meta-analysis of adverse event data suggests equivalent rates of surgical complications with lower rates of medical complications in patients undergoing minimally invasive TLIF/PLIF compared with open surgery. The quality of the current comparative evidence is low to very low, with significant inherent bias.

Relational event models for longitudinal network data with an application to interhospital patient transfers.

PubMed

Vu, Duy; Lomi, Alessandro; Mascia, Daniele; Pallotti, Francesca

2017-06-30

The main objective of this paper is to introduce and illustrate relational event models, a new class of statistical models for the analysis of time-stamped data with complex temporal and relational dependencies. We outline the main differences between recently proposed relational event models and more conventional network models based on the graph-theoretic formalism typically adopted in empirical studies of social networks. Our main contribution involves the definition and implementation of a marked point process extension of currently available models. According to this approach, the sequence of events of interest is decomposed into two components: (a) event time and (b) event destination. This decomposition transforms the problem of selection of event destination in relational event models into a conditional multinomial logistic regression problem. The main advantages of this formulation are the possibility of controlling for the effect of event-specific data and a significant reduction in the estimation time of currently available relational event models. We demonstrate the empirical value of the model in an analysis of interhospital patient transfers within a regional community of health care organizations. We conclude with a discussion of how the models we presented help to overcome some the limitations of statistical models for networks that are currently available. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

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

DOE PAGES

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

2018-02-02

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

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

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

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

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

Wave-height hazard analysis in Eastern Coast of Spain - Bayesian approach using generalized Pareto distribution

NASA Astrophysics Data System (ADS)

Egozcue, J. J.; Pawlowsky-Glahn, V.; Ortego, M. I.

2005-03-01

Standard practice of wave-height hazard analysis often pays little attention to the uncertainty of assessed return periods and occurrence probabilities. This fact favors the opinion that, when large events happen, the hazard assessment should change accordingly. However, uncertainty of the hazard estimates is normally able to hide the effect of those large events. This is illustrated using data from the Mediterranean coast of Spain, where the last years have been extremely disastrous. Thus, it is possible to compare the hazard assessment based on data previous to those years with the analysis including them. With our approach, no significant change is detected when the statistical uncertainty is taken into account. The hazard analysis is carried out with a standard model. Time-occurrence of events is assumed Poisson distributed. The wave-height of each event is modelled as a random variable which upper tail follows a Generalized Pareto Distribution (GPD). Moreover, wave-heights are assumed independent from event to event and also independent of their occurrence in time. A threshold for excesses is assessed empirically. The other three parameters (Poisson rate, shape and scale parameters of GPD) are jointly estimated using Bayes' theorem. Prior distribution accounts for physical features of ocean waves in the Mediterranean sea and experience with these phenomena. Posterior distribution of the parameters allows to obtain posterior distributions of other derived parameters like occurrence probabilities and return periods. Predictives are also available. Computations are carried out using the program BGPE v2.0.

[Social-psychological factors contributing to male juvenile delinquency].

PubMed

Wei, Hong-Ping; Yang, Fang-Ru

2011-11-01

To study the major social-psychological factors contributing to male juvenile delinquency. One hundred and thirty-seven cases of male juvenile delinquents (delinquent group) and 145 aged-matched male students (control group) were enrolled in this case-control study. A questionnaire survey was conducted using the Adolescent Self-Rating Life Events Check List, the Coping Style Questionnaire, the Family Environment Scale-Chinese version, and the Social Support Rating Scale. The monovariate analysis showed that the total score and the scores of some factors of negative life events, the scores of immature coping styles and family conflicts, and the proportion of broken families in the delinquent group were significantly higher than those in the control group. In contrast, the scores of educational levels, study stress factor in the negative life events, mature coping styles, family environments and social supports were significantly lower in the delinquent group than those in the control group. The multivariate factors analysis showed that 7 variables were enrolled into the discriminatory equations, including negative life events (interpersonal relationship and healthy adaptation), self-condemn styles, family conflicts, subjective supports, objective supports, and utilization of social supports. The total accuracy of this equation was 92.2%. Negative life events in the interpersonal relationship and healthy adaptation, self-condemn styles, family conflicts, and weak social support system may be major social-psychological factors contributing to male juvenile delinquency.

Composite Analysis of Cold Season Atmospheric River Events: Extreme Precipitation and Flooding over the Western United States

NASA Astrophysics Data System (ADS)

Eldardiry, H.; Hossain, F.

2017-12-01

Atmospheric Rivers (ARs) are narrow elongated corridors with horizontal water vapor transport located within the warm sector of extratropical cyclones. While it is widely known that most of heavy rainfall events across the western United States (US) are driven by ARs, the connection between atmospheric conditions and precipitation during an AR event has not been fully documented. In this study, we present a statistical analysis of the connection between precipitation, temperature, wind, and snowpack during the cold season AR events hitting the coastal regions of the western US. For each AR event, the precipitation and other atmospheric variables are retrieved through the dynamic downscaling of NCEP/NCAR Reanalysis product using the Advanced Research Weather Research and Forecasting Model (ARW-WRF). The results show a low frequency of precipitation (below 0.3) during AR events that reflects the connection of AR with extreme precipitation. Examining the horizontal wind speed during AR events indicates a high correlation (above 0.7) with precipitation. In addition, high levels of snow water equivalence (SWE) are also noticed along the mountainous regions, e.g., Cascade Range and Sierra-Nevada mountain range, during most of AR events. Addressing the impact of duration on the frequency of precipitation, we develop Intensity-Duration-Frequency (IDF) curves during AR events that can potentially describe the future predictability of precipitation along the north and south coast. To complement our analysis, we further investigate the flooding events recorded in the National Centers for Environmental Information (NCEI) storm events database. While some flooding events are attributed to heavy rainfall associated with an AR event, other flooding events are significantly connected to the increase in the snowmelt before the flooding date. Thus, we introduce an index that describes the contribution of rainfall vs snowmelt and categorizes the flooding events during an AR event into rain-driven and snow-driven events. Such categorization can provide insight into whether or not an AR will produce extreme precipitation or flooding. The results from such investigations are important to understand historical AR events and assess how precipitation and flooding might evolve in future climate.

Comparison of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on cardiovascular outcomes in hypertensive patients with type 2 diabetes mellitus: A PRISMA-compliant systematic review and meta-analysis.

PubMed

Lv, Xiaodan; Zhang, Yingshi; Niu, Yixuan; Song, Qi; Zhao, Qingchun

2018-04-01

Previous studies seem to show different effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) on cardiovascular (CV) events in hypertensive patients with type 2 diabetes mellitus (T2DM). Our objective was to analyze which are preferable on the incidence of all-cause mortality, CV death, and major CV events in hypertensive patients with T2DM. PubMed, MEDLINE, and EMBASE were searched for randomized controlled trials (RCTs) published up to June 2016 with ACEI or ARBs as the intervention for hypertensive patients with T2DM. The primary end points were all-cause mortality and CV death. The secondary end points were myocardial infarction (MI), stroke, heart failure (HF), and CV events. Two investigators extracted the information independently. Data were pooled using a fixed-effects model or a random-effects model if significant heterogeneity was present. A total of 13 trials were included for analysis, 5 ACEI trials (24,976 patients) and 8 ARB trials (22,032 patients) followed for a mean of 3.8 years. Treatment with ACEI was associated with significantly reduction in all-cause mortality [odds ratio (OR) 0.87; 95% confidence interval (95% CI), 0.80-0.94], CV death (OR 0.81; 95% CI, 0.68-0.98), and other CV outcomes such as MI (0R 0.77; 95% CI, 0.66-0.90), stroke (OR 0.88; 95% CI, 0.78-0.99), HF (OR 0.65; 95% CI, 0.47-0.90), and CV events (OR 0.83; 95% CI, 0.73-0.95), whereas ARBs therapy had no significant reduction in the results of many primary and secondary outcomes. This meta-analysis suggests that treatment with ACEI showed a significant CV protection for all-cause mortality, CV death, and major CV events, whereas ARBs had no benefits on these outcomes except MI. In consideration of high mortality and morbidity, ACEI was preferable than ARBs on patients with hypertension and T2DM.

Genetic consequences of sequential founder events by an island-colonizing bird.

PubMed

Clegg, Sonya M; Degnan, Sandie M; Kikkawa, Jiro; Moritz, Craig; Estoup, Arnaud; Owens, Ian P F

2002-06-11

The importance of founder events in promoting evolutionary changes on islands has been a subject of long-running controversy. Resolution of this debate has been hindered by a lack of empirical evidence from naturally founded island populations. Here we undertake a genetic analysis of a series of historically documented, natural colonization events by the silvereye species-complex (Zosterops lateralis), a group used to illustrate the process of island colonization in the original founder effect model. Our results indicate that single founder events do not affect levels of heterozygosity or allelic diversity, nor do they result in immediate genetic differentiation between populations. Instead, four to five successive founder events are required before indices of diversity and divergence approach that seen in evolutionarily old forms. A Bayesian analysis based on computer simulation allows inferences to be made on the number of effective founders and indicates that founder effects are weak because island populations are established from relatively large flocks. Indeed, statistical support for a founder event model was not significantly higher than for a gradual-drift model for all recently colonized islands. Taken together, these results suggest that single colonization events in this species complex are rarely accompanied by severe founder effects, and multiple founder events and/or long-term genetic drift have been of greater consequence for neutral genetic diversity.

Gambling score in earthquake prediction analysis

NASA Astrophysics Data System (ADS)

Molchan, G.; Romashkova, L.

2011-03-01

The number of successes and the space-time alarm rate are commonly used to characterize the strength of an earthquake prediction method and the significance of prediction results. It has been recently suggested to use a new characteristic to evaluate the forecaster's skill, the gambling score (GS), which incorporates the difficulty of guessing each target event by using different weights for different alarms. We expand parametrization of the GS and use the M8 prediction algorithm to illustrate difficulties of the new approach in the analysis of the prediction significance. We show that the level of significance strongly depends (1) on the choice of alarm weights, (2) on the partitioning of the entire alarm volume into component parts and (3) on the accuracy of the spatial rate measure of target events. These tools are at the disposal of the researcher and can affect the significance estimate. Formally, all reasonable GSs discussed here corroborate that the M8 method is non-trivial in the prediction of 8.0 ≤M < 8.5 events because the point estimates of the significance are in the range 0.5-5 per cent. However, the conservative estimate 3.7 per cent based on the number of successes seems preferable owing to two circumstances: (1) it is based on relative values of the spatial rate and hence is more stable and (2) the statistic of successes enables us to construct analytically an upper estimate of the significance taking into account the uncertainty of the spatial rate measure.

Stress, self-esteem, and suicidal ideation in late adolescents.

PubMed

Wilburn, Victor R; Smith, Delores E

2005-01-01

The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The hypothesis that self-esteem would moderate the effects of life stressors on suicidal ideation was supported at the .06 level. A significant minority of the sample indicated having thoughts severe enough to be classified as clinical suicidal ideation. In general, participants who had experienced negative life events in the 6 to 12 months prior to participating in the study had lower self-esteem than those who had similar stresses within the prior six months. However, the opposite was true for clinical suicidal ideators; those who experienced negative life stressors recently had lower self-esteem than those who experienced negative life events six months to a year in the past.

Appraisals of negative events by preadolescent children of divorce.

PubMed

Sheets, V; Sandler, I; West, S G

1996-10-01

This study investigated the appraisals of the significance of negative events made by 256 preadolescent children of divorce. Appraisals were assessed by a 24-item self-report scale. Confirmatory factor analysis of this scale found support for a 3-dimensional model: negative self-appraisal, negative other-appraisal, and material loss. Differentiation between the dimensions of appraisal increased with age in both cross-sectional and over-time data. Evidence for convergent and discriminant validity of the self-report measure of appraisals was found with scores derived from children's open-ended descriptions of their appraisals. Cross-sectional structural equation models found significant paths between negative appraisal and psychological symptoms, over and above the direct effects of the traditional life event measure of stress. Structural equation modeling of longitudinal (5.5 months) data found a significant path from Time 1 appraisal to Time 2 anxiety for the older children.

Incidence and Risk Factors for Perioperative Cardiovascular and Respiratory Adverse Events in Pediatric Patients With Congenital Heart Disease Undergoing Noncardiac Procedures.

PubMed

Lee, Sandra; Reddington, Elise; Koutsogiannaki, Sophia; Hernandez, Michael R; Odegard, Kirsten C; DiNardo, James A; Yuki, Koichi

2018-04-27

While mortality and adverse perioperative events after noncardiac surgery in children with a broad range of congenital cardiac lesions have been investigated using large multiinstitutional databases, to date single-center studies addressing adverse outcomes in children with congenital heart disease (CHD) undergoing noncardiac surgery have only included small numbers of patients with significant heart disease. The primary objective of this study was to determine the incidences of perioperative cardiovascular and respiratory events in a large cohort of patients from a single institution with a broad range of congenital cardiac lesions undergoing noncardiac procedures and to determine risk factors for these events. We identified 3010 CHD patients presenting for noncardiac procedures in our institution over a 5-year period. We collected demographic information, including procedure performed, cardiac diagnosis, ventricular function as assessed by echocardiogram within 6 months of the procedure, and classification of CHD into 3 groups (minor, major, or severe CHD) based on residual lesion burden and cardiovascular functional status. Characteristics related to conduct of anesthesia care were also collected. The primary outcome variables for our analysis were the incidences of intraoperative cardiovascular and respiratory events. Univariable and multivariable logistic regressions were used to determine risk factors for these 2 outcomes. The incidence of cardiovascular events was 11.5% and of respiratory events was 4.7%. Univariate analysis and multivariable analysis demonstrated that American Society of Anesthesiologists (≥3), emergency cases, major and severe CHD, single-ventricle physiology, ventricular dysfunction, orthopedic surgery, general surgery, neurosurgery, and pulmonary procedures were associated with perioperative cardiovascular events. Respiratory events were associated with American Society of Anesthesiologists (≥4) and otolaryngology, gastrointestinal, general surgery, and maxillofacial procedures. Intraoperative cardiovascular events and respiratory events in patients with CHD were relatively common. While cardiovascular events were highly associated with cardiovascular status, respiratory events were not associated with cardiovascular status.

Predictability of rogue events.

PubMed

Birkholz, Simon; Brée, Carsten; Demircan, Ayhan; Steinmeyer, Günter

2015-05-29

Using experimental data from three different rogue wave supporting systems, determinism, and predictability of the underlying dynamics are evaluated with methods of nonlinear time series analysis. We included original records from the Draupner platform in the North Sea as well as time series from two optical systems in our analysis. One of the latter was measured in the infrared tail of optical fiber supercontinua, the other in the fluence profiles of multifilaments. All three data sets exhibit extreme-value statistics and exceed the significant wave height in the respective system by a factor larger than 2. Nonlinear time series analysis indicates a different degree of determinism in the systems. The optical fiber scenario is found to be driven by quantum noise whereas rogue waves emerge as a consequence of turbulence in the others. With the large number of rogue events observed in the multifilament system, we can systematically explore the predictability of such events in a turbulent system. We observe that rogue events do not necessarily appear without a warning, but are often preceded by a short phase of relative order. This surprising finding sheds some new light on the fascinating phenomenon of rogue waves.

Age, cumulative trauma and stressful life events, and post-traumatic stress symptoms among older adults in prison: do subjective impressions matter?

PubMed

Maschi, Tina; Morgen, Keith; Zgoba, Kristen; Courtney, Deborah; Ristow, Jennifer

2011-10-01

The aging prison population in the United States presents a significant public health challenge with high rates of trauma and mental health issues that the correctional system alone is ill-prepared to address. The purpose of this study was to examine the relationship of age, objective, and subjective measures of trauma and stressful life events and post-traumatic stress symptoms among older adults in prison. Data were gathered from 334 prisoners (aged 55+) housed in the New Jersey Department of Corrections, as of September 2010. An anonymous self-report, self-administered survey was mailed to the total population of 1,000 prisoners aged 55 years and older. Objective and subjective trauma was measured using the Life Stressors Checklist-Revised (LSC-R), and post-traumatic stress symptoms were measured using the Civilian Version of the Post-traumatic Stress Scale. Results of a path analysis revealed that past year subjective impressions of traumatic and stressful life events had a positive and significant relationship to current post-traumatic stress symptoms. Age was found to have a significant and inverse relationship to subjective traumatic and stressful life events. That is, younger participants reported higher levels of cumulative traumatic and stressful life events and past year subjective ratings of being bothered by these past events. These findings have significance for interdisciplinary/interprofessional practice and appropriate institutional and community care, including reentry planning of older adults in the criminal justice system.

The role of tributary mixing in chemical variations at a karst spring, Milandre, Switzerland

NASA Astrophysics Data System (ADS)

Perrin, J.; Jeannin, P.-Y.; Cornaton, F.

2007-01-01

SummarySolute concentration variations during flood events were investigated in a karst aquifer of the Swiss Jura. Observations were made at the spring, and at the three main subterraneous tributaries feeding the spring. A simple transient flow and transport numerical model was able to reproduce chemographs and hydrographs observed at the spring, as a result of a mixing of the concentration and discharge of the respective tributaries. Sensitivity analysis carried out with the model showed that it is possible to produce chemical variations at the spring even if all tributaries have constant (but different for each of them) solute concentrations. This process is called tributary mixing. The good match between observed and modelled curves indicate that, in the phreatic zone, tributary mixing is probably an important process that shapes spring chemographs. Chemical reactions and other mixing components (e.g. from low permeability volumes) have a limited influence. Dissolution-related (calcium, bicarbonate, specific conductance) and pollution-related parameters (nitrate, chloride, potassium) displayed slightly different behaviours: during moderate flood events, the former showed limited variations compared to the latter. During large flood events, both presented chemographs with significant changes. No significant event water participates in moderate flood events and tributary mixing will be the major process shaping chemographs. Variations are greater for parameters with higher spatial variability (e.g. pollution-related). Whereas for large flood events, the contribution of event water becomes significant and influences the chemographs of all the parameters. As a result, spring water vulnerability to an accidental pollution is low during moderate flood events and under base flow conditions. It strongly increases during large flood events, because event water contributes to the spring discharge.

[Effects of long-term isolation and anticipation of significant event on sleep: results of the project "Mars-520"].

PubMed

Zavalko, I M; Rasskazova, E I; Gordeev, S A; Palatov, S Iu; Kovrov, G V

2013-01-01

The purpose of the research was to study effect of long-term isolation on night sleep. The data were collected during international ground simulation of an interplanetary manned flight--"Mars-500". The polysomnographic recordings of six healthy men were performed before, four times during and after 520-days confinement. During the isolation sleep efficiency and delta-latency decreased, while sleep latency increased. Post-hoc analysis demonstrate significant differences between background and the last (1.5 months before the end of the experiment) measure during isolation. Frequency of nights with low sleep efficiency rose on the eve of the important for the crew events (simulation of Mars landing and the end of the confinement). Two weeks after the landing simulation, amount of the nights with a low sleep efficiency significantly decreased. Therefore, anticipation of significant event under condition of long-term isolation might result in sleep worsening in previously healthy men, predominantly difficulties getting to sleep.

Accident study of torrential protective structures based on the French RTM database

NASA Astrophysics Data System (ADS)

Boncompain, Ingrid; Quefféléan, Yann; Carladous, Simon

2017-04-01

Torrential protective structures such as dikes, sediment traps, and check dams aim to reduce damage on elements at risk. They are built given a reference scenario. Nevertheless, this scenario can be exceeded or structures can fail because of their design or their ageing. We later talk about "accidents". The 1996 Aras disaster near Biescas (Spain) showed that consequences can be significant: 35 of 40 check dams were destroyed which involved 87 fatalities in a campsite. The accident probability and its consequences must be taken into account to analyze risk. Databases are useful tools to extract needed information. In France, the Restoration of Mountainous Areas department (RTM) has been public funded to develop a database, specific to mountainous areas (the Alps and the Pyrenees). Almost 12 500 check dams, 80 sediment traps and 600 dikes were registered in public forests in 2011. These samples were assumed significant for check dams and sediment traps but not for dikes because the most part was missing. In parallel, more than 31 000 torrential events were registered. Given these elements, an accident study was developed. We first extracted 1 925 events with accidents on protective structures: 39 % occurred during the 19th century and 53 % have occurred since 1900. Sediment traps were involved in 37 events, check dams in 336, and dikes in 1488. Then, a detailed analysis was specifically carried out for check dams. Event phenomena were extracted: torrential flood, liquid flood, snow avalanche, rock fall, and landslide. Accident typology was also specified: scouring, breaking of several check dams, total or partial destruction of one structure, overflowing. Causes of accidents on check dams were first analyzed. Torrential floods were responsible of 85 % of events (284 of 336) even if other phenomena must be also taken into account. Almost 45 % of events (152 of 336) involved total destruction of one or several check dams. Taking into account events for the last 150 years, 30 events were registered with destruction of several check dams: the annual probability of occurrence is 3.10-4. Analyzing consequences, only 11 of previously retained events (1925) were registered with fatalities. Finally, these quantitative elements were compared to qualitative feedback analysis from field practitioners and were illustrated with the 1987 Saint-Antoine event, in Modane. The total or partial destruction of 25 check dams released between 20 000 and 30 000 m3, which was one third of the estimated debris flow volume (85 000 m3) which damaged an industrial area. The lack of their maintenance partially explained this accident. As a conclusion, we must keep in mind that these results are limited to available data (all events have not been necessarily reported). Accidents on check dams are rare according to these data. It can be due to their general maintenance. This first analysis could be improved taking into account expert analysis, completing with information from other countries databases and formalizing the approach through a dependability analysis framework.

Evaluation of the fibromyalgia impact questionnaire at baseline as a predictor for time to pain improvement in two clinical trials of pregabalin.

PubMed

Bushmakin, A G; Cappelleri, J C; Chandran, A B; Zlateva, G

2013-01-01

The Fibromyalgia Impact Questionnaire (FIQ) is a patient-reported outcome that evaluates the impact of fibromyalgia (FM) on daily life. This study evaluated the relationships between the functional status of FM patients, measured with the FIQ at baseline, and median time to a clinically relevant pain reduction. Data were derived from two randomised, placebo-controlled trials that evaluated pregabalin 300, 450 and 600 mg/day for the treatment of FM. The Kaplan-Meier (nonparametric) method was applied to estimate median times to 'transient' and 'stable' events. The transient event was defined as a ≥ 27.9% improvement on an 11-point daily pain diary scale (0 = no pain, 10 = worst possible pain), and the stable event was defined as the mean of the daily improvements ≥ 27.9% relative to baseline over the subsequent study duration starting on the day of the transient event. A parametric model using time-to-event analysis was developed for evaluating the relationship between baseline FIQ score and the median time to these events. Median time was longer among patients treated with placebo relative to pregabalin for the transient events (11-12 days vs. 5-7 days) and stable events (86 days vs. 13-29 days). A significant association was observed between baseline FIQ scores and median time to transient and stable events (p < 0.001). Median times to events were similar between the studies. For transient pain reduction events, median times ranged from 3.0 to 4.5 days for baseline FIQ scores of 10, and 9.1-9.6 days for FIQ scores of 100; for stable pain reduction events, the median time ranged from 11.0 to 13.0 days and from 27.0 to 28.5 days for baseline FIQ scores of 10 and 100 respectively. Time to a clinically relevant reduction in pain was significantly associated with FM severity at baseline as measured by the FIQ. Such an analysis can inform patient and physician expectations in clinical practice. © 2012 Blackwell Publishing Ltd.

Infection burden among medical events onboard cargo ships: a four-year study.

PubMed

Marimoutou, Cyril; Tufo, Davide; Chaudet, Hervé; Abdul Samad, Marc; Gentile, Gaëtan; Drancourt, Michel

2017-05-01

. Cargo ships are medically isolated, yet neglected environments. We aimed to know about medical events onboard cargo ships. We reviewed all the medical events onboard a large commercial 471-cargo ship company for 4 years. Medical events were recorded within 20 categories as routinely used by Medical Maritime Consulting Centers, using a 4-level medical gravity score. The χ 2 test and logistic regression and correspondence analyses were used for the analysis of qualitative variables. Excluding wounds and burns, a total of 322 illness events were notified by onboard health officers for 471 ships totalizing 46 navigation/months. 250 non-infectious events and 72 cases of infection yielded an incidence of 7.75 medical events for 1000 person-years. Infections comprised 25 digestive tract infections, 17 skin infections, 8 urinary tract infections, 5 dental infections, 4 isolated fevers, 3 Ear-Nose-Throat and respiratory tract infections, 2 ocular infections, myalgia and orchitis and 1 case of mediastinal infection. The mean age for sailors diagnosed with infection (37.7 ± 10.5 years) was significantly younger than the mean age of sailors diagnosed with non-infectious disease (40.8 ± 11.2 years) ( P  = 0.04). In affected sailors, the proportion of death and hospitalization among infectious disease cases (26/69, 37.7%) was significantly higher than the proportion of death and hospitalization for non-infectious disease cases (48/242, 19.8%) ( P   =  0.02). The correspondence analysis showed that the routes may be classified according to two main independent risks, digestive infections and skin infections. We observed a statistically significant correlation between the severity of medical events and the maritime route "North Europe-OI-Australia-India-North Europe". These data illustrate a previously underreported variability of the medical risks in various maritime routes; and help promoting targeted medical interventions including the implementation of onboard point-of-care laboratories, to further increase the rapidity of the diagnosis and the medical management onboard cargo ships. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Results from the OPERA experiment in the CNGS beam

NASA Astrophysics Data System (ADS)

Di Marco, N.; OPERA Collaboration

2016-05-01

The OPERA experiment at the Gran Sasso underground laboratory was designed to study ν μ → ν τ oscillations in appearance mode in the CNGS neutrino beam. In this paper we report the detection of the 5 th ν τ candidate event found in the analysis of an enlarged data sample. Given the number of analysed events and the low background, ν μ → ν τ oscillations have been established with a significance of 5.1σ. The analysis of the present electron neutrino sample in the framework of the 3 + 1 sterile model is also presented. Finally the analysis of the muon charge ratio in the cosmic ray sample is discussed.

Development and assessment of stressful life events subscales - A preliminary analysis.

PubMed

Buccheri, Teresa; Musaad, Salma; Bost, Kelly K; Fiese, Barbara H

2018-01-15

Stress affects people of all ages, genders, and cultures and is associated with physical and psychological complications. Stressful life events are an important research focus and a psychometrically valid measure could provide useful clinical information. The purpose of the study was to develop a reliable and valid measurement of stressful life events and to assess its reliability and validity using established measures of social support, stress, depression, anxiety and maternal and child health. The authors used an adaptation from the Social Readjustment Rating Scale (SRRS) to describe the prevalence of life events; they developed a 4-factor stressful life events subscales and used Medical Outcomes Social Support Scale, Social Support Scale, Depression, Anxiety and Stress Scale and 14 general health items for validity analysis. Analyses were performed with descriptive statistics, Cronbach's alpha, Spearman's rho, Chi-square test or Fisher's exact test and Wilcoxon 2-sample test. The 4-factor stressful life events subscales showed acceptable reliability. The resulting subscale scores were significantly associated with established measures of social support, depression, anxiety, stress, and caregiver health indicators. The study presented a number of limitations in terms of design and recall bias. Despite the presence of a number of limitations, the study provided valuable insight and suggested that further investigation is needed in order to determine the effectiveness of the measures in revealing the family's wellbeing and to develop and strengthen a more detailed analysis of the stressful life events/health association. Copyright © 2017 Elsevier B.V. All rights reserved.

Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events.

PubMed

Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka

2018-01-01

An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors. From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality. During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, p=0.005). The receiver operating characteristic curve revealed that 5mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p<0.001). In the validation cohort, the presence of a large IAD (IAD ≥5mmHg) was significantly associated with the primary endpoint (p=0.021). IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5mmHg. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Using high-frequency sensors to identify hydroclimatological controls on storm-event variability in catchment nutrient fluxes and source zone activation

NASA Astrophysics Data System (ADS)

Blaen, Phillip; Khamis, Kieran; Lloyd, Charlotte; Krause, Stefan

2017-04-01

At the river catchment scale, storm events can drive highly variable behaviour in nutrient and water fluxes, yet short-term dynamics are frequently missed by low resolution sampling regimes. In addition, nutrient source contributions can vary significantly within and between storm events. Our inability to identify and characterise time dynamic source zone contributions severely hampers the adequate design of land use management practices in order to control nutrient exports from agricultural landscapes. Here, we utilise an 8-month high-frequency (hourly) time series of streamflow, nitrate concentration (NO3) and fluorescent dissolved organic matter concentration (FDOM) derived from optical in-situ sensors located in a headwater agricultural catchment. We characterised variability in flow and nutrient dynamics across 29 storm events. Storm events represented 31% of the time series and contributed disproportionately to nutrient loads (43% of NO3 and 36% of CDOM) relative to their duration. Principal components analysis of potential hydroclimatological controls on nutrient fluxes demonstrated that a small number of components, representing >90% of variance in the dataset, were highly significant model predictors of inter-event variability in catchment nutrient export. Hysteresis analysis of nutrient concentration-discharge relationships suggested spatially discrete source zones existed for NO3 and FDOM, and that activation of these zones varied on an event-specific basis. Our results highlight the benefits of high-frequency in-situ monitoring for characterising complex short-term nutrient dynamics and unravelling connections between hydroclimatological variability and river nutrient export and source zone activation under extreme flow conditions. These new process-based insights are fundamental to underpinning the development of targeted management measures to reduce nutrient loading of surface waters.

Exercise-induced hypertension, cardiovascular events, and mortality in patients undergoing exercise stress testing: a systematic review and meta-analysis.

PubMed

Schultz, Martin G; Otahal, Petr; Cleland, Verity J; Blizzard, Leigh; Marwick, Thomas H; Sharman, James E

2013-03-01

The prognostic relevance of a hypertensive response to exercise (HRE) is ill-defined in individuals undergoing exercise stress testing. The study described here was intended to provide a systematic review and meta-analysis of published literature to determine the value of exercise-related blood pressure (BP) (independent of office BP) for predicting cardiovascular (CV) events and mortality. Online databases were searched for published longitudinal studies reporting exercise-related BP and CV events and mortality rates. We identified for review 12 longitudinal studies with a total of 46,314 individuals without significant coronary artery disease, with total CV event and mortality rates recorded over a mean follow-up of 15.2±4.0 years. After adjustment for age, office BP, and CV risk factors, an HRE at moderate exercise intensity carried a 36% greater rate of CV events and mortality (95% CI, 1.02-1.83, P = 0.039) than that of subjects without an HRE. Additionally, each 10mm Hg increase in systolic BP during exercise at moderate intensity was accompanied by a 4% increase in CV events and mortality, independent of office BP, age, or CV risk factors (95% CI, 1.01-1.07, P = 0.02). Systolic BP at maximal workload was not significantly associated with the outcome of an increased rate of CV, whether analyzed as a categorical (HR=1.49, 95% CI, 0.90-2.46, P = 0.12) or a continuous (HR=1.01, 95% CI, 0.98-1.04, P = 0.53) variable. An HRE at moderate exercise intensity during exercise stress testing is an independent risk factor for CV events and mortality. This highlights the need to determine underlying pathophysiological mechanisms of exercise-induced hypertension.

The OPERA experiment

NASA Astrophysics Data System (ADS)

Agafonova, N.; Aleksandrov, A.; Anokhina, A.; Aoki, S.; Ariga, A.; Ariga, T.; Bender, D.; Bertolin, A.; Bozza, C.; Brugnera, R.; Buonaura, A.; Buontempo, S.; Büttner, B.; Chernyavsky, M.; Chukanov, A.; Consiglio, L.; D'Ambrosio, N.; De Lellis, G.; De Serio, M.; Del Amo Sanchez, P.; Di Crescenzo, A.; Di Ferdinando, D.; Di Marco, N.; Dmitrievski, S.; Dracos, M.; Duchesneau, D.; Dusini, S.; Dzhatdoev, T.; Ebert, J.; Ereditato, A.; Fini, R. A.; Fukuda, T.; Galati, G.; Garfagnini, A.; Giacomelli, G.; Göllnitz, C.; Goldberg, J.; Gornushkin, Y.; Grella, G.; Guler, M.; Gustavino, C.; Hagner, C.; Hara, T.; Hollnagel, A.; Hosseini, B.; Ishida, H.; Ishiguro, K.; Jakovcic, K.; Jollet, C.; Kamiscioglu, C.; Kamiscioglu, M.; Kawada, J.; Kim, J. H.; Kim, S. H.; Kitagawa, N.; Klicek, B.; Kodama, K.; Komatsu, M.; Kose, U.; Kreslo, I.; Lauria, A.; Lenkeit, J.; Ljubicic, A.; Longhin, A.; Loverre, P.; Malgin, A.; Malenica, M.; Mandrioli, G.; Matsuo, T.; Matveev, V.; Mauri, N.; Medinaceli, E.; Meregaglia, A.; Mikado, S.; Monacelli, P.; Montesi, M. C.; Morishima, K.; Muciaccia, M. T.; Naganawa, N.; Naka, T.; Nakamura, M.; Nakano, T.; Nakatsuka, Y.; Niwa, K.; Ogawa, S.; Okateva, N.; Olshevsky, A.; Omura, T.; Ozaki, K.; Paoloni, A.; Park, B. D.; Park, I. G.; Pasqualini, L.; Pastore, A.; Patrizii, L.; Pessard, H.; Pistillo, C.; Podgrudkov, D.; Polukhina, N.; Pozzato, M.; Pupilli, F.; Roda, M.; Rokujo, H.; Roganova, T.; Rosa, G.; Ryazhskaya, O.; Sato, O.; Schembri, A.; Shakiryanova, I.; Shchedrina, T.; Sheshukov, A.; Shibuya, H.; Shiraishi, T.; Shoziyoev, G.; Simone, S.; Sioli, M.; Sirignano, C.; Sirri, G.; Spinetti, M.; Stanco, L.; Starkov, N.; Stellacci, S. M.; Stipcevic, M.; Strauss, T.; Strolin, P.; Takahashi, S.; Tenti, M.; Terranova, F.; Tioukov, V.; Tufanli, S.; Vilain, P.; Vladimirov, M.; Votano, L.; Vuilleumier, J. L.; Wilquet, G.; Wonsak, B.; Yoon, C. S.; Zemskova, S.; Zghiche, A.

2015-10-01

The OPERA experiment was designed to study νμ →ντ oscillations in appearance mode using the CERN to Gran Sasso high energy neutrino beam. From 2008 to 2012, 19505 CNGS neutrino interactions were recorded in the OPERA detector. At the present status of the analysis, 4 ντ candidate events have been observed, establishing the oscillation mechanism in the atmospheric sector with a significance of 4.2 σ. The oscillation analysis will be presented in detail and the candidate events will be described. The final measurement of the atmospheric muon charge ratio in the TeV region will be also reported.

Method and apparatus for detecting and determining event characteristics with reduced data collection

NASA Technical Reports Server (NTRS)

Totman, Peter D. (Inventor); Everton, Randy L. (Inventor); Egget, Mark R. (Inventor); Macon, David J. (Inventor)

2007-01-01

A method and apparatus for detecting and determining event characteristics such as, for example, the material failure of a component, in a manner which significantly reduces the amount of data collected. A sensor array, including a plurality of individual sensor elements, is coupled to a programmable logic device (PLD) configured to operate in a passive state and an active state. A triggering event is established such that the PLD records information only upon detection of the occurrence of the triggering event which causes a change in state within one or more of the plurality of sensor elements. Upon the occurrence of the triggering event, the change in state of the one or more sensor elements causes the PLD to record in memory which sensor element detected the event and at what time the event was detected. The PLD may be coupled with a computer for subsequent downloading and analysis of the acquired data.

Optimizing collection of adverse event data in cancer clinical trials supporting supplemental indications.

PubMed

Kaiser, Lee D; Melemed, Allen S; Preston, Alaknanda J; Chaudri Ross, Hilary A; Niedzwiecki, Donna; Fyfe, Gwendolyn A; Gough, Jacqueline M; Bushnell, William D; Stephens, Cynthia L; Mace, M Kelsey; Abrams, Jeffrey S; Schilsky, Richard L

2010-12-01

Although much is known about the safety of an anticancer agent at the time of initial marketing approval, sponsors customarily collect comprehensive safety data for studies that support supplemental indications. This adds significant cost and complexity to the study but may not provide useful new information. The main purpose of this analysis was to assess the amount of safety and concomitant medication data collected to determine a more optimal approach in the collection of these data when used in support of supplemental applications. Following a prospectively developed statistical analysis plan, we reanalyzed safety data from eight previously completed prospective randomized trials. A total of 107,884 adverse events and 136,608 concomitant medication records were reviewed for the analysis. Of these, four grade 1 to 2 and nine grade 3 and higher events were identified as drug effects that were not included in the previously established safety profiles and could potentially have been missed using subsampling. These events were frequently detected in subsamples of 400 patients or larger. Furthermore, none of the concomitant medication records contributed to labeling changes for the supplemental indications. Our study found that applying the optimized methodologic approach, described herein, has a high probability of detecting new drug safety signals. Focusing data collection on signals that cause physicians to modify or discontinue treatment ensures that safety issues of the highest concern for patients and regulators are captured and has significant potential to relieve strain on the clinical trials system.

Assessing change in health professions volunteers' perceptions after participating in Special Olympics healthy athlete events.

PubMed

Freudenthal, Jacqueline J; Boyd, Linda D; Tivis, Rick

2010-09-01

This study assessed perceptions of health professions student and faculty volunteers who participated with athletes at the 2009 Special Olympics World Winter Games in Healthy Athlete venues. The volunteers' perceptions and expectations of the abilities of intellectually disabled athletes were measured by administering pre-event and post-event questionnaires consisting of demographic questions and the Prognostic Belief Scale (PBS). Invitations to participate in the study were sent to 165 students and faculty members; of those, eighty (48.5 percent response rate) responded to the pre-event questionnaire, and sixty-seven (40.6 percent response rate) responded to the post-event questionnaire. Of the eighty respondents to the pre-event questionnaire, fifty-five (68.7 percent) also completed the post-event questionnaire. The ANOVA comparing pre- and post-event PBS scores between groups found a trend towards higher scores among the volunteers, but analysis did not demonstrate a significant effect in either group (p=.68) or the interaction of group by time (p=.46). Despite the findings from the PBS, participants' statements suggest the experience had an impact on their perceptions and expectations. Although not statistically significant, this study found a positive trend pre- to post-event in the volunteers' perceptions of the abilities of athletes with intellectual disabilities. In addition to didactic and clinical education, volunteer experiences may enhance care providers' knowledge, skill, and confidence levels for treating clients with intellectual disabilities.

Stress, Self-Esteem, and Suicidal Ideation in Late Adolescents

ERIC Educational Resources Information Center

Wilburn, Victor R.; Smith, Delores E.

2005-01-01

The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The…

Adverse life events as risk factors for behavioural and emotional problems in a 7-year follow-up of a population-based child cohort.

PubMed

Rasmussen, Cathrine Skovmand; Nielsen, Louise Gramstrup; Petersen, Dorthe Janne; Christiansen, Erik; Bilenberg, Niels

2014-04-01

The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events. Data on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change. Parental divorce significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers, decreasers, high persisters and low persisters), we found that children with a consistently high level of behavioural problems also had the highest number of adverse life events compared with any other group. Family break-up was found to be a significant risk factor. This supports findings in previous studies. The fact that no other risk factor proved to be of significance might be due to lack of power in the study. Children experiencing high levels of adverse life events are at high risk of chronic problem behaviour. Thus these risk factors should be assessed in daily clinical practice.

Amplitude and Recurrence Time of LP activity at Mt. Etna, Italy

NASA Astrophysics Data System (ADS)

Cauchie, Léna; Saccorotti, Gilberto; Bean, Christopher

2013-04-01

The manifestation of Long-Period (LP) activity is attested on many volcanoes worldwide and is thought to be associated with the resonant oscillations of subsurface, fluid-filled, cracks and conduits. Nonetheless the actual source mechanism that originates the resonance is still unclear. Different models have been proposed so far, including (i) fluid flow instabilities as periodic degassing and (ii) brittle failure in viscous magmas. Since LP activity usually precedes and accompanies volcanic eruption, the understanding of these sources is crucial for the hazard assessment and eruption early warning. The work is aimed at improving the understanding of the LP source mechanism through a statistical analysis of detailed LP catalogues. The behaviour of LP activity is compared with the empirical laws governing earthquakes recurrence (e.g., Gutenberg-Richter [GR] and Gamma-law distributions), in order to understand what relationships, if any, exist between these two apparently different earthquake classes. In particular, about 13000 events were detected on Mount Etna in August 2005 through a STA/LTA method. For this given period, the volcano does not present particular sign of unrest. The manifestation of the LP events is sustained in time over all the period of analysis. From the analysis of the directional properties, it turns out that the events of this first catalog propagate from 2 distinct sources . Furthermore, the events exhibit a high degree of waveform similarity, and provide a criterion for classification/source separation. The events were then grouped into families of comparable waveforms, resulting also in a separation for their source locations. We then used template signals of each family for a Matched-Filtering of the continuous data streams, in order to discriminate small-amplitude events previously undetected by the STA/LTA triggering method. This procedure allowed for a significant enrichment of the catalogues. The retrieved amplitude distributions, similar for both families, differ instead significantly from the Gutenberg-Richter law, and the inter-event times distributions don't follow a typical Gamma-law. In order to compare these results with a catalogue for which the source mechanism is well-established, we applied the same analysis procedure to a dataset from Stromboli Volcano, where LP activity is closely related to VLP (Very-Long-Period) pulses, in turn associated with the summit explosions. Again, catalogues of thousands of LP events were achieved over one month of seismic records (July 2011). Our results indicate a similar behaviour in terms of both amplitude and inter-event time distributions, with respect to what observed at Mt. Etna. This suggests that the Etna's LP data are likely related with a degassing process occurring at depth. Nonetheless, further studies are needed in order to quantify the time recurrence and amplitude distribution of brittle failure in viscous, stressed magmas. Hopefully, these steps will lead to an improved understanding of LP activity in different volcanic contexts, in turn clarifying its significance in terms of eruption forecasting.

Impact of Percutaneous Coronary Revascularization of Severe Coronary Lesions on Secondary Branches.

PubMed

Cano-García, Macarena; Millán-Gómez, Mercedes; Sánchez-González, Carlos; Alonso-Briales, Juan H; Muñoz-Jiménez, Luz D; Carrasco-Chinchilla, Fernando; Domínguez-Franco, Antonio; Muñoz-García, Antonio J; Bullones-Ramírez, Juan A; Álvarez-Rubiera, Jesús M; de Mora-Martín, Manuel; de Teresa-Galván, Eduardo; Hernández-García, José M; Urbano-Carrillo, Cristóbal A; Jiménez-Navarro, Manuel F

2018-05-30

To analyze the percutaneous revascularization strategy for severe lesions in the secondary branches (SB) (diameter ≥ 2mm) of major epicardial arteries compared with conservative treatment. This study analyzed patients with severe SB lesions who underwent percutaneous revascularization treatment compared with patients who received pharmacological treatment. The study examined the percentage of branch-related events (cardiovascular death, myocardial infarction attributable to SB, or the need for revascularization of the SB). We analyzed 679 SB lesions (662 patients). After a mean follow-up of 22.2±10.5 months, there were no significant differences between the 2 treatment groups regarding the percentage of death from cardiovascular causes (1.7% vs 0.4%; P=.14), nonfatal acute myocardial infarction (AMI) (1.7% vs 1.7%; P=.96), the need for SB revascularization (4.1% vs 5.4%; P=.45) or in the total percentage of events (5.1% vs 6.3%; P=.54). The variables showing an association with event occurrence on multivariate analysis were diabetes (SHR, 2.87; 95%CI, 1.37-5.47; P=.004), prior AMI (SHR, 3.54; 95%CI, 1.77-7.30; P<.0001), SB reference diameter (SHR, 0.16; 95%CI, 0.03-0.97; P=.047), and lesion length (SHR, 3.77; 95%CI, 1.03-1.13; P<.0001). These results remained the same after the propensity score analysis. The percentage of SB-related events during follow-up is low, with no significant differences between the 2 treatment strategies. The variables associated with event occurrence in the multivariate analysis were the presence of diabetes mellitus, prior AMI, and greater lesion length. Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Significant social events and increasing use of life-sustaining treatment: trend analysis using extracorporeal membrane oxygenation as an example.

PubMed

Chen, Yen-Yuan; Chen, Likwang; Huang, Tien-Shang; Ko, Wen-Je; Chu, Tzong-Shinn; Ni, Yen-Hsuan; Chang, Shan-Chwen

2014-03-04

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan. Taiwan's extracorporeal membrane oxygenation uses from 2000 to 2009 were collected from National Health Insurance Research Dataset. The number of the worldwide extracorporeal membrane oxygenation cases was mainly estimated using Extracorporeal Life Support Registry Report International Summary July 2012. The trend of Taiwan's crude annual incidence rate of extracorporeal membrane oxygenation use was compared with that of the rest of the world. Each trend of extracorporeal membrane oxygenation use was examined using joinpoint regression. The measurement was the crude annual incidence rate of extracorporeal membrane oxygenation use. Each of the Taiwan's crude annual incidence rates was much higher than the worldwide one in the same year. Both the trends of Taiwan's and worldwide crude annual incidence rates have significantly increased since 2000. Joinpoint regression selected the model of the Taiwan's trend with one joinpoint in 2006 as the best-fitted model, implying that the significant social events in 2006 were significantly associated with the trend change of extracorporeal membrane oxygenation use following 2006. In addition, significantly social events highlighted by the media are more likely to be associated with the increase of extracorporeal membrane oxygenation use than being fully covered by National Health Insurance. Significant social events, such as a well-known person's successful extracorporeal membrane oxygenation use highlighted by the mass media, are associated with the use of life-sustaining treatment such as extracorporeal membrane oxygenation.

Effect of Intravitreal Anti-Vascular Endothelial Growth Factor Therapy on the Risk of Arterial Thromboembolic Events: A Meta-Analysis

PubMed Central

Lu, Guo-Cai; Wei, Rui-Li

2012-01-01

Background Intravitreal anti-vascular endothelial growth factor (VEGF) monoclonal antibodies are used in ocular neovascular diseases. A consensus has emerged that intravenous anti-VEGF can increase the risk of arterial thromboembolic events. However, the role of intravitreal anti-VEGF in arterial thromboembolism is controversial. Therefore, we did a systematic review and meta-analysis to investigate the effects of intravitreal anti-VEGF on the risk of arterial thromboembolic events. Methods Electronic databases were searched to identify relevant randomized clinical trials comparing intravitreal anti-VEGF with controls. Criteria for inclusion in our meta-analysis included a study duration of no less than 12 months, the use of a randomized control group not receiving any intravitreal active agent, and the availability of outcome data for arterial thromboembolic events, myocardial infarction, cerebrovascular accidents, and vascular death. The risk ratios and 95% CIs were calculated using a fixed-effects or random-effects model, depending on the heterogeneity of the included studies. Results A total of 4942 patients with a variety of ocular neovascular diseases from 13 randomized controlled trials were identified and included for analysis. There was no significant difference between intravitreal anti-VEGF and control in the risk of all events, with risk ratios of 0.87 (95% CI, 0.64 to 1.19) for arterial thromboembolic events, 0.96 (95% CI, 0.55–1.68) for cerebrovascular accidents, 0.69 (95% CI 0.40–1.21) for myocardial infarctions, and 0.68 (95% CI, 0.37–1.27) for vascular death. Conclusions The strength evidence suggests that the intravitreal use of anti-VEGF antibodies is not associated with an increased risk of arterial thromboembolic events. PMID:22829940

The cost of nurse-sensitive adverse events.

PubMed

Pappas, Sharon Holcombe

2008-05-01

The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. The growing transparency of quality and cost outcomes motivates healthcare leaders to optimize the effectiveness of nurse staffing. Most hospitals have robust cost accounting systems that provide actual patient-level direct costs. These systems allow an analysis of the cost consumed by patients during a hospital stay. By knowing the cost of complications, leaders have the ability to justify the cost of improved staffing when quality evidence shows that higher nurse staffing improves quality. An analysis was performed on financial and clinical data from hospital databases of 3,200 inpatients. The purpose was to establish a methodology to determine actual cost per case. Three diagnosis-related groups were the focus of the analysis. Five adverse events were analyzed along with the costs. A regression analysis reported that the actual direct cost of an adverse event was dollars 1,029 per case in the congestive heart failure cases and dollars 903 in the surgical cases. There was a significant increase in the cost per case in medical patients with urinary tract infection and pressure ulcers and in surgical patients with urinary tract infection and pneumonia. The odds of pneumonia occurring in surgical patients decreased with additional registered nurse hours per patient day. Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.

Adverse Events following 12 and 18 Month Vaccinations: a Population-Based, Self-Controlled Case Series Analysis

PubMed Central

Wilson, Kumanan; Hawken, Steven; Kwong, Jeffrey C.; Deeks, Shelley; Crowcroft, Natasha S.; Van Walraven, Carl; Potter, Beth K.; Chakraborty, Pranesh; Keelan, Jennifer; Pluscauskas, Michael; Manuel, Doug

2011-01-01

Background Live vaccines have distinct safety profiles, potentially causing systemic reactions one to 2 weeks after administration. In the province of Ontario, Canada, live MMR vaccine is currently recommended at age 12 months and 18 months. Methods Using the self-controlled case series design we examined 271,495 12 month vaccinations and 184,312 18 month vaccinations to examine the relative incidence of the composite endpoint of emergency room visits or hospital admissions in consecutive one day intervals following vaccination. These were compared to a control period 20 to 28 days later. In a post-hoc analysis we examined the reasons for emergency room visits and the average acuity score at presentation for children during the at-risk period following the 12 month vaccine. Results Four to 12 days post 12 month vaccination, children had a 1.33 (1.29–1.38) increased relative incidence of the combined endpoint compared to the control period, or at least one event during the risk interval for every 168 children vaccinated. Ten to 12 days post 18 month vaccination, the relative incidence was 1.25 (95%, 1.17–1.33) which represented at least one excess event for every 730 children vaccinated. The primary reason for increased events was statistically significant elevations in emergency room visits following all vaccinations. There were non-significant increases in hospital admissions. There were an additional 20 febrile seizures for every 100,000 vaccinated at 12 months. Conclusions There are significantly elevated risks of primarily emergency room visits approximately one to two weeks following 12 and 18 month vaccination. Future studies should examine whether these events could be predicted or prevented. PMID:22174753

The Pandemic Pendulum: A Critical Analysis of Federal and State Preparedness for a Pandemic Event

DTIC Science & Technology

2009-03-01

of employee illness and absenteeism , coupled with the closely meshed and interdependent systems of trade and commerce.18 WHO also proclaimed it...outbreak of Ebola, a naturally occurring pathogen with no known cure .20 The manifestation of Pandemic Influenza in Indonesia and Ebola in Congo are but...event of significant and sustained absenteeism ? (Transportation) Does the state anticipate need for supplementation of local government

Combined image and genomic analysis of high-grade serous ovarian cancer reveals PTEN loss as a common driver event and prognostic classifier.

PubMed

Martins, Filipe C; Santiago, Ines de; Trinh, Anne; Xian, Jian; Guo, Anne; Sayal, Karen; Jimenez-Linan, Mercedes; Deen, Suha; Driver, Kristy; Mack, Marie; Aslop, Jennifer; Pharoah, Paul D; Markowetz, Florian; Brenton, James D

2014-12-17

TP53 and BRCA1/2 mutations are the main drivers in high-grade serous ovarian carcinoma (HGSOC). We hypothesise that combining tissue phenotypes from image analysis of tumour sections with genomic profiles could reveal other significant driver events. Automatic estimates of stromal content combined with genomic analysis of TCGA HGSOC tumours show that stroma strongly biases estimates of PTEN expression. Tumour-specific PTEN expression was tested in two independent cohorts using tissue microarrays containing 521 cases of HGSOC. PTEN loss or downregulation occurred in 77% of the first cohort by immunofluorescence and 52% of the validation group by immunohistochemistry, and is associated with worse survival in a multivariate Cox-regression model adjusted for study site, age, stage and grade. Reanalysis of TCGA data shows that hemizygous loss of PTEN is common (36%) and expression of PTEN and expression of androgen receptor are positively associated. Low androgen receptor expression was associated with reduced survival in data from TCGA and immunohistochemical analysis of the first cohort. PTEN loss is a common event in HGSOC and defines a subgroup with significantly worse prognosis, suggesting the rational use of drugs to target PI3K and androgen receptor pathways for HGSOC. This work shows that integrative approaches combining tissue phenotypes from images with genomic analysis can resolve confounding effects of tissue heterogeneity and should be used to identify new drivers in other cancers.

Caffeine Increases the Linearity of the Visual BOLD Response

PubMed Central

Liu, Thomas T.; Liau, Joy

2009-01-01

Although the blood oxygenation level dependent (BOLD) signal used in most functional magnetic resonance imaging (fMRI) studies has been shown to exhibit nonlinear characteristics, most analyses assume that the BOLD signal responds in a linear fashion to stimulus. This assumption of linearity can lead to errors in the estimation of the BOLD response, especially for rapid event-related fMRI studies. In this study, we used a rapid event-related design and Volterra kernel analysis to assess the effect of a 200 mg oral dose of caffeine on the linearity of the visual BOLD response. The caffeine dose significantly (p < 0.02) increased the linearity of the BOLD response in a sample of 11 healthy volunteers studied on a 3 Tesla MRI system. In addition, the agreement between nonlinear and linear estimates of the hemodynamic response function was significantly increased (p= 0.013) with the caffeine dose. These findings indicate that differences in caffeine usage should be considered as a potential source of bias in the analysis of rapid event-related fMRI studies. PMID:19854278

Gender comparisons of medical students' psychosocial profiles.

PubMed

Hojat, M; Glaser, K; Xu, G; Veloski, J J; Christian, E B

1999-05-01

This study was designed to compare male and female medical students on selected personality attributes that could influence their academic attainment and personal success. Participants were 1157 medical students (743 men, 414 women) who completed a set of psychosocial questionnaires measuring intensity and chronicity of loneliness, general anxiety, test anxiety, neuroticism, depression, extraversion, self-esteem, locus of control, perceptions of parents, general health and appraisals of stressful life events. Data were analysed by employing multivariate and univariate analysis of variance and chi-square analysis. Jefferson Medical College. Medical students. Men scored significantly higher on the intensity of loneliness, and women scored higher on general anxiety, test anxiety and neuroticism scales, but the magnitudes of the effect size estimates were not large. No significant gender difference was observed on measures of chronicity of loneliness, depression, extraversion, self-esteem, external locus of control, perception of general health and perceptions of the mother and the father. Women who experienced stressful life events, such as death in the family or personal illness, appraised these events more negatively than did their male counterparts. Implications of the findings for medical education and practice are discussed.

Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis.

PubMed

March-Llanes, Jaume; Marqués-Feixa, Laia; Mezquita, Laura; Fañanás, Lourdes; Moya-Higueras, Jorge

2017-12-01

The main objective of the present research was to analyze the relations between stressful life events and the externalizing and internalizing spectra of psychopathology using meta-analytical procedures. After removing the duplicates, a total of 373 papers were found in a literature search using several bibliographic databases, such as the PsycINFO, Medline, Scopus, and Web of Science. Twenty-seven studies were selected for the meta-analytical analysis after applying different inclusion and exclusion criteria in different phases. The statistical procedure was performed using a random/mixed-effects model based on the correlations found in the studies. Significant positive correlations were found in cross-sectional and longitudinal studies. A transactional effect was then found in the present study. Stressful life events could be a cause, but also a consequence, of psychopathological spectra. The level of controllability of the life events did not affect the results. Special attention should be given to the usage of stressful life events in gene-environment interaction and correlation studies, and also for clinical purposes.

Young doctors' problem solving strategies on call may be improved.

PubMed

Michelsen, Jens; Malchow-Møller, Axel; Charles, Peder; Eika, Berit

2013-03-01

The first year following graduation from medical school is challenging as learning from books changes to workplace-based learning. Analysis and reflection on experience may ease this transition. We used Significant Event Analysis (SEA) as a tool to explore what pre-registration house officers (PRHOs) consider successful and problematic events, and to identify what problem-solving strategies they employ. A senior house officer systematically led the PRHO through the SEA of one successful and one problematic event following a night call. The PRHO wrote answers to questions about diagnosis, what happened, how he or she contributed and what knowledge-gaining activities the PRHO would prioritise before the next call. By using an inductive, thematic data analysis, we identified five problem-solving strategies: non-analytical reasoning, analytical reasoning, communication with patients, communication with colleagues and professional behaviour. On average, 1.5 strategies were used in the successful events and 1.2 strategies in the problematic events. Most PRHOs were unable to suggest activities other than reading textbooks. SEA was valuable for the identification of PRHOs' problem-solving strategies in a natural setting. PRHOs should be assisted in increasing their repertoire of strategies, and they should also be helped to "learn to learn" as they were largely unable to point to new learning strategies. not relevant. not relevant.

High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis.

PubMed

Hannan, Amanda L; Hing, Wayne; Simas, Vini; Climstein, Mike; Coombes, Jeff S; Jayasinghe, Rohan; Byrnes, Joshua; Furness, James

2018-01-01

Aerobic capacity has been shown to be inversely proportionate to cardiovascular mortality and morbidity and there is growing evidence that high-intensity interval training (HIIT) appears to be more effective than moderate-intensity continuous training (MICT) in improving cardiorespiratory fitness within the cardiac population. Previously published systematic reviews in cardiovascular disease have neither investigated the effect that the number of weeks of intervention has on cardiorespiratory fitness changes, nor have adverse events been collated. We aimed to undertake a systematic review and meta-analysis of randomized controlled trials (RCTs) within the cardiac population that investigated cardiorespiratory fitness changes resulting from HIIT versus MICT and to collate adverse events. A critical narrative synthesis and meta-analysis was conducted after systematically searching relevant databases up to July 2017. We searched for RCTs that compared cardiorespiratory fitness changes resulting from HIIT versus MICT interventions within the cardiac population. Seventeen studies, involving 953 participants (465 for HIIT and 488 for MICT) were included in the analysis. HIIT was significantly superior to MICT in improving cardiorespiratory fitness overall (SMD 0.34 mL/kg/min; 95% confidence interval [CI; 0.2-0.48]; p <0.00001; I 2 =28%). There were no deaths or cardiac events requiring hospitalization reported in any study during training. Overall, there were more adverse events reported as a result of the MICT (n=14) intervention than the HIIT intervention (n=9). However, some adverse events (n=5) were not classified by intervention group. HIIT is superior to MICT in improving cardiorespiratory fitness in participants of cardiac rehabilitation (CR). Improvements in cardiorespiratory fitness are significant for CR programs of >6-week duration. Programs of 7-12 weeks' duration resulted in the largest improvements in cardiorespiratory fitness for patients with coronary artery disease. HIIT appears to be as safe as MICT for CR participants.

High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis

PubMed Central

Hannan, Amanda L; Hing, Wayne; Simas, Vini; Climstein, Mike; Coombes, Jeff S; Jayasinghe, Rohan; Byrnes, Joshua; Furness, James

2018-01-01

Background Aerobic capacity has been shown to be inversely proportionate to cardiovascular mortality and morbidity and there is growing evidence that high-intensity interval training (HIIT) appears to be more effective than moderate-intensity continuous training (MICT) in improving cardiorespiratory fitness within the cardiac population. Previously published systematic reviews in cardiovascular disease have neither investigated the effect that the number of weeks of intervention has on cardiorespiratory fitness changes, nor have adverse events been collated. Objective We aimed to undertake a systematic review and meta-analysis of randomized controlled trials (RCTs) within the cardiac population that investigated cardiorespiratory fitness changes resulting from HIIT versus MICT and to collate adverse events. Methods A critical narrative synthesis and meta-analysis was conducted after systematically searching relevant databases up to July 2017. We searched for RCTs that compared cardiorespiratory fitness changes resulting from HIIT versus MICT interventions within the cardiac population. Results Seventeen studies, involving 953 participants (465 for HIIT and 488 for MICT) were included in the analysis. HIIT was significantly superior to MICT in improving cardiorespiratory fitness overall (SMD 0.34 mL/kg/min; 95% confidence interval [CI; 0.2–0.48]; p<0.00001; I2=28%). There were no deaths or cardiac events requiring hospitalization reported in any study during training. Overall, there were more adverse events reported as a result of the MICT (n=14) intervention than the HIIT intervention (n=9). However, some adverse events (n=5) were not classified by intervention group. Conclusion HIIT is superior to MICT in improving cardiorespiratory fitness in participants of cardiac rehabilitation (CR). Improvements in cardiorespiratory fitness are significant for CR programs of >6-week duration. Programs of 7–12 weeks’ duration resulted in the largest improvements in cardiorespiratory fitness for patients with coronary artery disease. HIIT appears to be as safe as MICT for CR participants. PMID:29416382

1−1=Counterfactual: on the potency and significance of quantum non-events

PubMed Central

Cohen, E.

2016-01-01

We study the unique role played in quantum mechanics by non-events or ‘counterfactuals’. Our earlier analysis of ‘quantum oblivion’ has revealed some subtle stages in the measurement process, which may end up in self-cancellation. To these findings, we now add two insights derived by two time-symmetric interpretations of quantum mechanics. (i) Like all quantum interactions, the non-event is formed by the conjunction of forward-plus-backward-evolving wave functions. (ii) Then, it is another feature of such dual evolutions, namely the involvement of negative masses and energies, that enables Nature to make some events ‘unhappen’ while leaving causal traces. PMID:27091159

CoinCalc-A new R package for quantifying simultaneities of event series

NASA Astrophysics Data System (ADS)

Siegmund, Jonatan F.; Siegmund, Nicole; Donner, Reik V.

2017-01-01

We present the new R package CoinCalc for performing event coincidence analysis (ECA), a novel statistical method to quantify the simultaneity of events contained in two series of observations, either as simultaneous or lagged coincidences within a user-specific temporal tolerance window. The package also provides different analytical as well as surrogate-based significance tests (valid under different assumptions about the nature of the observed event series) as well as an intuitive visualization of the identified coincidences. We demonstrate the usage of CoinCalc based on two typical geoscientific example problems addressing the relationship between meteorological extremes and plant phenology as well as that between soil properties and land cover.

1-1=Counterfactual: on the potency and significance of quantum non-events.

PubMed

Elitzur, A C; Cohen, E

2016-05-28

We study the unique role played in quantum mechanics by non-events or 'counterfactuals'. Our earlier analysis of 'quantum oblivion' has revealed some subtle stages in the measurement process, which may end up in self-cancellation. To these findings, we now add two insights derived by two time-symmetric interpretations of quantum mechanics. (i) Like all quantum interactions, the non-event is formed by the conjunction of forward-plus-backward-evolving wave functions. (ii) Then, it is another feature of such dual evolutions, namely the involvement of negative masses and energies, that enables Nature to make some events 'unhappen' while leaving causal traces. © 2016 The Author(s).

Effects of daily kangaroo care on cardiorespiratory parameters in preterm infants.

PubMed

Mitchell, A J; Yates, C; Williams, K; Hall, R W

2013-01-01

Kangaroo care (KC) has possible benefits for promoting physiological stability and positive developmental outcomes in preterm infants. The purpose of this study was to compare bradycardia and oxygen desaturation events in preterm infants in standard incubator care versus KC. Thirty-eight infants 27 to 30 weeks gestational age were randomly assigned to 2 hours of KC daily between days of life 5 to 10 or to standard incubator care. Infants were monitored for bradycardia (heart rate <80) or oxygen desaturation (<80%). Analysis of hourly events was based on three sets of data: standard care group 24 hours daily, KC group during incubator time 22 hours daily, and KC group during holding time 2 hours daily. The KC group had fewer bradycardia events per hour while being held compared to time spent in an incubator (p = 0.048). The KC group also had significantly fewer oxygen desaturation events while being held than while in the incubator (p = 0.017) and significantly fewer desaturation events than infants in standard care (p = 0.02). KC reduces bradycardia and oxygen desaturation events in preterm infants, providing physiological stability and possible benefits for neurodevelopmental outcomes.

Adverse events among Ontario home care clients associated with emergency room visit or hospitalization: a retrospective cohort study

PubMed Central

2013-01-01

Background Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes. The study reports on the incidence of HC adverse events, the magnitude of the events, the types of events that occur, and the consequences experienced by HC clients in the province of Ontario. Methods A retrospective cohort design was used, utilizing comprehensive secondary databases available for Ontario HC clients from the years 2008 and 2009. The data were derived from the Canadian Home Care Reporting System, the Hospital Discharge Abstract Database, the National Ambulatory Care Reporting System, the Ontario Mental Health Reporting System, and the Continuing Care Reporting System. Descriptive analysis was used to identify the type and frequency of the adverse events recorded and the consequences of the events. Logistic regression analysis was used to examine the association between the events and their consequences. Results The study found that the incident rate for adverse events for the HC clients included in the cohort was 13%. The most frequent adverse events identified in the databases were injurious falls, injuries from other than a fall, and medication-related incidents. With respect to outcomes, we determined that an injurious fall was associated with a significant increase in the odds of a client requiring long-term-care facility admission and of client death. We further determined that three types of events, delirium, sepsis, and medication-related incidents were associated directly with an increase in the odds of client death. Conclusions Our study concludes that 13% of clients in homecare experience an adverse event annually. We also determined that an injurious fall was the most frequent of the adverse events and was associated with increased admission to long-term care or death. We recommend the use of tools that are presently available in Canada, such as the Resident Assessment Instrument and its Clinical Assessment Protocols, for assessing and mitigating the risk of an adverse event occurring. PMID:23800280

The role of risk factors and trigger factors in cerebrovascular events after mitral valve replacement: implications for antithrombotic management.

PubMed

Butchart, E G; Moreno de la Santa, P; Rooney, S J; Lewis, P A

1994-03-01

To determine the effect of risk factors and trigger factors on cerebrovascular events, 622 patients who survived mitral valve replacement between December 1979 and December 1992 were analyzed. Ninety-six patients suffered 139 nonhemorrhagic cerebrovascular events. Data were available on 138 events in 95 patients. There were 32 transient ischemic attacks (TIAs), 57 reversible ischemic neurological deficits (RINDs), and 49 strokes. Age, sex, atrial fibrillation, left atrial size, systemic hypertension, and abnormal body mass index did not discriminate between patients who suffered events and those who did not. In contrast, smoking status differed significantly between patients who suffered events and those who did not. Among current or recent ex-smokers, the risk of stroke or RIND was significantly higher than in non-smokers (p < < 0.001). The odds ratio of suffering any type of event in patients who smoked at any time postoperatively versus those who did not smoke was 2.9 (95% confidence interval: 1.8 to 4.6). Of 61 patients contacted directly, 30% recalled an infective episode immediately prior to their event. A diurnal and seasonal influence on events was also detected with peaks in the morning and in the winter months, respectively (both p < 0.001). It is concluded that there is persuasive evidence for the involvement of several nonprosthetic factors in the incidence of cerebrovascular events after mitral valve replacement. This has implications for patient management and for future analysis of prosthetic heart valve series.

Analysis of Acute Transfusion Reactions and Their Occurrence Times

PubMed Central

Hatayama, Yuki; Matsumoto, Satoko; Hamada, Eiko; Kojima, Nao; Hara, Ayako; Hino, Norihiko; Motokura, Toru

2018-01-01

Acute transfusion reactions (ATRs) are significantly relevant to the morbidity and mortality of patients. ATRs are mostly not severe and rarely cause severe conditions, including anaphylactic shock. The aim of this study was to clarify the frequency of ATRs and the time of event occurrence. A total of 18,745 transfusions were administered to 11,718 patients during a 3-year period. Adverse reactions including at least one sign or symptom were collected through a report system in 143 of 2,478 (5.7%) platelet concentrate transfusions, 105 of 6,629 (1.6%) red blood cell component transfusions and 51 of 2,307 (2.2%) fresh frozen plasma transfusions. Allergic signs and symptoms accounted for 70% of all adverse events. Severe signs and symptoms were observed in 7.1% of patients. These events appeared significantly earlier than those of non-severe signs and symptoms (median time 20 min vs 100 min, P < 0.05). For patients who have had repetitive transfusion-associated adverse events, preventive treatments for adverse events should be proactively promoted. PMID:29599628

Modeling changes in extreme snowfall events in the Central Rocky Mountains Region with the Fully-Coupled WRF-Hydro Modeling System

NASA Astrophysics Data System (ADS)

gochis, David; rasmussen, Roy; Yu, Wei; Ikeda, Kyoko

2014-05-01

Modeling of extreme weather events often require very finely resolved treatment of atmospheric circulation structures in order to produce and localize large magnitudes of moisture fluxes that result in extreme precipitation. This is particularly true for cool season orographic precipitation processes where the representation of landform can significantly influence vertical velocity profiles and cloud moisture entrainment rates. In this work we report on recent progress in high resolution regional climate modeling of the Colorado Headwaters region using an updated version of the Weather Research and Forecasting (WRF) model and a hydrological extension package called WRF-Hydro. Previous work has shown that the WRF-Hydro modeling system forced by high resolution WRF model output can produce credible depictions of winter orographic precipitation and resultant monthly and annual river flows. Here we present results from a detailed study of an extreme springtime snowfall event that occurred along the Colorado Front Range in March of 2003. First an analysis of the simulated streamflows resulting from the melt out of that event are presented followed by an analysis of projected streamflows from the event where the atmospheric forcing in the WRF model is perturbed using the Psuedo-Global-Warming (PGW) perturbation methodology. Results from the impact of warming on total precipitation, snow-rain partitioning and surface hydrological fluxes (evapotranspiration and runoff) will be discussed in the context of how potential changes in temperature impact the amount of precipitation, the phase of precipitation (rain vs. snow) and the timing and amplitude of streamflow responses. It is shown that under the assumptions of the PGW method, intense precipitation rates increase during the event and, more importantly, that more precipitation falls as rain versus snow which significantly amplifies the runoff response from one where runoff is produced gradually to where runoff is more rapidly translated into streamflow values that approach significant flooding risks.

Age-related incidence of desaturation events and the cardiac responses on stroke index, cardiac index, and heart rate measured by continuous bioimpedance noninvasive cardiac output monitoring in infants and children undergoing general anesthesia.

PubMed

King, Michael R; Anderson, T Anthony; Sui, Jinghu; He, Guoluo; Poon, Kwun Yee T; Coté, Charles J

2016-08-01

To assess the effects of desaturation on stroke index (SI), cardiac index (CI), and heart rate (HR) using the ICON continuous noninvasive cardiac output monitor in children undergoing general anesthesia. Retrospective analysis of a prospectively collected data set. Pediatric operating rooms in a tertiary academic medical center. Children younger than 20 years who experienced desaturation while undergoing general anesthesia. All records were retrospectively searched for desaturation events defined as a recorded Spo2 ≤ 90%. We compared the data from the prior 4 minutes (baseline) with mild, moderate, and severe levels of desaturation. The relationship between Spo2 and percent change in SI, CI, and HR from baseline was assessed using a generalized linear model with repeated measures and the least-squares method. Data from 446 patients were reviewed; 38 events were eligible for analysis after exclusions. There were significant decreases in SI at all saturation ranges below 95%: -6.5% (P < .001) for 85%-95%, -8.9% (P = .002) for 71%-84%, and -11% (P < .001) for ≤70%. Based on the result from the regression, Spo2 was associated with change in SI with borderline significance (P = .053) but not that of HR and CI. There was a strong relationship to desaturation events with young age (P < .001), particularly infants younger than 6 months. Events associated with desaturation in children under general anesthesia were significantly associated with decreased SI with a greater effect with lower saturation nadirs. It is unclear if other concurrent events could have also contributed to adverse hemodynamic responses during desaturation. In most children, a compensatory increase in HR generally offsets concurrent decreases in CI. It would appear that bradycardia is a late manifestation of hypoxemia. Copyright © 2016 Elsevier Inc. All rights reserved.

Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis.

PubMed

van Walraven, Carl; Hart, Robert G; Singer, Daniel E; Laupacis, Andreas; Connolly, Stuart; Petersen, Palle; Koudstaal, Peter J; Chang, Yuchiao; Hellemons, Beppie

2002-11-20

Patients with nonvalvular atrial fibrillation (AF) have an increased risk of stroke and other vascular events. To compare the risk of vascular and bleeding events in patients with nonvalvular AF treated with vitamin K -inhibiting oral anticoagulants or acetylsalicylic acid (aspirin). Pooled analysis of patient-level data from 6 published, randomized clinical trials. A total of 4052 patients with AF randomly assigned to receive therapeutic doses of oral anticoagulant or aspirin with or without low-dose oral anticoagulants. Ischemic and hemorrhagic stroke, other cardiovascular events, all-cause death, and major bleeding events. Person-year incidence rates were calculated to provide crude comparisons. Relative efficacy was assessed using proportional hazards modeling stratified by study. The variation of the oral anticoagulant's relative effect by pertinent patient factors was explored with interaction terms. All analyses were conducted using the intention-to-treat principle. Patients receiving oral anticoagulant and aspirin were balanced for important prognostic factors. There was no significant heterogeneity between trials in the relative efficacy of oral anticoagulant vs aspirin for any outcome. Patients receiving oral anticoagulant were significantly less likely to experience any stroke (2.4 vs 4.5 events per 100 patient-years; hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.43-0.71), ischemic stroke (HR, 0.48; 95% CI, 0.37-0.63), or cardiovascular events (HR, 0.71; 95% CI, 0.59-0.85) but were more likely to experience major bleeding (2.2 vs 1.3 events per 100 patient-years; HR, 1.71; 95% CI, 1.21-2.41). The reduction in ischemic stroke risk was similar in patients with paroxysmal AF (1.5 vs 4.7 events per 100 patient-years; HR, 0.32; 95% CI, 0.16-0.61; P<.001). Treating 1000 patients with AF for 1 year with oral anticoagulant rather than aspirin would prevent 23 ischemic strokes while causing 9 additional major bleeds. Overall all-cause survival did not differ but appeared to improve for oral anticoagulant patients 3 years after therapy was started. Compared with aspirin, oral anticoagulant significantly decreases the risk of all strokes, ischemic strokes, and cardiovascular events for patients with nonvalvular chronic or paroxysmal AF but modestly increases the absolute risk of major bleeding. The balance of benefits and risks varies by patient subgroup.

Carbonate-platform response to the Toarcian Oceanic Anoxic Event in the southern hemisphere: Implications for climatic change and biotic platform demise

NASA Astrophysics Data System (ADS)

Han, Zhong; Hu, Xiumian; Kemp, David B.; Li, Juan

2018-05-01

The Toarcian Oceanic Anoxic Event (T-OAE, ∼183 Ma) was a profound short-term environmental perturbation associated with the large-scale release of 13C-depleted carbon into the global ocean-atmosphere system, which resulted in a significant negative carbon-isotope excursion (CIE). The general lack of characteristic T-OAE records outside of the northern hemisphere means that the precise environmental effects and significance of this event are uncertain. Many biotic carbonate platforms of the northern hemisphere western Tethys drowned or shifted to non-skeletal platforms during the early Toarcian. However, southern hemisphere records of Toarcian carbonate platforms are rare, and thus the extent and significance of biotic platform demise during the T-OAE is unclear. Here we present high-resolution geochemical and sedimentological data across two Pliensbachian-Toarcian shallow-water carbonate-platform sections exposed in the Tibetan Himalaya. These sections were located paleogeographically on the open southeastern tropical Tethyan margin in the southern hemisphere. The T-OAE in the Tibetan Himalaya is marked by a negative CIE in organic matter. Our sedimentological analysis of the two sections reveals an abundance of storm deposits within the T-OAE interval, which emphasizes a close link between warming and tropical storms during the T-OAE event, in line with evidence recently provided from western Tethyan sections of the northern hemisphere. In addition, our analysis also reveals extensive biotic carbonate-platform demise by drowning or changing to non-skeletal carbonates coincident with the onset of the CIE. Taken together, our results suggest that rapid and pervasive seawater warming in response to carbon release likely played a significant role in sudden biotic carbonate platform demise, and suppression/postponement of biotic platform re-development along the whole tropical/subtropical Tethyan margin.

Interpreting Significant Discrete-Time Periods in Survival Analysis.

ERIC Educational Resources Information Center

Schumacker, Randall E.; Denson, Kathleen B.

Discrete-time survival analysis is a new method for educational researchers to employ when looking at the timing of certain educational events. Previous continuous-time methods do not allow for the flexibility inherent in a discrete-time method. Because both time-invariant and time-varying predictor variables can now be used, the interaction of…

Effect of lunar phase on frequency of psychogenic nonepileptic events in the EMU.

PubMed

Bolen, Robert D; Campbell, Zeke; Dennis, William A; Koontz, Elizabeth H; Pritchard, Paul B

2016-06-01

Studies of the effect of a full moon on seizures have yielded mixed results, despite a continuing prevailing belief regarding the association of lunar phase with human behavior. The potential effect of a full moon on psychogenic nonepileptic events has not been as well studied, despite what anecdotal accounts from most epilepsy monitoring unit (EMU) staff would suggest. We obtained the dates and times of all events from patients diagnosed with psychogenic nonepileptic events discharged from our EMU over a two-year period. The events were then plotted on a 29.5-day lunar calendar. Events were also broken down into lunar quarters for statistical analysis. We found a statistically significant increase in psychogenic nonepileptic events during the new moon quarter in our EMU during our studied timeframe. Our results are not concordant with the results of a similarly designed past study, raising the possibility that psychogenic nonepileptic events are not influenced by lunar phase. Copyright © 2016 Elsevier Inc. All rights reserved.

The MACHO Project: Microlensing Results from 5.7 Years of LMC Observations

NASA Astrophysics Data System (ADS)

Becker, A. C.; Alcock, C.; Allsman, R. A.; Alves, D.; Axelrod, T. S.; Bennett, D. P.; Cook, K. H.; Drake, A. J.; Freeman, K. C.; Geha, M.; Griest, K.; Lehner, M. J.; Marshall, S. L.; Minniti, D.; Nelson, C. A.; Peterson, B. A.; Popowski, P.; Pratt, M. R.; Quinn, P. J.; Rodgers, A. W.; Stubbs, C. W.; Sutherland, W.; Tomaney, A. B.; Vandehei, T.; Welch, D. L.; MACHO Collaboration

1999-12-01

We report on our search for microlensing towards the Large Magellanic Cloud (LMC). Analysis of 5.7 years of photometry on 11.9 million stars in the LMC reveals 17 candidate microlensing events. A careful treatment of our detection efficiency shows that this is significantly more than the 2 to 4 events expected from lensing by known stellar populations. The timescales (t) of the events range from 34 to 230 days. The spatial distribution of events is probably inconsistent with LMC/LMC disk self-lensing, but consistent with an extended lens distribution such as a Milky Way or LMC halo. The optical depth results appear consistent with, but are lower than, our previous 2.1 year results. Besides a factor of 3.4 increase in exposure, this new work also includes an improved efficiency determination, improved likelihood analysis, and more thorough testing of robustness and systematic errors, especially in regards to the treatment of potential backgrounds to microlensing, such as supernovae in galaxies behind the LMC.

The role of event water, a rapid shallow flow component, and catchment size in summer stormflow

USGS Publications Warehouse

Brown, V.A.; McDonnell, Jeffery J.; Burns, Douglas A.; Kendall, C.

1999-01-01

Seven nested headwater catchments (8 to 161 ha) were monitored during five summer rain events to evaluate storm runoff components and the effect of catchment size on water sources. Two-component isotopic hydrograph separation showed that event-water contributions near the time of peakflow ranged from 49% to 62% in the 7 catchments during the highest intensity event. The proportion of event water in stormflow was greater than could be accounted for by direct precipitation onto saturated areas. DOC concentrations in stormflow were strongly correlated with stream 18O composition. Bivariate mixing diagrams indicated that the large event water contributions were likely derived from flow through the soil O-horizon. Results from two-tracer, three-component hydrograph separations showed that the throughfall and O-horizon soil-water components together could account for the estimated contributions of event water to stormflow. End-member mixing analysis confirmed these results. Estimated event-water contributions were inversely related to catchment size, but the relation was significant for only the event with greatest rainfall intensity. Our results suggest that perched, shallow subsurface flow provides a substantial contribution to summer stormflow in these small catchments, but the relative contribution of this component decreases with catchment size.Seven nested headwater catchments (8 to 161 ha) were monitored during five summer rain events to evaluate storm runoff components and the effect of catchment size on water sources. Two-component isotopic hydrograph separation showed that event-water contributions near the time of peakflow ranged from 49% to 62% in the 7 catchments during the highest intensity event. The proportion of event water in stormflow was greater than could be accounted for by direct precipitation onto saturated areas. DOC concentrations in stormflow were strongly correlated with stream 18O composition. Bivariate mixing diagrams indicated that the large event water contributions were likely derived from flow through the soil O-horizon. Results from two-tracer, three-component hydrograph separations showed that the throughfall and O-horizon soil-water components together could account for the estimated contributions of event water to stormflow. End-member mixing analysis confirmed these results. Estimated event-water contributions were inversely related to catchment size, but the relation was significant for only the event with greatest rainfall intensity. Our results suggest that perched, shallow subsurface flow provides a substantial contribution to summer stormflow in these small catchments, but the relative contribution of this component decreases with catchment size.

Inhaled antibiotics in non-cystic fibrosis bronchiectasis: A meta-analysis.

PubMed

Xu, Li; Zhang, Fei; Du, Shuai; Yu, Qi; Chen, Lin; Long, Li-Hui; Li, Ya-Ming; Jia, Ai-Hua

2016-09-01

To evaluate the efficacy and safety of inhaled antibiotics for the treatment of non-cystic fibrosis bronchiectasis (NCFB). Pubmed, Cochrane library, Embase, Elsevier, OVID, Springerlink, Web of knowledge and NEJM were searched for randomized controlled trials (RCTs) on inhaled antibiotics in treatment of NCFB from inception until April 2015. Meta-analysis was conducted to assess the efficacy and safety of inhaled antibiotics in the treatment of NCFB. Twelve RCTs involving 1154 participants were included. They showed that inhaled antibiotics were more effective in reduction of sputum bacterial density, eradication of P. aeruginosa, prolonged time to exacerbation and reduction of new pathogens emergence with no significant difference in adverse events compared with control groups. However, we did not find significant benefits of inhaled antibiotics in reducing the risk of acute exacerbation, improving health-related quality of life and reduction of P. aeruginosa resistance. Moreover, inhaled antibiotics exerted a statistically significant reduction in FEV1%. Inhaled antibiotics may be an alternative pathway to inhibit airway inflammation with no more adverse events in patients with NCFB.

Time compression of soil erosion by the effect of largest daily event. A regional analysis of USLE database.

NASA Astrophysics Data System (ADS)

Gonzalez-Hidalgo, J. C.; Batalla, R.; Cerda, A.; de Luis, M.

2009-04-01

When Thornes and Brunsden wrote in 1977 "How often one hears the researcher (and no less the undergraduate) complain that after weeks of observation "nothing happened" only to learn that, the day after his departure, a flood caused unprecedent erosion and channel changes!" (Thornes and Brunsden, 1977, p. 57), they focussed on two different problems in geomorphological research: the effects of extreme events and the temporal compression of geomorphological processes. The time compression is one of the main characteristic of erosion processes. It means that an important amount of the total soil eroded is produced in very short temporal intervals, i.e. few events mostly related to extreme events. From magnitude-frequency analysis we know that few events, not necessarily extreme by magnitude, produce high amount of geomorphological work. Last but not least, extreme isolated events are a classical issue in geomorphology by their specific effects, and they are receiving permanent attention, increased at present because of scenarios of global change. Notwithstanding, the time compression of geomorphological processes could be focused not only on the analysis of extreme events and the traditional magnitude-frequency approach, but on new complementary approach based on the effects of largest events. The classical approach define extreme event as a rare event (identified by its magnitude and quantified by some deviation from central value), while we define largest events by the rank, whatever their magnitude. In a previous research on time compression of soil erosion, using USLE soil erosion database (Gonzalez-Hidalgo et al., EGU 2007), we described a relationship between the total amount of daily erosive events recorded by plot and the percentage contribution to total soil erosion of n-largest aggregated daily events. Now we offer a further refined analysis comparing different agricultural regions in USA. To do that we have analyzed data from 594 erosion plots from USLE database with different record periods, and located in different climatic regions. Results indicate that there are no significant differences in the mean contribution of aggregated 5-largest daily erosion events between different agricultural divisions (i.e. different regional climate), and the differences detected can be attributed to specific site and plots conditions. Expected contribution of 5-largest daily event for 100 total daily events recorded is estimated around 40% of total soil erosion. We discuss the possible causes of such results and the applicability of them to the design of field research on soil erosion plots.

Analysis of arrhythmic events is useful to detect lead failure earlier in patients followed by remote monitoring.

PubMed

Nishii, Nobuhiro; Miyoshi, Akihito; Kubo, Motoki; Miyamoto, Masakazu; Morimoto, Yoshimasa; Kawada, Satoshi; Nakagawa, Koji; Watanabe, Atsuyuki; Nakamura, Kazufumi; Morita, Hiroshi; Ito, Hiroshi

2018-03-01

Remote monitoring (RM) has been advocated as the new standard of care for patients with cardiovascular implantable electronic devices (CIEDs). RM has allowed the early detection of adverse clinical events, such as arrhythmia, lead failure, and battery depletion. However, lead failure was often identified only by arrhythmic events, but not impedance abnormalities. To compare the usefulness of arrhythmic events with conventional impedance abnormalities for identifying lead failure in CIED patients followed by RM. CIED patients in 12 hospitals have been followed by the RM center in Okayama University Hospital. All transmitted data have been analyzed and summarized. From April 2009 to March 2016, 1,873 patients have been followed by the RM center. During the mean follow-up period of 775 days, 42 lead failure events (atrial lead 22, right ventricular pacemaker lead 5, implantable cardioverter defibrillator [ICD] lead 15) were detected. The proportion of lead failures detected only by arrhythmic events, which were not detected by conventional impedance abnormalities, was significantly higher than that detected by impedance abnormalities (arrhythmic event 76.2%, 95% CI: 60.5-87.9%; impedance abnormalities 23.8%, 95% CI: 12.1-39.5%). Twenty-seven events (64.7%) were detected without any alert. Of 15 patients with ICD lead failure, none has experienced inappropriate therapy. RM can detect lead failure earlier, before clinical adverse events. However, CIEDs often diagnose lead failure as just arrhythmic events without any warning. Thus, to detect lead failure earlier, careful human analysis of arrhythmic events is useful. © 2017 Wiley Periodicals, Inc.

Monte Carlo sensitivity analysis of unknown parameters in hazardous materials transportation risk assessment.

PubMed

Pet-Armacost, J J; Sepulveda, J; Sakude, M

1999-12-01

The US Department of Transportation was interested in the risks associated with transporting Hydrazine in tanks with and without relief devices. Hydrazine is both highly toxic and flammable, as well as corrosive. Consequently, there was a conflict as to whether a relief device should be used or not. Data were not available on the impact of relief devices on release probabilities or the impact of Hydrazine on the likelihood of fires and explosions. In this paper, a Monte Carlo sensitivity analysis of the unknown parameters was used to assess the risks associated with highway transport of Hydrazine. To help determine whether or not relief devices should be used, fault trees and event trees were used to model the sequences of events that could lead to adverse consequences during transport of Hydrazine. The event probabilities in the event trees were derived as functions of the parameters whose effects were not known. The impacts of these parameters on the risk of toxic exposures, fires, and explosions were analyzed through a Monte Carlo sensitivity analysis and analyzed statistically through an analysis of variance. The analysis allowed the determination of which of the unknown parameters had a significant impact on the risks. It also provided the necessary support to a critical transportation decision even though the values of several key parameters were not known.

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

PubMed

Hwang, Thomas J

2013-01-01

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

The electrical heart axis and ST events in fetal monitoring: A post-hoc analysis following a multicentre randomised controlled trial.

PubMed

Vullings, Rik; Verdurmen, Kim M J; Hulsenboom, Alexandra D J; Scheffer, Stephanie; de Lau, Hinke; Kwee, Anneke; Wijn, Pieter F F; Amer-Wåhlin, Isis; van Laar, Judith O E H; Oei, S Guid

2017-01-01

Reducing perinatal morbidity and mortality is one of the major challenges in modern health care. Analysing the ST segment of the fetal electrocardiogram was thought to be the breakthrough in fetal monitoring during labour. However, its implementation in clinical practice yields many false alarms and ST monitoring is highly dependent on cardiotocogram assessment, limiting its value for the prediction of fetal distress during labour. This study aims to evaluate the relation between physiological variations in the orientation of the fetal electrical heart axis and the occurrence of ST events. A post-hoc analysis was performed following a multicentre randomised controlled trial, including 1097 patients from two participating centres. All women were monitored with ST analysis during labour. Cases of fetal metabolic acidosis, poor signal quality, missing blood gas analysis, and congenital heart disease were excluded. The orientation of the fetal electrical heart axis affects the height of the initial T/QRS baseline, and therefore the incidence of ST events. We grouped tracings with the same initial baseline T/QRS value. We depicted the number of ST events as a function of the initial baseline T/QRS value with a linear regression model. A significant increment of ST events was observed with increasing height of the initial T/QRS baseline, irrespective of the fetal condition; correlation coefficient 0.63, p<0.001. The most frequent T/QRS baseline is 0.12. The orientation of the fetal electrical heart axis and accordingly the height of the initial T/QRS baseline should be taken into account in fetal monitoring with ST analysis.

Adverse events and treatment failure leading to discontinuation of recently approved antipsychotic drugs in schizophrenia: A network meta-analysis.

PubMed

Tonin, Fernanda S; Piazza, Thais; Wiens, Astrid; Fernandez-Llimos, Fernando; Pontarolo, Roberto

2015-12-01

Objective:We aimed to gather evidence of the discontinuation rates owing to adverse events or treatment failure for four recently approved antipsychotics (asenapine, blonanserin, iloperidone, and lurasidone).Methods: A systematic review followed by pairwise meta-analysis and mixed treatment comparison meta analysis(MTC) was performed, including randomized controlled trials (RCTs) that compared the use of the above-mentioned drugs versus placebo in patients with schizophrenia. An electronic search was conducted in PubMed, Scopus, Science Direct, Scielo, the Cochrane Library, and International Pharmaceutical Abstracts(January 2015). The included trials were at least single blinded. The main outcome measures extracted were discontinuation owing to adverse events and discontinuation owing to treatment failure.Results: Fifteen RCTs were identified (n = 5400 participants) and 13 of them were amenable for use in our meta-analyses. No significant differences were observed between any of the four drugs and placebo as regards discontinuation owing to adverse events, whether in pairwise meta-analysis or in MTC. All drugs presented a better profile than placebo on discontinuation owing to treatment failure, both in pairwise meta-analysis and MTC. Asenapine was found to be the best therapy in terms of tolerability owing to failure,while lurasidone was the worst treatment in terms of adverse events. The evidence around blonanserin is weak.Conclusion: MTCs allowed the creation of two different rank orders of these four antipsychotic drugs in two outcome measures. This evidence-generating method allows direct and indirect comparisons, supporting approval and pricing decisions when lacking sufficient, direct, head-to-head trials.

Robustness of Multiple Objective Decision Analysis Preference Functions

DTIC Science & Technology

2002-06-01

p p′ : The probability of some event. ,i ip q : The probability of event . i Π : An aggregation of proportional data used in calculating a test ...statistical tests of the significance of the term and also is conducted in a multivariate framework rather than the ROSA univariate approach. A...residual error is ˆ−e = y y (45) The coefficient provides a ready indicator of the contribution for the associated variable and statistical tests

Numerical 3D flow simulation of attached cavitation structures at ultrasonic horn tips and statistical evaluation of flow aggressiveness via load collectives

NASA Astrophysics Data System (ADS)

Mottyll, S.; Skoda, R.

2015-12-01

A compressible inviscid flow solver with barotropic cavitation model is applied to two different ultrasonic horn set-ups and compared to hydrophone, shadowgraphy as well as erosion test data. The statistical analysis of single collapse events in wall-adjacent flow regions allows the determination of the flow aggressiveness via load collectives (cumulative event rate vs collapse pressure), which show an exponential decrease in agreement to studies on hydrodynamic cavitation [1]. A post-processing projection of event rate and collapse pressure on a reference grid reduces the grid dependency significantly. In order to evaluate the erosion-sensitive areas a statistical analysis of transient wall loads is utilised. Predicted erosion sensitive areas as well as temporal pressure and vapour volume evolution are in good agreement to the experimental data.

A Multilevel Analysis of U.S. Hospital Patient Safety Culture Relationships With Perceptions of Voluntary Event Reporting.

PubMed

Burlison, Jonathan D; Quillivan, Rebecca R; Kath, Lisa M; Zhou, Yinmei; Courtney, Sam C; Cheng, Cheng; Hoffman, James M

2016-11-03

Patient safety events offer opportunities to improve patient care, but, unfortunately, events often go unreported. Although some barriers to event reporting can be reduced with electronic reporting systems, insight on organizational and cultural factors that influence reporting frequency may help hospitals increase reporting rates and improve patient safety. The purpose of this study was to evaluate the associations between dimensions of patient safety culture and perceived reporting practices of safety events of varying severity. We conducted a cross-sectional survey study using previously collected data from The Agency for Healthcare Research and Quality Hospital Survey of Patient Safety Culture as predictors and outcome variables. The dataset included health-care professionals in U.S. hospitals, and data were analyzed using multilevel modeling techniques. Data from 223,412 individuals, 7816 work areas/units, and 967 hospitals were analyzed. Whether examining near miss, no harm, or potential for harm safety events, the dimension feedback about error accounted for the most unique predictive variance in the outcome frequency of events reported. Other significantly associated variables included organizational learning, nonpunitive response to error, and teamwork within units (all P < 0.001). As the perceived severity of the safety event increased, more culture dimensions became significantly associated with voluntary reporting. To increase the likelihood that a patient safety event will be voluntarily reported, our study suggests placing priority on improving event feedback mechanisms and communication of event-related improvements. Focusing efforts on these aspects may be more efficient than other forms of culture change.

A Multilevel Analysis of U.S. Hospital Patient Safety Culture Relationships with Perceptions of Voluntary Event Reporting

PubMed Central

Burlison, Jonathan D.; Quillivan, Rebecca R.; Kath, Lisa M.; Zhou, Yinmei; Courtney, Sam C.; Cheng, Cheng; Hoffman, James M.

2016-01-01

Objectives Patient safety events offer opportunities to improve patient care, but, unfortunately, events often go unreported. Although some barriers to event reporting can be reduced with electronic reporting systems, insight on organizational and cultural factors that influence reporting frequency may help hospitals increase reporting rates and improve patient safety. The purpose of this study was to evaluate the associations between dimensions of patient safety culture and perceived reporting practices of safety events of varying severity. Methods We conducted a cross-sectional survey study using previously collected data from The Agency for Healthcare Research and Quality Hospital Survey of Patient Safety Culture as predictors and outcome variables. The dataset included healthcare professionals in U.S. hospitals, and data were analyzed by using multilevel modeling techniques. Results Data from 223,412 individuals, 7816 work areas/units and 967 hospitals were analyzed. Whether examining Near-miss, No harm, or Potential for harm safety events, the dimension Feedback about error accounted for the most unique predictive variance in the outcome Frequency of events reported. Other significantly associated variables included Organizational learning, Nonpunitive response to error, and Teamwork within units (all p<.001). As the perceived severity of the safety event increased, more culture dimensions became significantly associated with voluntary reporting. Conclusions To increase the likelihood that a patient safety event will be voluntarily reported, our study suggests placing priority on improving event feedback mechanisms and communication of event-related improvements. Focusing efforts on these aspects may be more efficient than other forms of culture change. PMID:27820722

Real-time detection of organic contamination events in water distribution systems by principal components analysis of ultraviolet spectral data.

PubMed

Zhang, Jian; Hou, Dibo; Wang, Ke; Huang, Pingjie; Zhang, Guangxin; Loáiciga, Hugo

2017-05-01

The detection of organic contaminants in water distribution systems is essential to protect public health from potential harmful compounds resulting from accidental spills or intentional releases. Existing methods for detecting organic contaminants are based on quantitative analyses such as chemical testing and gas/liquid chromatography, which are time- and reagent-consuming and involve costly maintenance. This study proposes a novel procedure based on discrete wavelet transform and principal component analysis for detecting organic contamination events from ultraviolet spectral data. Firstly, the spectrum of each observation is transformed using discrete wavelet with a coiflet mother wavelet to capture the abrupt change along the wavelength. Principal component analysis is then employed to approximate the spectra based on capture and fusion features. The significant value of Hotelling's T 2 statistics is calculated and used to detect outliers. An alarm of contamination event is triggered by sequential Bayesian analysis when the outliers appear continuously in several observations. The effectiveness of the proposed procedure is tested on-line using a pilot-scale setup and experimental data.

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

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

Jankovsky, Zachary Kyle; Denman, Matthew R.

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

On the relation of earthquake stress drop and ground motion variability

NASA Astrophysics Data System (ADS)

Oth, Adrien; Miyake, Hiroe; Bindi, Dino

2017-07-01

One of the key parameters for earthquake source physics is stress drop since it can be directly linked to the spectral level of ground motion. Stress drop estimates from moment corner frequency analysis have been shown to be extremely variable, and this to a much larger degree than expected from the between-event ground motion variability. This discrepancy raises the question whether classically determined stress drop variability is too large, which would have significant consequences for seismic hazard analysis. We use a large high-quality data set from Japan with well-studied stress drop data to address this issue. Nonparametric and parametric reference ground motion models are derived, and the relation of between-event residuals for Japan Meteorological Agency equivalent seismic intensity and peak ground acceleration with stress drop is analyzed for crustal earthquakes. We find a clear correlation of the between-event residuals with stress drops estimates; however, while the island of Kyushu is characterized by substantially larger stress drops than Honshu, the between-event residuals do not reflect this observation, leading to the appearance of two event families with different stress drop levels yet similar range of between-event residuals. Both the within-family and between-family stress drop variations are larger than expected from the ground motion between-event variability. A systematic common analysis of these parameters holds the potential to provide important constraints on the relative robustness of different groups of data in the different parameter spaces and to improve our understanding on how much of the observed source parameter variability is likely to be true source physics variability.

Multipoint connectivity analysis of the May 2007 solar energetic particle events

NASA Astrophysics Data System (ADS)

Chollet, E. E.; Mewaldt, R. A.; Cummings, A. C.; Gosling, J. T.; Haggerty, D. K.; Hu, Q.; Larson, D.; Lavraud, B.; Leske, R. A.; Opitz, A.; Roelof, E. C.; Russell, C. T.; Sauvaud, J.-A.

2010-12-01

In May of 2007, the STEREO Ahead and Behind spacecraft, along with the ACE spacecraft situated between the two STEREO spacecraft, observed two small solar energetic particle (SEP) events. STEREO-A and -B observed nearly identical time profiles in the 19 May event, but in the 23 May event, the protons arrived significantly earlier at STEREO-A than at STEREO-B and the time-intensity profiles were markedly different. We present SEP anisotropy, suprathermal electron pitch angle and solar wind data to demonstrate distortion in the magnetic field topology produced by the passage of multiple interplanetary coronal mass ejections on 22 and 23 May, causing the two spacecraft to magnetically connect to different points back at the Sun. This pair of events illustrates the power of multipoint observations in detailed interpretation of complex events, since only a small shift in observer location results in different magnetic field line connections and different SEP time-intensity profiles.

Relation of Gemfibrozil Treatment and High Density Lipoprotein (HDL) Subpopulation Profile with Cardiovascular Events in the Veterans Affairs HDL Intervention Trial (VA-HIT)

PubMed Central

Asztalos, Bela F.; Collins, Dorothea; Horvath, Katalin V.; Bloomfield, Hanna E.; Robins, Sander J.; Schaefer, Ernst J.

2007-01-01

Objective The significant cardiovascular disease (CVD) event reduction in VA-HIT could not be fully explained by the 6% increase in HDL-C with the fibrate, gemfibrozil. We examined whether measurement of HDL subpopulations provided additional information relative to CVD-risk reduction. Methods and Results HDL subpopulations were characterized by 2-dimensional gel-electrophoresis in subjects who were treated with gemfibrozil (n=754) or placebo (n=741). In this study, samples obtained at the 3-month visit were used and data were analyzed prospectively using CVD events (CHD death, MI, or stroke) during the 5.1 years follow up. Analyses in the gemfibrozil arm showed that subjects with recurrent CVD events had significantly higher preβ-1 and had significantly lower α-1 and α-2 HDL levels than those without such events. Preβ-1 level was a significant positive predictor; α-1 and α-2 levels were significant negative risk factors for future CVD events. α-2 level was superior to HDL-C level in CVD-risk assessment after adjustment for established risk factors. Gemfibrozil treatment was associated with 3%-6% decreases in the small, lipid-poor preβ-1 HDL and in the large, lipid-rich α-1 and α-2 HDL and with increases in the small α-3 (3%) and preα-3 (16%) HDLs. Conclusions While the use of gemfibrozil has been associated with reduction in CVD events in VA-HIT, HDL subpopulation analysis indicates that gemfibrozil-mediated improvement in CVD risk might not be the result of its effects on HDL. It is quite possible that much of the cardiovascular benefits of gemfibrozil are due to a much wider spectrum of effects on metabolic processes that is not reflected by changes in blood lipids and HDL subpopulations. PMID:18078862

Analysis of Lower Body Kinematic and Kinetic: Differences Between Age and Handicap in Golfers of Various Ages and Skill Levels

NASA Astrophysics Data System (ADS)

Smilensky, Alexander

The purpose of this thesis was to provide a preliminary analysis of lower body golf swing biomechanics. Fourteen golfers of various ages and handicaps performed 10 swings off a tee with their driver. This study focused on a number of dependent variables including lead knee joint flexion angles, internal/external rotations, valgus/varus angles, as well as ground reaction forces normalized to body weight (%BW), X-Factor angle and club head velocity. Dependent variables were analyzed at four specifically defined events (start, initiation of downswing, contact and swing termination). Simple linear regressions were performed using age and handicap as independent variables to see if patterns could be determined at any of the events. No significant trends or results were reported within our sample. An analysis of variance (ANOVA) was then used to examine the effect of event on specific dependent variables. A number of differences were reported within each of the variables across the four events. This study hoped to provide a more comprehensive understanding of the movement patterns occurring at the lower body with special focus on the lead knee.

Applying traditional signal processing techniques to social media exploitation for situational understanding

NASA Astrophysics Data System (ADS)

Abdelzaher, Tarek; Roy, Heather; Wang, Shiguang; Giridhar, Prasanna; Al Amin, Md. Tanvir; Bowman, Elizabeth K.; Kolodny, Michael A.

2016-05-01

Signal processing techniques such as filtering, detection, estimation and frequency domain analysis have long been applied to extract information from noisy sensor data. This paper describes the exploitation of these signal processing techniques to extract information from social networks, such as Twitter and Instagram. Specifically, we view social networks as noisy sensors that report events in the physical world. We then present a data processing stack for detection, localization, tracking, and veracity analysis of reported events using social network data. We show using a controlled experiment that the behavior of social sources as information relays varies dramatically depending on context. In benign contexts, there is general agreement on events, whereas in conflict scenarios, a significant amount of collective filtering is introduced by conflicted groups, creating a large data distortion. We describe signal processing techniques that mitigate such distortion, resulting in meaningful approximations of actual ground truth, given noisy reported observations. Finally, we briefly present an implementation of the aforementioned social network data processing stack in a sensor network analysis toolkit, called Apollo. Experiences with Apollo show that our techniques are successful at identifying and tracking credible events in the physical world.

Multifractal Analysis in Mining Microseismicity and its Application to Seismic Hazard Analysis in Mines

NASA Astrophysics Data System (ADS)

Pasten, D.; Comte, D.; Vallejos, J.

2013-05-01

During the last decades several authors showing that the spatial distribution of earthquakes follows multifractal laws and the most interesting behavior is the decreasing of the fratal dimensions before the ocurrence of a large earthquake, and also before its main aftershocks. A multifractal analysis to over 55920 microseismicity events recorded from January 2006 to January 2009 at Creighton mine, Canada was applied. In order to work with a complete catalogue in magnitude, it was taken the data associated with the linear part of the Gutenber-Richter law, with magnitudes greater than -1.5. A multifractal analysis was performed using microseismic data, considering that significant earthquakes are those with magnitude MW ≥ 1.0. A moving window was used, containing a constant number of events in order to guarantee the precise estimations of the fractal dimensions. After different trials, we choose 200 events for the number of the data points in each windows. Two consecutive windows were shifted by 20 events. The complete data set was separated in six sections and this multifractal analysis was applied for each section of 9320 data. The multifractal analysis of each section shows that there is a systematic decreasing of the fractal dimension (Dq) with time before the occurrence of rockburst or natural event with magnitude greater than MW ≥ 1.0, as it is observed in the seismic sequence of large earthquakes. This metodology was repeated for minimum magnitudes MW ≥ 1.5 and MW ≥ 2.0, obtaining same results. The best result was obtained using MW >= 2.0, a right answer rate vary between fifty and eighty percent. The result shows the possibility to use systematically the determination of the Dq parameter in order to detect the next rockburst or natural event in the studied mine. This project has been financially suppoerted by FONDECyT No 3120237 Grant (D.P).

Clinical Outcomes of Root Reimplantation and Bentall Procedure: Propensity Score Matching Analysis.

PubMed

Lee, Heemoon; Cho, Yang Hyun; Sung, Kiick; Kim, Wook Sung; Park, Kay-Hyun; Jeong, Dong Seop; Park, Pyo Won; Lee, Young Tak

2018-03-26

This study aimed to evaluate the clinical outcomes of aortic root replacement(ARR) surgery:Root reimplantation as valve-sparing root replacement(VSR) and the Bentall procedure. We retrospectively reviewed 216 patients who underwent ARR between 1995 and 2013 at Samsung Medical Center. Patients were divided into two groups, depending on the procedure they underwent: Bentall(n=134) and VSR(n=82). The mean follow-up duration was 100.9±56.4 months. There were 2 early deaths in the Bentall group and none in the VSR group(p=0.53). Early morbidities were not different between the groups. Overall mortality was significantly lower in the VSR group (HR=0.12,p=0.04). Despite the higher reoperation rate in the VSR group(p=0.03), major adverse valve-related events(MAVRE) did not differ between the groups(p=0.28). Bleeding events were significantly higher in the Bentall group during follow-up(10 in Bentall group, 0 in VSR group, p=0.04). here were 6 thromboembolic events only in the Bentall group(p=0.11). We performed a propensity score matching analysis comparing the groups(134 Bentall vs 43 VSR). Matched analysis gave similar results, i.e. HR=0.17 and p=0.10 for overall mortality and HR=1.01 and p=0.99 for MAVRE. Although there was marginal significance in the propensity matched analysis, it is plausible to anticipate a survival benefit with VSR during long-term follow-up. Despite a higher reoperation for aortic valves, VSR can be a viable option in patients who decline life-long anticoagulation, especially the young or the patients in whom anticoagulation is contraindicated. Copyright © 2018. Published by Elsevier Inc.

Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

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

Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp

2016-03-15

PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (tmore » test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.« less

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery?

PubMed

Frandon, Julien; Rodiere, Mathieu; Arvieux, Catherine; Vendrell, Anne; Boussat, Bastien; Sengel, Christian; Broux, Christophe; Bricault, Ivan; Ferretti, Gilbert; Thony, Frédéric

2015-01-01

We aimed to compare clinical outcomes and early adverse events of operative management (OM), nonoperative management (NOM), and NOM with splenic artery embolization (SAE) in blunt splenic injury (BSI) and identify the prognostic factors. Medical records of 136 consecutive patients with BSI admitted to a trauma center from 2005 to 2010 were retrospectively reviewed. Patients were separated into three groups: OM, NOM, and SAE. We focused on associated injuries and early adverse events. Multivariate analysis was performed on 23 prognostic factors to find predictors. The total survival rate was 97.1%, with four deaths all occurred in the OM group. The spleen salvage rate was 91% in NOM and SAE. At least one adverse event was observed in 32.8%, 62%, and 96% of patients in NOM, SAE, and OM groups, respectively (P < 0.001). We found significantly more deaths, infectious complications, pleural drainage, acute renal failures, and pancreatitis in OM and more pseudocysts in SAE. Six prognostic factors were statistically significant for one or more adverse events: simplified acute physiology score 2 ≥25 for almost all adverse events, age ≥50 years for acute respiratory syndrome, limb fracture for secondary bleeding, thoracic injury for pleural drainage, and at least one associated injury for pseudocyst. Adverse events were not related to the type of BSI management. Patients with BSI present worse outcome and more adverse events in OM, but this is related to the severity of injury. The main predictor of adverse events remains the severity of injury.

Catalogue of 55-80 MeV solar proton events extending through solar cycles 23 and 24

NASA Astrophysics Data System (ADS)

Paassilta, Miikka; Raukunen, Osku; Vainio, Rami; Valtonen, Eino; Papaioannou, Athanasios; Siipola, Robert; Riihonen, Esa; Dierckxsens, Mark; Crosby, Norma; Malandraki, Olga; Heber, Bernd; Klein, Karl-Ludwig

2017-06-01

We present a new catalogue of solar energetic particle events near the Earth, covering solar cycle 23 and the majority of solar cycle 24 (1996-2016), based on the 55-80 MeV proton intensity data gathered by the Solar and Heliospheric Observatory/the Energetic and Relativistic Nuclei and Electron experiment (SOHO/ERNE). In addition to ERNE proton and heavy ion observations, data from the Advanced Composition Explorer/Electron, Proton and Alpha Monitor (ACE/EPAM) (near-relativistic electrons), SOHO/EPHIN (Electron Proton Helium Instrument) (relativistic electrons), SOHO/LASCO (Large Angle and Spectrometric Coronagraph) (coronal mass ejections, CMEs) and Geostationary Operational Environmental Satellite (GOES) soft X-ray experiments are also considered and the associations between the particle and CME/X-ray events deduced to obtain a better understanding of each event. A total of 176 solar energetic particle (SEP) events have been identified as having occurred during the time period of interest; their onset and solar release times have been estimated using both velocity dispersion analysis (VDA) and time-shifting analysis (TSA) for protons, as well as TSA for near-relativistic electrons. Additionally, a brief statistical analysis was performed on the VDA and TSA results, as well as the X-rays and CMEs associated with the proton/electron events, both to test the viability of the VDA and to investigate possible differences between the two solar cycles. We find, in confirmation of a number of previous studies, that VDA results for protons that yield an apparent path length of 1 AU < s ≾ 3 AU seem to be useful, but those outside this range are probably unreliable, as evidenced by the anticorrelation between apparent path length and release time estimated from the X-ray activity. It also appears that even the first-arriving energetic protons apparently undergo significant pitch angle scattering in the interplanetary medium, with the resulting apparent path length being on average about twice the length of the spiral magnetic field. The analysis indicates an increase in high-energy SEP events originating from the far-eastern solar hemisphere; for instance, such an event with a well-established associated GOES flare has so far occurred three times during cycle 24 but possibly not at all during cycle 23. The generally lower level of solar activity during cycle 24, as opposed to cycle 23, has probably caused a significant decrease in total ambient pressure in the interplanetary space, leading to a larger proportion of SEP-associated halo-type CMEs. Taken together, these observations point to a qualitative difference between the two solar cycles.

[Therapeutic effect and safety of montelukast sodium combined with budesonide in children with cough variant asthma: a Meta analysis].

PubMed

Wei, Yan; Li, Dong-Sheng; Liu, Jian-Jun; Zhang, Jing; Zhao, Hai-En

2016-11-01

To evaluate the therapeutic effect and safety of montelukast sodium combined with budesonide in children with cough variant asthma. The databases CNKI, Wanfang Data, VIP, PubMed, EMbase, and BioMed Central were searched for randomized controlled trials (RCTs) of montelukast sodium combined with budesonide in the treatment of children with cough variant asthma. Data extraction and quality assessment were performed for RCTs which met the inclusion criteria, and RevMan 5.3 software was used to perform quality assessment of the articles included and Meta analysis. A total of 11 RCTs involving 1 097 patients were included. The results of the Meta analysis showed that compared with the control group (inhalation of budesonide alone), the observation group (inhalation of montelukast sodium combined with budesonide) had significantly higher overall response rate and more improved pulmonary function parameters including forced expiratory volume in the first second, percentage of forced expiratory volume in the first second, and peak expiratory flow, as well as significantly lower recurrence rate (P<0.01). The incidence of adverse events showed no significant difference between the two groups. Inhalation of montelukast sodium combined with budesonide has a significant effect in children with cough variant asthma and does not increase the incidence of adverse events.

Using patients’ experiences of adverse events to improve health service delivery and practice: protocol of a data linkage study of Australian adults age 45 and above

PubMed Central

Walton, Merrilyn; Smith-Merry, Jennifer; Harrison, Reema; Manias, Elizabeth; Iedema, Rick; Kelly, Patrick

2014-01-01

Introduction Evidence of patients’ experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit; investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia. Methods and analysis The 45 and Up Study is a cohort of 265 000 adults aged 45 years and above in NSW. Patients who were hospitalised between 1 January and 30 June 2014 will be identified from this cohort using data linkage and a random sample of 20 000 invited to participate. A cross-sectional survey (including qualitative and quantitative components) will capture patients’ experiences in hospital and specifically of adverse events. Approximately 25% of respondents are likely to report experiencing an adverse event. Quantitative components will capture the nature and type of events as well as common features of patients’ experiences. Qualitative data provide contextual knowledge of their condition and care and the impact of the event on individuals. Respondents who do not report an adverse event will report their experience in hospital and be the control group. Statistical and thematic analysis will be used to present a patient perspective of their experiences in hospital; the characteristics of patients experiencing an adverse event; experiences of information sharing after an event (open disclosure) and the other avenues of redress pursued. Interviews with key policymakers and a document analysis will be used to create a map of the current practice. Ethics and dissemination Dissemination via a one-day workshop, peer-reviewed publications and conference presentations will enable effective clinical responses and service provision and policy responses to adverse events to be developed. PMID:25311039

Initiating Event Analysis of a Lithium Fluoride Thorium Reactor

NASA Astrophysics Data System (ADS)

Geraci, Nicholas Charles

The primary purpose of this study is to perform an Initiating Event Analysis for a Lithium Fluoride Thorium Reactor (LFTR) as the first step of a Probabilistic Safety Assessment (PSA). The major objective of the research is to compile a list of key initiating events capable of resulting in failure of safety systems and release of radioactive material from the LFTR. Due to the complex interactions between engineering design, component reliability and human reliability, probabilistic safety assessments are most useful when the scope is limited to a single reactor plant. Thus, this thesis will study the LFTR design proposed by Flibe Energy. An October 2015 Electric Power Research Institute report on the Flibe Energy LFTR asked "what-if?" questions of subject matter experts and compiled a list of key hazards with the most significant consequences to the safety or integrity of the LFTR. The potential exists for unforeseen hazards to pose additional risk for the LFTR, but the scope of this thesis is limited to evaluation of those key hazards already identified by Flibe Energy. These key hazards are the starting point for the Initiating Event Analysis performed in this thesis. Engineering evaluation and technical study of the plant using a literature review and comparison to reference technology revealed four hazards with high potential to cause reactor core damage. To determine the initiating events resulting in realization of these four hazards, reference was made to previous PSAs and existing NRC and EPRI initiating event lists. Finally, fault tree and event tree analyses were conducted, completing the logical classification of initiating events. Results are qualitative as opposed to quantitative due to the early stages of system design descriptions and lack of operating experience or data for the LFTR. In summary, this thesis analyzes initiating events using previous research and inductive and deductive reasoning through traditional risk management techniques to arrive at a list of key initiating events that can be used to address vulnerabilities during the design phases of LFTR development.

Principals' reports of adults' alcohol use in Australian secondary schools.

PubMed

Ward, Bernadette M; Kippen, Rebecca; Buykx, Penny; Munro, Geoffrey; McBride, Nyanda; Wiggers, John

2016-02-29

Schools provide opportunities for parents and the wider community to connect and support the physical and emotional wellbeing of their children. Schools therefore have the potential to play a role in the socialisation of alcohol use through school policies and practices regarding consumption of alcohol by adults at school events in the presence of children. This survey was undertaken to a) compare the extent to which alcohol is used at secondary school events, when children are present, in the states of New South Wales (NSW) and Victoria (VIC), Australia; b) describe principals' level of agreement with these practices; c) their awareness of state policies on this issue; and d) the predictors of such events. A random sample of secondary schools, stratified to represent metropolitan and non-metropolitan schools were invited to participate. Bivariate and multivariate analysis were conducted with p values < 0.05 considered significant. A total of 241 (43%) schools consented to participate in the study. Fifteen percent of participating NSW schools and 57% of VIC schools held at least one event in which alcohol was consumed by adults in the presence of children in the year before the survey. Of the 100 reported events, 78% were Year 12 graduation dinners, and 18% were debutante balls. Compared to NSW principals, VIC principals were significantly more likely to agree with the use of alcohol at these events; significantly less likely to be aware of their state education department policy on this issue; have a policy at their own school or support policy that prohibits alcohol use at such events; and less likely to report having enough information to make decisions about this. There is a growing focus on adults' use of alcohol at school events when children are present. Schools can play an important role in educating and socialising children about alcohol via both the curriculum and policies regarding adults' alcohol use at school events. Findings from this study suggest education department and school-based policies that prohibit or restrict the use of alcohol, are significant predictors of adults' alcohol use at school events when children are present.

Outcomes of cataract surgery with residents as primary surgeons in the Veterans Affairs Healthcare System.

PubMed

Payal, Abhishek R; Gonzalez-Gonzalez, Luis A; Chen, Xi; Cakiner-Egilmez, Tulay; Chomsky, Amy; Baze, Elizabeth; Vollman, David; Lawrence, Mary G; Daly, Mary K

2016-03-01

To explore visual outcomes, functional visual improvement, and events in resident-operated cataract surgery cases. Veterans Affairs Ophthalmic Surgery Outcomes Database Project across 5 Veterans Affairs Medical Centers. Retrospective data analysis of deidentified data. Cataract surgery cases with residents as primary surgeons were analyzed for logMAR corrected distance visual acuity (CDVA) and vision-related quality of life (VRQL) measured by the modified National Eye Institute Vision Function Questionnaire and 30 intraoperative and postoperative events. In some analyses, cases without events (Group A) were compared with cases with events (Group B). The study included 4221 cataract surgery cases. Preoperative to postoperative CDVA improved significantly in both groups (P < .0001), although the level of improvement was less in Group B (P = .03). A CDVA of 20/40 or better was achieved in 96.64% in Group A and 88.25% in Group B (P < .0001); however, Group B had a higher prevalence of preoperative ocular comorbidities (P < .0001). Cases with 1 or more events were associated with a higher likelihood of a postoperative CDVA worse than 20/40 (odds ratio, 3.82; 95% confidence interval, 2.92-5.05; P < .0001) than those who did not experience an event. Both groups had a significant increase in VRQL from preoperative levels (both P < .0001); however, the level of preoperative to postoperative VRQL improvement was significantly less in Group B (P < .0001). Resident-operated cases with and without events had an overall significant improvement in visual acuity and visual function compared with preoperatively, although this improvement was less marked in those that had an event. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Influence of adjunctive lacosamide in patients with seizures: a systematic review and meta-analysis.

PubMed

Liu, Hongju; Xu, Xiaoli

2018-07-01

Adjunctive lacosamide treatment might be promising to treat seizures. However, the results remained controversial. We conducted a systematic review and meta-analysis to compare the efficacy and safety of adjunctive lacosamide versus placebo in patients with seizures. PubMed, EMbase, Web of science, EBSCO and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of adjunctive lacosamide versus placebo on seizures were included. Two investigators independently searched articles, extracted data and assessed the quality of included studies. The primary outcomes were 50% responder rate and seizure freedom. Four RCTs involving 1199 patients were included in the meta-analysis. Overall, compared with placebo treatment, adjunctive lacosamide treatment was associated with a significantly increased 50% responder rate (RR = 1.89; 95% CI = 1.51-2.36; P < 0.00001) and seizure freedom (RR = 4.97; 95% CI = 1.78-13.91; P = 0.002), but improved dizziness (RR = 3.97; 95% CI = 2.91-5.42; P < 0.00001), nausea (RR = 2.85; 95% CI = 1.75-4.66; P < 0.0001), vomiting (RR = 4.11; 95% CI = 2.23-7.57; P < 0.00001), diplopia (RR = 6.85; 95% CI = 3.36-13.94; P < 0.00001), treatment-emergent adverse events (RR = 2.29; 95% CI = 1.93-2.71; P < 0.00001) and serious adverse events (RR = 2.52; 95% CI = 1.33-4.78; P = 0.005). Compared to placebo, adjunctive lacosamide resulted in a significantly improved 50% responder rate and seizure freedom, but with increased dizziness, nausea, vomiting, diplopia, treatment-emergent adverse events and serious adverse events.

Outcome and risk factors assessment for adverse events in advanced esophageal cancer patients after self-expanding metal stents placement.

PubMed

Rodrigues-Pinto, E; Pereira, P; Coelho, R; Andrade, P; Ribeiro, A; Lopes, S; Moutinho-Ribeiro, P; Macedo, G

2017-02-01

Self-expanding metal stents (SEMS) are the treatment of choice for advanced esophageal cancers. Literature is scarce on risk factors predictors for adverse events after SEMS placement. Assess risk factors for adverse events after SEMS placement in advanced esophageal cancer and evaluate survival after SEMS placement. Cross-sectional study of patients with advanced esophageal cancer referred for SEMS placement, during a period of 3 years. Ninety-seven patients with advanced esophageal cancer placed SEMS. Adverse events were more common when tumors were located at the level of the distal esophagus/cardia (47% vs 23%, P = 0.011, OR 3.1), with statistical significance being kept in the multivariate analysis (OR 3.1, P = 0.018). Time until adverse events was lower in the tumors located at the level of the distal esophagus/cardia (P = 0.036). Survival was higher in patients who placed SEMS with curative intent (327 days [126-528] vs. 119 days [91-147], P = 0.002) and in patients submitted subsequently to surgery compared with those who did just chemo/radiotherapy or who did not do further treatment (563 days [378-748] vs. 154 days [133-175] vs. 46 days [20-72], P < 0.001). Subsequent treatment kept statistical significance in the multivariate analysis (HR 3.4, P < 0.001). SEMS allow palliation of dysphagia in advanced esophageal cancer and are associated with an increased out-of-hospital survival, as long as there are conditions for further treatments. Tumors located at the level of the distal esophagus/cardia are associated with a greater number of adverse events, which also occur earlier. © 2016 International Society for Diseases of the Esophagus.

Modelling home advantage in the Summer Olympic Games.

PubMed

Balmer, N J; Nevill, A M; Williams, A M

2003-06-01

Home advantage in team games is well proven and the influence of the crowd upon officials' decisions has been identified as a plausible cause. The aim of this study was to assess the significance of home advantage for five event groups selected from the Summer Olympic Games between 1896 and 1996, and put home advantage in team games in context with other sports. The five event groups were athletics and weightlifting (predominantly objectively judged), boxing and gymnastics (predominantly subjectively judged) and team games (involving subjective decisions). The proportion of points won was analysed as a binomial response variable using generalized linear interactive modelling. Preliminary exploration of the data highlighted the need to control for the proportion of competitors entered and to split the analysis pre- and post-war. Highly significant home advantage was found in event groups that were either subjectively judged or rely on subjective decisions. In contrast, little or no home advantage (and even away advantage) was observed for the two objectively judged groups. Officiating system was vital to both the existence and extent of home advantage. Our findings suggest that crowd noise has a greater influence upon officials' decisions than players' performances, as events with greater officiating input enjoyed significantly greater home advantage.

Long-term stormwater quantity and quality analysis using continuous measurements in a French urban catchment.

PubMed

Sun, Siao; Barraud, Sylvie; Castebrunet, Hélène; Aubin, Jean-Baptiste; Marmonier, Pierre

2015-11-15

The assessment of urban stormwater quantity and quality is important for evaluating and controlling the impact of the stormwater to natural water and environment. This study mainly addresses long-term evolution of stormwater quantity and quality in a French urban catchment using continuous measured data from 2004 to 2011. Storm event-based data series are obtained (716 rainfall events and 521 runoff events are available) from measured continuous time series. The Mann-Kendall test is applied to these event-based data series for trend detection. A lack of trend is found in rainfall and an increasing trend in runoff is detected. As a result, an increasing trend is present in the runoff coefficient, likely due to growing imperviousness of the catchment caused by urbanization. The event mean concentration of the total suspended solid (TSS) in stormwater does not present a trend, whereas the event load of TSS has an increasing tendency, which is attributed to the increasing event runoff volume. Uncertainty analysis suggests that the major uncertainty in trend detection results lies in uncertainty due to available data. A lack of events due to missing data leads to dramatically increased uncertainty in trend detection results. In contrast, measurement uncertainty in time series data plays a trivial role. The intra-event distribution of TSS is studied based on both M(V) curves and pollutant concentrations of absolute runoff volumes. The trend detection test reveals no significant change in intra-event distributions of TSS in the studied catchment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analysis of horse movements from non-commercial horse properties in New Zealand.

PubMed

Rosanowski, S M; Cogger, N; Rogers, C W; Bolwell, C F; Benschop, J; Stevenson, M A

2013-09-01

To investigate property-level factors associated with the movement of horses from non-commercial horse properties, including the size and location of the property, number and reason for keeping horses. Using a cross-sectional survey 2,912 questionnaires were posted to randomly selected non-commercial horse properties listed in a rural property database. The survey collected information about the number of horses, and reasons for keeping horses on the property, and any movement of horses in the previous 12 months. Three property-level outcomes were investigated; the movement status of the property, the frequency of movement events, and the median distance travelled from a property. Associations were examined using logistic regression and Kruskal-Wallis analysis of variance. In total 62.0% (488/791) of respondents reported at least one movement event in the year prior to the survey, for a total of 22,050 movement events. The number of movement events from a property varied significantly by the number of horses on the property (p<0.02), while the median distance travelled per property varied significantly by both region (p<0.03) and property size (p<0.01). Region, property size, the number of horses kept, and keeping horses for competition, recreation, racing or as pets were all significantly associated with movement status in the multivariable analyses (p<0.001). This study showed that there are characteristics of non-commercial horse properties that influence movement behaviour. During an exotic disease outbreak the ability to identify properties with these characteristics for targeted control will enhance the effectiveness of control measures.

Triiodothyronine and brain natriuretic peptide: similar long-term prognostic values for chronic heart failure.

PubMed

Kozdag, Guliz; Ertas, Gokhan; Kilic, Teoman; Acar, Eser; Sahin, Tayfun; Ural, Dilek

2010-01-01

Although low levels of free triiodothyronine and high levels of brain natriuretic peptide have been shown as independent predictors of death in chronic heart failure patients, few studies have compared their prognostic values. The aim of this prospective study was to measure free triiodothyronine and brain natriuretic peptide levels and to compare their prognostic values among such patients.A total of 334 patients (mean age, 62 ± 13 yr; 218 men) with ischemic and nonischemic dilated cardiomyopathy were included in the study. The primary endpoint was a major cardiac event.During the follow-up period, 92 patients (28%) experienced a major cardiac event. Mean free triiodothyronine levels were lower and median brain natriuretic peptide levels were higher in patients with major cardiac events than in those without. A significant negative correlation was found between free triiodothyronine and brain natriuretic peptide levels. Receiver operating characteristic curve analysis showed that the predictive cutoff values were < 2.12 pg/mL for free triiodothyronine and > 686 pg/mL for brain natriuretic peptide. Cumulative survival was significantly lower among patients with free triiodothyronine < 2.12 pg/mL and among patients with brain natriuretic peptide > 686 pg/mL. In multivariate analysis, the significant independent predictors of major cardiac events were age, free triiodothyronine, and brain natriuretic peptide.In the present study, free triiodothyronine and brain natriuretic peptide had similar prognostic values for predicting long-term prognosis in chronic heart failure patients. These results also suggested that combining these biomarkers may provide an important risk indicator for patients with heart failure.

Sitagliptin on carotid intima-media thickness in type 2 diabetes patients receiving primary or secondary prevention of cardiovascular disease: A subgroup analysis of the PROLOGUE study.

PubMed

Tanaka, Atsushi; Yoshida, Hisako; Nanasato, Mamoru; Oyama, Jun-Ichi; Ishizu, Tomoko; Ajioka, Masayoshi; Ishiki, Ryoji; Saito, Makoto; Shibata, Yoshisato; Kaku, Kohei; Maemura, Koji; Higashi, Yukihito; Inoue, Teruo; Murohara, Toyoaki; Node, Koichi

2018-05-19

Whether a dipeptidyl peptidase-4 (DPP-4) inhibitor can attenuate atherosclerosis is still controversial. Some clinical trials reported that DPP-4 inhibitors in diabetes patients without a previous history of cardiovascular (CV) events could reduce carotid intima-media thickness (IMT). However, in the PROLOGUE study, which enrolled diabetes patients both with and without previous CV events, sitagliptin failed to slow the progression of carotid IMT relative to conventional therapy. We hypothesized that the effect of DPP-4 inhibitors on carotid atherosclerosis might be different between the primary and secondary prevention groups. We performed a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in carotid IMT in subgroups with or without previous CV events. No significant difference in the IMT changes between the treatment groups was found in the secondary prevention subgroup (sitagliptin, N = 102; conventional, 111). However, in the primary prevention subgroup (sitagliptin, 120; conventional, 109), we found significant inhibitory effects of sitagliptin on mean and max internal carotid artery IMT [estimated group difference: -0.096 mm (95% CI -0.175 to -0.018, p = 0.017) and -0.162 mm (95% CI -0.272 to -0.052, p = 0.004), respectively], although there was no significant difference in the common carotid artery IMT. Our data suggest that there is a favorable effect of DPP-4 inhibitor treatment on carotid atherosclerosis in diabetes patients without previous CV events. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of Modal Acoustic Emission to Monitor Damage Progression in Carbon Fiber/Epoxy Tows and Implications for Composite Structures

NASA Technical Reports Server (NTRS)

Waller, Jess M.; Saulsberry, Regor L.; Lucero, Ralph; Nichols, Charles T.; Wentzel, Daniel J.

2010-01-01

ASTM-based ILH methods were found to give a reproducible, quantitative estimate of the stress threshold at which significant accumulated damage began to occur. a) FR events are low energy (<2 V(exp 20 microsec) b) FR events occur close to the observed failure locus. c) FR events consist of more than 30% fiber breakage (>300 kHz) d) FR events show a consistent hierarchy of cooperative damage for composite tow, and for the COPV tested, regardless of applied load. Application of ILH or related stress profiles could lead to robust pass/fail acceptance criteria based on the FR. Initial application of FR and FFT analysis of AE data acquired on COPVs is promising.

Asynchronous sampled-data approach for event-triggered systems

NASA Astrophysics Data System (ADS)

Mahmoud, Magdi S.; Memon, Azhar M.

2017-11-01

While aperiodically triggered network control systems save a considerable amount of communication bandwidth, they also pose challenges such as coupling between control and event-condition design, optimisation of the available resources such as control, communication and computation power, and time-delays due to computation and communication network. With this motivation, the paper presents separate designs of control and event-triggering mechanism, thus simplifying the overall analysis, asynchronous linear quadratic Gaussian controller which tackles delays and aperiodic nature of transmissions, and a novel event mechanism which compares the cost of the aperiodic system against a reference periodic implementation. The proposed scheme is simulated on a linearised wind turbine model for pitch angle control and the results show significant improvement against the periodic counterpart.

Drought, flood and rainfall analysis under climate change in Crete, Greece

NASA Astrophysics Data System (ADS)

Tapoglou, Evdokia; Vozinaki, Anthi-Eirini; Tsanis, Ioannis; Nerantzaki, Sofia; Nikolaidis, Nikolaos

2017-04-01

In this study an analysis on the drought frequency and magnitude under climate change in Crete, Greece is performed. The analysis was performed for the time period from 1983-2100, divided into three sub-periods (1983-1999, 2000-2049 and 2050-2099) for inter-comparison. Two climate models were studied MPI-ESM-LR-r1-CSC-REMO and EC-EARTH-r12-SMHI-RCA4, following three possible representative concentration pathways (+2.6, +4.5 and +8.5 W/m2). In order to perform the analysis the results of a SWAT simulation which covered the entity of Crete using 352 subbasins, was used. Drought events are recognized by using the Standardized Precipitation Index (SPI) to identify the meteorological drought events and Standardized Runoff Index (SRI) for hydrological droughts. SPI and SRI drought indices, were used in order to identify the number of drought events for each climate model and scenario. In all cases, an increase in both severity and number of drought events was calculated for the future periods, compared to the baseline period 1983-1999. This increase was smaller for the +2.6 W/m2 scenario and largest for the +8.5 W/m2. The magnitude of events with 10 and 100 years return period was calculated for the subbasins of Crete and the most vulnerable were identified, both in terms of severity and the change throughout the years in index magnitude. Next a flood frequency analysis was performed for the entity of Crete Island in order to calculate the magnitude of events with 10 and 100 years return period. In order to perform the flood frequency analysis, the results of the SWAT simulation in terms of runoff in each subbasin are used. By calculating the magnitude of flood events with 10 and 100 years return period and the change in the magnitude throughout the time periods the most vulnerable subbasins are identified. The same frequency analysis was performed for the precipitation at each subbasin, and the magnitude of extreme precipitation events with 10 and 100 years return period was calculated. In this case the most significant changes appeared in Chania prefecture, having a 25-50% increase in extreme precipitation magnitude for the 10 years and the 100 years return period until the end of the third study period. Drought and flood frequency analysis can be proved a valuable tool in water management and infrastructure projects planning providing an integrated analysis for extreme event magnitude anticipation in Crete. The research reported in this paper was fully supported by the Project "Innovative solutions to climate change adaptation and governance in the water management of the Region of Crete - AQUAMAN" funded within the framework of the EEA Financial Mechanism 2009-2014.

Optimal filter parameters for low SNR seismograms as a function of station and event location

NASA Astrophysics Data System (ADS)

Leach, Richard R.; Dowla, Farid U.; Schultz, Craig A.

1999-06-01

Global seismic monitoring requires deployment of seismic sensors worldwide, in many areas that have not been studied or have few useable recordings. Using events with lower signal-to-noise ratios (SNR) would increase the amount of data from these regions. Lower SNR events can add significant numbers to data sets, but recordings of these events must be carefully filtered. For a given region, conventional methods of filter selection can be quite subjective and may require intensive analysis of many events. To reduce this laborious process, we have developed an automated method to provide optimal filters for low SNR regional or teleseismic events. As seismic signals are often localized in frequency and time with distinct time-frequency characteristics, our method is based on the decomposition of a time series into a set of subsignals, each representing a band with f/Δ f constant (constant Q). The SNR is calculated on the pre-event noise and signal window. The band pass signals with high SNR are used to indicate the cutoff filter limits for the optimized filter. Results indicate a significant improvement in SNR, particularly for low SNR events. The method provides an optimum filter which can be immediately applied to unknown regions. The filtered signals are used to map the seismic frequency response of a region and may provide improvements in travel-time picking, azimuth estimation, regional characterization, and event detection. For example, when an event is detected and a preliminary location is determined, the computer could automatically select optimal filter bands for data from non-reporting stations. Results are shown for a set of low SNR events as well as 379 regional and teleseismic events recorded at stations ABKT, KIV, and ANTO in the Middle East.

When All the Ducks Line Up

NASA Technical Reports Server (NTRS)

Henwood, Bart E.

2007-01-01

This viewgraph presentation gives an overview of the N2NA Pylon overheat mishap. The contents include: 1) Investigation Process; 2) Bottom Line; 3) Event Description / Damage; 4) Causal Tree Analysis; 5) Significant Observations; and 6) Major Recommendations.

Analysis of changes in tornadogenesis conditions over Northern Eurasia based on a simple index of atmospheric convective instability

NASA Astrophysics Data System (ADS)

Chernokulsky, A. V.; Kurgansky, M. V.; Mokhov, I. I.

2017-12-01

A simple index of convective instability (3D-index) is used for analysis of weather and climate processes that favor to the occurrence of severe convective events including tornadoes. The index is based on information on the surface air temperature and humidity. The prognostic ability of the index to reproduce severe convective events (thunderstorms, showers, tornadoes) is analyzed. It is shown that most tornadoes in North Eurasia are characterized by high values of the 3D-index; furthermore, the 3D-index is significantly correlated with the available convective potential energy. Reanalysis data (for recent decades) and global climate model simulations (for the 21st century) show an increase in the frequency of occurrence of favorable for tornado formation meteorological conditions in the regions of Northern Eurasia. The most significant increase is found on the Black Sea coast and in the south of the Far East.

Impact of exercise pulmonary hypertension on postoperative outcome in primary mitral regurgitation.

PubMed

Magne, Julien; Donal, Erwan; Mahjoub, Haifa; Miltner, Beatrice; Dulgheru, Raluca; Thebault, Christophe; Pierard, Luc A; Pibarot, Philippe; Lancellotti, Patrizio

2015-03-01

The management of asymptomatic patients with mitral regurgitation (MR) remains controversial. Exercise-induced pulmonary hypertension (ExPHT) was recently reported as a strong predictor of rapid onset of symptoms. We hypothesised that ExPHT is a predictor of postoperative cardiovascular events in patients with primary MR. One hundred and two patients with primary MR, no or mild symptoms (New York heart association (NYHA) ≤2), and no LV dysfunction/dilatation, were prospectively recruited in 3 centres and underwent exercise-stress echocardiography. The presence of ExPHT was defined as an exercise systolic pulmonary arterial pressure >60 mm Hg. All patients were closely followed up and operated on when indication for surgery was reached. Postoperative events were defined as the occurrence of atrial fibrillation (AF), stroke, cardiac-related hospitalisation or death. Among the 102 patients included, 59 developed ExPHT (58%). These patients were significantly older than those without ExPHT (p=0.01). During a mean postoperative follow-up of 50±23 months, 28 patients (26%) experienced a predefined cardiovascular event. Patients with ExPHT had significantly higher rate of postoperative events (39% vs 12%, p=0.005); the rate of events was still higher in these patients (32% vs 9%, p=0.013), even when excluding early postoperative AF (ie, within 48 h). Event-free survival was significantly lower in the ExPHT group (all events: 5-year: 60±8% vs 88±5%, p=0.007, events without early AF: 5-year: 67±7% vs 90±4%, p=0.02). Using Cox multivariable analysis, ExPHT remained independently associated with higher risk of postoperative events in all models (all p≤0.04). ExPHT is associated with increased risk of adverse cardiac events following mitral valve surgery in patients with primary MR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Bio-inspired approach for intelligent unattended ground sensors

NASA Astrophysics Data System (ADS)

Hueber, Nicolas; Raymond, Pierre; Hennequin, Christophe; Pichler, Alexander; Perrot, Maxime; Voisin, Philippe; Moeglin, Jean-Pierre

2015-05-01

Improving the surveillance capacity over wide zones requires a set of smart battery-powered Unattended Ground Sensors capable of issuing an alarm to a decision-making center. Only high-level information has to be sent when a relevant suspicious situation occurs. In this paper we propose an innovative bio-inspired approach that mimics the human bi-modal vision mechanism and the parallel processing ability of the human brain. The designed prototype exploits two levels of analysis: a low-level panoramic motion analysis, the peripheral vision, and a high-level event-focused analysis, the foveal vision. By tracking moving objects and fusing multiple criteria (size, speed, trajectory, etc.), the peripheral vision module acts as a fast relevant event detector. The foveal vision module focuses on the detected events to extract more detailed features (texture, color, shape, etc.) in order to improve the recognition efficiency. The implemented recognition core is able to acquire human knowledge and to classify in real-time a huge amount of heterogeneous data thanks to its natively parallel hardware structure. This UGS prototype validates our system approach under laboratory tests. The peripheral analysis module demonstrates a low false alarm rate whereas the foveal vision correctly focuses on the detected events. A parallel FPGA implementation of the recognition core succeeds in fulfilling the embedded application requirements. These results are paving the way of future reconfigurable virtual field agents. By locally processing the data and sending only high-level information, their energy requirements and electromagnetic signature are optimized. Moreover, the embedded Artificial Intelligence core enables these bio-inspired systems to recognize and learn new significant events. By duplicating human expertise in potentially hazardous places, our miniature visual event detector will allow early warning and contribute to better human decision making.

Time distributions of solar energetic particle events: Are SEPEs really random?

NASA Astrophysics Data System (ADS)

Jiggens, P. T. A.; Gabriel, S. B.

2009-10-01

Solar energetic particle events (SEPEs) can exhibit flux increases of several orders of magnitude over background levels and have always been considered to be random in nature in statistical models with no dependence of any one event on the occurrence of previous events. We examine whether this assumption of randomness in time is correct. Engineering modeling of SEPEs is important to enable reliable and efficient design of both Earth-orbiting and interplanetary spacecraft and future manned missions to Mars and the Moon. All existing engineering models assume that the frequency of SEPEs follows a Poisson process. We present analysis of the event waiting times using alternative distributions described by Lévy and time-dependent Poisson processes and compared these with the usual Poisson distribution. The results show significant deviation from a Poisson process and indicate that the underlying physical processes might be more closely related to a Lévy-type process, suggesting that there is some inherent “memory” in the system. Inherent Poisson assumptions of stationarity and event independence are investigated, and it appears that they do not hold and can be dependent upon the event definition used. SEPEs appear to have some memory indicating that events are not completely random with activity levels varying even during solar active periods and are characterized by clusters of events. This could have significant ramifications for engineering models of the SEP environment, and it is recommended that current statistical engineering models of the SEP environment should be modified to incorporate long-term event dependency and short-term system memory.

Impact and recovery process of mini flash crashes: An empirical study.

PubMed

Braun, Tobias; Fiegen, Jonas A; Wagner, Daniel C; Krause, Sebastian M; Guhr, Thomas

2018-01-01

In an Ultrafast Extreme Event (or Mini Flash Crash), the price of a traded stock increases or decreases strongly within milliseconds. We present a detailed study of Ultrafast Extreme Events in stock market data. In contrast to popular belief, our analysis suggests that most of the Ultrafast Extreme Events are not necessarily due to feedbacks in High Frequency Trading: In at least 60 percent of the observed Ultrafast Extreme Events, the largest fraction of the price change is due to a single market order. In times of financial crisis, large market orders are more likely which leads to a significant increase of Ultrafast Extreme Events occurrences. Furthermore, we analyze the 100 trades following each Ultrafast Extreme Events. While we observe a tendency of the prices to partially recover, less than 40 percent recover completely. On the other hand we find 25 percent of the Ultrafast Extreme Events to be almost recovered after only one trade which differs from the usually found price impact of market orders.

Impact and recovery process of mini flash crashes: An empirical study

PubMed Central

Wagner, Daniel C.; Krause, Sebastian M.; Guhr, Thomas

2018-01-01

In an Ultrafast Extreme Event (or Mini Flash Crash), the price of a traded stock increases or decreases strongly within milliseconds. We present a detailed study of Ultrafast Extreme Events in stock market data. In contrast to popular belief, our analysis suggests that most of the Ultrafast Extreme Events are not necessarily due to feedbacks in High Frequency Trading: In at least 60 percent of the observed Ultrafast Extreme Events, the largest fraction of the price change is due to a single market order. In times of financial crisis, large market orders are more likely which leads to a significant increase of Ultrafast Extreme Events occurrences. Furthermore, we analyze the 100 trades following each Ultrafast Extreme Events. While we observe a tendency of the prices to partially recover, less than 40 percent recover completely. On the other hand we find 25 percent of the Ultrafast Extreme Events to be almost recovered after only one trade which differs from the usually found price impact of market orders. PMID:29782503

Model-Based Adaptive Event-Triggered Control of Strict-Feedback Nonlinear Systems.

PubMed

Li, Yuan-Xin; Yang, Guang-Hong

2018-04-01

This paper is concerned with the adaptive event-triggered control problem of nonlinear continuous-time systems in strict-feedback form. By using the event-sampled neural network (NN) to approximate the unknown nonlinear function, an adaptive model and an associated event-triggered controller are designed by exploiting the backstepping method. In the proposed method, the feedback signals and the NN weights are aperiodically updated only when the event-triggered condition is violated. A positive lower bound on the minimum intersample time is guaranteed to avoid accumulation point. The closed-loop stability of the resulting nonlinear impulsive dynamical system is rigorously proved via Lyapunov analysis under an adaptive event sampling condition. In comparing with the traditional adaptive backstepping design with a fixed sample period, the event-triggered method samples the state and updates the NN weights only when it is necessary. Therefore, the number of transmissions can be significantly reduced. Finally, two simulation examples are presented to show the effectiveness of the proposed control method.

Platelet larger cell ratio (P-LCR) in patients with dyslipidemia.

PubMed

Grotto, H Z W; Noronha, J F A

2004-10-01

We have described preliminary results of platelet larger cell ratio (P-LCR) analysis, provided by an automated hematology analyzer in patients with hypercholesterolemia and/or hypertriglyceremia. P-LCR values were significantly higher in patients (n = 41) than in control normal group (n = 20) (P < 0.0001). Larger platelets are more reactive and contribute to vasooclusive events in patients with dyslipidemia. P-LCR may be used as an indicator of risk factor for thromboembolic ischemic events.

A search for hep solar neutrinos at the Sudbury Neutrino Observatory

NASA Astrophysics Data System (ADS)

Winchester, Timothy J.

Solar neutrinos from the fusion hep reaction, (helium-3 fusing with a proton to become helium-4, releasing a positron and neutrino), have previously remained undetected due to their flux being about one one-thousandth that of boron-8 neutrinos. These neutrinos are interesting theoretically because they are less dependent on solar composition than other solar neutrinos, and therefore provide a somewhat independent test of the Standard Solar Model. In this analysis, we develop a new event fitter for existing data from the Sudbury Neutrino Observatory. We also use the fitter to remove backgrounds that previously limited the fiducial volume, which we increase by 30%. We use a modified Wald-Wolfowitz test to increase the amount of live time by 200 days (18%) and show that this data is consistent with the previously-used data. Finally, we develop a Bayesian analysis technique to make full use of the posterior distributions of energy returned by the event fitter. In the first significant detection of hep neutrinos, we find that the most-probable rate of hep events is 3.5 x 10. 4 /cm. 2/s, which is significantly higher than the theoretical prediction. We find that the 95% credible region extends from 1.0 to 7.2 x 10. 4 /cm. 2/s, and that we can therefore exclude a rate of 0 hep events at greater than 95% probability.

Impact of the 2015 El Nino event on winter air quality in China

NASA Astrophysics Data System (ADS)

Chang, Luyu; Xu, Jianming; Tie, Xuexi; Wu, Jianbin

2016-09-01

During the winter of 2015, there was a strong El Nino (ENSO) event, resulting in significant anomalies for meteorological conditions in China. Analysis shows that the meteorological conditions in December 2015 (compared to December 2014) had several important anomalies, including the following: (1) the surface southeasterly winds were significantly enhanced in the North China Plain (NCP); (2) the precipitation was increased in the south of eastern China; and (3) the wind speeds were decreased in the middle-north of eastern China, while slightly increased in the south of eastern China. These meteorological anomalies produced important impacts on the aerosol pollution in eastern China. In the NCP region, the PM2.5 concentrations were significantly increased, with a maximum increase of 80-100 μg m-3. A global chemical/transport model (MOZART-4) was applied to study the individual contribution of the changes in winds and precipitation to PM2.5 concentrations. This study suggests that the 2015El Nino event had significant effects on air pollution in eastern China, especially in the NCP region, including the capital city of Beijing, in which aerosol pollution was significantly enhanced in the already heavily polluted capital city of China.

COMCAN; COMCAN2A; system safety common cause analysis. [IBM360; CDC CYBER176,175; FORTRAN IV (30%) and BAL (70%) (IBM360), FORTRAN IV (97%) and COMPASS (3%) (CDC CYBER176)

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

Burdick, G.R.; Wilson, J.R.

COMCAN2A and COMCAN are designed to analyze complex systems such as nuclear plants for common causes of failure. A common cause event, or common mode failure, is a secondary cause that could contribute to the failure of more than one component and violates the assumption of independence. Analysis of such events is an integral part of system reliability and safety analysis. A significant common cause event is a secondary cause common to all basic events in one or more minimal cut sets. Minimal cut sets containing events from components sharing a common location or a common link are called commonmore » cause candidates. Components share a common location if no barrier insulates any one of them from the secondary cause. A common link is a dependency among components which cannot be removed by a physical barrier (e.g., a common energy source or common maintenance instructions).IBM360;CDC CYBER176,175; FORTRAN IV (30%) and BAL (70%) (IBM360), FORTRAN IV (97%) and COMPASS (3%) (CDC CYBER176).; OS/360 (IBM360) and NOS/BE 1.4 (CDC CYBER176), NOS 1.3 (CDC CYBER175); 140K bytes of memory for COMCAN and 242K (octal) words of memory for COMCAN2A.« less

Extreme events in total ozone over the Northern mid-latitudes: an analysis based on long-term data sets from five European ground-based stations

NASA Astrophysics Data System (ADS)

Rieder, Harald E.; Jancso, Leonhardt M.; Rocco, Stefania Di; Staehelin, Johannes; Maeder, Joerg A.; Peter, Thomas; Ribatet, Mathieu; Davison, Anthony C.; de Backer, Hugo; Koehler, Ulf; Krzyścin, Janusz; Vaníček, Karel

2011-11-01

We apply methods from extreme value theory to identify extreme events in high (termed EHOs) and low (termed ELOs) total ozone and to describe the distribution tails (i.e. very high and very low values) of five long-term European ground-based total ozone time series. The influence of these extreme events on observed mean values, long-term trends and changes is analysed. The results show a decrease in EHOs and an increase in ELOs during the last decades, and establish that the observed downward trend in column ozone during the 1970-1990s is strongly dominated by changes in the frequency of extreme events. Furthermore, it is shown that clear ‘fingerprints’ of atmospheric dynamics (NAO, ENSO) and chemistry [ozone depleting substances (ODSs), polar vortex ozone loss] can be found in the frequency distribution of ozone extremes, even if no attribution is possible from standard metrics (e.g. annual mean values). The analysis complements earlier analysis for the world's longest total ozone record at Arosa, Switzerland, confirming and revealing the strong influence of atmospheric dynamics on observed ozone changes. The results provide clear evidence that in addition to ODS, volcanic eruptions and strong/moderate ENSO and NAO events had significant influence on column ozone in the European sector.

Using a Six Sigma Fishbone Analysis Approach To Evaluate the Effect of Extreme Weather Events on Salmonella Positives in Young Chicken Slaughter Establishments.

PubMed

Linville, John W; Schumann, Douglas; Aston, Christopher; Defibaugh-Chavez, Stephanie; Seebohm, Scott; Touhey, Lucy

2016-12-01

A six sigma fishbone analysis approach was used to develop a machine learning model in SAS, Version 9.4, by using stepwise linear regression. The model evaluated the effect of a wide variety of variables, including slaughter establishment operational measures, normal (30-year average) weather, and extreme weather events on the rate of Salmonella -positive carcasses in young chicken slaughter establishments. Food Safety and Inspection Service (FSIS) verification carcass sampling data, as well as corresponding data from the National Oceanographic and Atmospheric Administration and the Federal Emergency Management Agency, from September 2011 through April 2015, were included in the model. The results of the modeling show that in addition to basic establishment operations, normal weather patterns, differences from normal and disaster events, including time lag weather and disaster variables, played a role in explaining the Salmonella percent positive that varied by slaughter volume quartile. Findings show that weather and disaster events should be considered as explanatory variables when assessing pathogen-related prevalence analysis or research and slaughter operational controls. The apparent significance of time lag weather variables suggested that at least some of the impact on Salmonella rates occurred after the weather events, which may offer opportunities for FSIS or the poultry industry to implement interventions to mitigate those effects.

Key drivers of precipitation isotopes in Windhoek, Namibia (2012-2016)

NASA Astrophysics Data System (ADS)

Kaseke, K. F.; Wang, L.; Wanke, H.

2017-12-01

Southern African climate is characterized by large variability with precipitation model estimates varying by as much as 70% during summer. This difference between model estimates is partly because most models associate precipitation over Southern Africa with moisture inputs from the Indian Ocean while excluding inputs from the Atlantic Ocean. However, growing evidence suggests that the Atlantic Ocean may also contribute significant amounts of moisture to the region. This four-year (2012-2016) study investigates the isotopic composition (δ18O, δ2H and δ17O) of event-scale precipitation events, the key drivers of isotope variations and the origins of precipitation experienced in Windhoek, Namibia. Results indicate large storm-to-storm isotopic variability δ18O (25‰), δ2H (180‰) and δ17O (13‰) over the study period. Univariate analysis showed significant correlations between event precipitation isotopes and local meteorological parameters; lifted condensation level, relative humidity (RH), precipitation amount, average wind speed, surface and air temperature (p < 0.05). The number of significant correlations between local meteorological parameters and monthly isotopes was much lower suggesting loss of information through data aggregation. Nonetheless, the most significant isotope driver at both event and monthly scales was RH, consistent with the semi-arid classification of the site. Multiple linear regression analysis suggested RH, precipitation amount and air temperature were the most significant local drivers of precipitation isotopes accounting for about 50% of the variation implying that about 50% could be attributed to source origins. HYSLPIT trajectories indicated that 78% of precipitation originated from the Indian Ocean while 21% originated from the Atlantic Ocean. Given that three of the four study years were droughts while two of the three drought years were El Niño related, our data also suggests that δ'17O-δ'18O could be a useful tool to differentiate local vs synoptic (El Niño) droughts.

The influence of individual socioeconomic status on the clinical outcomes in ischemic stroke patients with different neighborhood status in Shanghai, China

PubMed Central

Yan, Han; Liu, Baoxin; Meng, Guilin; Shang, Bo; Jie, Qiqiang; Wei, Yidong; Liu, Xueyuan

2017-01-01

Objective: Socioeconomic status (SES) is being recognized as an important factor in both social and medical problems. The aim of present study is to examine the relationship between SES and ischemic stroke and investigate whether SES is a predictor of clinical outcomes among patients with different neighborhood status from Shanghai, China. Methods: A total of 471 first-ever ischemic stroke patients aged 18-80 years were enrolled in this retrospective study. The personal SES of each patient was evaluated using a summed score derived from his or her educational level, household income, occupation, and medical reimbursement rate. Clinical adverse events and all-cause mortality were analyzed to determine whether SES was a prognostic factor, its prognostic impact was then assessed based on different neighborhood status using multivariable Cox proportional hazard models after adjusting for other covariates. Results: The individual SES showed a significant positive correlation with neighborhood status (r = 0.370; P < 0.001). The incidence of clinical adverse events and mortality were significantly higher in low SES patients compared with middle and high SES patients (P = 0.001 and P = 0.037, respectively). After adjusting other risk factors and neighborhood status, Kaplan-Meier analysis showed clinical adverse events and deaths were still higher in the low SES patients (all P < 0.05). Multivariate Cox regression analysis demonstrated that both personal SES and neighborhood status are independent prognostic factors for ischemic stroke (all P < 0.05). Besides, among patients with low and middle neighborhood status, lower individual SES was significantly associated with clinical adverse events and mortality (all P < 0.05). Conclusion: Both individual SES and neighborhood status are significantly associated with the prognosis after ischemic stroke. A lower personal SES as well as poorer neighborhood status may significantly increase risk for adverse clinical outcomes among ischemic stroke patients. PMID:28138313

[Changes of monocyte and monocyte-platelet aggregates in different subgroups of thrombotic events in patients with acute myocardial infarction during PCI].

PubMed

Wang, Sheng; Sun, Cuifang; Liao, Wang; Wu, Zhongwei; Wang, Yudai; Huang, Xiuxian; Lu, Sijia; Dong, Xiaoli; Shuai, Fujie; Li, Bin

2017-07-01

Objective To investigate the impact of thrombotic events on the alterations of monocyte and monocyte-platelet aggregates (MPAs) in patients with acute myocardial infarction (AMI) during percutaneous coronary intervention (PCI). Methods Blood was collected before PCI for flow cytometry. Monocyte subsets and MPAs were detected by four-color platform (CDl4-APC, CDl6-PE-Cy7, CD86-PE and CD41-Alexa Fluor R 488). According to the expression of the platelet surface marker CD41, the number of monocyte subsets and MPAs was analyzed using the fluorescent microspheres of absolute counting tube. The Wilcoxon rank sum test and receiver operating characteristic (ROC) curve analysis were performed. Results CD14 + CD16 ++ monocytes in intraprocedural thrombotic events (IPTE) group were significantly fewer than those in non-IPTE group, and the percentage in total mononuclear cells decreased. Compared with non-IPTE group, MPA binding ratio and monocyte subset MPA binding ratio were significantly higher in IPTE group. ROC analysis showed that MPA binding ratio and subgroup MPA binding ratio had a better predictive value for IPTE in patients with AMI. Conclusion The CD14 + CD16 ++ monocytes in IPTE group were significantly fewer than those in the non-IPTE group. MPA binding ratio and MPA binding ratio of monocyte subsets were significantly higher in the IPTE group than in the non-IPTE group, so they have a good predictive value for IPTE in patients with AMI.

Probing the DPRK nuclear test-site to low magnitude using seismic pattern detectors

NASA Astrophysics Data System (ADS)

Kvaerna, T.; Gibbons, S. J.; Mykkeltveit, S.

2017-12-01

Six declared nuclear explosions at North Korea's Punggye-ri test-site between October 2006 and September 2017 were detected seismically both at regional and teleseismic distances. The similarity of body-wave signals from explosion to explosion allows us to locate these events relative to each other with high accuracy. Greater uncertainty in the relative time measurements for the most recent test on 3 September 2017 results in a greater uncertainty in the relative location estimate for this event, although it appears to have taken place below optimal overburden close to the peak of Mount Mantap. A number of smaller events, detected mainly at regional distances, have been identified as being at, or very close to, the test site. Due to waveform differences and available station coverage, a simple double-difference relative location is often not possible. In addition to the apparent collapse event some 8 minutes after the declared nuclear test, small seismic events have been detected on 25 May 2014, 11 September 2016, 23 September 2017, and 12 October 2017. The signals from these events differ significantly from those from the declared nuclear tests with far weaker Pn and far stronger Lg phases. Multi-channel correlation analysis and empirical matched field processing allow us to categorize these weaker seismic events with far greater confidence than classical waveform analysis allows.

Systematic profiling of alternative splicing signature reveals prognostic predictor for ovarian cancer.

PubMed

Zhu, Junyong; Chen, Zuhua; Yong, Lei

2018-02-01

The majority of genes are alternatively spliced and growing evidence suggests that alternative splicing is modified in cancer and is associated with cancer progression. Systematic analysis of alternative splicing signature in ovarian cancer is lacking and greatly needed. We profiled genome-wide alternative splicing events in 408 ovarian serous cystadenocarcinoma (OV) patients in TCGA. Seven types of alternative splicing events were curated and prognostic analyses were performed with predictive models and splicing network built for OV patients. Among 48,049 mRNA splicing events in 10,582 genes, we detected 2,611 alternative splicing events in 2,036 genes which were significant associated with overall survival of OV patients. Exon skip events were the most powerful prognostic factors among the seven types. The area under the curve of the receiver-operator characteristic curve for prognostic predictor, which was built with top significant alternative splicing events, was 0.937 at 2,000 days of overall survival, indicating powerful efficiency in distinguishing patient outcome. Interestingly, splicing correlation network suggested obvious trends in the role of splicing factors in OV. In summary, we built powerful prognostic predictors for OV patients and uncovered interesting splicing networks which could be underlying mechanisms. Copyright © 2017 Elsevier Inc. All rights reserved.

Naturalistic Cycling Study: Identifying Risk Factors for On-Road Commuter Cyclists

PubMed Central

Johnson, Marilyn; Charlton, Judith; Oxley, Jennifer; Newstead, Stuart

2010-01-01

The study aim was to identify risk factors for collisions/near-collisions involving on-road commuter cyclists and drivers. A naturalistic cycling study was conducted in Melbourne, Australia, with cyclists wearing helmet-mounted video cameras. Video recordings captured cyclists’ perspective of the road and traffic behaviours including head checks, reactions and manoeuvres. The 100-car naturalistic driving study analysis technique was adapted for data analysis and events were classified by severity: collision, near-collision and incident. Participants were adult cyclists and each filmed 12 hours of commuter cycling trips over a 4-week period. In total, 127 hours and 38 minutes were analysed for 13 participants, 54 events were identified: 2 collisions, 6 near-collisions and 46 incidents. Prior to events, 88.9% of cyclists travelled in a safe/legal manner. Sideswipe was the most frequent event type (40.7%). Most events occurred at an intersection/intersection-related location (70.3%). The vehicle driver was judged at fault in the majority of events (87.0%) and no post-event driver reaction was observed (83.3%). Cross tabulations revealed significant associations between event severity and: cyclist reaction, cyclist post-event manoeuvre, pre-event driver behaviour, other vehicle involved, driver reaction, visual obstruction, cyclist head check (left), event type and vehicle location (p<0.05). Frequent head checks suggest cyclists had high situational awareness and their reactive behaviour to driver actions led to successful avoidance of collisions/near-collisions. Strategies to improve driver awareness of on-road cyclists and to indicate early before turning/changing lanes when sharing the roadway with cyclists are discussed. Findings will contribute to the development of effective countermeasures to reduce cyclist trauma. PMID:21050610

Naturalistic cycling study: identifying risk factors for on-road commuter cyclists.

PubMed

Johnson, Marilyn; Charlton, Judith; Oxley, Jennifer; Newstead, Stuart

2010-01-01

The study aim was to identify risk factors for collisions/near-collisions involving on-road commuter cyclists and drivers. A naturalistic cycling study was conducted in Melbourne, Australia, with cyclists wearing helmet-mounted video cameras. Video recordings captured cyclists' perspective of the road and traffic behaviours including head checks, reactions and manoeuvres. The 100-car naturalistic driving study analysis technique was adapted for data analysis and events were classified by severity: collision, near-collision and incident. Participants were adult cyclists and each filmed 12 hours of commuter cycling trips over a 4-week period. In total, 127 hours and 38 minutes were analysed for 13 participants, 54 events were identified: 2 collisions, 6 near-collisions and 46 incidents. Prior to events, 88.9% of cyclists travelled in a safe/legal manner. Sideswipe was the most frequent event type (40.7%). Most events occurred at an intersection/intersection-related location (70.3%). The vehicle driver was judged at fault in the majority of events (87.0%) and no post-event driver reaction was observed (83.3%). Cross tabulations revealed significant associations between event severity and: cyclist reaction, cyclist post-event manoeuvre, pre-event driver behaviour, other vehicle involved, driver reaction, visual obstruction, cyclist head check (left), event type and vehicle location (p<0.05). Frequent head checks suggest cyclists had high situational awareness and their reactive behaviour to driver actions led to successful avoidance of collisions/near-collisions. Strategies to improve driver awareness of on-road cyclists and to indicate early before turning/changing lanes when sharing the roadway with cyclists are discussed. Findings will contribute to the development of effective countermeasures to reduce cyclist trauma.

Cost analysis of youth violence prevention.

PubMed

Sharp, Adam L; Prosser, Lisa A; Walton, Maureen; Blow, Frederic C; Chermack, Stephen T; Zimmerman, Marc A; Cunningham, Rebecca

2014-03-01

Effective violence interventions are not widely implemented, and there is little information about the cost of violence interventions. Our goal is to report the cost of a brief intervention delivered in the emergency department that reduces violence among 14- to 18-year-olds. Primary outcomes were total costs of implementation and the cost per violent event or violence consequence averted. We used primary and secondary data sources to derive the costs to implement a brief motivational interviewing intervention and to identify the number of self-reported violent events (eg, severe peer aggression, peer victimization) or violence consequences averted. One-way and multi-way sensitivity analyses were performed. Total fixed and variable annual costs were estimated at $71,784. If implemented, 4208 violent events or consequences could be prevented, costing $17.06 per event or consequence averted. Multi-way sensitivity analysis accounting for variable intervention efficacy and different cost estimates resulted in a range of $3.63 to $54.96 per event or consequence averted. Our estimates show that the cost to prevent an episode of youth violence or its consequences is less than the cost of placing an intravenous line and should not present a significant barrier to implementation.

Stressful life events, sexual orientation, and cardiometabolic risk among young adults in the United States.

PubMed

Hatzenbuehler, Mark L; Slopen, Natalie; McLaughlin, Katie A; McLaughlin, Kate A

2014-10-01

The goal of the present study was to examine whether sexual minority young adults are more vulnerable to developing cardiometabolic risk following exposure to stressful life events than heterosexual young adults. Data came from the National Longitudinal Study for Adolescent Health (Shin, Edwards, & Heeren, 2009; Brummett et al., 2013), a prospective nationally representative study of U.S. adolescents followed into young adulthood. A total of 306 lesbian, gay, and bisexual (LGB) respondents and 6,667 heterosexual respondents met inclusion criteria for this analysis. Measures of cumulative stressful life events were drawn from all 4 waves of data collection; sexual orientation and cardiometabolic biomarkers were assessed at Wave 4 (2008-2009). Gay/bisexual men exposed to 1-2 (β = 0.71, p = .01) and 5+ (β = 0.87, p = .01) stressful life events had a statistically significant elevation in cardiometabolic risk, controlling for demographics, health behaviors, and socioeconomic status. Moreover, in models adjusted for all covariates, lesbian/bisexual (β = 0.52, p = .046) women with 5+ stressful life events had a statistically significant elevation in cardiometabolic risk. There was no relationship between stressful life events and cardiometabolic risk among heterosexual men or women. Stressful life events during childhood, adolescence, and young adulthood place LGB young adults at heightened risk for elevated cardiometabolic risk as early as young adulthood. The mechanisms underlying this relationship require future study.

Importance of high-density lipoprotein cholesterol levels in elderly diabetic individuals with type IIb dyslipidemia: A 2-year survey of cardiovascular events.

PubMed

Ina, Koichiro; Hayashi, Toshio; Araki, Atsushi; Kawashima, Seinosuke; Sone, Hirohito; Watanabe, Hiroshi; Ohrui, Takashi; Yokote, Koutaro; Takemoto, Minoru; Kubota, Kiyoshi; Noda, Mitsuhiko; Noto, Hiroshi; Ding, Qun-Fang; Zhang, Jie; Yu, Ze-Yun; Yoon, Byung-Koo; Nomura, Hideki; Kuzuya, Masafumi

2014-10-01

The risk factors for ischemic heart disease (IHD) or cerebrovascular accident (CVA) in elderly diabetic individuals with type IIb dyslipidemia are not fully known. Therefore, we investigated the relationship between lipid levels and IHD and CVA in diabetic individuals with type IIb dyslipidemia. The Japan Cholesterol and Diabetes Mellitus Study is a prospective cohort study of 4014 type 2 diabetic patients (1936 women; age 67.4 ± 9.5 years). The primary end-points were the onset of IHD or CVA. Lipid and glucose levels, and other factors were investigated in relation to the occurrence of IHD or CVA. A total of 462 participants were included in the group of patients with type IIb dyslipidemia. The 462 diabetic participants with type IIb dyslipidemia were divided into those who were aged <65 years, 65-74 years and >75 years (n=168, 190 and 104, respectively). High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol/HDL-C were significantly associated with the risk of cardiovascular events in diabetic individuals with type IIb dyslipidemia who were aged <65 years, and HDL-C and diastolic blood pressure was significantly associated with cardiovascular events in patients aged 65-74 years. Non-HDL-C was not significantly associated with the risk of cardiovascular events. Multiple regression analysis showed that lower HDL-C was significantly associated with the risk of cardiovascular events in diabetic individuals with type IIb dyslipidemia who were aged <65 years and 65-74 years. Lower HDL-C was an important risk factor for cardiovascular events in diabetic individuals with type IIb dyslipidemia who were aged <75 years. © 2013 Japan Geriatrics Society.

The reliability and validity of subjective notational analysis in comparison to global positioning system tracking to assess athlete movement patterns.

PubMed

Doğramac, Sera N; Watsford, Mark L; Murphy, Aron J

2011-03-01

Subjective notational analysis can be used to track players and analyse movement patterns during match-play of team sports such as futsal. The purpose of this study was to establish the validity and reliability of the Event Recorder for subjective notational analysis. A course was designed, replicating ten minutes of futsal match-play movement patterns, where ten participants undertook the course. The course allowed a comparison of data derived from subjective notational analysis, to the known distances of the course, and to GPS data. The study analysed six locomotor activity categories, focusing on total distance covered, total duration of activities and total frequency of activities. The values between the known measurements and the Event Recorder were similar, whereas the majority of significant differences were found between the Event Recorder and GPS values. The reliability of subjective notational analysis was established with all ten participants being analysed on two occasions, as well as analysing five random futsal players twice during match-play. Subjective notational analysis is a valid and reliable method of tracking player movements, and may be a preferred and more effective method than GPS, particularly for indoor sports such as futsal, and field sports where short distances and changes in direction are observed.

MUSiC - A general search for deviations from monte carlo predictions in CMS

NASA Astrophysics Data System (ADS)

Biallass, Philipp A.; CMS Collaboration

2009-06-01

A model independent analysis approach in CMS is presented, systematically scanning the data for deviations from the Monte Carlo expectation. Such an analysis can contribute to the understanding of the detector and the tuning of the event generators. Furthermore, due to the minimal theoretical bias this approach is sensitive to a variety of models of new physics, including those not yet thought of. Events are classified into event classes according to their particle content (muons, electrons, photons, jets and missing transverse energy). A broad scan of various distributions is performed, identifying significant deviations from the Monte Carlo simulation. The importance of systematic uncertainties is outlined, which are taken into account rigorously within the algorithm. Possible detector effects and generator issues, as well as models involving Supersymmetry and new heavy gauge bosons are used as an input to the search algorithm.

MUSiC - A Generic Search for Deviations from Monte Carlo Predictions in CMS

NASA Astrophysics Data System (ADS)

Hof, Carsten

2009-05-01

We present a model independent analysis approach, systematically scanning the data for deviations from the Standard Model Monte Carlo expectation. Such an analysis can contribute to the understanding of the CMS detector and the tuning of the event generators. Furthermore, due to the minimal theoretical bias this approach is sensitive to a variety of models of new physics, including those not yet thought of. Events are classified into event classes according to their particle content (muons, electrons, photons, jets and missing transverse energy). A broad scan of various distributions is performed, identifying significant deviations from the Monte Carlo simulation. We outline the importance of systematic uncertainties, which are taken into account rigorously within the algorithm. Possible detector effects and generator issues, as well as models involving supersymmetry and new heavy gauge bosons have been used as an input to the search algorithm.

Uncertainty analysis in fault tree models with dependent basic events.

PubMed

Pedroni, Nicola; Zio, Enrico

2013-06-01

In general, two types of dependence need to be considered when estimating the probability of the top event (TE) of a fault tree (FT): "objective" dependence between the (random) occurrences of different basic events (BEs) in the FT and "state-of-knowledge" (epistemic) dependence between estimates of the epistemically uncertain probabilities of some BEs of the FT model. In this article, we study the effects on the TE probability of objective and epistemic dependences. The well-known Frèchet bounds and the distribution envelope determination (DEnv) method are used to model all kinds of (possibly unknown) objective and epistemic dependences, respectively. For exemplification, the analyses are carried out on a FT with six BEs. Results show that both types of dependence significantly affect the TE probability; however, the effects of epistemic dependence are likely to be overwhelmed by those of objective dependence (if present). © 2012 Society for Risk Analysis.

Work accidents and self-esteem of nursing professional in hospital settings.

PubMed

Santos, Sérgio Valverde Marques Dos; Macedo, Flávia Ribeiro Martins; Silva, Luiz Almeida da; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

2017-04-20

to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work.

Work accidents and self-esteem of nursing professional in hospital settings

PubMed Central

dos Santos, Sérgio Valverde Marques; Macedo, Flávia Ribeiro Martins; da Silva, Luiz Almeida; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

2017-01-01

Abstract Objective: to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. Method: descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. Results: of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. Conclusion: factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work. PMID:28443993

Periodic extinction of families and genera

NASA Technical Reports Server (NTRS)

Raup, D. M.; Sepkoski, J. J. Jr; Sepkoski JJ, J. r. (Principal Investigator)

1986-01-01

Eight major episodes of biological extinction of marine families over the past 250 million years stand significantly above local background (P < 0.05). These events are more pronounced when analyzed at the level of genus, and generic data exhibit additional apparent extinction events in the Aptian (Cretaceous) and Pliocene (Tertiary) Stages. Time-series analysis of these records strongly suggests a 26-million-year periodicity. This conclusion is robust even when adjusted for simultaneous testing of many trial periods. When the time series is limited to the four best-dated events (Cenomanian, Maestrichtian, upper Eocene, and middle Miocene), the hypothesis of randomness is also rejected for the 26-million-year period (P < 0.0002).

Paid malpractice claims for adverse events in inpatient and outpatient settings.

PubMed

Bishop, Tara F; Ryan, Andrew M; Ryan, Andrew K; Casalino, Lawrence P

2011-06-15

An analysis of paid malpractice claims may provide insight into the prevalence and seriousness of adverse medical events in the outpatient setting. To report and compare the number, magnitude, and type of paid malpractice claims for events in inpatient and outpatient settings. Retrospective analysis of malpractice claims paid on behalf of physicians in outpatient and inpatient settings using data from the National Practitioner Data Bank from 2005 through 2009. We evaluated trends in claims paid by setting, characteristics of paid claims, and factors associated with payment amount. Number of paid claims, mean and median payment amounts, types of errors, and outcomes of errors. In 2009, there were 10,739 malpractice claims paid on behalf of physicians. Of these paid claims, 4910 (47.6%; 95% confidence interval [CI], 46.6%-48.5%) were for events in the inpatient setting, 4448 (43.1%; 95% CI, 42.1%-44.0%) were for events in the outpatient setting, and 966 (9.4%; 95% CI, 8.8%-9.9%) involved events in both settings. The proportion of payments for events in the outpatient setting increased by a small but statistically significant amount, from 41.7% (95% CI, 40.9%-42.6%) in 2005 to 43.1% (95% CI, 42.1%-44.0%) in 2009 (P < .001 for trend across years). In the outpatient setting, the most common reason for a paid claim was diagnostic (45.9%; 95% CI, 44.4%-47.4%), whereas in the inpatient setting the most common reason was surgical (34.1%; 95% CI, 32.8%-35.4%). Major injury and death were the 2 most common outcomes in both settings. Mean payment amount for events in the inpatient setting was significantly higher than in the outpatient setting ($362,965; 95% CI, $348,192-$377,738 vs $290,111; 95% CI, $278,289-$301,934; P < .001). In 2009, the number of paid malpractice claims reported to the National Practitioner Data Bank for events in the outpatient setting was similar to the number in the inpatient setting.

A Basis Function Approach to Simulate Storm Surge Events for Coastal Flood Risk Assessment

NASA Astrophysics Data System (ADS)

Wu, Wenyan; Westra, Seth; Leonard, Michael

2017-04-01

Storm surge is a significant contributor to flooding in coastal and estuarine regions, especially when it coincides with other flood producing mechanisms, such as extreme rainfall. Therefore, storm surge has always been a research focus in coastal flood risk assessment. Often numerical models have been developed to understand storm surge events for risk assessment (Kumagai et al. 2016; Li et al. 2016; Zhang et al. 2016) (Bastidas et al. 2016; Bilskie et al. 2016; Dalledonne and Mayerle 2016; Haigh et al. 2014; Kodaira et al. 2016; Lapetina and Sheng 2015), and assess how these events may change or evolve in the future (Izuru et al. 2015; Oey and Chou 2016). However, numeric models often require a lot of input information and difficulties arise when there are not sufficient data available (Madsen et al. 2015). Alternative, statistical methods have been used to forecast storm surge based on historical data (Hashemi et al. 2016; Kim et al. 2016) or to examine the long term trend in the change of storm surge events, especially under climate change (Balaguru et al. 2016; Oh et al. 2016; Rueda et al. 2016). In these studies, often the peak of surge events is used, which result in the loss of dynamic information within a tidal cycle or surge event (i.e. a time series of storm surge values). In this study, we propose an alternative basis function (BF) based approach to examine the different attributes (e.g. peak and durations) of storm surge events using historical data. Two simple two-parameter BFs were used: the exponential function and the triangular function. High quality hourly storm surge record from 15 tide gauges around Australia were examined. It was found that there are significantly location and seasonal variability in the peak and duration of storm surge events, which provides additional insights in coastal flood risk. In addition, the simple form of these BFs allows fast simulation of storm surge events and minimises the complexity of joint probability analysis for flood risk analysis considering multiple flood producing mechanisms. This is the first step in applying a Monte Carlo based joint probability method for flood risk assessment.

Risk factors for adverse events after vaccinations performed during the initial hospitalization of infants born prematurely.

PubMed

Wilińska, Maria; Warakomska, Małgorzata; Głuszczak-Idziakowska, Ewa; Jackowska, Teresa

There are significant delays in implementing vaccination among preterm infants. Description of the frequency and kinds of adverse events following immunization in preterms. Establishment of the group of preterms who will distinctively be susceptible to adverse events. Demographical, clinical data and the occurrence of adverse events after DTaP, HIB and pneumococcal vaccination among preterms during their initial hospitalization were prospectively collected with the use of an electronic data form between 1st June 2011 and 31st May 2015. The analysis was conducted on 138 patients. The groups were divided according to maturity (I: ≤ GA 28w n=73 and GA 29-36 w n=65). There were no statistically significant differences between the groups in the occurrence of adverse events. Out of the total group, following vaccination apnoea developed in 6 newborns (4%) and activity dysfunctions were observed in 13 newborns (10%). The occurrence of apnoea after vaccination positively correlated with the time of non-invasive ventilation and the occurrence of late infection. There were no statistically significant demographical or clinical risk factors for the development of activity dysfunctions following vaccination. Term vaccination in clinically stable preterm infants is a safe medical procedure. However, long-term non-invasive respiratory support and late infections are risk factors for apnea following vaccinations. In these patients vaccinations should be considered during hospitalization.

Obstructive sleep apnea combined dyslipidemia render additive effect on increasing atherosclerotic cardiovascular diseases prevalence.

PubMed

Cao, Zhiyong; Zhang, Ping; He, Zhiqing; Yang, Jing; Liang, Chun; Ren, Yusheng; Wu, Zonggui

2016-05-26

Current study was designed to investigate the effects of obstructive sleep apnea (OSA) combined dyslipidemia on the prevalence of atherosclerotic cardiovascular diseases (ASCVD). This was a cross-sectional study and subjects with documented dyslipidemia and without previous diagnosis of OSA were enrolled. Polysomnography was applied to evaluate apnea-hypopnea index (AHI). Based on AHI value, subjects were classified into four groups: without OSA, mild, moderate and severe OSA groups. Clinical characteristics and laboratory examination data were recorded. Relationship between AHI event and lipid profiles was analyzed, and logistic regression analysis was used to evaluate the effects of OSA combined dyslipidemia on ASCVD prevalence. Totally 248 subjects with dyslipidemia were enrolled. Compared to the other 3 groups, subjects with severe OSA were older, male predominant and had higher smoking rate. In addition, subjects with severe OSA had higher body mass index, waist-hip ratio, blood pressure, and higher rates of overweight and obesity. Serum levels of fasting plasma glucose, glycated hemoglobin, LDL-C and CRP were all significantly higher. ASCVD prevalence was considerably higher in subjects with severe OSA. AHI event in the severe OSA group was up to 35.4 ± 5.1 events per hour which was significantly higher than the other groups (P < 0.05 for trend). Pearson correlation analysis showed that only LDL-C was positively correlated with AHI events (r = 0.685, P < 0.05). Logistic regression analysis revealed that in unadjusted model, compared to dyslipidemia plus no-OSA group (reference group), OSA enhanced ASCVD risk in subjects with dyslipidemia, regardless of OSA severity. After extensively adjusted for confounding variables, the odds of dyslipidemia plus mild-OSA was reduced to insignificance. While the effects of moderate- and severe-OSA on promoting ASCVD risk in subjects with dyslipidemia remained significant, with severe-OSA most prominent (odds ratio: 1.52, 95% confidence interval: 1.13-2.02). OSA combined dyslipidemia conferred additive adverse effects on cardiovascular system, with severe-OSA most prominent.

Thromboembolic events in cancer patients on active treatment with cisplatin-based chemotherapy: another look!

PubMed

Abdel-Razeq, Hikmat; Mansour, Asem; Abdulelah, Hazem; Al-Shwayat, Anas; Makoseh, Mohammad; Ibrahim, Mohammad; Abunasser, Mahmoud; Rimawi, Dalia; Al-Rabaiah, Abeer; Alfar, Rozan; Abufara, Alaa'; Ibrahim, Alaa; Bawaliz, Anas; Ismael, Yousef

2018-01-01

The risk of thromboembolic events is higher among cancer patients, especially in patients undergoing chemotherapy. Cisplatin-based regimens claim to be associated with a very high thromboembolic rate. In this study, we report on our own experience with thrombosis among patients on active cisplatin-based chemotherapy. Medical records and hospital databases were searched for all the patients treated with any cisplatin-based regimen for any kind of cancer. Thrombosis was considered cisplatin-related if diagnosed any time after the first dose and up to 4 weeks after the last. The Khorana risk assessment model was performed in all cases. A total of 1677 patients (65.5% males, median age: 50 years) treated with cisplatin-based regimens were identified. Head and neck (22.9%), lung (22.2%), lymphoma and gastric (11.4% each) were the most common primary tumors. Thromboembolic events were reported in 110 (6.6%); the highest was in patients with gastric cancer (20.9%) and the lowest in patients with head and neck cancers (2.3%) and lymphoma (1.6%). Thrombosis included deep vein thrombosis (DVT) in 69 (62.7%), pulmonary embolism (PE) in 18 (16.9%) and arterial thrombosis in 17 (15.6%). A majority (51.1%) of the patients had stage IV disease and only 16% had stage I or II.In a multivariate analysis, significantly higher rates of thrombosis were associated with gastric as the primary tumor, advanced-stage disease, female sex but not age, and the Khorana risk score or type of cisplatin regimen. While the presence of CVC was significantly associated with the risk of thrombosis ( p  < 0.0001) in the univariate analysis, and such significance was lost in the multivariate analysis (odds ratio, 1.098; 95%CI, 0.603-1.999, p  = 0.7599). Thromboembolic events in cancer patients on active cisplatin-based chemotherapy were commonly encountered. Gastric cancer, regardless of other clinical variables, was associated with the highest risk.

The skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysis

PubMed Central

Machado, Natalia P.; dos Reis Neto, Edgard Torres; Soares, Maria Roberta M. P.; Freitas, Daniele S.; Porro, Adriana; Ciconelli, Rozana M.; Pinheiro, Marcelo M.

2013-01-01

OBJECTIVE: We evaluated the incidence of and the main risk factors associated with cutaneous adverse events in patients with chronic inflammatory arthritis following anti-TNF-α therapy. METHODS: A total of 257 patients with active arthritis who were taking TNF-α blockers, including 158 patients with rheumatoid arthritis, 87 with ankylosing spondylitis and 12 with psoriatic arthritis, were enrolled in a 5-year prospective analysis. Patients with overlapping or other rheumatic diseases were excluded. Anthropometric, socioeconomic, demographic and clinical data were evaluated, including the Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index and Psoriasis Area Severity Index. Skin conditions were evaluated by two dermatology experts, and in doubtful cases, skin lesion biopsies were performed. Associations between adverse cutaneous events and clinical, demographic and epidemiological variables were determined using the chi-square test, and logistic regression analyses were performed to identify risk factors. The significance level was set at p<0.05. RESULTS: After 60 months of follow-up, 71 adverse events (73.85/1000 patient-years) were observed, of which allergic and immune-mediated phenomena were the most frequent events, followed by infectious conditions involving bacterial (47.1%), parasitic (23.5%), fungal (20.6%) and viral (8.8%) agents. CONCLUSION: The skin is significantly affected by adverse reactions resulting from the use of TNF-α blockers, and the main risk factors for cutaneous events were advanced age, female sex, a diagnosis of rheumatoid arthritis, disease activity and the use of infliximab. PMID:24141833

Relationship satisfaction reduces the risk of maternal infectious diseases in pregnancy: the Norwegian Mother and Child Cohort Study.

PubMed

Henriksen, Roger Ekeberg; Torsheim, Torbjørn; Thuen, Frode

2015-01-01

The aims of this study were to explore the degree to which relationship satisfaction predicts the risk of infectious diseases during pregnancy and to examine whether relationship satisfaction moderates the association between stressful life events and the risk of infections. This was a prospective study based on data from the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Pregnant women (n = 67,244) completed questionnaires concerning relationship satisfaction and nine different categories of infectious diseases as well as socioeconomic characteristics and stressful life events. Associations between the predictor variables and the infectious diseases were assessed by logistic regression analyses. A multiple regression analysis was performed to assess a possible interaction of relationship satisfaction with stressful life events on the risk for infectious diseases. After controlling for marital status, age, education, income, and stressful life events, high levels of relationship satisfaction at week 15 of gestation were found to predict a significantly lower risk for eight categories of infectious diseases at gestational weeks 17-30. No significant interaction effect was found between relationship satisfaction and stressful life events on the risk for infections.

[Risk Management: concepts and chances for public health].

PubMed

Palm, Stefan; Cardeneo, Margareta; Halber, Marco; Schrappe, Matthias

2002-01-15

Errors are a common problem in medicine and occur as a result of a complex process involving many contributing factors. Medical errors significantly reduce the safety margin for the patient and contribute additional costs in health care delivery. In most cases adverse events cannot be attributed to a single underlying cause. Therefore an effective risk management strategy must follow a system approach, which is based on counting and analysis of near misses. The development of defenses against the undesired effects of errors should be the main focus rather than asking the question "Who blundered?". Analysis of near misses (which in this context can be compared to indicators) offers several methodological advantages as compared to the analysis of errors and adverse events. Risk management is an integral element of quality management.

Do climate extreme events foster violent civil conflicts? A coincidence analysis

NASA Astrophysics Data System (ADS)

Schleussner, Carl-Friedrich; Donges, Jonathan F.; Donner, Reik V.

2014-05-01

Civil conflicts promoted by adverse environmental conditions represent one of the most important potential feedbacks in the global socio-environmental nexus. While the role of climate extremes as a triggering factor is often discussed, no consensus is yet reached about the cause-and-effect relation in the observed data record. Here we present results of a rigorous statistical coincidence analysis based on the Munich Re Inc. extreme events database and the Uppsala conflict data program. We report evidence for statistically significant synchronicity between climate extremes with high economic impact and violent conflicts for various regions, although no coherent global signal emerges from our analysis. Our results indicate the importance of regional vulnerability and might aid to identify hot-spot regions for potential climate-triggered violent social conflicts.

Direct tubulin polymerization perturbation contributes significantly to the induction of micronuclei in vivo.

PubMed

ter Haar, E; Day, B W; Rosenkranz, H S

1996-03-09

The computational analysis data presented indicate a significant mechanistic association between the ability of a chemical to cause tubulin polymerization perturbation (TPP), via direct interaction with the protein, and the in vivo induction of micronuclei (MN). Since it is known that TPP is not a genotoxic event, the analyses suggest that the induction of MN by a non-genotoxic mechanism is a significant alternate pathway.

Switch to agalsidase alfa after shortage of agalsidase beta in Fabry disease: a systematic review and meta-analysis of the literature.

PubMed

Pisani, Antonio; Bruzzese, Dario; Sabbatini, Massimo; Spinelli, Letizia; Imbriaco, Massimo; Riccio, Eleonora

2017-03-01

In 2009, the agalsidase beta shortage resulted in switching to agalsidase alfa treatment for many Fabry disease patients, offering the unique opportunity to compare the effects of the two drugs. Because single studies describing effects of switching on the disease course are limited and inconclusive, we performed a systematic review and meta-analysis of existing data. Relevant studies were identified in the PubMed, Cochrane, ISI Web, and SCOPUS databases from July 2009 to September 2015. The following parameters were analyzed: clinical events, changes in organ function or structure, disease-related symptoms, lyso-Gb3 plasma levels, and adverse effects. The nine studies (217 patients) included in our systematic review showed only marginal differences in most of the evaluated parameters. Seven of these studies were included in the meta-analysis (176 patients). The pooled incidence rate of major adverse events was reported for five studies (150 patients) and was equal to 0.04 events per person-year. No significant change was observed after the shift in glomerular filtration rate, whereas left ventricular mass index, left ventricular posterior wall dimension, and ejection fraction were significantly reduced over time. Our data showed that the switch to agalsidase alfa was well tolerated and associated with stable clinical conditions.Genet Med 19 3, 275-282.

An aftermath analysis of the 2014 coal mine accident in Soma, Turkey: Use of risk performance indicators based on historical experience.

PubMed

Spada, Matteo; Burgherr, Peter

2016-02-01

On the 13th of May 2014 a fire related incident in the Soma coal mine in Turkey caused 301 fatalities and more than 80 injuries. This has been the largest coal mine accident in Turkey, and in the OECD country group, so far. This study investigated if such a disastrous event should be expected, in a statistical sense, based on historical observations. For this purpose, PSI's ENSAD database is used to extract accident data for the period 1970-2014. Four different cases are analyzed, i.e., OECD, OECD w/o Turkey, Turkey and USA. Analysis of temporal trends for annual numbers of accidents and fatalities indicated a non-significant decreasing tendency for OECD and OECD w/o Turkey and a significant one for USA, whereas for Turkey both measures showed an increase over time. The expectation analysis revealed clearly that an event with the consequences of the Soma accident is rather unlikely for OECD, OECD w/o Turkey and USA. In contrast, such a severe accident has a substantially higher expectation for Turkey, i.e. it cannot be considered an extremely rare event, based on historical experience. This indicates a need for improved safety measures and stricter regulations in the Turkish coal mining sector in order to get closer to the rest of OECD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness and safety of vedolizumab for treatment of Crohn's disease: a systematic review and meta-analysis.

PubMed

Moćko, Paweł; Kawalec, Paweł; Smela-Lipińska, Beata; Pilc, Andrzej

2016-10-01

The aim of this systematic review (SR) and meta-analysis was to assess the efficacy and safety of vedolizumab in the treatment of Crohn's disease (CD). A systematic literature search was conducted in Medline/PubMed, Embase and Cochrane Library until 25 January, 2015. Included studies were critically appraised according to the PRISMA protocol. Assessment in specified subgroups of CD patients and meta-analysis with Revman software were performed. Two randomized controlled trial (RCTs) were included in a meta-analysis for the induction phase of therapy: GEMINI II and GEMINI III. The clinical response was significantly higher for patients who received vedolizumab compared to placebo in the general population (risk benefit (RB) = 1.48; p = 0.0006) and in both analyzed subgroups: patients with previous failure of anti-TNFs treatment (RB = 1.51; p = 0.006) and patients naive to earlier anti-TNFs (RB = 1.41; p = 0.001). The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for patients who received vedolizumab compared to placebo (RB = 1.77; p = 0.003; RB = 2.29; p = 0.0004; respectively). Meta-analysis for adverse events, serious adverse events (SAEs) and serious infections, revealed that vedolizumab was as safe as placebo in the induction phase of therapy. The clinical response was significantly higher for patients who received vedolizumab in the general population and in both analyzed subgroups of patients. The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for vedolizumab, but no significant differences were revealed in the subgroup of patients with previous TNF antagonist failure.

Radiological Exposure Devices (RED) Technical Basis for Threat Profile.

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

Bland, Jesse John; Potter, Charles A.; Homann, Steven

Facilities that manufacture, store or transport significant quantities of radiological material must protect against the risk posed by sabotage events. Much of the analysis of this type of event has been focused on the threat from a radiological dispersion device (RDD) or "dirty bomb" scenario, in which a malicious assailant would, by explosives or other means, loft a significant quantity of radioactive material into a plume that would expose and contaminate people and property. Although the consequences in cost and psychological terror would be severe, no intentional RDD terrorism events are on record. Conversely, incidents in which a victim ormore » victims were maliciously exposed to a Radiological Exposure Device (RED), without dispersal of radioactive material, are well documented. This paper represents a technical basis for the threat profile related to the risk of nefarious use of an RED, including assailant and material characterization. Radioactive materials of concern are detailed in Appendix A.« less

Classifying hydrological events to quantify their impact on nitrate leaching across three spatial scales

NASA Astrophysics Data System (ADS)

Bauwe, Andreas; Tiemeyer, Bärbel; Kahle, Petra; Lennartz, Bernd

2015-12-01

Nitrate is one of the most important sources of pollution for surface waters in tile-drained agricultural areas. In order to develop appropriate management strategies to reduce nitrate losses, it is crucial to first understand the underlying hydrological processes. In this study, we used Principle Component Analysis (PCA) and Linear Discriminant Analysis (LDA) to analyze 212 discharge events between 2004 and 2011 across three spatial scales (68 events at the collector drain, 72 at the ditch, and 72 at the brook) to identify the controlling factors for hydrograph response characteristics and their influence on nitrate concentration patterns. Our results showed that the 212 hydrological events can be classified into six different types: summer events (28%), snow-dominated events (10%), events controlled by rainfall duration (16%), rainfall totals (8%), dry antecedent conditions (10%), and events controlled by wet antecedent conditions (14%). The relatively large number of unclassified events (15%) demonstrated the difficulty in separating event types due to mutually influencing variables. NO3-N concentrations showed a remarkably consistent pattern during the discharge events regardless of event type, with minima at the beginning, increasing concentrations at the rising limb, and maxima around peak discharge. However, the level of NO3-N concentrations varied notably among the event types. The highest average NO3-N concentrations were found for events controlled by rainfall totals (NO3-N = 17.1 mg/l), events controlled by wet antecedent conditions (NO3-N = 17.1 mg/l), and snowmelt (NO3-N = 15.2 mg/l). Average maximum NO3-N concentrations were significantly lower during summer events (NO3-N = 10.2 mg/l) and events controlled by dry antecedent conditions (NO3-N = 11.7 mg/l). The results have furthermore shown that similar hydrological and biogeochemical processes determine the hydrograph and NO3-N response on storm events at various spatial scales. The management of tile-drained agricultural land to reduce NO3-N losses should focus explicitly on flow events and, more specifically, active management should preferably be conducted in the winter season for discharge events after snowmelt, after heavy rain storms and when the soil moisture conditions are wet.

Detection of sleep disordered breathing and its central/obstructive character using nasal cannula and finger pulse oximeter.

PubMed

Sommermeyer, Dirk; Zou, Ding; Grote, Ludger; Hedner, Jan

2012-10-15

To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHI(auto)) was calculated using both signals, and a respiratory disturbance index (RDI(auto)) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m(2)) were included in the analysis. AHI(manual) (19.4 ± 18.5 events/h) correlated highly significantly with AHI(auto) (19.9 ± 16.5 events/h) and RDI(auto) (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p < 0.001) with a mean difference of -0.5 ± 6.6 and -1.0 ± 6.1 events/h. The automatic analysis of AHI(auto) and RDI(auto) detected sleep apnea (cutoff AHI(manual) ≥ 15 events/h) with a sensitivity/specificity of 0.90/0.97 and 0.86/0.94, respectively. The automated obstructive/central apnea indices correlated closely with manually scoring (r = 0.87 and 0.95, p < 0.001) with mean difference of -4.3 ± 7.9 and 0.3 ± 1.5 events/h, respectively. Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep.

Hylan G-F 20 Versus Low Molecular Weight Hyaluronic Acids for Knee Osteoarthritis: A Meta-Analysis.

PubMed

Zhao, Hongmou; Liu, Hongliang; Liang, Xiaojun; Li, Yi; Wang, Junhu; Liu, Cheng

2016-10-01

Hyaluronic acid injection has been reported to decrease pain compared with baseline levels in knee joint osteoarthritis. Hylan G-F 20 is distinguished from the other products by its chemical structure and relatively higher molecular weight. Many trials have compared hylan G-F 20 and low molecular weight hyaluronic acids (LMWHAs); however, their relative efficacy and safety are still debated. The aim was to compare the effectiveness and safety of intra-articular injection of hylan G-F 20 and LMWHA in the treatment of knee joint osteoarthritis. A comprehensive search of the literature up to February 2016 was performed; multiple databases were searched with 'Synvisc' or 'hylan' or 'hyaluronan' as free word terms. The pain-related outcomes and treatment-related adverse events from intent-to-treat analyzed studies were pooled for meta-analysis; other functional outcomes were included in the qualitative analysis. Twenty trials with a total of 3034 patients and 3153 knees were included, with a pooled dropout rate of 7.2 %. The pooled pain-related outcomes at 2 to 3 months reached a statistically significant difference in favor of hylan G-F 20 (I 2  = 88 %; random effects; P = 0.02), and the significance still existed with exclusion (in order to eliminate heterogeneity) of the three studies that most favored hylan G-F 20 (I 2  = 51 %; fixed effect; P = 0.03). No significant difference was reached for other group and subgroup analyses. No significant difference was reached in comparing the patients with treatment-related adverse events (seven trials; 2025 patients; P = 0.13) or the treatment-related adverse events (six trials; 1633 patients; P = 0.14). According to the current results, limited evidence showed a superior effect favoring hylan G-F 20 over LMWHA in the period from 2 to 3 months post-injection for pain-related outcomes. There was no evidence of increased risk of treatment-related adverse events for hylan G-F 20 injections.

Eradication of hepatitis C virus and non-liver-related non-acquired immune deficiency syndrome-related events in human immunodeficiency virus/hepatitis C virus coinfection.

PubMed

Berenguer, Juan; Rodríguez-Castellano, Elena; Carrero, Ana; Von Wichmann, Miguel A; Montero, Marta; Galindo, María J; Mallolas, Josep; Crespo, Manuel; Téllez, María J; Quereda, Carmen; Sanz, José; Barros, Carlos; Tural, Cristina; Santos, Ignacio; Pulido, Federico; Guardiola, Josep M; Rubio, Rafael; Ortega, Enrique; Montes, María L; Jusdado, Juan J; Gaspar, Gabriel; Esteban, Herminia; Bellón, José M; González-García, Juan

2017-08-01

We assessed non-liver-related non-acquired immunodeficiency syndrome (AIDS)-related (NLR-NAR) events and mortality in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with interferon (IFN) and ribavirin (RBV), between 2000 and 2008. The censoring date was May 31, 2014. Cox regression analysis was performed to assess the adjusted hazard rate (HR) of overall death in responders and nonresponders. Fine and Gray regression analysis was conducted to determine the adjusted subhazard rate (sHR) of NLR deaths and NLR-NAR events considering death as the competing risk. The NLR-NAR events analyzed included diabetes mellitus, chronic renal failure, cardiovascular events, NLR-NAR cancer, bone events, and non-AIDS-related infections. The variables for adjustment were age, sex, past AIDS, HIV transmission category, nadir CD4 + T-cell count, antiretroviral therapy, HIV RNA, liver fibrosis, HCV genotype, and exposure to specific anti-HIV drugs. Of the 1,625 patients included, 592 (36%) had a sustained viral response (SVR). After a median 5-year follow-up, SVR was found to be associated with a significant decrease in the hazard of diabetes mellitus (sHR, 0.57; 95% confidence interval [CI], 0.35-0.93; P = 0.024) and decline in the hazard of chronic renal failure close to the threshold of significance (sHR, 0.43; 95% CI, 0.17-1.09; P = 0.075). Our data suggest that eradication of HCV in coinfected patients is associated not only with a reduction in the frequency of death, HIV progression, and liver-related events, but also with a reduced hazard of diabetes mellitus and possibly of chronic renal failure. These findings argue for the prescription of HCV therapy in coinfected patients regardless of fibrosis stage. (Hepatology 2017;66:344-356). © 2017 The Authors. Hepatology published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases.

Proton pump inhibitor monotherapy and the risk of cardiovascular events in patients with gastro-esophageal reflux disease: a meta-analysis.

PubMed

Sun, S; Cui, Z; Zhou, M; Li, R; Li, H; Zhang, S; Ba, Y; Cheng, G

2017-02-01

Proton pump inhibitors (PPIs) are commonly used as potent gastric acid secretion antagonists for gastro-esophageal disorders and their overall safety in patients with gastro-esophageal reflux disease (GERD) is considered to be good and they are well-tolerated. However, recent studies have suggested that PPIs may be a potential independent risk factor for cardiovascular adverse events. The aim of our meta-analysis was to examine the association between PPI monotherapy and cardiovascular events in patients with GERD. A literature search involved examination of relevant databases up to July 2015 including PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov, as well as selected randomized controlled trials (RCTs) reporting cardiovascular events with PPI exposure in GERD patients. In addition, the pooled risk ratio (RR) and heterogeneity were assessed based on a fixed effects model of the meta-analysis and the I 2 statistic, respectively. Seventeen RCTs covering 7540 patients were selected. The pooled data suggested that the use of PPIs was associated with a 70% increased cardiovascular risk (RR=1.70, 95% CI: [1.13-2.56], P=.01, I 2 =0%). Furthermore, higher risks of adverse cardiovascular events in the omeprazole subgroup (RR=3.17, 95% CI: [1.43-7.03], P=.004, I 2 =25%) and long-term treatment subgroup (RR=2.33, 95% CI: [1.33-4.08], P=.003, I 2 =0%) were found. PPI monotherapy can be a risk factor for cardiovascular adverse events. Omeprazole could significantly increase the risk of cardiovascular events and, so, should be used carefully. © 2016 John Wiley & Sons Ltd.

Big Data Tools as Applied to ATLAS Event Data

NASA Astrophysics Data System (ADS)

Vukotic, I.; Gardner, R. W.; Bryant, L. A.

2017-10-01

Big Data technologies have proven to be very useful for storage, processing and visualization of derived metrics associated with ATLAS distributed computing (ADC) services. Logfiles, database records, and metadata from a diversity of systems have been aggregated and indexed to create an analytics platform for ATLAS ADC operations analysis. Dashboards, wide area data access cost metrics, user analysis patterns, and resource utilization efficiency charts are produced flexibly through queries against a powerful analytics cluster. Here we explore whether these techniques and associated analytics ecosystem can be applied to add new modes of open, quick, and pervasive access to ATLAS event data. Such modes would simplify access and broaden the reach of ATLAS public data to new communities of users. An ability to efficiently store, filter, search and deliver ATLAS data at the event and/or sub-event level in a widely supported format would enable or significantly simplify usage of machine learning environments and tools like Spark, Jupyter, R, SciPy, Caffe, TensorFlow, etc. Machine learning challenges such as the Higgs Boson Machine Learning Challenge, the Tracking challenge, Event viewers (VP1, ATLANTIS, ATLASrift), and still to be developed educational and outreach tools would be able to access the data through a simple REST API. In this preliminary investigation we focus on derived xAOD data sets. These are much smaller than the primary xAODs having containers, variables, and events of interest to a particular analysis. Being encouraged with the performance of Elasticsearch for the ADC analytics platform, we developed an algorithm for indexing derived xAOD event data. We have made an appropriate document mapping and have imported a full set of standard model W/Z datasets. We compare the disk space efficiency of this approach to that of standard ROOT files, the performance in simple cut flow type of data analysis, and will present preliminary results on its scaling characteristics with different numbers of clients, query complexity, and size of the data retrieved.

[Adverse events in patients from a pediatric hospital.

PubMed

Ornelas-Aguirre, José Manuel; Arriaga-Dávila, José de Jesús; Domínguez-Serrano, María Isabel; Guzmán-Bihouet, Beatriz Filomena; Navarrete-Navarro, Susana

2013-01-01

Background: detection of adverse events is part of the safety management in hospitalized patients. The objective of this study was to describe the incidence of adverse events that occurred in a pediatric hospital. Methods: cross-sectional study of the adverse events occurred in a pediatric hospital from 2007 to 2009. Factors associated with their developmental causes were identified. The statistical analysis was descriptive and bivariate, with contingency tables to estimate the relationship between those factors. A p value = 0.05 was considered significant. Results: a total of 177 adverse events were registered. When they began, human factor occurred in 23 cases (13 %, OR = 1.41, p = 0.001), organizational factor was present in 71 cases (40 %, OR = 1.91, p = 0.236) and technical factor in 46 cases (26 %, OR = 0.87, p = 0.01). Blows or bruises from falls as a result of adverse events occurred in 71 cases (40 %, 95 % CI = 64-78). Conclusions: we found 1.84 events per 100 hospital discharges during the study period. The fall of patients ranked first of the adverse events identified.

Child exposure to serious life events, COMT, and aggression: Testing differential susceptibility theory.

PubMed

Hygen, Beate Wold; Belsky, Jay; Stenseng, Frode; Lydersen, Stian; Guzey, Ismail Cuneyt; Wichstrøm, Lars

2015-08-01

Both genetic and environmental factors contribute to individual differences in aggression. Catechol-O-methyltransferase Val158Met (COMT), a common, functional polymorphism, has been implicated in aggression and aggression traits, as have childhood experiences of adversity. It is unknown whether these effects are additive or interactional and, in the case of interaction, whether they conform to a diathesis-stress or differential susceptibility model. We examined Gene × Environment interactions between COMT and serious life events on measures of childhood aggression and contrasted these 2 models. The sample was composed of community children (N = 704); 355 were boys, and the mean age was 54.8 months (SD = 3.0). The children were genotyped for COMT rs4680 and assessed for serious life events and by teacher-rated aggression. Regression analysis showed no main effects of COMT and serious life events on aggression. However, a significant interactive effect of childhood serious life events and COMT genotype was observed: Children who had faced many serious life events and were Val homozygotes exhibited more aggression (p = .02) than did their Met-carrying counterparts. Notably, in the absence of serious life events, Val homozygotes displayed significantly lower aggression scores than did Met carriers (p = .03). When tested, this constellation of findings conformed to the differential susceptibility hypothesis: In this case, Val homozygotes are more malleable to the effect of serious life events on aggression and not simply more vulnerable to the negative effect of having experienced many serious life events. (c) 2015 APA, all rights reserved).

Fifteen years after parental divorce: mental health and experienced life-events.

PubMed

Angarne-Lindberg, Teresia; Wadsby, Marie

2009-01-01

The children who experienced their parents' divorce when the divorce rate in Sweden had begun to grow to higher levels than in preceding decades are today adults. The aim of this study was to investigate if adults who had experienced parental divorce 15 years before the time of our study, differed in mental health from those with continuously married parents, taking into account life events other than the divorce. Instruments used were the Symptom Checklist (SCL-90) measuring mental health and the Life Event questionnaire capturing the number and experience of occurred events. Forty-eight persons, who were 7-18 years old when their parents divorced, constituted the divorce group, and 48 persons matched on age, sex and growth environment formed the study groups. The SCL-90 showed a limited difference between the groups, but not concerning total mental health. A main finding was a difference with regard to sex and age; women aged 22-27 in the divorce group displayed poorer mental health than other participants in both groups. The results from the Life Event questionnaire showed that the divorce group had experienced a significantly larger number of events, and more life events were described as negative with difficult adjustment. A regression analysis showed a significant relation between the SCL-90, Global Severity Index and life events experienced as negative with difficult adjustment, divorce events excluded, but not with the divorce itself. It seems highly desirable to pay more attention than has thus far been paid to girls with experience of childhood divorce at age 7-12.

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery?

PubMed Central

Frandon, Julien; Rodiere, Mathieu; Arvieux, Catherine; Vendrell, Anne; Boussat, Bastien; Sengel, Christian; Broux, Christophe; Bricault, Ivan; Ferretti, Gilbert; Thony, Frédéric

2015-01-01

PURPOSE We aimed to compare clinical outcomes and early adverse events of operative management (OM), nonoperative management (NOM), and NOM with splenic artery embolization (SAE) in blunt splenic injury (BSI) and identify the prognostic factors. METHODS Medical records of 136 consecutive patients with BSI admitted to a trauma center from 2005 to 2010 were retrospectively reviewed. Patients were separated into three groups: OM, NOM, and SAE. We focused on associated injuries and early adverse events. Multivariate analysis was performed on 23 prognostic factors to find predictors. RESULTS The total survival rate was 97.1%, with four deaths all occurred in the OM group. The spleen salvage rate was 91% in NOM and SAE. At least one adverse event was observed in 32.8%, 62%, and 96% of patients in NOM, SAE, and OM groups, respectively (P < 0.001). We found significantly more deaths, infectious complications, pleural drainage, acute renal failures, and pancreatitis in OM and more pseudocysts in SAE. Six prognostic factors were statistically significant for one or more adverse events: simplified acute physiology score 2 ≥25 for almost all adverse events, age ≥50 years for acute respiratory syndrome, limb fracture for secondary bleeding, thoracic injury for pleural drainage, and at least one associated injury for pseudocyst. Adverse events were not related to the type of BSI management. CONCLUSION Patients with BSI present worse outcome and more adverse events in OM, but this is related to the severity of injury. The main predictor of adverse events remains the severity of injury. PMID:26081719

Patent foramen ovale transcatheter closure vs. medical therapy on recurrent vascular events: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Rengifo-Moreno, Pablo; Palacios, Igor F; Junpaparp, Parichart; Witzke, Christian F; Morris, D Lynn; Romero-Corral, Abel

2013-11-01

In patients with cryptogenic stroke, transcatheter (TC) closure of a patent foramen ovale (PFO) has not been shown to better prevent recurrent vascular events than medical therapy. However, randomized controlled trials (RCT) to date have included few vascular events, and lack of power has been raised as an important concern. To conduct a systematic review and meta-analysis of existing RCT published studies assessing the recurrence of vascular events after TC PFO closure when compared to medical therapy. Using the search terms "patent foramen ovale", "PFO", "stroke", "percutaneous closure" and "transcatheter closure", Medline, Pubmed, Embase, and Cochrane databases were reviewed from inception through April 2013, with no language restrictions. Only studies in adult humans were considered. Additional references were obtained from the bibliographies of studies reviewed. The following criteria were used for study selection: 1) randomized controlled trial, 2) subjects were adult patients with cryptogenic stroke who were randomized to TC PFO closure or medical treatment (antiplatelet therapy and/or anticoagulation), and 3) reported outcomes included cardiac death, all death, stroke, transient ischemic attack, and peripheral embolism. Methodological and descriptive data, adverse events (including raw data and risk estimates), as well as procedural success and complications were abstracted in duplicate from each study independently, and agreement was tested. We followed rigorously the recommended guidelines for reporting and conducting and assessing quality of meta-analysis of RCT. The primary endpoints pre-specified in advance were recurrent vascular events, and composite endpoint of death, and recurrent vascular events. Three studies were identified as meeting selection criteria. These included a total of 2,303 patients, with 1,150 patients randomized to TC PFO closure and 1,153 patients randomized to medical therapy. Mean follow-up was 3.5 years. Baseline characteristics (age, sex, and cardiovascular risk factors) were similar across studies. Intention-to-treat analyses showed a statistically significant risk reduction in stroke and/or transient ischemic attack in the TC PFO closure group when compared to medical treatment, pooled HR = 0.59, 95%CI (0.36-0.97), P = 0.04. The combined outcome of death, and vascular events, showed a borderline statistically significant benefit for TC PFO closure when compared to medical treatment, pooled HR = 0.67, 95%CI (0.44-1.00), P = 0.05 Subjects with a substantial PFO shunt seem to benefit the most with TC PFO closure, pooled HR = 0.35, 95%CI (0.12-1.03), P = 0.06, however, it did not reach statistical significance. These results suggest that in patients with cryptogenic stroke, TC PFO closure may be beneficial in reducing the risk of recurrent vascular events when compared to medical treatment. The benefit of TC PFO closure may be greater in patients with a substantial shunt.

Classifying hydrological events to quantify their impact on nitrate leaching across three spatial scales

NASA Astrophysics Data System (ADS)

Bauwe, Andreas; Tiemeyer, Bärbel; Kahle, Petra; Lennartz, Bernd

2015-04-01

Nitrate is one of the most important sources of pollution for surface waters in tile-drained agricultural areas. In order to develop appropriate management strategies to reduce nitrate losses, it is crucial to first understand the underlying hydrological processes. In this study, we used Principle Component Analysis (PCA) and Linear Discriminant Analysis (LDA) to analyze 212 storm events between 2004 and 2011 across three spatial scales (collector drain, ditch, and brook) to identify the controlling factors for hydrograph response characteristics and their influence on nitrate concentration patterns. Our results showed that the 212 hydrological events can be classified into six different types: summer events (28%), snow-dominated events (10%), events controlled by rainfall duration (16%), rainfall totals (8%), dry antecedent conditions (10%), and events controlled by wet antecedent conditions (14%). The relatively large number of unclassified events (15%) demonstrated the difficulty in separating event types due to mutually influencing variables. NO3-N concentrations showed a remarkably consistent pattern during the discharge events regardless of event type, with minima at the beginning, increasing concentrations at the rising limb, and maxima around peak discharge. However, the level of NO3-N concentrations varied notably among the event types. The highest average NO3-N concentrations were found for events controlled by rainfall totals (NO3-N=17.1 mg/l), events controlled by wet antecedent conditions (NO3-N=17.1 mg/l), and snowmelt (NO3-N=15.2 mg/l). Average maximum NO3-N concentrations were significantly lower during summer events (NO3-N=10.2 mg/l) and events controlled by dry antecedent conditions (NO3-N=11.7 mg/l). The results have furthermore shown that similar hydrological and biogeochemical processes determine the hydrograph and NO3-N response on storm events at various spatial scales. The management of tile-drained agricultural land to reduce NO3-N losses should focus explicitly on flow events and, more specifically, active management should preferably be conducted in the winter season for discharge events after snowmelt, after heavy rain storms and when the soil moisture conditions are wet.

Tolerability of buprenorphine transdermal system in nursing home patients with advanced dementia: a randomized, placebo-controlled trial (DEP.PAIN.DEM).

PubMed

Erdal, Ane; Flo, Elisabeth; Aarsland, Dag; Selbaek, Geir; Ballard, Clive; Slettebo, Dagrun D; Husebo, Bettina S

2018-01-01

Buprenorphine transdermal system is increasingly prescribed in people with advanced dementia, but no clinical trial has investigated the safety and factors associated with discontinuation due to adverse events in this population. One hundred sixty-two people with advanced dementia and significant depression from 47 nursing homes were included and randomized to active analgesic treatment (acetaminophen/buprenorphine) or identical placebo for 13 weeks. In this secondary analysis, the main outcomes were time to and reasons for discontinuation of buprenorphine due to adverse events. Change in daytime activity as measured by actigraphy was a secondary outcome. Of the 44 patients who received active buprenorphine 5 µg/hour, 52.3% (n=23) discontinued treatment due to adverse events compared to 13.3% (6 of 45) in the placebo group ( p <0.001). Psychiatric and neurological adverse events were the most frequently reported causes of discontinuation (69.6%, n=16). Concomitant use of antidepressants significantly increased the risk of discontinuation (HR 23.2, 95% CI: 2.95-182, p =0.003). Adjusted for age, sex, cognitive function, pain and depression at baseline, active buprenorphine was associated with 24.0 times increased risk of discontinuation (Cox model, 95% CI: 2.45-235, p =0.006). Daytime activity dropped significantly during the second day of active treatment (-21.4%, p =0.005) and decreased by 12.9% during the first week ( p =0.053). Active buprenorphine had significantly higher risk of discontinuation compared with placebo in people with advanced dementia and depression, mainly due to psychiatric and neurological adverse events. Daytime activity dropped significantly during the first week of treatment. Concomitant use of antidepressants further reduced the tolerability of buprenorphine.

Prevalence, Predictors and Clinical Outcome of Residual Pulmonary Hypertension Following Tricuspid Annuloplasty.

PubMed

Chen, Yan; Liu, Ju-Hua; Chan, Daniel; Sit, Ko-Yung; Wong, Chun-Ka; Ho, Kar-Lai; Ho, Lai-Ming; Zhen, Zhe; Lam, Yui-Ming; Lau, Chu-Pak; Au, Wing-Kok; Tse, Hung-Fat; Yiu, Kai-Hang

2016-07-22

Tricuspid annuloplasty is increasingly performed during left heart valve surgery, but the long-term clinical outcome postoperatively is not satisfactory. The aim of this study was to determine whether residual pulmonary hypertension (PHT) contributes to the adverse outcome. One-hundred thirty-seven patients (age 61±11 years; men, 30%) who underwent tricuspid annuloplasty during left-side valve surgery were enrolled. The mean pulmonary artery systolic pressure before surgery was 49±13 mm Hg and 32±15 mm Hg following surgery. Patients were divided into 3 groups according to postoperative pulmonary artery systolic pressure: no residual PHT (n=78, 57%), mild residual PHT (n=43, 31%), or significant residual PHT (n=16, 12%). A preoperative larger right ventricular (RV) geometry and tricuspid valve tethering area were associated with mild or significant residual PHT. A total of 24 adverse events (20 heart failures and 4 cardiovascular deaths) occurred during a median follow-up of 25 months. Kaplan-Meier survival curve demonstrated that patients with significant residual PHT had the highest percentage of adverse events followed by those with mild residual PHT. Patients with no residual PHT had a very low risk of adverse events. Multivariable Cox regression analysis revealed that both mild (hazard ratio=4.94; 95% CI =1.34-18.16; P=0.02) and significant residual PHT (hazard ratio=8.67; 95% CI =2.43-30.98; P<0.01) were independent factors associated with adverse events. The present study demonstrated that 43% of patients who underwent tricuspid annuloplasty had residual PHT. The presence of mild or significant residual PHT was associated with adverse events in these patients. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Identification of homogeneous regions for rainfall regional frequency analysis considering typhoon event in South Korea

NASA Astrophysics Data System (ADS)

Heo, J. H.; Ahn, H.; Kjeldsen, T. R.

2017-12-01

South Korea is prone to large, and often disastrous, rainfall events caused by a mixture of monsoon and typhoon rainfall phenomena. However, traditionally, regional frequency analysis models did not consider this mixture of phenomena when fitting probability distributions, potentially underestimating the risk posed by the more extreme typhoon events. Using long-term observed records of extreme rainfall from 56 sites combined with detailed information on the timing and spatial impact of past typhoons from the Korea Meteorological Administration (KMA), this study developed and tested a new mixture model for frequency analysis of two different phenomena; events occurring regularly every year (monsoon) and events only occurring in some years (typhoon). The available annual maximum 24 hour rainfall data were divided into two sub-samples corresponding to years where the annual maximum is from either (1) a typhoon event, or (2) a non-typhoon event. Then, three-parameter GEV distribution was fitted to each sub-sample along with a weighting parameter characterizing the proportion of historical events associated with typhoon events. Spatial patterns of model parameters were analyzed and showed that typhoon events are less commonly associated with annual maximum rainfall in the North-West part of the country (Seoul area), and more prevalent in the southern and eastern parts of the country, leading to the formation of two distinct typhoon regions: (1) North-West; and (2) Southern and Eastern. Using a leave-one-out procedure, a new regional frequency model was tested and compared to a more traditional index flood method. The results showed that the impact of typhoon on design events might previously have been underestimated in the Seoul area. This suggests that the use of the mixture model should be preferred where the typhoon phenomena is less frequent, and thus can have a significant effect on the rainfall-frequency curve. This research was supported by a grant(2017-MPSS31-001) from Supporting Technology Development Program for Disaster Management funded by Ministry of Public Safety and Security(MPSS) of the Korean government.

Coupled atmosphere-ocean-wave simulations of a storm event over the Gulf of Lion and Balearic Sea

USGS Publications Warehouse

Renault, Lionel; Chiggiato, Jacopo; Warner, John C.; Gomez, Marta; Vizoso, Guillermo; Tintore, Joaquin

2012-01-01

The coastal areas of the North-Western Mediterranean Sea are one of the most challenging places for ocean forecasting. This region is exposed to severe storms events that are of short duration. During these events, significant air-sea interactions, strong winds and large sea-state can have catastrophic consequences in the coastal areas. To investigate these air-sea interactions and the oceanic response to such events, we implemented the Coupled Ocean-Atmosphere-Wave-Sediment Transport Modeling System simulating a severe storm in the Mediterranean Sea that occurred in May 2010. During this event, wind speed reached up to 25 m.s-1 inducing significant sea surface cooling (up to 2°C) over the Gulf of Lion (GoL) and along the storm track, and generating surface waves with a significant height of 6 m. It is shown that the event, associated with a cyclogenesis between the Balearic Islands and the GoL, is relatively well reproduced by the coupled system. A surface heat budget analysis showed that ocean vertical mixing was a major contributor to the cooling tendency along the storm track and in the GoL where turbulent heat fluxes also played an important role. Sensitivity experiments on the ocean-atmosphere coupling suggested that the coupled system is sensitive to the momentum flux parameterization as well as air-sea and air-wave coupling. Comparisons with available atmospheric and oceanic observations showed that the use of the fully coupled system provides the most skillful simulation, illustrating the benefit of using a fully coupled ocean-atmosphere-wave model for the assessment of these storm events.

Patent foramen ovale closure vs medical therapy for stroke prevention: meta-analysis of randomized trials and review of heterogeneity in meta-analyses.

PubMed

Udell, Jacob A; Opotowsky, Alexander R; Khairy, Paul; Silversides, Candice K; Gladstone, David J; O'Gara, Patrick T; Landzberg, Michael J

2014-10-01

Patent foramen ovale (PFO) might be a risk factor for unexplained ("cryptogenic") stroke or transient ischemic attack (TIA). We sought to determine the efficacy and safety of transcatheter PFO closure compared with antithrombotic therapy for secondary prevention of cerebrovascular events among patients with cryptogenic stroke. We performed a systematic review and meta-analysis of MedLine and Embase (from inception to March 2013) for randomized controlled trials (RCTs) that compared transcatheter PFO closure with medical therapy in subjects with cryptogenic stroke. Data were independently extracted on trial conduct quality, baseline characteristics, efficacy, and safety events from published articles and appendices. Risk ratios (RRs) and 95% confidence intervals (CIs) for the composite of stroke or TIA, and adverse cardiovascular events including atrial fibrillation/flutter were constructed. Three RCTs of 2303 subjects with previous stroke, TIA, or systemic arterial embolism (mean age, 45.7 years; 47.3% women; mean follow-up, 2.6 years) were included. PFO closure did not significantly reduce the risk of recurrent stroke/TIA (3.7% vs 5.2%; RR, 0.73; 95% CI, 0.50-1.07; P = 0.10); however, an increased risk of incident atrial fibrillation/flutter was detected (3.8% vs 1.0%; RR, 3.67; 95% CI, 1.95-6.89; P < 0.0001). No significant heterogeneity was detected for any end point among subgroups of patients stratified according to age, sex, index cardiovascular event, device type, interatrial shunt size, and presence of an atrial septal aneurysm (all P interactions ≥ 0.09). Meta-analysis of RCTs that assessed transcatheter PFO closure for secondary prevention of cerebrovascular events in subjects with cryptogenic stroke does not demonstrate benefit compared with antithrombotic therapy, and suggests potential risks. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

"Confused by Multiple Deities, Ancient Egyptians Embraced Monotheism": Analysing Historical Thinking and Inclusion in Egyptian History Textbooks

ERIC Educational Resources Information Center

Abdou, Ehaab D.

2016-01-01

Egyptian history textbooks are examined through the prism of historical thinking dimensions and skills, utilizing a critical discourse analysis. The analysis focuses on how the textbooks portray two historically significant events: the advent of Christianity (ca. 33 CE) and Islam (ca. 641 CE) to Egypt. It reveals that the historical narrative…

Automated Electroglottographic Inflection Events Detection. A Pilot Study.

PubMed

Codino, Juliana; Torres, María Eugenia; Rubin, Adam; Jackson-Menaldi, Cristina

2016-11-01

Vocal-fold vibration can be analyzed in a noninvasive way by registering impedance changes within the glottis, through electroglottography. The morphology of the electroglottographic (EGG) signal is related to different vibratory patterns. In the literature, a characteristic knee in the descending portion of the signal has been reported. Some EGG signals do not exhibit this particular knee and have other types of events (inflection events) throughout the ascending and/or descending portion of the vibratory cycle. The goal of this work is to propose an automatic method to identify and classify these events. A computational algorithm was developed based on the mathematical properties of the EGG signal, which detects and reports events throughout the contact phase. Retrospective analysis of EGG signals obtained during routine voice evaluation of adult individuals with a variety of voice disorders was performed using the algorithm as well as human raters. Two judges, both experts in clinical voice analysis, and three general speech pathologists performed manual and visual evaluation of the sample set. The results obtained by the automatic method were compared with those of the human raters. Statistical analysis revealed a significant level of agreement. This automatic tool could allow professionals in the clinical setting to obtain an automatic quantitative and qualitative report of such events present in a voice sample, without having to manually analyze the whole EGG signal. In addition, it might provide the speech pathologist with more information that would complement the standard voice evaluation. It could also be a valuable tool in voice research. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea.

PubMed

Jeon, WooTaek; Hong, ChangHyung; Lee, ChangHo; Kim, Dong Kee; Han, Mooyoung; Min, SungKil

2005-04-01

The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.

Experimental Observations and Theoretical Modeling of VLF Scattering During LEP Events

NASA Astrophysics Data System (ADS)

Mitchell, M. F.; Moore, R. C.

2012-12-01

Recent experimental observations of very low frequency (VLF) scattering during lightning-induced election precipitation (LEP) events are presented. A spread spectrum analysis technique is applied to these observations, demonstrating a significant dependence on frequency. For LEP events, the scattered field amplitude and phase both exhibit strong frequency dependence, as do the event onset delays (relative to the causative lightning flash) and the event onset durations. The experimental observations are compared with the predictions of an Earth-ionosphere waveguide propagation and scattering model. The Long-Wave Propagation Capability (LWPC) code is used to demonstrate that the scattered field amplitude and phase depend sensitively on the electrical properties of the scattering body and the ionosphere between the scatterer and the receiver. The observed frequency-dependent onset times and durations, on the other hand, are attributed to the scattering source characteristics. These measurements can also be used to study radiation belt dynamics.

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

Sattison, M.B.; Thatcher, T.A.; Knudsen, J.K.

The US Nuclear Regulatory Commission (NRC) has been using full-power. Level 1, limited-scope risk models for the Accident Sequence Precursor (ASP) program for over fifteen years. These models have evolved and matured over the years, as have probabilistic risk assessment (PRA) and computer technologies. Significant upgrading activities have been undertaken over the past three years, with involvement from the Offices of Nuclear Reactor Regulation (NRR), Analysis and Evaluation of Operational Data (AEOD), and Nuclear Regulatory Research (RES), and several national laboratories. Part of these activities was an RES-sponsored feasibility study investigating the ability to extend the ASP models to includemore » contributors to core damage from events initiated with the reactor at low power or shutdown (LP/SD), both internal events and external events. This paper presents only the LP/SD internal event modeling efforts.« less

Fluctuations of conserved charges in relativistic heavy ion collisions: An introduction

NASA Astrophysics Data System (ADS)

Asakawa, Masayuki; Kitazawa, Masakiyo

2016-09-01

Bulk fluctuations of conserved charges measured by event-by-event analysis in relativistic heavy ion collisions are observables which are believed to carry significant amount of information on the hot medium created by the collisions. Active studies have been done recently experimentally, theoretically, and on the lattice. In particular, non-Gaussianity of the fluctuations has acquired much attention recently. In this review, we give a pedagogical introduction to these issues, and survey recent developments in this field of research. Starting from the definition of cumulants, basic concepts in fluctuation physics, such as thermal fluctuations in statistical mechanics and time evolution of fluctuations in diffusive systems, are described. Phenomena which are expected to occur in finite temperature and/or density QCD matter and their measurement by event-by-event analyses are also elucidated.

Classification of Meteorological Influences Surrounding Extreme Precipitation Events in the United States using the MERRA-2 Reanalysis

NASA Technical Reports Server (NTRS)

Collow, Allie Marquardt; Bosilovich, Mike; Ullrich, Paul; Hoeck, Ian

2017-01-01

Extreme precipitation events can have a large impact on society through flooding that can result in property destruction, crop losses, economic losses, the spread of water-borne diseases, and fatalities. Observations indicate there has been a statistically significant increase in extreme precipitation events over the past 15 years in the Northeastern United States and other localized regions of the country have become crippled with record flooding events, for example, the flooding that occurred in the Southeast United States associated with Hurricane Matthew in October 2016. Extreme precipitation events in the United States can be caused by various meteorological influences such as extratropical cyclones, tropical cyclones, mesoscale convective complexes, general air mass thunderstorms, upslope flow, fronts, and the North American Monsoon. Reanalyses, such as the Modern Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2), have become a pivotal tool to study the meteorology surrounding extreme precipitation events. Using days classified as an extreme precipitation events based on a combination of observational gauge and radar data, two techniques for the classification of these events are used to gather additional information that can be used to determine how events have changed over time using atmospheric data from MERRA-2. The first is self organizing maps, which is an artificial neural network that uses unsupervised learning to cluster like patterns and the second is an automated detection technique that searches for characteristics in the atmosphere that define a meteorological phenomena. For example, the automated detection for tropical cycles searches for a defined area of suppressed sea level pressure, alongside thickness anomalies aloft, indicating the presence of a warm core. These techniques are employed for extreme precipitation events in preselected regions that were chosen based an analysis of the climatology of precipitation.

Dosimetric Predictors of Symptomatic Cardiac Events after Conventional-Dose Chemoradiation Therapy for Inoperable Non-Small Cell Lung Cancer.

PubMed

Yegya-Raman, Nikhil; Wang, Kyle; Kim, Sinae; Reyhan, Meral; Deek, Matthew P; Sayan, Mutlay; Li, Diana; Patel, Malini; Malhotra, Jyoti; Aisner, Joseph; Marks, Lawrence B; Jabbour, Salma K

2018-06-05

We hypothesized that higher cardiac doses correlates with clinically significant cardiotoxicity after standard-dose chemoradiation therapy (CRT) (∼60 Gy) for inoperable non-small cell lung cancer (NSCLC). We retrospectively reviewed the records of 140 patients with inoperable NSCLC treated with concurrent CRT from 2007-2015. Extracted data included baseline cardiac status, dosimetric parameters to the whole heart (WH) and cardiac substructures, and the development of post-CRT symptomatic cardiac events (acute coronary syndrome [ACS], arrhythmia, pericardial effusion, pericarditis, and congestive heart failure [CHF]). Competing risks analysis was used to estimate time to cardiac events. Median follow-up was 47.4 months. Median radiation therapy dose was 61.2 Gy (interquartile range, 60-66 Gy). Forty patients (28.6%) developed 47 symptomatic cardiac events at a median of 15.3 months to first event. On multivariate analysis, higher WH doses and baseline cardiac status were associated with an increased risk of symptomatic cardiac events. The 4-year cumulative incidence of symptomatic cardiac events was 48.6% versus 18.5% for mean WH dose ≥ 20 Gy versus < 20 Gy, respectively (p = 0.0002). Doses to the WH, ventricles, and left anterior descending artery were associated with ACS/CHF, whereas doses to the WH and atria were not associated with supraventricular arrhythmias. Symptomatic cardiac events (p = 0.0001) were independently associated with death. Incidental cardiac irradiation was associated with subsequent symptomatic cardiac events, particularly ACS/CHF, and symptomatic cardiac events were associated with inferior survival. These results support the minimization of cardiac doses among patients with inoperable NSCLC receiving standard-dose CRT. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Cinacalcet, Fibroblast Growth Factor-23, and Cardiovascular Disease in Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial.

PubMed

Moe, Sharon M; Chertow, Glenn M; Parfrey, Patrick S; Kubo, Yumi; Block, Geoffrey A; Correa-Rotter, Ricardo; Drüeke, Tilman B; Herzog, Charles A; London, Gerard M; Mahaffey, Kenneth W; Wheeler, David C; Stolina, Maria; Dehmel, Bastian; Goodman, William G; Floege, Jürgen

2015-07-07

Patients with kidney disease have disordered bone and mineral metabolism, including elevated serum concentrations of fibroblast growth factor-23 (FGF23). These elevated concentrations are associated with cardiovascular and all-cause mortality. The objective was to determine the effects of the calcimimetic cinacalcet (versus placebo) on reducing serum FGF23 and whether changes in FGF23 are associated with death and cardiovascular events. This was a secondary analysis of a randomized clinical trial comparing cinacalcet to placebo in addition to conventional therapy (phosphate binders/vitamin D) in patients receiving hemodialysis with secondary hyperparathyroidism (intact parathyroid hormone ≥300 pg/mL). The primary study end point was time to death or a first nonfatal cardiovascular event (myocardial infarction, hospitalization for angina, heart failure, or a peripheral vascular event). This analysis included 2985 patients (77% of randomized) with serum samples at baseline and 2602 patients (67%) with samples at both baseline and week 20. The results demonstrated that a significantly larger proportion of patients randomized to cinacalcet had ≥30% (68% versus 28%) reductions in FGF23. Among patients randomized to cinacalcet, a ≥30% reduction in FGF23 between baseline and week 20 was associated with a nominally significant reduction in the primary composite end point (relative hazard, 0.82; 95% confidence interval, 0.69-0.98), cardiovascular mortality (relative hazard, 0.66; 95% confidence interval, 0.50-0.87), sudden cardiac death (relative hazard, 0.57; 95% confidence interval, 0.37-0.86), and heart failure (relative hazard, 0.69; 95% confidence interval, 0.48-0.99). Treatment with cinacalcet significantly lowers serum FGF23. Treatment-induced reductions in serum FGF23 are associated with lower rates of cardiovascular death and major cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00345839. © 2015 American Heart Association, Inc.

Cholinesterase Inhibitors for Lewy Body Disorders: A Meta-Analysis

PubMed Central

Yasue, Ichiro; Iwata, Nakao

2016-01-01

Background: We performed a meta-analysis of cholinesterase inhibitors for patients with Lewy body disorders, such as Parkinson’s disease, Parkinson’s disease dementia, and dementia with Lewy bodies. Methods: The meta-analysis included only randomized controlled trials of cholinesterase inhibitors for Lewy body disorders. Results: Seventeen studies (n = 1798) were assessed. Cholinesterase inhibitors significantly improved cognitive function (standardized mean difference [SMD] = −0.53], behavioral disturbances (SMD = −0.28), activities of daily living (SMD = −0.28), and global function (SMD = −0.52) compared with control treatments. Changes in motor function were not significantly different from control treatments. Furthermore, the cholinesterase inhibitor group had a higher all-cause discontinuation (risk ratio [RR] = 1.48, number needed to harm [NNH] = 14), discontinuation due to adverse events (RR = 1.59, NNH = 20), at least one adverse event (RR = 1.13, NNH = 11), nausea (RR = 2.50, NNH = 13), and tremor (RR = 2.30, NNH = 20). Conclusions: Cholinesterase inhibitors appear beneficial for the treatment of Lewy body disorders without detrimental effects on motor function. However, a careful monitoring of treatment compliance and side effects is required. PMID:26221005

Measurement of Non-Stationary Characteristics of a Landfall Typhoon at the Jiangyin Bridge Site.

PubMed

He, Xuhui; Qin, Hongxi; Tao, Tianyou; Liu, Wenshuo; Wang, Hao

2017-09-22

The wind-sensitive long-span suspension bridge is a vital element in land transportation. Understanding the wind characteristics at the bridge site is thus of great significance to the wind- resistant analysis of such a flexible structure. In this study, a strong wind event from a landfall typhoon called Soudelor recorded at the Jiangyin Bridge site with the anemometer is taken as the research object. As inherent time-varying trends are frequently captured in typhoon events, the wind characteristics of Soudelor are analyzed in a non-stationary perspective. The time-varying mean is first extracted with the wavelet-based self-adaptive method. Then, the non-stationary turbulent wind characteristics, e.g.; turbulence intensity, gust factor, turbulence integral scale, and power spectral density, are investigated and compared with the results from the stationary analysis. The comparison highlights the importance of non-stationary considerations of typhoon events, and a transition from stationarity to non-stationarity for the analysis of wind effects. The analytical results could help enrich the database of non-stationary wind characteristics, and are expected to provide references for the wind-resistant analysis of engineering structures in similar areas.

Measurement of Non-Stationary Characteristics of a Landfall Typhoon at the Jiangyin Bridge Site

PubMed Central

Qin, Hongxi; Tao, Tianyou; Liu, Wenshuo

2017-01-01

The wind-sensitive long-span suspension bridge is a vital element in land transportation. Understanding the wind characteristics at the bridge site is thus of great significance to the wind- resistant analysis of such a flexible structure. In this study, a strong wind event from a landfall typhoon called Soudelor recorded at the Jiangyin Bridge site with the anemometer is taken as the research object. As inherent time-varying trends are frequently captured in typhoon events, the wind characteristics of Soudelor are analyzed in a non-stationary perspective. The time-varying mean is first extracted with the wavelet-based self-adaptive method. Then, the non-stationary turbulent wind characteristics, e.g.; turbulence intensity, gust factor, turbulence integral scale, and power spectral density, are investigated and compared with the results from the stationary analysis. The comparison highlights the importance of non-stationary considerations of typhoon events, and a transition from stationarity to non-stationarity for the analysis of wind effects. The analytical results could help enrich the database of non-stationary wind characteristics, and are expected to provide references for the wind-resistant analysis of engineering structures in similar areas. PMID:28937641

Decreasing Phosphorus Loss in Tile-Drained Landscapes Using Flue Gas Desulfurization Gypsum.

PubMed

King, K W; Williams, M R; Dick, W A; LaBarge, G A

2016-09-01

Elevated phosphorus (P) loading from agricultural nonpoint-source pollution continues to impair inland waterbodies throughout the world. The application of flue gas desulfurization (FGD) gypsum to agricultural fields has been suggested to decrease P loading because of its high calcium content and P sorbing potential. A before-after control-impact paired field experiment was used to examine the water quality effects of successive FGD gypsum applications (2.24 Mg ha; 1 ton acre each) to an Ohio field with high soil test P levels (>480 ppm Mehlich-3 P). Analysis of covariance was used to compare event discharge, dissolved reactive P (DRP), and total P (TP) concentrations and loadings in surface runoff and tile discharge between the baseline period (86 precipitation events) and Treatment Period 1 (42 precipitation events) and Treatment Period 2 (84 precipitation events). Results showed that, after the first application of FGD gypsum, event mean DRP and TP concentrations in treatment field tile water were significantly reduced by 21 and 10%, respectively, and DRP concentrations in surface runoff were significantly reduced by 14%; however, no significant reductions were noted in DRP or TP loading. After the second application, DRP and TP loads were significantly reduced in surface runoff (DRP, 41%; TP 40%), tile discharge (DRP, 35%; TP, 15%), and combined (surface + tile) discharge (DRP, 36%; TP, 38%). These findings indicate that surface application of FGD gypsum can be used as a tool to address elevated P concentrations and loadings in drainage waters. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Probiotics in Helicobacter pylori eradication therapy: A systematic review and meta-analysis

PubMed Central

Zhang, Min-Min; Qian, Wei; Qin, Ying-Yi; He, Jia; Zhou, Yu-Hao

2015-01-01

AIM: To summarize the evidence from randomized controlled trials (RCTs) regarding the effect of probiotics by using a meta-analytic approach. METHODS: In July 2013, we searched PubMed, EMBASE, Ovid, the Cochrane Library, and three Chinese databases (Chinese Biomedical Literature Database, Chinese Medical Current Content, and Chinese Scientific Journals database) to identify relevant RCTs. We included RCTs investigating the effect of a combination of probiotics and standard therapy (probiotics group) with standard therapy alone (control group). Risk ratios (RRs) were used to measure the effect of probiotics plus standard therapy on Helicobacter pylori (H. pylori) eradication rates, adverse events, and patient compliance using a random-effect model. RESULTS: We included data on 6997 participants from 45 RCTs, the overall eradication rates of the probiotic group and the control group were 82.31% and 72.08%, respectively. We noted that the use of probiotics plus standard therapy was associated with an increased eradication rate by per-protocol set analysis (RR = 1.11; 95%CI: 1.08-1.15; P < 0.001) or intention-to-treat analysis (RR = 1.13; 95%CI: 1.10-1.16; P < 0.001). Furthermore, the incidence of adverse events was 21.44% in the probiotics group and 36.27% in the control group, and it was found that the probiotics plus standard therapy significantly reduced the risk of adverse events (RR = 0.59; 95%CI: 0.48-0.71; P < 0.001), which demonstrated a favorable effect of probiotics in reducing adverse events associated with H. pylori eradication therapy. The specific reduction in adverse events ranged from 30% to 59%, and this reduction was statistically significant. Finally, probiotics plus standard therapy had little or no effect on patient compliance (RR = 0.98; 95%CI: 0.68-1.39; P = 0.889). CONCLUSION: The use of probiotics plus standard therapy was associated with an increase in the H. pylori eradication rate, and a reduction in adverse events resulting from treatment in the general population. However, this therapy did not improve patient compliance. PMID:25892886

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation.

PubMed

Bruins Slot, Karsten Mh; Berge, Eivind

2018-03-06

Factor Xa inhibitors and vitamin K antagonists (VKAs) are now recommended in treatment guidelines for preventing stroke and systemic embolic events in people with atrial fibrillation (AF). This is an update of a Cochrane review previously published in 2013. To assess the effectiveness and safety of treatment with factor Xa inhibitors versus VKAs for preventing cerebral or systemic embolic events in people with AF. We searched the trials registers of the Cochrane Stroke Group and the Cochrane Heart Group (September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (August 2017), MEDLINE (1950 to April 2017), and Embase (1980 to April 2017). We also contacted pharmaceutical companies, authors and sponsors of relevant published trials. We used outcome data from marketing authorisation applications of apixaban, edoxaban and rivaroxaban that were submitted to regulatory authorities in Europe and the USA. We included randomised controlled trials (RCTs) that directly compared the effects of long-term treatment (lasting more than four weeks) with factor Xa inhibitors versus VKAs for preventing cerebral and systemic embolism in people with AF. The primary efficacy outcome was the composite endpoint of all strokes and systemic embolic events. Two review authors independently extracted data, and assessed the quality of the trials and the risk of bias. We calculated a weighted estimate of the typical treatment effect across trials using the odds ratio (OR) with 95% confidence interval (CI) by means of a fixed-effect model. In case of moderate or high heterogeneity of treatment effects, we used a random-effects model to compare the overall treatment effects. We also performed a pre-specified sensitivity analysis excluding any open-label studies. We included data from 67,688 participants randomised into 13 RCTs. The included trials directly compared dose-adjusted warfarin with either apixaban, betrixaban, darexaban, edoxaban, idraparinux, idrabiotaparinux, or rivaroxaban. The majority of the included data (approximately 90%) was from apixaban, edoxaban, and rivaroxaban.The composite primary efficacy endpoint of all strokes (both ischaemic and haemorrhagic) and non-central nervous systemic embolic events was reported in all of the included studies. Treatment with a factor Xa inhibitor significantly decreased the number of strokes and systemic embolic events compared with dose-adjusted warfarin in participants with AF (OR 0.89, 95% CI 0.82 to 0.97; 13 studies; 67,477 participants; high-quality evidence).Treatment with a factor Xa inhibitor significantly reduced the number of major bleedings compared with warfarin (OR 0.78, 95% CI 0.73 to 0.84; 13 studies; 67,396 participants; moderate-quality evidence). There was, however, statistically significant and high heterogeneity (I 2 = 83%). When we repeated this analysis using a random-effects model, it did not show a statistically significant decrease in the number of major bleedings (OR 0.88, 95% CI 0.66 to 1.17). A pre-specified sensitivity analysis excluding all open-label studies showed that treatment with a factor Xa inhibitor significantly reduced the number of major bleedings compared with warfarin (OR 0.75, 95% CI 0.69 to 0.81), but high heterogeneity was also observed in this analysis (I 2 = 72%). The same sensitivity analysis using a random-effects model also showed a statistically significant decrease in the number of major bleedings in participants treated with factor Xa inhibitors (OR 0.76, 95% CI 0.60 to 0.96).Treatment with a factor Xa inhibitor significantly reduced the risk of intracranial haemorrhages (ICHs) compared with warfarin (OR 0.50, 95% CI 0.42 to 0.59; 12 studies; 66,259 participants; high-quality evidence). We observed moderate, but statistically significant heterogeneity (I 2 = 55%). The pre-specified sensitivity analysis excluding open-label studies showed that treatment with a factor Xa inhibitor significantly reduced the number of ICHs compared with warfarin (OR 0.47, 95% CI 0.40 to 0.56), with low, non-statistically significant heterogeneity (I 2 = 27%).Treatment with a factor Xa inhibitor also significantly reduced the number of all-cause deaths compared with warfarin (OR 0.89, 95% 0.83 to 0.95; 10 studies; 65,624 participants; moderate-quality evidence). Treatment with factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in people with AF. The absolute effect of factor Xa inhibitors compared with warfarin treatment was, however, rather small. Factor Xa inhibitors also reduced the number of ICHs, all-cause deaths and major bleedings compared with warfarin, although the evidence for a reduction in the latter is less robust.

Increasing Student Success Using Online Quizzing in Introductory (Majors) Biology

PubMed Central

Orr, Rebecca; Foster, Shellene

2013-01-01

Students often complain about their perceived disconnect between the time and effort spent studying and their subsequent performance on exams. Robert Bjork's research asserts that retrieval of stored information acts as a memory modifier, and that using tests as learning events creates “desirable difficulties that enhance learning.” To determine the effect of utilizing testing as a learning event in the introductory (majors) biology classroom, we used an online homework platform to give required quizzes throughout the course. Analysis of exam grades earned by those taking 100% of pre-exam quizzes indicates that not only does this group have a significantly higher exam average than the group of students who took 0% of the pre-exam quizzes, but they also have a significantly higher exam average than the class average. Through detailed, statistical analysis, the benefit of quizzing is demonstrated to be significant for students of diverse academic abilities. Pre-exam quizzing using an online homework platform is an effective way to increase student performance on exams and allows class time to be utilized for teaching activities. PMID:24006398

Statistical Analysis of the Links between Blocking and Nor'easters

NASA Astrophysics Data System (ADS)

Booth, J. F.; Pfahl, S.

2015-12-01

Nor'easters can be loosely defined as extratropical cyclones that develop as they progress northward along the eastern coast of North America. The path makes it possible for these storms to generate storm surge along the coastline and/or heavy precipitation or snow inland. In the present analysis, the path of the storms is investigated relative to the behavior of upstream blocking events over the North Atlantic Ocean. For this analysis, two separate Lagrangian tracking methods are used to identify the extratropical cyclone paths and the blocking events. Using the cyclone paths, Nor'easters are identified and blocking statistics are calculated for the days prior to, during and following the occurrence of the Nor'easters. The path, strength and intensification rates of the cyclones are compared with the strength and location of the blocks. In the event that a Nor'easter occurs, the likelihood of the presence of block at the southeast tip of Greenland is statistically significantly increased, i.e., the presence of a block concurrent with a Nor'easter happens more often than by random coincidence. However no significant link between the strength of the storms and the strength of the block is identified. These results suggest that the presence of the block mainly affects the path of the Nor'easters. On the other hand, in the event of blocking at the southeast tip of Greenland, the likelihood of a Nor'easter, as opposed to a different type of storm is no greater than what one might expect from randomly sampling cyclone tracks. The results confirm a long held understanding in forecast meteorology that upstream blocking is a necessary but not sufficient condition for generating a Nor'easter.

Comparative coronary risks of apixaban, rivaroxaban and dabigatran: a meta-analysis and adjusted indirect comparison

PubMed Central

Loke, Yoon K; Pradhan, Shiva; Yeong, Jessica Ka-yan; Kwok, Chun Shing

2014-01-01

Aims There are concerns regarding increased risk of acute coronary syndrome with dabigatran. We aimed to assess whether alternative treatment options such as rivaroxaban or apixaban carry a similar risk as compared with dabigatran. Methods We searched MEDLINE and EMBASE for randomized controlled trials of apixaban, dabigatran or rivaroxaban against control (placebo, heparin or vitamin K antagonist). We pooled odds ratios (OR) for adverse coronary events (acute coronary syndrome or myocardial infarction) using fixed effect meta-analysis and assessed heterogeneity with I2. We conducted adjusted indirect comparisons to compare risk of adverse coronary events with apixaban or rivaroxaban vs. dabigatran. Results Twenty-seven randomized controlled trials met the inclusion criteria. Dabigatran was associated with a significantly increased risk of adverse coronary events in pooled analysis of nine trials (OR 1.45, 95% CI 1.14, 1.86). There was no signal for coronary risk with apixaban from nine trials (pooled OR 0.89, 95% CI 0.78, 1.03) or rivaroxaban from nine trials (pooled OR 0.81, 95% CI 0.72, 0.93). Overall, adjusted indirect comparison suggested that both apixaban (OR 0.61, 95% CI 0.44, 0.85) and rivaroxaban (OR 0.54; 95% CI 0.39, 0.76) were associated with lower coronary risk than dabigatran. Restricting the indirect comparison to a vitamin K antagonist as a common control, yielded similar findings, OR 0.57 (95% CI 0.39, 0.85) for apixaban vs. dabigatran and 0.53 (95% CI 0.37, 0.77) for rivaroxaban vs. dabigatran. Conclusions There are significant differences in the comparative safety of apixaban, rivaroxaban and dabigatran with regards to acute coronary adverse events. PMID:24617578

Reconstruction of improvised explosive device blast loading to personnel in the open

NASA Astrophysics Data System (ADS)

Wiri, Suthee; Needham, Charles

2016-05-01

Significant advances in reconstructing attacks by improvised explosive devices (IEDs) and other blast events are reported. A high-fidelity three-dimensional computational fluid dynamics tool, called Second-order Hydrodynamic Automatic Mesh Refinement Code, was used for the analysis. Computer-aided design models for subjects or vehicles in the scene accurately represent geometries of objects in the blast field. A wide range of scenario types and blast exposure levels were reconstructed including free field blast, enclosed space of vehicle cabin, IED attack on a vehicle, buried charges, recoilless rifle operation, rocket-propelled grenade attack and missile attack with single subject or multiple subject exposure to pressure levels from ˜ 27.6 kPa (˜ 4 psi) to greater than 690 kPa (>100 psi). To create a full 3D pressure time-resolved reconstruction of a blast event for injury and blast exposure analysis, a combination of intelligence data and Blast Gauge data can be used to reconstruct an actual in-theatre blast event. The methodology to reconstruct an event and the "lessons learned" from multiple reconstructions in open space are presented. The analysis uses records of blast pressure at discrete points, and the output is a spatial and temporal blast load distribution for all personnel involved.

A Foreign Object Damage Event Detector Data Fusion System for Turbofan Engines

NASA Technical Reports Server (NTRS)

Turso, James A.; Litt, Jonathan S.

2004-01-01

A Data Fusion System designed to provide a reliable assessment of the occurrence of Foreign Object Damage (FOD) in a turbofan engine is presented. The FOD-event feature level fusion scheme combines knowledge of shifts in engine gas path performance obtained using a Kalman filter, with bearing accelerometer signal features extracted via wavelet analysis, to positively identify a FOD event. A fuzzy inference system provides basic probability assignments (bpa) based on features extracted from the gas path analysis and bearing accelerometers to a fusion algorithm based on the Dempster-Shafer-Yager Theory of Evidence. Details are provided on the wavelet transforms used to extract the foreign object strike features from the noisy data and on the Kalman filter-based gas path analysis. The system is demonstrated using a turbofan engine combined-effects model (CEM), providing both gas path and rotor dynamic structural response, and is suitable for rapid-prototyping of control and diagnostic systems. The fusion of the disparate data can provide significantly more reliable detection of a FOD event than the use of either method alone. The use of fuzzy inference techniques combined with Dempster-Shafer-Yager Theory of Evidence provides a theoretical justification for drawing conclusions based on imprecise or incomplete data.

Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events, and risk of depression: a meta-analysis.

PubMed

Risch, Neil; Herrell, Richard; Lehner, Thomas; Liang, Kung-Yee; Eaves, Lindon; Hoh, Josephine; Griem, Andrea; Kovacs, Maria; Ott, Jurg; Merikangas, Kathleen Ries

2009-06-17

Substantial resources are being devoted to identify candidate genes for complex mental and behavioral disorders through inclusion of environmental exposures following the report of an interaction between the serotonin transporter linked polymorphic region (5-HTTLPR) and stressful life events on an increased risk of major depression. To conduct a meta-analysis of the interaction between the serotonin transporter gene and stressful life events on depression using both published data and individual-level original data. Search of PubMed, EMBASE, and PsycINFO databases through March 2009 yielded 26 studies of which 14 met criteria for the meta-analysis. Criteria for studies for the meta-analyses included published data on the association between 5-HTTLPR genotype (SS, SL, or LL), number of stressful life events (0, 1, 2, > or = 3) or equivalent, and a categorical measure of depression defined by the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) or the International Statistical Classification of Diseases, 10th Revision (ICD-10) or use of a cut point to define depression from standardized rating scales. To maximize our ability to use a common framework for variable definition, we also requested original data from all studies published prior to 2008 that met inclusion criteria. Of the 14 studies included in the meta-analysis, 10 were also included in a second sex-specific meta-analysis of original individual-level data. Logistic regression was used to estimate the effects of the number of short alleles at 5-HTTLPR, the number of stressful life events, and their interaction on depression. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated separately for each study and then weighted averages of the individual estimates were obtained using random-effects meta-analysis. Both sex-combined and sex-specific meta-analyses were conducted. Of a total of 14,250 participants, 1769 were classified as having depression; 12,481 as not having depression. In the meta-analysis of published data, the number of stressful life events was significantly associated with depression (OR, 1.41; 95% CI,1.25-1.57). No association was found between 5-HTTLPR genotype and depression in any of the individual studies nor in the weighted average (OR, 1.05; 95% CI, 0.98-1.13) and no interaction effect between genotype and stressful life events on depression was observed (OR, 1.01; 95% CI, 0.94-1.10). Comparable results were found in the sex-specific meta-analysis of individual-level data. This meta-analysis yielded no evidence that the serotonin transporter genotype alone or in interaction with stressful life events is associated with an elevated risk of depression in men alone, women alone, or in both sexes combined.

Numerical modeling and analysis of the effect of complex Greek topography on tornadogenesis

NASA Astrophysics Data System (ADS)

Matsangouras, I. T.; Pytharoulis, I.; Nastos, P. T.

2014-07-01

Tornadoes have been reported in Greece over recent decades in specific sub-geographical areas and have been associated with strong synoptic forcing. While it has been established that meteorological conditions over Greece are affected at various scales by the significant variability of topography, the Ionian Sea to the west and the Aegean Sea to the east, there is still uncertainty regarding topography's importance on tornadic generation and development. The aim of this study is to investigate the role of topography in significant tornadogenesis events that were triggered under strong synoptic scale forcing over Greece. Three tornado events that occurred over the last years in Thebes (Boeotia, 17 November 2007), Vrastema (Chalkidiki, 12 February 2010) and Vlychos (Lefkada, 20 September 2011) were selected for numerical experiments. These events were associated with synoptic scale forcing, while their intensities were T4-T5 (on the TORRO scale), causing significant damage. The simulations were performed using the non-hydrostatic weather research and forecasting model (WRF), initialized by European Centre for Medium-Range Weather Forecasts (ECMWF) gridded analyses, with telescoping nested grids that allow for the representation of atmospheric circulations ranging from the synoptic scale down to the mesoscale. In the experiments, the topography of the inner grid was modified by: (a) 0% (actual topography) and (b) -100% (without topography), making an effort to determine whether the occurrence of tornadoes - mainly identified by various severe weather instability indices - could be indicated by modifying topography. The principal instability variables employed consisted of the bulk Richardson number (BRN) shear, the energy helicity index (EHI), the storm-relative environmental helicity (SRH), and the maximum convective available potential energy (MCAPE, for parcels with maximum θe). Additionally, a model verification was conducted for every sensitivity experiment accompanied by analysis of the absolute vorticity budget. Numerical simulations revealed that the complex topography constituted an important factor during the 17 November 2007 and 12 February 2010 events, based on EHI, SRH, BRN, and MCAPE analyses. Conversely, topography around the 20 September 2011 event was characterized as the least significant factor based on EHI, SRH, BRN, and MCAPE analyses.

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

PubMed Central

Hwang, Thomas J.

2013-01-01

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

Response of equatorial and low latitude mesosphere lower thermospheric dynamics to the northern hemispheric sudden stratospheric warming events

NASA Astrophysics Data System (ADS)

Koushik, N.; Kumar, Karanam Kishore; Ramkumar, Geetha; Subrahmanyam, K. V.

2018-04-01

The changes in zonal mean circulation and meridional temperature gradient brought about by Sudden Stratospheric Warming (SSW) events in polar middle atmosphere are found to significantly affect the low latitude counterparts. Several studies have revealed the signatures of SSW events in the low latitude Mesosphere- Lower Thermosphere (MLT) region. Using meteor wind radar observations, the present study investigates the response of semidiurnal oscillations and quasi 2-day waves in the MLT region, simultaneously over low latitude and equatorial stations Thumba (8.5oN, 76.5oE) and Kototabang (0.2oS, 100oE). Unlike many case studies, the present analysis examines the response of low and equatorial latitude MLT region to typical polar stratospheric conditions viz., Quiet winter, Major SSW winter and Minor SSW winter. The present results show that (i) the amplitudes of semidiurnal oscillations and quasi 2-day waves in the equatorial and low latitude MLT region enhance in association with major SSW events, (ii) the semidiurnal oscillations show significant enhancement selectively in the zonal and meridional components over the Northern Hemispheric low latitude and the equatorial stations, respectively (iii) The minor SSW event of January 2012 resulted in anomalously large amplitudes of quasi 2- day waves without any notable increase in the amplitude of semidiurnal oscillations. The significance of the present study lies in comprehensively bringing out the signatures of SSW events in the semidiurnal oscillations and quasi 2-day waves in low latitude and equatorial MLT region, simultaneously for the first time over these latitudes.

a Comparison Between Chemically Dependent Mothers and Drug-Free Mothers: Lifestyle during the Perinatal Period

NASA Astrophysics Data System (ADS)

Uskokovic, Lila Milica

This study compared maternal lifestyle variables pertinent to the perinatal period in groups of chemically dependent mothers and drug-free mothers. Twenty-nine cocaine -abusing mothers were compared to 29 drug-free mothers carefully matched on age, race, education, and primipara versus multipara status. The drug history of each chemically dependent woman was explicitly documented. The chemically dependent group was subdivided into two groups, mothers who abused cocaine and those who abused cocaine with concomitant opiate use. Each of these two subgroups was compared to its respective matched drug-free control group. Finally, a comparison was made between the two drug subgroups. All subjects were interviewed within 48 hours after delivery using the following measures: State-Trait Anxiety Inventory (A-State), Center for Epidemiologic Studies - Depression Scale, The Self-Esteem Scale, Maternal Adjustment and Maternal Attitude Questionnaire, The Neonatal Perception Inventory, The Psychiatric Epidemiology Research Interview Life Events Scale, Maternal Social Support Index, and Short Marital Adjustment Test. A t-test analysis revealed significant differences (p <.05) between the total experimental group and its matched control group on state anxiety, depression, self-esteem, maternal adjustment and attitudes, and life events. An analysis of covariance indicated that life events was the only significant variable when the influence of all other variables was removed. Comparisons made between each drug subgroup and its respective matched control group showed similar results, except that those who abused opiates with cocaine did not differ from their controls on depression and maternal adjustment and attitudes. No significant differences were obtained in the drug subgroup comparisons. These results identify increased life events and specific negative affect states that clinical intervention programs should address to assure the best possible outcome for chemically dependent mothers and their infants.

Dietary change and reduced breast cancer events among women without hot flashes after treatment of early-stage breast cancer: subgroup analysis of the Women's Healthy Eating and Living Study1234

PubMed Central

Pierce, John P; Natarajan, Loki; Caan, Bette J; Flatt, Shirley W; Kealey, Sheila; Gold, Ellen B; Hajek, Richard A; Newman, Vicky A; Rock, Cheryl L; Pu, Minya; Saquib, Nazmus; Stefanick, Marcia L; Thomson, Cynthia A; Parker, Barbara

2009-01-01

Background: A diet high in vegetables, fruit, and fiber and low in fat decreased additional risk of secondary breast cancer events in women without hot flashes (HF−) compared with that in women with hot flashes (HF+), possibly through lowered concentrations of circulating estrogens. Objective: The objective was to investigate the intervention effect by baseline quartiles of dietary pattern among breast cancer survivors in the HF− subgroup of the Women's Healthy Eating and Living Study. Design: A randomized controlled trial compared a putative cancer prevention diet with a diet of 5 servings of vegetables and fruit daily in early-stage breast cancer survivors. Participants did not experience hot flashes at baseline (n = 896). We confirmed cancer status for 96% of participants ≈7.3 y after enrollment. Results: The study intervention achieved a large between-group difference in dietary pattern that, at 4 y, was not significantly different across baseline quartiles of dietary pattern. The intervention group experienced fewer breast cancer events than did the comparison group for all of the baseline quartiles. This difference was significant only in upper baseline quartiles of intake of vegetables, fruit, and fiber and in the lowest quartile of fat. A significant trend for fewer breast cancer events was observed across quartiles of vegetable-fruit and fiber consumption. Conclusions: The secondary analysis showing the decreased risk in the HF− subgroup was not explained by amount of change in dietary pattern achieved. The difference was strongest in the quartile with the most putatively cancer-preventive dietary pattern at baseline. PMID:19339393

Statistical analysis of life history calendar data.

PubMed

Eerola, Mervi; Helske, Satu

2016-04-01

The life history calendar is a data-collection tool for obtaining reliable retrospective data about life events. To illustrate the analysis of such data, we compare the model-based probabilistic event history analysis and the model-free data mining method, sequence analysis. In event history analysis, we estimate instead of transition hazards the cumulative prediction probabilities of life events in the entire trajectory. In sequence analysis, we compare several dissimilarity metrics and contrast data-driven and user-defined substitution costs. As an example, we study young adults' transition to adulthood as a sequence of events in three life domains. The events define the multistate event history model and the parallel life domains in multidimensional sequence analysis. The relationship between life trajectories and excess depressive symptoms in middle age is further studied by their joint prediction in the multistate model and by regressing the symptom scores on individual-specific cluster indices. The two approaches complement each other in life course analysis; sequence analysis can effectively find typical and atypical life patterns while event history analysis is needed for causal inquiries. © The Author(s) 2012.

ELF whistler events with a reduced intensity observed by the DEMETER spacecraft

NASA Astrophysics Data System (ADS)

Zahlava, J.; Nemec, F.; Santolik, O.; Kolmasova, I.; Parrot, M.

2017-12-01

A survey of VLF frequency-time spectrograms obtained by the DEMETER spacecraft (2004-2010, altitude about 700 km) revealed that the intensity of fractional hop whistlers is sometimes significantly reduced at specific frequencies. These frequencies are typically above about 3.4 kHz (second cutoff frequency of the Earth-ionosphere waveguide), and they vary smoothly in time. The events were explained by the wave propagation in the Earth-ionosphere waveguide, and a resulting interference of the first few waveguide modes. We analyze the events whose frequency-time structure is rather similar, but at frequencies below 1 kHz. Altogether, 284 events are identified during the periods with active Burst mode, when high resolution data are measured by DEMETER. The vast majority of events (93%) occurs during the nighttime. All six electromagnetic field components are available, which allows us to perform a detailed wave analysis. An overview of the properties of these events is presented, and their possible origin is discussed.

Substantial increase in concurrent droughts and heatwaves in the United States

PubMed Central

Mazdiyasni, Omid; AghaKouchak, Amir

2015-01-01

A combination of climate events (e.g., low precipitation and high temperatures) may cause a significant impact on the ecosystem and society, although individual events involved may not be severe extremes themselves. Analyzing historical changes in concurrent climate extremes is critical to preparing for and mitigating the negative effects of climatic change and variability. This study focuses on the changes in concurrences of heatwaves and meteorological droughts from 1960 to 2010. Despite an apparent hiatus in rising temperature and no significant trend in droughts, we show a substantial increase in concurrent droughts and heatwaves across most parts of the United States, and a statistically significant shift in the distribution of concurrent extremes. Although commonly used trend analysis methods do not show any trend in concurrent droughts and heatwaves, a unique statistical approach discussed in this study exhibits a statistically significant change in the distribution of the data. PMID:26324927

Substantial increase in concurrent droughts and heatwaves in the United States.

PubMed

Mazdiyasni, Omid; AghaKouchak, Amir

2015-09-15

A combination of climate events (e.g., low precipitation and high temperatures) may cause a significant impact on the ecosystem and society, although individual events involved may not be severe extremes themselves. Analyzing historical changes in concurrent climate extremes is critical to preparing for and mitigating the negative effects of climatic change and variability. This study focuses on the changes in concurrences of heatwaves and meteorological droughts from 1960 to 2010. Despite an apparent hiatus in rising temperature and no significant trend in droughts, we show a substantial increase in concurrent droughts and heatwaves across most parts of the United States, and a statistically significant shift in the distribution of concurrent extremes. Although commonly used trend analysis methods do not show any trend in concurrent droughts and heatwaves, a unique statistical approach discussed in this study exhibits a statistically significant change in the distribution of the data.

Enhancing the Effectiveness of Significant Event Analysis: Exploring Personal Impact and Applying Systems Thinking in Primary Care

PubMed Central

McNaughton, Elaine; Bruce, David; Holly, Deirdre; Forrest, Eleanor; Macleod, Marion; Kennedy, Susan; Power, Ailsa; Toppin, Denis; Black, Irene; Pooley, Janet; Taylor, Audrey; Swanson, Vivien; Kelly, Moya; Ferguson, Julie; Stirling, Suzanne; Wakeling, Judy; Inglis, Angela; McKay, John; Sargeant, Joan

2016-01-01

Introduction: Significant event analysis (SEA) is well established in many primary care settings but can be poorly implemented. Reasons include the emotional impact on clinicians and limited knowledge of systems thinking in establishing why events happen and formulating improvements. To enhance SEA effectiveness, we developed and tested “guiding tools” based on human factors principles. Methods: Mixed-methods development of guiding tools (Personal Booklet—to help with emotional demands and apply a human factors analysis at the individual level; Desk Pad—to guide a team-based systems analysis; and a written Report Format) by a multiprofessional “expert” group and testing with Scottish primary care practitioners who submitted completed enhanced SEA reports. Evaluation data were collected through questionnaire, telephone interviews, and thematic analysis of SEA reports. Results: Overall, 149/240 care practitioners tested the guiding tools and submitted completed SEA reports (62.1%). Reported understanding of how to undertake SEA improved postintervention (P < .001), while most agreed that the Personal Booklet was practical (88/123, 71.5%) and relevant to dealing with related emotions (93/123, 75.6%). The Desk Pad tool helped focus the SEA on systems issues (85/123, 69.1%), while most found the Report Format clear (94/123, 76.4%) and would recommend it (88/123, 71.5%). Most SEA reports adopted a systems approach to analyses (125/149, 83.9%), care improvement (74/149, 49.7), or planned actions (42/149, 28.2%). Discussion: Applying human factors principles to SEA potentially enables care teams to gain a systems-based understanding of why things go wrong, which may help with related emotional demands and with more effective learning and improvement. PMID:27583996

The effects of anaesthetics on postoperative physiological reactions: a meta-analysis.

PubMed

Wang, Na; Wang, Jinguo; Zhang, Rui; Wang, Fei; Wang, Rui

2015-10-01

This study aimed to systematically investigate the effects of different anaesthetics on postoperative physiological reactions compared with placebo. The literature search was conducted using three databases: PubMed, EMBASE, and the Cochrane Library. Studies published from January 1990 to January 2015 were screened. The language was restricted to English. Heterogeneity was analyzed by the Q test and I(2) statistic. A fixed-effect model was used for homogenous data and a random-effects model for heterogeneous data. The odds ratio (OR) and 95% confidence interval (CI) were calculated to monitor the incidences of overall adverse events, arterial blood pressure, and cardiac abnormalities. Sensitivity analysis was performed to estimate the strength of the meta-analysis, and publication bias was analyzed using Egger's test. A total of 24 articles were included in this meta-analysis. There were 1,810 and 1,806 cases in the anaesthetic group and the placebo group, respectively. The incidence of overall adverse events was significantly lower in the anaesthetic group compared with the placebo group (OR = 0.57; 95% CI, 0.38-0.84). No publication bias was observed, and no inverse estimates were calculated using sensitivity analysis. There was no significant difference for the incidence of arterial blood pressure (OR = 4.62; 95% CI, 0.90-23.70) and cardiac abnormalities (OR = 1.18; 95% CI, 0.53-2.63) between the two groups. Although the incidence of overall adverse events was decreased in the anaesthetic group, it is impossible to determine whether the use of anaesthetics during surgical operation has a protective effect on postoperative physiological reactions. © 2015 Wiley Publishing Asia Pty Ltd.

Enhancing the Effectiveness of Significant Event Analysis: Exploring Personal Impact and Applying Systems Thinking in Primary Care.

PubMed

Bowie, Paul; McNaughton, Elaine; Bruce, David; Holly, Deirdre; Forrest, Eleanor; Macleod, Marion; Kennedy, Susan; Power, Ailsa; Toppin, Denis; Black, Irene; Pooley, Janet; Taylor, Audrey; Swanson, Vivien; Kelly, Moya; Ferguson, Julie; Stirling, Suzanne; Wakeling, Judy; Inglis, Angela; McKay, John; Sargeant, Joan

2016-01-01

Significant event analysis (SEA) is well established in many primary care settings but can be poorly implemented. Reasons include the emotional impact on clinicians and limited knowledge of systems thinking in establishing why events happen and formulating improvements. To enhance SEA effectiveness, we developed and tested "guiding tools" based on human factors principles. Mixed-methods development of guiding tools (Personal Booklet-to help with emotional demands and apply a human factors analysis at the individual level; Desk Pad-to guide a team-based systems analysis; and a written Report Format) by a multiprofessional "expert" group and testing with Scottish primary care practitioners who submitted completed enhanced SEA reports. Evaluation data were collected through questionnaire, telephone interviews, and thematic analysis of SEA reports. Overall, 149/240 care practitioners tested the guiding tools and submitted completed SEA reports (62.1%). Reported understanding of how to undertake SEA improved postintervention (P < .001), while most agreed that the Personal Booklet was practical (88/123, 71.5%) and relevant to dealing with related emotions (93/123, 75.6%). The Desk Pad tool helped focus the SEA on systems issues (85/123, 69.1%), while most found the Report Format clear (94/123, 76.4%) and would recommend it (88/123, 71.5%). Most SEA reports adopted a systems approach to analyses (125/149, 83.9%), care improvement (74/149, 49.7), or planned actions (42/149, 28.2%). Applying human factors principles to SEA potentially enables care teams to gain a systems-based understanding of why things go wrong, which may help with related emotional demands and with more effective learning and improvement.

Statistical significance of task related deep brain EEG dynamic changes in the time-frequency domain.

PubMed

Chládek, J; Brázdil, M; Halámek, J; Plešinger, F; Jurák, P

2013-01-01

We present an off-line analysis procedure for exploring brain activity recorded from intra-cerebral electroencephalographic data (SEEG). The objective is to determine the statistical differences between different types of stimulations in the time-frequency domain. The procedure is based on computing relative signal power change and subsequent statistical analysis. An example of characteristic statistically significant event-related de/synchronization (ERD/ERS) detected across different frequency bands following different oddball stimuli is presented. The method is used for off-line functional classification of different brain areas.

The Sensitivity of Adverse Event Cost Estimates to Diagnostic Coding Error

PubMed Central

Wardle, Gavin; Wodchis, Walter P; Laporte, Audrey; Anderson, Geoffrey M; Baker, Ross G

2012-01-01

Objective To examine the impact of diagnostic coding error on estimates of hospital costs attributable to adverse events. Data Sources Original and reabstracted medical records of 9,670 complex medical and surgical admissions at 11 hospital corporations in Ontario from 2002 to 2004. Patient specific costs, not including physician payments, were retrieved from the Ontario Case Costing Initiative database. Study Design Adverse events were identified among the original and reabstracted records using ICD10-CA (Canadian adaptation of ICD10) codes flagged as postadmission complications. Propensity score matching and multivariate regression analysis were used to estimate the cost of the adverse events and to determine the sensitivity of cost estimates to diagnostic coding error. Principal Findings Estimates of the cost of the adverse events ranged from $16,008 (metabolic derangement) to $30,176 (upper gastrointestinal bleeding). Coding errors caused the total cost attributable to the adverse events to be underestimated by 16 percent. The impact of coding error on adverse event cost estimates was highly variable at the organizational level. Conclusions Estimates of adverse event costs are highly sensitive to coding error. Adverse event costs may be significantly underestimated if the likelihood of error is ignored. PMID:22091908

Tool for Constructing Data Albums for Significant Weather Events

NASA Astrophysics Data System (ADS)

Kulkarni, A.; Ramachandran, R.; Conover, H.; McEniry, M.; Goodman, H.; Zavodsky, B. T.; Braun, S. A.; Wilson, B. D.

2012-12-01

Case study analysis and climatology studies are common approaches used in Atmospheric Science research. Research based on case studies involves a detailed description of specific weather events using data from different sources, to characterize physical processes in play for a given event. Climatology-based research tends to focus on the representativeness of a given event, by studying the characteristics and distribution of a large number of events. To gather relevant data and information for case studies and climatology analysis is tedious and time consuming; current Earth Science data systems are not suited to assemble multi-instrument, multi mission datasets around specific events. For example, in hurricane science, finding airborne or satellite data relevant to a given storm requires searching through web pages and data archives. Background information related to damages, deaths, and injuries requires extensive online searches for news reports and official storm summaries. We will present a knowledge synthesis engine to create curated "Data Albums" to support case study analysis and climatology studies. The technological challenges in building such a reusable and scalable knowledge synthesis engine are several. First, how to encode domain knowledge in a machine usable form? This knowledge must capture what information and data resources are relevant and the semantic relationships between the various fragments of information and data. Second, how to extract semantic information from various heterogeneous sources including unstructured texts using the encoded knowledge? Finally, how to design a structured database from the encoded knowledge to store all information and to support querying? The structured database must allow both knowledge overviews of an event as well as drill down capability needed for detailed analysis. An application ontology driven framework is being used to design the knowledge synthesis engine. The knowledge synthesis engine is being applied to build a portal for hurricane case studies at the Global Hydrology and Resource Center (GHRC), a NASA Data Center. This portal will auto-generate Data Albums for specific hurricane events, compiling information from distributed resources such as NASA field campaign collections, relevant data sets, storm reports, pictures, videos and other useful sources.

On the Interpretation of the Fermi-GBM Transient Observed in Coincidence with LIGO Gravitational-wave Event GW150914

NASA Astrophysics Data System (ADS)

Connaughton, V.; Burns, E.; Goldstein, A.; Blackburn, L.; Briggs, M. S.; Christensen, N.; Hui, C. M.; Kocevski, D.; Littenberg, T.; McEnery, J. E.; Racusin, J.; Shawhan, P.; Veitch, J.; Wilson-Hodge, C. A.; Bhat, P. N.; Bissaldi, E.; Cleveland, W.; Giles, M. M.; Gibby, M. H.; von Kienlin, A.; Kippen, R. M.; McBreen, S.; Meegan, C. A.; Paciesas, W. S.; Preece, R. D.; Roberts, O. J.; Stanbro, M.; Veres, P.

2018-01-01

The weak transient detected by the Fermi Gamma-ray Burst Monitor (GBM) 0.4 s after GW150914 has generated much speculation regarding its possible association with the black hole binary merger. Investigation of the GBM data by Connaughton et al. revealed a source location consistent with GW150914 and a spectrum consistent with a weak, short gamma-ray burst. Greiner et al. present an alternative technique for fitting background-limited data in the low-count regime, and call into question the spectral analysis and the significance of the detection of GW150914-GBM presented in Connaughton et al. The spectral analysis of Connaughton et al. is not subject to the limitations of the low-count regime noted by Greiner et al. We find Greiner et al. used an inconsistent source position and did not follow the steps taken in Connaughton et al. to mitigate the statistical shortcomings of their software when analyzing this weak event. We use the approach of Greiner et al. to verify that our original spectral analysis is not biased. The detection significance of GW150914-GBM is established empirically, with a false-alarm rate (FAR) of ∼ {10}-4 Hz. A post-trials false-alarm probability (FAP) of 2.2× {10}-3 (2.9σ ) of this transient being associated with GW150914 is based on the proximity in time to the gravitational-wave event of a transient with that FAR. The FAR and the FAP are unaffected by the spectral analysis that is the focus of Greiner et al.

Regional and local increases in storm intensity in the San Francisco Bay Area, USA, between 1890 and 2010

NASA Astrophysics Data System (ADS)

Russo, Tess A.; Fisher, Andrew T.; Winslow, Dustin M.

2013-04-01

Studies of extreme precipitation have documented changes at the continental scale during the twentieth century, but few studies have quantified changes at small to regional spatial scales during the same time. We analyze historic data from over 600 precipitation stations in the San Francisco Bay Area (SFBA), California, to assess whether there have been statistically significant changes in extreme precipitation between 1890 and 2010. An annual exceedance probability analysis of extreme precipitation events in the SFBA, coupled with a Markov chain Monte Carlo algorithm, reveals an increase in the occurrence of large events. The depth-duration-frequency characteristics of maximum annual precipitation events having durations of 1 h to 60 days indicate on average an increase in storm intensity in the last 120 years, with the intensity of the largest (least frequent) events increasing the most. Mean annual precipitation (MAP) also increased during the study period, but the relative increase in extreme event intensity exceeds that of MAP, indicating that a greater fraction of precipitation fell during large events. Analysis of data from subareas within the SFBA region indicates considerable heterogeneity in the observed nonstationarity; for example, the 5 day, 25 year event exceedance depth changed by +26%, +16%, and -1% in San Francisco, Santa Rosa, and San Jose, respectively. These results emphasize the importance of analyzing local data for accurate risk assessment, emergency planning, resource management, and climate model calibration.

Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change

PubMed Central

Davies, Grace I.; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

2014-01-01

Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia. PMID:25546280

Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.

PubMed

Davies, Grace I; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

2014-12-23

Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

FPGA Based Wavelet Trigger in Radio Detection of Cosmic Rays

NASA Astrophysics Data System (ADS)

Szadkowski, Zbigniew; Szadkowska, Anna

2014-12-01

Experiments which show coherent radio emission from extensive air showers induced by ultra-high-energy cosmic rays are designed for a detailed study of the development of the electromagnetic part of air showers. Radio detectors can operate with 100 % up time as, e.g., surface detectors based on water-Cherenkov tanks. They are being developed for ground-based experiments (e.g., the Pierre Auger Observatory) as another type of air-shower detector in addition to fluorescence detectors, which operate with only ˜10 % of duty on dark nights. The radio signals from air showers are caused by coherent emission from geomagnetic radiation and charge-excess processes. The self-triggers in radio detectors currently in use often generate a dense stream of data, which is analyzed afterwards. Huge amounts of registered data require significant manpower for off-line analysis. Improvement of trigger efficiency is a relevant factor. The wavelet trigger, which investigates on-line the power of radio signals (˜ V2/ R), is promising; however, it requires some improvements with respect to current designs. In this work, Morlet wavelets with various scaling factors were used for an analysis of real data from the Auger Engineering Radio Array and for optimization of the utilization of the resources in an FPGA. The wavelet analysis showed that the power of events is concentrated mostly in a limited range of the frequency spectrum (consistent with a range imposed by the input analog band-pass filter). However, we found several events with suspicious spectral characteristics, where the signal power is spread over the full band-width sampled by a 200 MHz digitizer with significant contribution of very high and very low frequencies. These events may not originate from cosmic ray showers but could be the result of human contamination. The engine of the wavelet analysis can be implemented in the modern powerful FPGAs and can remove suspicious events on-line to reduce the trigger rate.

Towards a global flood detection system using social media

NASA Astrophysics Data System (ADS)

de Bruijn, Jens; de Moel, Hans; Jongman, Brenden; Aerts, Jeroen

2017-04-01

It is widely recognized that an early warning is critical in improving international disaster response. Analysis of social media in real-time can provide valuable information about an event or help to detect unexpected events. For successful and reliable detection systems that work globally, it is important that sufficient data is available and that the algorithm works both in data-rich and data-poor environments. In this study, both a new geotagging system and multi-level event detection system for flood hazards was developed using Twitter data. Geotagging algorithms that regard one tweet as a single document are well-studied. However, no algorithms exist that combine several sequential tweets mentioning keywords regarding a specific event type. Within the time frame of an event, multiple users use event related keywords that refer to the same place name. This notion allows us to treat several sequential tweets posted in the last 24 hours as one document. For all these tweets, we collect a series of spatial indicators given in the tweet metadata and extract additional topological indicators from the text. Using these indicators, we can reduce ambiguity and thus better estimate what locations are tweeted about. Using these localized tweets, Bayesian change-point analysis is used to find significant increases of tweets mentioning countries, provinces or towns. In data-poor environments detection of events on a country level is possible, while in other, data-rich, environments detection on a city level is achieved. Additionally, on a city-level we analyse the spatial dependence of mentioned places. If multiple places within a limited spatial extent are mentioned, detection confidence increases. We run the algorithm using 2 years of Twitter data with flood related keywords in 13 major languages and validate against a flood event database. We find that the geotagging algorithm yields significantly more data than previously developed algorithms and successfully deals with ambiguous place names. In addition, we show that our detection system can both quickly and reliably detect floods, even in countries where data is scarce, while achieving high detail in countries where more data is available.

Amino-terminal pro-B-type natriuretic peptide and high-sensitivity C-reactive protein but not cystatin C predict cardiovascular events in male patients with peripheral artery disease independently of ambulatory pulse pressure.

PubMed

Skoglund, Per H; Arpegård, Johannes; Ostergren, Jan; Svensson, Per

2014-03-01

Patients with peripheral arterial disease (PAD) are at high risk for cardiovascular (CV) events. We have previously shown that ambulatory pulse pressure (APP) predicts CV events in PAD patients. The biomarkers amino-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and cystatin C are related to a worse outcome in patients with CV disease, but their predictive values have not been studied in relation to APP. Blood samples and 24-hour measurements of ambulatory blood pressure were examined in 98 men referred for PAD evaluation during 1998-2001. Patients were followed for a median of 71 months. The outcome variable was CV events defined as either CV mortality or any hospitalization for myocardial infarction, stroke, or coronary revascularization. The predictive values of log(NT-proBNP), log(hs-CRP), and log(cystatin C) alone and together with APP were assessed by multivariable Cox regression. Area under the curve (AUC) and net reclassification improvement (NRI) were calculated compared with a model containing other significant risk factors. During follow-up, 36 patients had at least 1 CV event. APP, log(NT-proBNP), and log(hs-CRP) all predicted CV events in univariable analysis, whereas log(cystatin C) did not. In multivariable analysis log(NT-proBNP) (hazard ratio (HR) = 1.62; 95% confidence interval (CI) = 1.05-2.51) and log(hs-CRP) (HR = 1.63; 95% CI = 1.19-2.24) predicted events independently of 24-hour PP. The combination of log(NT-proBNP), log(hs-CRP), and average day PP improved risk discrimination (AUC = 0.833 vs. 0.736; P < 0.05) and NRI (37%; P < 0.01) when added to other significant risk factors. NT-proBNP and hs-CRP predict CV events independently of APP and the combination of hs-CRP, NT-proBNP, and day PP improves risk discrimination in PAD patients.

Long-term Changes in Extreme Air Pollution Meteorology and the Implications for Air Quality.

PubMed

Hou, Pei; Wu, Shiliang

2016-03-31

Extreme air pollution meteorological events, such as heat waves, temperature inversions and atmospheric stagnation episodes, can significantly affect air quality. Based on observational data, we have analyzed the long-term evolution of extreme air pollution meteorology on the global scale and their potential impacts on air quality, especially the high pollution episodes. We have identified significant increasing trends for the occurrences of extreme air pollution meteorological events in the past six decades, especially over the continental regions. Statistical analysis combining air quality data and meteorological data further indicates strong sensitivities of air quality (including both average air pollutant concentrations and high pollution episodes) to extreme meteorological events. For example, we find that in the United States the probability of severe ozone pollution when there are heat waves could be up to seven times of the average probability during summertime, while temperature inversions in wintertime could enhance the probability of severe particulate matter pollution by more than a factor of two. We have also identified significant seasonal and spatial variations in the sensitivity of air quality to extreme air pollution meteorology.

Modeling carbon production and transport during ELMs in DIII-D

NASA Astrophysics Data System (ADS)

Hogan, J.; Wade, M.; Coster, D.; Lasnier, C.

2004-11-01

Large-scale Type I ELM events could provide a significant C source in ITER, and C production rates depend on incident D flux density and surface temperature, quantities which can vary significantly during an ELM event. Recent progress on DIII-D has improved opportunities for code comparison. Fast time-scale measurements of divertor CIII evolution [1] and fast edge CER measurements of C profile evolution during low-density DIII-D LSN ELMy H-modes (type I) [2] have been modeled using the solps5.0/Eirene99 coupled edge code and time dependent thermal analysis codes. An ELM model based on characteristics of MHD peeling-ballooning modes reproduces the pedestal evolution. Qualitative agreement for the CIII evolution during an ELM event is found using the Roth et al annealing model for chemical sputtering and the sensitivity to other models is described. Significant ELM-to-ELM variations in observed maximum divertor target IR temperature during nominally identical ELMs are investigated with models for C emission from micron-scale dust particles. [1] M Groth, M Fenstermacher et al J Nucl Mater 2003, [2] M Wade, K Burrell et al PSI-16

48 CFR 2110.7003 - Significant events.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Significant events. 2110..., AND OTHER PURCHASE DESCRIPTIONS Contract Specifications 2110.7003 Significant events. The contractor is required to inform the contracting officer of all significant events. ...

48 CFR 2110.7003 - Significant events.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Significant events. 2110..., AND OTHER PURCHASE DESCRIPTIONS Contract Specifications 2110.7003 Significant events. The contractor is required to inform the contracting officer of all significant events. ...

48 CFR 2110.7003 - Significant events.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Significant events. 2110..., AND OTHER PURCHASE DESCRIPTIONS Contract Specifications 2110.7003 Significant events. The contractor is required to inform the contracting officer of all significant events. ...

48 CFR 2110.7003 - Significant events.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Significant events. 2110..., AND OTHER PURCHASE DESCRIPTIONS Contract Specifications 2110.7003 Significant events. The contractor is required to inform the contracting officer of all significant events. ...

Earthquake prediction analysis based on empirical seismic rate: the M8 algorithm

NASA Astrophysics Data System (ADS)

Molchan, G.; Romashkova, L.

2010-12-01

The quality of space-time earthquake prediction is usually characterized by a 2-D error diagram (n, τ), where n is the fraction of failures-to-predict and τ is the local rate of alarm averaged in space. The most reasonable averaging measure for analysis of a prediction strategy is the normalized rate of target events λ(dg) in a subarea dg. In that case the quantity H = 1 - (n + τ) determines the prediction capability of the strategy. The uncertainty of λ(dg) causes difficulties in estimating H and the statistical significance, α, of prediction results. We investigate this problem theoretically and show how the uncertainty of the measure can be taken into account in two situations, viz., the estimation of α and the construction of a confidence zone for the (n, τ)-parameters of the random strategies. We use our approach to analyse the results from prediction of M >= 8.0 events by the M8 method for the period 1985-2009 (the M8.0+ test). The model of λ(dg) based on the events Mw >= 5.5, 1977-2004, and the magnitude range of target events 8.0 <= M < 8.5 are considered as basic to this M8 analysis. We find the point and upper estimates of α and show that they are still unstable because the number of target events in the experiment is small. However, our results argue in favour of non-triviality of the M8 prediction algorithm.

High-Resolution Genome-Wide Analysis of Irradiated (UV and γ-Rays) Diploid Yeast Cells Reveals a High Frequency of Genomic Loss of Heterozygosity (LOH) Events

PubMed Central

St. Charles, Jordan; Hazkani-Covo, Einat; Yin, Yi; Andersen, Sabrina L.; Dietrich, Fred S.; Greenwell, Patricia W.; Malc, Ewa; Mieczkowski, Piotr; Petes, Thomas D.

2012-01-01

In diploid eukaryotes, repair of double-stranded DNA breaks by homologous recombination often leads to loss of heterozygosity (LOH). Most previous studies of mitotic recombination in Saccharomyces cerevisiae have focused on a single chromosome or a single region of one chromosome at which LOH events can be selected. In this study, we used two techniques (single-nucleotide polymorphism microarrays and high-throughput DNA sequencing) to examine genome-wide LOH in a diploid yeast strain at a resolution averaging 1 kb. We examined both selected LOH events on chromosome V and unselected events throughout the genome in untreated cells and in cells treated with either γ-radiation or ultraviolet (UV) radiation. Our analysis shows the following: (1) spontaneous and damage-induced mitotic gene conversion tracts are more than three times larger than meiotic conversion tracts, and conversion tracts associated with crossovers are usually longer and more complex than those unassociated with crossovers; (2) most of the crossovers and conversions reflect the repair of two sister chromatids broken at the same position; and (3) both UV and γ-radiation efficiently induce LOH at doses of radiation that cause no significant loss of viability. Using high-throughput DNA sequencing, we also detected new mutations induced by γ-rays and UV. To our knowledge, our study represents the first high-resolution genome-wide analysis of DNA damage-induced LOH events performed in any eukaryote. PMID:22267500

Analysis of mechanical system of extreme rainfall events using backward tracking on information from the atmosphere circulation pattern for the 2000-2015 precipitation record in South Korea

NASA Astrophysics Data System (ADS)

So, B. J.; Kwon, H. H.

2016-12-01

A natural disaster for flood and drought have occurred in different parts of the world, and the disasters caused by significant extreme hydrological event in past years. Several studies examining stochastic analysis based nonstationary analysis reported for forecasting and outlook for extreme hydrological events, but there is the procedure to select predictor variables. In this study, we analyzed mechanical system of extreme rainfall events using backward tracking to determine the predictors of nonstationary considering the atmosphere circulation pattern. First, observed rainfall data of KMA (Korea Meteorological Administration) and ECMWF ERA-Interm data were constructed during the 2000-2015 period. Then, the 7day backward tracking were performed to establish the path of air mass using the LAGRANTO Tool considering the observed rainfall stations located in S. Korea as a starting point, The tracking information for rainfall event were clustered and then, we extracts the main influence factor based on the categorized tracking path considering to information of rainfall magnitude (e.g,, mega-sized, medium-sized). Finally, the nonstationary predictors are determined through a combination of factors affecting the nonstationary rainfall simulation techniques. The predictors based on a mechanical structure is expected to be able to respond to external factors such as climate change. In addition, this method can be used to determine the prediction factor in different geographical areas by different position.

Impact of Extended-Duration Shifts on Medical Errors, Adverse Events, and Attentional Failures

PubMed Central

Barger, Laura K; Ayas, Najib T; Cade, Brian E; Cronin, John W; Rosner, Bernard; Speizer, Frank E; Czeisler, Charles A

2006-01-01

Background A recent randomized controlled trial in critical-care units revealed that the elimination of extended-duration work shifts (≥24 h) reduces the rates of significant medical errors and polysomnographically recorded attentional failures. This raised the concern that the extended-duration shifts commonly worked by interns may contribute to the risk of medical errors being made, and perhaps to the risk of adverse events more generally. Our current study assessed whether extended-duration shifts worked by interns are associated with significant medical errors, adverse events, and attentional failures in a diverse population of interns across the United States. Methods and Findings We conducted a Web-based survey, across the United States, in which 2,737 residents in their first postgraduate year (interns) completed 17,003 monthly reports. The association between the number of extended-duration shifts worked in the month and the reporting of significant medical errors, preventable adverse events, and attentional failures was assessed using a case-crossover analysis in which each intern acted as his/her own control. Compared to months in which no extended-duration shifts were worked, during months in which between one and four extended-duration shifts and five or more extended-duration shifts were worked, the odds ratios of reporting at least one fatigue-related significant medical error were 3.5 (95% confidence interval [CI], 3.3–3.7) and 7.5 (95% CI, 7.2–7.8), respectively. The respective odds ratios for fatigue-related preventable adverse events, 8.7 (95% CI, 3.4–22) and 7.0 (95% CI, 4.3–11), were also increased. Interns working five or more extended-duration shifts per month reported more attentional failures during lectures, rounds, and clinical activities, including surgery and reported 300% more fatigue-related preventable adverse events resulting in a fatality. Conclusions In our survey, extended-duration work shifts were associated with an increased risk of significant medical errors, adverse events, and attentional failures in interns across the United States. These results have important public policy implications for postgraduate medical education. PMID:17194188

Painful and provocative events scale and fearlessness about death among Veterans: Exploratory factor analysis.

PubMed

Poindexter, Erin K; Nazem, Sarra; Forster, Jeri E

2017-01-15

The interpersonal theory of suicide suggests three proximal risk factors for suicide: perceived burdensomeness, thwarted belongingness, and acquired capability. Previous literature indicates that repetitive exposure to painful and provocative events is related to increased acquired capability for suicide. Despite this, research related to the assessment of painful and provocative events has been insufficient. Research has inconsistently administered the Painful and Provocative Events Scale (PPES; a painful and provocative events assessment), and no study has examined the factor structure of the English PPES. This study explored the factor structure of the PPES and the relation between factors and fearlessness about death. The sample was a cross-sectional, self-report study comprised of 119 Veterans (Mage = 46.5, SD = 13.5). Findings from an exploratory factor analysis indicated a four-factor solution for the PPES; however, no factor from the PPES significantly related to fearlessness about death (measured by the Acquired Capability for Suicide Scale - Fearlessness About Death Scale; all p >.21). Cross-sectional, small Veteran sample. Findings suggest that the PPES lacks the psychometric properties necessary to reliably investigate painful and provocative factors. Consequently, this measure may not reliably capture and explain how painful and provocative events relate to fearlessness about death, which is a barrier to improving suicide risk assessment and prediction. Recommendations for the construction of a new PPES are offered. Published by Elsevier B.V.

Efficacy and safety profile of xanthines in COPD: a network meta-analysis.

PubMed

Cazzola, Mario; Calzetta, Luigino; Barnes, Peter J; Criner, Gerard J; Martinez, Fernando J; Papi, Alberto; Gabriella Matera, Maria

2018-06-30

Theophylline can still have a role in the management of stable chronic obstructive pulmonary disease (COPD), but its use remains controversial, mainly due to its narrow therapeutic window. Doxofylline, another xanthine, is an effective bronchodilator and displays a better safety profile than theophylline. Therefore, we performed a quantitative synthesis to compare the efficacy and safety profile of different xanthines in COPD.The primary end-point of this meta-analysis was the impact of xanthines on lung function. In addition, we assessed the risk of adverse events by normalising data on safety as a function of person-weeks. Data obtained from 998 COPD patients were selected from 14 studies and meta-analysed using a network approach.The combined surface under the cumulative ranking curve (SUCRA) analysis of efficacy (change from baseline in forced expiratory volume in 1 s) and safety (risk of adverse events) showed that doxofylline was superior to aminophylline (comparable efficacy and significantly better safety), bamiphylline (significantly better efficacy and comparable safety), and theophylline (comparable efficacy and significantly better safety).Considering the overall efficacy/safety profile of the investigated agents, the results of this quantitative synthesis suggest that doxofylline seems to be the best xanthine for the treatment of COPD. Copyright ©ERS 2018.

Clinical Features and Risk Factors of Skeletal-Related Events in Genitourinary Cancer Patients with Bone Metastasis: A Retrospective Analysis of Prostate Cancer, Renal Cell Carcinoma, and Urothelial Carcinoma.

PubMed

Owari, Takuya; Miyake, Makito; Nakai, Yasushi; Morizawa, Yosuke; Itami, Yoshitaka; Hori, Shunta; Anai, Satoshi; Tanaka, Nobumichi; Fujimoto, Kiyohide

2018-06-06

The objective of the present study was to report the incidence of skeletal-related events (SREs) and identify risk factors for SREs in patients with genitourinary cancer with newly diagnosed bone metastasis. This retrospective study included 180 patients with bone metastasis from prostate cancer (PCa; n = 111), renal cell carcinoma (RCC; n = 43), and urothelial carcinoma (UC; n = 26). Clinical factors at the time of diagnosis of bone metastasis were evaluated with Cox proportional hazards regression analysis to identify independent risk factors for SREs. During follow-up, 29 (26%) patients with PCa, 30 (70%) with RCC, and 15 (58%) with UC developed SREs. Treatment with bone-modifying agents (BMAs) before the development of SREs and within 6 months from the diagnosis of bone metastasis significantly delayed the time to first SRE as compared to nonuse of BMAs. Multivariate analysis identified type of primary cancer (PCa vs. RCC, PCa vs. UC), performance status, and bone pain as significant independent predictive risk factors for SREs. Treatment with BMAs significantly delayed the development of first SREs. The identified predictors of SREs might be useful to select patients who would benefit most from early treatment with BMAs. © 2018 S. Karger AG, Basel.

Risk Analysis of Earth-Rock Dam Failures Based on Fuzzy Event Tree Method

PubMed Central

Fu, Xiao; Gu, Chong-Shi; Su, Huai-Zhi; Qin, Xiang-Nan

2018-01-01

Earth-rock dams make up a large proportion of the dams in China, and their failures can induce great risks. In this paper, the risks associated with earth-rock dam failure are analyzed from two aspects: the probability of a dam failure and the resulting life loss. An event tree analysis method based on fuzzy set theory is proposed to calculate the dam failure probability. The life loss associated with dam failure is summarized and refined to be suitable for Chinese dams from previous studies. The proposed method and model are applied to one reservoir dam in Jiangxi province. Both engineering and non-engineering measures are proposed to reduce the risk. The risk analysis of the dam failure has essential significance for reducing dam failure probability and improving dam risk management level. PMID:29710824

Genomic analysis of diffuse pediatric low-grade gliomas identifies recurrent oncogenic truncating rearrangements in the transcription factor MYBL1

PubMed Central

Ramkissoon, Lori A.; Horowitz, Peleg M.; Craig, Justin M.; Ramkissoon, Shakti H.; Rich, Benjamin E.; Schumacher, Steven E.; McKenna, Aaron; Lawrence, Michael S.; Bergthold, Guillaume; Brastianos, Priscilla K.; Tabak, Barbara; Ducar, Matthew D.; Van Hummelen, Paul; MacConaill, Laura E.; Pouissant-Young, Tina; Cho, Yoon-Jae; Taha, Hala; Mahmoud, Madeha; Bowers, Daniel C.; Margraf, Linda; Tabori, Uri; Hawkins, Cynthia; Packer, Roger J.; Hill, D. Ashley; Pomeroy, Scott L.; Eberhart, Charles G.; Dunn, Ian F.; Goumnerova, Liliana; Getz, Gad; Chan, Jennifer A.; Santagata, Sandro; Hahn, William C.; Stiles, Charles D.; Ligon, Azra H.; Kieran, Mark W.; Beroukhim, Rameen; Ligon, Keith L.

2013-01-01

Pediatric low-grade gliomas (PLGGs) are among the most common solid tumors in children but, apart from BRAF kinase mutations or duplications in specific subclasses, few genetic driver events are known. Diffuse PLGGs comprise a set of uncommon subtypes that exhibit invasive growth and are therefore especially challenging clinically. We performed high-resolution copy-number analysis on 44 formalin-fixed, paraffin-embedded diffuse PLGGs to identify recurrent alterations. Diffuse PLGGs exhibited fewer such alterations than adult low-grade gliomas, but we identified several significantly recurrent events. The most significant event, 8q13.1 gain, was observed in 28% of diffuse astrocytoma grade IIs and resulted in partial duplication of the transcription factor MYBL1 with truncation of its C-terminal negative-regulatory domain. A similar recurrent deletion-truncation breakpoint was identified in two angiocentric gliomas in the related gene v-myb avian myeloblastosis viral oncogene homolog (MYB) on 6q23.3. Whole-genome sequencing of a MYBL1-rearranged diffuse astrocytoma grade II demonstrated MYBL1 tandem duplication and few other events. Truncated MYBL1 transcripts identified in this tumor induced anchorage-independent growth in 3T3 cells and tumor formation in nude mice. Truncated transcripts were also expressed in two additional tumors with MYBL1 partial duplication. Our results define clinically relevant molecular subclasses of diffuse PLGGs and highlight a potential role for the MYB family in the biology of low-grade gliomas. PMID:23633565

Energetic Particles of keV–MeV Energies Observed near Reconnecting Current Sheets at 1 au

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

Khabarova, Olga V.; Zank, Gary P.

2017-07-01

We provide evidence for particle acceleration up to ∼5 MeV at reconnecting current sheets in the solar wind based on both case studies and a statistical analysis of the energetic ion and electron flux data from the five Advanced Composition Explorer Electron, Proton, and Alpha Monitor (EPAM) detectors. The case study of a typical reconnection exhaust event reveals (i) a small-scale peak of the energetic ion flux observed in the vicinity of the reconnection exhaust and (ii) a long-timescale atypical energetic particle event (AEPE) encompassing the reconnection exhaust. AEPEs associated with reconnecting strong current sheets last for many hours, evenmore » days, as confirmed by statistical studies. The case study shows that time-intensity profiles of the ion flux may vary significantly from one EPAM detector to another partially because of the local topology of magnetic fields, but mainly because of the impact of upstream magnetospheric events; therefore, the occurrence of particle acceleration can be hidden. The finding of significant particle energization within a time interval of ±30 hr around reconnection exhausts is supported by a superposed epoch analysis of 126 reconnection exhaust events. We suggest that energetic particles initially accelerated via prolonged magnetic reconnection are trapped and reaccelerated in small- or medium-scale magnetic islands surrounding the reconnecting current sheet, as predicted by the transport theory of Zank et al. Other mechanisms of initial particle acceleration can contribute also.« less

Metagenomic Analysis of Airborne Bacterial Community and Diversity in Seoul, Korea, during December 2014, Asian Dust Event.

PubMed

Cha, Seho; Srinivasan, Sathiyaraj; Jang, Jun Hyeong; Lee, Dongwook; Lim, Sora; Kim, Kyung Sang; Jheong, Weonhwa; Lee, Dong-Won; Park, Eung-Roh; Chung, Hyun-Mi; Choe, Joonho; Kim, Myung Kyum; Seo, Taegun

2017-01-01

Asian dust or yellow sand events in East Asia are a major issue of environmental contamination and human health, causing increasing concern. A high amount of dust particles, especially called as particulate matter 10 (PM10), is transported by the wind from the arid and semi-arid tracks to the Korean peninsula, bringing a bacterial population that alters the terrestrial and atmospheric microbial communities. In this study, we aimed to explore the bacterial populations of Asian dust samples collected during November-December 2014. The dust samples were collected using the impinger method, and the hypervariable regions of the 16S rRNA gene were amplified using PCR followed by pyrosequencing. Analysis of the sequencing data were performed using Mothur software. The data showed that the number of operational taxonomic units and diversity index during Asian dust events were higher than those during non-Asian dust events. At the phylum level, the proportions of Proteobacteria, Actinobacteria, and Firmicutes were different between Asian dust and non-Asian dust samples. At the genus level, the proportions of the genus Bacillus (6.9%), Arthrobacter (3.6%), Blastocatella (2%), Planomicrobium (1.4%) were increased during Asian dust compared to those in non-Asian dust samples. This study showed that the significant relationship between bacterial populations of Asian dust samples and non-Asian dust samples in Korea, which could significantly affect the microbial population in the environment.

Metagenomic Analysis of Airborne Bacterial Community and Diversity in Seoul, Korea, during December 2014, Asian Dust Event

PubMed Central

Cha, Seho; Srinivasan, Sathiyaraj; Jang, Jun Hyeong; Lee, Dongwook; Lim, Sora; Kim, Kyung Sang; Jheong, Weonhwa; Lee, Dong-Won; Park, Eung-Roh; Chung, Hyun-Mi; Choe, Joonho; Kim, Myung Kyum; Seo, Taegun

2017-01-01

Asian dust or yellow sand events in East Asia are a major issue of environmental contamination and human health, causing increasing concern. A high amount of dust particles, especially called as particulate matter 10 (PM10), is transported by the wind from the arid and semi-arid tracks to the Korean peninsula, bringing a bacterial population that alters the terrestrial and atmospheric microbial communities. In this study, we aimed to explore the bacterial populations of Asian dust samples collected during November–December 2014. The dust samples were collected using the impinger method, and the hypervariable regions of the 16S rRNA gene were amplified using PCR followed by pyrosequencing. Analysis of the sequencing data were performed using Mothur software. The data showed that the number of operational taxonomic units and diversity index during Asian dust events were higher than those during non-Asian dust events. At the phylum level, the proportions of Proteobacteria, Actinobacteria, and Firmicutes were different between Asian dust and non-Asian dust samples. At the genus level, the proportions of the genus Bacillus (6.9%), Arthrobacter (3.6%), Blastocatella (2%), Planomicrobium (1.4%) were increased during Asian dust compared to those in non-Asian dust samples. This study showed that the significant relationship between bacterial populations of Asian dust samples and non-Asian dust samples in Korea, which could significantly affect the microbial population in the environment. PMID:28122054

Real-world clopidogrel utilization in acute coronary syndromes: patients selection and outcomes in a single-center experience.

PubMed

Castini, Diego; Persampieri, Simone; Cazzaniga, Sara; Ferrante, Giulia; Centola, Marco; Lucreziotti, Stefano; Salerno-Uriarte, Diego; Sponzilli, Carlo; Carugo, Stefano

2017-12-01

With this study, we sought to identify patient characteristics associated with clopidogrel prescription and its relationship with in-hospital adverse events in an unselected cohort of ACSs patients. We studied all consecutive patients admitted at our institution for ACSs from 2012 to 2014. Patients were divided into two groups based on clopidogrel or novel P2Y12 inhibitors (prasugrel or ticagrelor) prescription and the relationship between clopidogrel use and patient clinical characteristics and in-hospital adverse events was evaluated using logistic regression analysis. The population median age was 68 years (57-77 year) and clopidogrel was prescribed in 230 patients (46%). Patients characteristics associated with clopidogrel prescription were older age, female sex, non-ST-elevation ACS diagnosis, the presence of diabetes mellitus and anemia, worse renal and left ventricular functions and a higher Killip class. Patients on clopidogrel demonstrated a significantly higher incidence of in-hospital mortality (4.8%) than prasugrel and ticagrelor-treated patients (0.4%), while a nonstatistically significant trend emerged considering bleeding events. However, on multivariable logistic regression analysis female sex, the presence of anemia and Killip class were the only variables independently associated with in-hospital death. Patients treated with clopidogrel showed a higher in-hospital mortality. However, clinical variables associated with its use identify a population at high risk for adverse events and this seems to play a major role for the higher in-hospital mortality observed in clopidogrel-treated patients.

Severe weather detection by using Japanese Total Lightning Network

NASA Astrophysics Data System (ADS)

Hobara, Yasuhide; Ishii, Hayato; Kumagai, Yuri; Liu, Charlie; Heckman, Stan; Price, Colin

2015-04-01

In this paper we demonstrate the preliminary results from the first Japanese Total Lightning Network. The University of Electro-Communications (UEC) recently deployed Earth Networks Total Lightning System over Japan to conduct various lightning research projects. Here we analyzed the total lightning data in relation with 10 severe events such as gust fronts and tornadoes occurred in 2014 in mainland Japan. For the analysis of these events, lightning jump algorithm was used to identify the increase of the flash rate in prior to the severe weather events. We found that lightning jumps associated with significant increasing lightning activities for total lightning and IC clearly indicate the severe weather occurrence than those for CGs.

Low Probability Tail Event Analysis and Mitigation in BPA Control Area: Task One Report

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

Lu, Shuai; Makarov, Yuri V.

This is a report for task one of the tail event analysis project for BPA. Tail event refers to the situation in a power system when unfavorable forecast errors of load and wind are superposed onto fast load and wind ramps, or non-wind generators falling short of scheduled output, the imbalance between generation and load becomes very significant. This type of events occurs infrequently and appears on the tails of the distribution of system power imbalance; therefore, is referred to as tail events. This report analyzes what happened during the Electric Reliability Council of Texas (ERCOT) reliability event on Februarymore » 26, 2008, which was widely reported because of the involvement of wind generation. The objective is to identify sources of the problem, solutions to it and potential improvements that can be made to the system. Lessons learned from the analysis include the following: (1) Large mismatch between generation and load can be caused by load forecast error, wind forecast error and generation scheduling control error on traditional generators, or a combination of all of the above; (2) The capability of system balancing resources should be evaluated both in capacity (MW) and in ramp rate (MW/min), and be procured accordingly to meet both requirements. The resources need to be able to cover a range corresponding to the variability of load and wind in the system, additional to other uncertainties; (3) Unexpected ramps caused by load and wind can both become the cause leading to serious issues; (4) A look-ahead tool evaluating system balancing requirement during real-time operations and comparing that with available system resources should be very helpful to system operators in predicting the forthcoming of similar events and planning ahead; and (5) Demand response (only load reduction in ERCOT event) can effectively reduce load-generation mismatch and terminate frequency deviation in an emergency situation.« less

Incidence of paediatric fatal and non-fatal low speed vehicle run over events in Queensland, Australia: eleven year analysis

PubMed Central

2014-01-01

Background The purpose of this study was to estimate the incidence of fatal and non-fatal Low Speed Vehicle Run Over (LSVRO) events among children aged 0–15 years in Queensland, Australia, at a population level. Methods Fatal and non-fatal LSVRO events that occurred in children resident in Queensland over eleven calendar years (1999-2009) were identified using ICD codes, text description, word searches and medical notes clarification, obtained from five health related data bases across the continuum of care (pre-hospital to fatality). Data were manually linked. Population data provided by the Australian Bureau of Statistics were used to calculate crude incidence rates for fatal and non-fatal LSVRO events. Results There were 1611 LSVROs between 1999–2009 (IR = 16.87/100,000/annum). Incidence of non-fatal events (IR = 16.60/100,000/annum) was 61.5 times higher than fatal events (IR = 0.27/100,000/annum). LSVRO events were more common in boys (IR = 20.97/100,000/annum) than girls (IR = 12.55/100,000/annum), and among younger children aged 0–4 years (IR = 21.45/100000/annum; 39% or all events) than older children (5–9 years: IR = 16.47/100,000/annum; 10–15 years IR = 13.59/100,000/annum). A total of 896 (56.8%) children were admitted to hospital for 24 hours of more following an LSVRO event (IR = 9.38/100,000/annum). Total LSVROs increased from 1999 (IR = 14.79/100,000) to 2009 (IR = 18.56/100,000), but not significantly. Over the 11 year period, there was a slight (non –significant) increase in fatalities (IR = 0.37-0.42/100,000/annum); a significant decrease in admissions (IR = 12.39–5.36/100,000/annum), and significant increase in non-admissions (IR = 2.02-12.77/100,000/annum). Trends over time differed by age, gender and severity. Conclusion This is the most comprehensive, population-based epidemiological study on fatal and non-fatal LSVRO events to date. Results from this study indicate that LSVROs incur a substantial burden. Further research is required on the characteristics and risk factors associated with these events, in order to adequately inform injury prevention. Strategies are urgently required in order to prevent these events, especially among young children aged 0–4 years. PMID:24618226

The four faces of rumination to stressful events: A psychometric analysis.

PubMed

García, Felipe E; Duque, Almudena; Cova, Félix

2017-11-01

To increase the knowledge of rumination and its associations with stressful events, we explored the relationships between 4 types of rumination (brooding, reflection, intrusive, and deliberate rumination) in a sample of 750 adult participants who experienced a highly stressful event. We also explored the predictive value of the different types of rumination on posttraumatic stress symptoms and posttraumatic growth 6 months after the highly stressful event occurred. Participants completed the Ruminative Response Scale and the Event-Related Rumination Inventory. Brooding and reflection rumination were obtained from the Ruminative Response Scale, whereas deliberate and intrusive rumination were obtained from the Event-Related Rumination Inventory. Confirmatory factorial analyses were conducted using the 4 types of rumination to test 3 different models: (a) 4-factor model (brooding, reflection, intrusive, and deliberate rumination), (b) 2-factor model: adaptive rumination (reflection and deliberate) and maladaptive rumination (brooding and intrusive), and (c) 2-factor model: depressive rumination (brooding and reflection) and posttraumatic rumination (intrusive and deliberate). It was observed that the 4-factor model showed the best fit to the data. Moreover, 6 months later it was observed that the most significant predictor of posttraumatic symptoms was intrusive rumination, whereas deliberate rumination was the most significant predictor of posttraumatic growth. Results indicate that the 4 types of rumination are differentiated constructs. Ruminative thoughts experienced after a stressful event predicted posttraumatic consequences 6 months later. Implications of these findings are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Stressful Life Events, Sexual Orientation, and Cardiometabolic Risk Among Young Adults in the United States

PubMed Central

Hatzenbuehler, Mark L.; Slopen, Natalie; McLaughlin, Kate A.

2015-01-01

Objective The goal of the present study was to examine whether sexual minority young adults are more vulnerable to developing cardiometabolic risk following exposure to stressful life events than heterosexual young adults. Method Data came from the National Longitudinal Study for Adolescent Health (Shin, Edwards, & Heeren, 2009; Brummett et al., 2013), a prospective nationally representative study of U.S. adolescents followed into young adulthood. A total of 306 lesbian, gay, and bisexual (LGB) respondents and 6,667 heterosexual respondents met inclusion criteria for this analysis. Measures of cumulative stressful life events were drawn from all 4 waves of data collection; sexual orientation and cardiometabolic biomarkers were assessed at Wave 4 (2008–2009). Results Gay/bisexual men exposed to 1–2 (β = 0.71, p = .01) and 5 + (β = 0.87, p = .01) stressful life events had a statistically significant elevation in cardiometabolic risk, controlling for demographics, health behaviors, and socioeconomic status. Moreover, in models adjusted for all covariates, lesbian/bisexual (β = 0.52, p = .046) women with 5 + stressful life events had a statistically significant elevation in cardiometabolic risk. There was no relationship between stressful life events and cardiometabolic risk among heterosexual men or women. Conclusion Stressful life events during childhood, adolescence, and young adulthood place LGB young adults at heightened risk for elevated cardiometabolic risk as early as young adulthood. The mechanisms underlying this relationship require future study. PMID:25133830

Temporal relationship between the 2000 Miyake-Kozu seismovolcanic activity and the 2000 Tokai slow-slip event

NASA Astrophysics Data System (ADS)

Kawamura, Masashi; Yamaoka, Koshun

2009-02-01

We investigated the temporal relationship between the two events, namely, the seismovolcanic activity near the Miyakejima and Kozushima islands and the slow-slip event along the plate boundary in the Tokai district. The islands are located on the east of Tokai, and the Tokai slow-slip event was discovered immediately after the large crustal deformation caused by the volcanic activity in the Miyakejima-Kozushima regions ceased. However, the order of occurrence of these events is still controversial and its recognition will help us to understand the tectonic processes of the central part of Japan, where many volcanic and seismic activities occur. For this purpose, we applied the statistical approach (Kawamura, M., Yamaoka, K., 2006. Spatiotemporal characteristics of the displacement field revealed with principal component analysis and the mode-rotation technique, Tectonophys., 419, 55-73), which consists of principal component analysis (PCA) and a mode rotation procedure, to the displacement field provided by the nationwide GPS network (GEONET) in order to obtain the characteristic structures of spatiotemporal crustal deformation caused by the above two events. We divided the time period of analysis into two sections (namely, June 26, 1999 to June 25, 2000 and June 26, 2000 to June 25, 2002) by the day when the magma intrusion occurred beneath the Miyakejima volcano on June 26, 2000. The spatial and temporal modes for the first time period did not indicate any significant spatiotemporal patterns corresponding to the two events. This indicates the absence of episodic crustal deformations during this time period. On the contrary, the modes for the latter time period included the changes caused by these events. The two major modes included the spatiotemporal structures of the first and latter half periods of the Miyake-Kozu seismovolcanic activity. The characteristic pattern of the crustal deformation corresponding to the Tokai slow-slip event was found in the fourth mode, which was prominent after the beginning of the Miyake-Kozu seismovolcanic activity. From these results, we conclude that the crustal deformation caused by the Tokai slow-slip event did not start before the Miyake-Kozu seismovolcanic activity.

Mediation effect of beliefs about pleasure and emotional experience between social anhedonia and prediction of pleasant events.

PubMed

Hu, Hui-Xin; Chu, Min-Yi; Yang, Yin; Wang, Ling-Ling; Zhang, Rui-Ting; Lui, Simon S Y; Cheung, Eric F C; Chan, Raymond C K

2018-06-01

Few studies have examined whether there is a relationship between social anhedonia and prediction of future events and the role of beliefs about pleasure and emotional experience. In this study, 513 college students were recruited to complete a set of self-reported questionnaires, including the Revised Social Anhedonia Scale (CSAS), the Temporal Experience of Pleasure Scale (TEPS), the Belief about Pleasure Scale (BAPS) and the Beck Depression Inventory. Moreover, a checklist of 100 daily life events was also administrated to all participants. Mediation analysis found that social anhedonia had a direct impact on prediction of pleasant events. Emotional experience partly mediated the relationship between social anhedonia and subjective prediction of pleasant events. However, beliefs about pleasure had no significant mediation effect between social anhedonia and prediction of pleasant events, but were shown to influence the subjective prediction of pleasant events completely through emotional experience. These findings suggest that beliefs about pleasure and emotional experience may be considered promising factors for interventions in individuals with anhedonia. Copyright © 2018. Published by Elsevier B.V.

Thromboprophylaxis With Apixaban in Patients Undergoing Major Orthopedic Surgery: Meta-Analysis and Trial-Sequential Analysis.

PubMed

Caldeira, Daniel; Rodrigues, Filipe B; Pinto, Fausto J; Ferreira, Joaquim J; Costa, João

2017-01-01

Venous thromboembolism (VTE) is a potentially fatal complication of orthopedic surgery, and until recently, few antithrombotic compounds were available for postoperative thromboprophylaxis. The introduction of the non-vitamin K antagonists oral anticoagulants (NOAC), including apixaban, has extended the therapeutic armamentarium in this field. Therefore, estimation of NOAC net clinical benefit in comparison with the established treatment is needed to inform clinical decision making. Systematic review to assess the efficacy and safety of apixaban 2.5 mg twice a day versus low-molecular-weight heparins (LMWH) for thromboprophylaxis in patients undergoing knee or hip replacement. MEDLINE, Embase, and CENTRAL were searched from inception to September 2016, other systematic reviews, reference lists, and experts were consulted. All major orthopedic surgery randomized controlled trials comparing apixaban 2.5 mg twice daily with LMWH, reporting thrombotic and bleeding events. Two independent reviewers, using a predetermined form. The Cochrane tool to assess risk bias was used by two independent authors. RevMan software was used to estimate pooled risk ratio (RR) and 95% confidence intervals (95% CI) using random-effects meta-analysis. Trial sequential analysis (TSA) was performed in statistical significant results to evaluate whether cumulative sample size was powered for the obtained effect. Overall confidence in cumulative evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group methodology. Four studies comparing apixaban 2.5 mg twice daily with LMWH were included, with a total of 11.828 patients (55% undergoing knee and 45% hip replacement). The overall risk of bias across studies was low. In comparison with LMWH (all regimens), apixaban showed a significantly lower risk of VTE events and overall mortality combined (RR: 0.63, 95% CI: 0.42-0.95, I 2 = 84%, n = 8346), but not of major VTE events (RR: 0.62, 95% CI: 0.32-1.19, I 2 = 63%, n = 9493), or of symptomatic VTE events and VTE-related mortality combined (RR: 1.14, 95% CI: 0.68-1.90, I 2 = 0%, n = 11 879). Trial sequential analysis showed that the risk reduction obtained for VTE and mortality was based on underpowered cumulative sample size and effect dimension. Subgroup analysis according to LMWH regimens showed that apixaban reduced the risk of VTE events and overall mortality, and major VTE events, when compared with LMWH once daily, without differences between apixaban and LMWH twice daily. There is low to moderate evidence that in patients undergoing knee or hip replacement, apixaban seems equally effective and safe to LMWH twice a day. When compared with LMWH once a day, apixaban seems a superior thromboprophylaxis option. However, the results are underpowered which precludes definite answers regarding the true net clinical benefit of apixaban versus LMWH in this clinical context.

Acoustic emission from trabecular bone during mechanical testing: the effect of osteoporosis and osteoarthritis.

PubMed

Leichter, I; Bivas, A; Margulies, J Y; Roman, I; Simkin, A

1990-01-01

This study examines the relation between the nature of acoustic emission signals emitted from cancellous bone under compression and the mechanical properties of the tissue. The examined bone specimens were taken from 12 normal, 31 osteoporotic and six osteoarthritic femoral heads. The mechanical behaviour of the osteoporotic bone specimens was found to be significantly different from that of the normal specimens both in the pre-yield and post-yield ranges. In the osteoarthritic bones only the elastic behaviour was significantly different. The rates of acoustic events before yield and beyond it were found to be significantly higher both in the osteoporotic and osteoarthritic bone specimens. The average peak amplitude of the signals was also significantly higher in the diseased bones. Stepwise regression analysis showed that a combination of the acoustic emission parameters could significantly predict some mechanical properties of the bone. The energy absorbed during compression and the ultimate compressive stress of the specimens could be estimated from the rate of pre-yield acoustic events, the average amplitude of the signals and the rate of post-yield events. However, the explanation power of the acoustic emission parameters was only moderate. The nature of acoustic emission signals was thus demonstrated to be a potential tool for assessing bone quality.

Strong gravitational lensing of gravitational waves from double compact binaries—perspectives for the Einstein Telescope

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

Biesiada, Marek; Ding, Xuheng; Zhu, Zong-Hong

Gravitational wave (GW) experiments are entering their advanced stage which should soon open a new observational window on the Universe. Looking into this future, the Einstein Telescope (ET) was designed to have a fantastic sensitivity improving significantly over the advanced GW detectors. One of the most important astrophysical GW sources supposed to be detected by the ET in large numbers are double compact objects (DCO) and some of such events should be gravitationally lensed by intervening galaxies. We explore the prospects of observing gravitationally lensed inspiral DCO events in the ET. This analysis is a significant extension of our previousmore » paper [1]. We are using the intrinsic merger rates of the whole class of DCO (NS-NS,BH-NS,BH-BH) located at different redshifts as calculated by [2] by using StarTrack population synthesis evolutionary code. We discuss in details predictions from each evolutionary scenario. Our general conclusion is that ET would register about 50–100 strongly lensed inspiral events per year. Only the scenario in which nascent BHs receive strong kick gives the predictions of a few events per year. Such lensed events would be dominated by the BH-BH merging binary systems. Our results suggest that during a few years of successful operation ET will provide a considerable catalog of strongly lensed events.« less

Observational Evidence for the Effect of Amplification Bias in Gravitational Microlensing Experiments

NASA Astrophysics Data System (ADS)

Han, Cheongho; Jeong, Youngjin; Kim, Ho-Il

1998-11-01

Recently Alard, Mao, & Guibert and Alard proposed to detect the shift of a star's image centroid, δx, as a method to identify the lensed source among blended stars. Goldberg & Woźniak actually applied this method to the OGLE-1 database and found that seven of 15 events showed significant centroid shifts of δx >~ 0.2". The amount of centroid shift has been estimated theoretically by Goldberg; however, he treated the problem in general and did not apply it to a particular survey or field and therefore based his estimate on simple toy model luminosity functions (i.e., power laws). In this paper, we construct the expected distribution of δx for Galactic bulge events based on the precise stellar luminosity function observed by Holtzman et al. using the Hubble Space Telescope. Their luminosity function is complete up to MI ~ 9.0 (MV ~ 12), which corresponds to faint M-type stars. In our analysis we find that regular blending cannot produce a large fraction of events with measurable centroid shifts. By contrast, a significant fraction of events would have measurable centroid shifts if they are affected by amplification-bias blending. Therefore, the measurements of large centroid shifts for an important fraction of microlensing events of Goldberg & Woźniak confirm the prediction of Han & Alard that a large fraction of Galactic bulge events are affected by amplification-bias blending.

Insomnia medication use and the probability of an accidental event in an older adult population

PubMed Central

Avidan, Alon Y; Palmer, Liisa A; Doan, Justin F; Baran, Robert W

2010-01-01

Objective: This study examined the risk of accidental events in older adults prescribed a sedating antidepressant, long-acting benzodiazepine, short-acting benzodiazepine, and nonbenzodiazepine, relative to a reference group (selective melatonin receptor agonist). Methods: This was a retrospective cohort analysis of older adults (≥65 years) with newly initiated pharmacological treatment of insomnia. Data were collected from the Thomson MarketScan® Medicare Supplemental and Coordination of Benefits databases (January 1, 2000, through June 30, 2006). Probit models were used to evaluate the probability of an accidental event. Results: Data were analyzed for 445,329 patients. Patients taking a long-acting benzodiazepine (1.21 odds ratio [OR]), short-acting benzodiazepine (1.16 OR), or nonbenzodiazepine (1.12 OR) had a significantly higher probability of experiencing an accidental event during the first month following treatment initiation compared with patients taking the reference medication (P < 0.05 for all). A significantly higher probability of experiencing an accidental event was also observed during the 3-month period following the initiation of treatment (1.62 long-acting benzodiazepine, 1.60 short-acting benzodiazepine, 1.48 nonbenzodiazepine, and 1.56 sedating antidepressant; P < 0.05). Conclusions: Older adults taking an SAD or any of the benzodiazepine receptor agonists appear to have a greater risk of an accidental event compared with a reference group taking an MR. PMID:21701634

Real-World Use of Apixaban for Stroke Prevention in Atrial Fibrillation: A Systematic Review and Meta-Analysis.

PubMed

Proietti, Marco; Romanazzi, Imma; Romiti, Giulio Francesco; Farcomeni, Alessio; Lip, Gregory Y H

2018-01-01

The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published. Our aim was to summarize current evidence about real-world studies on apixaban for stroke prevention in atrial fibrillation. We performed a systematic review and meta-analysis of all observational real-world studies comparing apixaban with other available oral anticoagulant drugs. From the original 9680 results retrieved, 16 studies have been included in the final meta-analysis. Compared with warfarin, apixaban regular dose was more effective in reducing any thromboembolic event (odds ratio: 0.77; 95% confidence interval: 0.64-0.93), but no significant difference was found for stroke risk. Apixaban was as effective as dabigatran and rivaroxaban in reducing thromboembolic events and stroke. The risk of major bleeding was significantly lower for apixaban compared with warfarin, dabigatran, and rivaroxaban (relative risk reduction, 38%, 35%, and 46%, respectively). Similarly, the risk for intracranial hemorrhage was significantly lower for apixaban than warfarin and rivaroxaban (46% and 54%, respectively) but not dabigatran. The risk of gastrointestinal bleeding was lower with apixaban when compared with all oral anticoagulant agents ( P <0.00001 for all comparisons). Use of apixaban in real-life is associated with an overall similar effectiveness in reducing stroke and any thromboembolic events when compared with warfarin. A better safety profile was found with apixaban compared with warfarin, dabigatran, and rivaroxaban. © 2017 American Heart Association, Inc.

Admixture Mapping of Subclinical Atherosclerosis and Subsequent Clinical Events Among African Americans in Two Large Cohort Studies

PubMed Central

Shendre, Aditi; Wiener, Howard; Irvin, Marguerite R.; Zhi, Degui; Limdi, Nita A.; Overton, Edgar T.; Wassel, Christina L.; Divers, Jasmin; Rotter, Jerome I.; Post, Wendy S.; Shrestha, Sadeep

2017-01-01

Background Local ancestry may contribute to the disproportionate burden of subclinical and clinical cardiovascular disease (CVD) among admixed African Americans (AAs) compared to other populations, suggesting a rationale for admixture mapping. Methods and Results We estimated local European ancestry (LEA) using Local Ancestry Inference in adMixed Populations using Linkage Disequilibrium (LAMP-LD) and evaluated the association with common carotid artery intima-media thickness (cCIMT) using multivariable linear regression analysis among 1,554 AAs from the Multi-Ethnic Study of Atherosclerosis (MESA). We conducted secondary analysis to examine the significant cCIMT-LEA associations with clinical CVD events. We observed genome-wide significance in relation to cCIMT association with the secretion regulating guanine nucleotide exchange factor (SERGEF) gene (β=0.0137, P=2.98×10−4), also associated with higher odds of stroke (odds ratio (OR)=1.71, P=0.02). Several regions, in particular Ca2+-dependent secretion activator 1 (CADPS) gene region identified in MESA were also replicated in the Atherosclerosis Risk in Communities (ARIC) cohort. We observed other cCIMT-LEA regions associated with other clinical events, most notably the regions harboring creatine kinase, mitochondrial 2 (CKMT2) and Ras protein specific guanine nucleotide releasing factor 2 (RASGRF2) genes with all clinical events except stroke, the leucine rich repeat containing 3B (LRRC3B) gene with myocardial infarction, the protein arginine methyltransferase 3 (PRMT3) gene with stroke, and the lipoma high mobility group protein I-C (HMGIC) fusion partner-like 2 (LHFPL2) gene with hard and all coronary heart disease. Conclusions We identified several novel LEA regions, in addition to previously identified genomic regions, associated with cCIMT and CVD events among African Americans. PMID:28408707

Forecasting volcanic unrest using seismicity: The good, the bad and the time consuming

NASA Astrophysics Data System (ADS)

Salvage, Rebecca; Neuberg, Jurgen W.

2013-04-01

Volcanic eruptions are inherently unpredictable in nature, with scientists struggling to forecast the type and timing of events, in particular in real time scenarios. Current understanding suggests that the use of statistical patterns within precursory datasets of seismicity prior to eruptive events could hold the potential to be used as real time forecasting tools. They allow us to determine times of clear deviation in data, which might be indicative of volcanic unrest. The identification of low frequency seismic swarms and the acceleration of this seismicity prior to observed volcanic unrest may be key in developing forecasting tools. The development of these real time forecasting models which can be implemented at volcano observatories is of particular importance since the identification of early warning signals allows danger to the proximal population to be minimized. We concentrate on understanding the significance and development of these seismic swarms as unrest develops at the volcano. In particular, analysis of accelerations in event rate, amplitude and energy rates released by seismicity prior to eruption suggests that these are important indicators of developing unrest. Real time analysis of these parameters simultaneously allows possible improvements to forecasting models. Although more time and computationally intense, cross correlation techniques applied to continuous seismicity prior to volcanic unrest scenarios allows all significant seismic events to be analysed, rather than only those which can be detected by an automated identification system. This may allow a more accurate forecast since all precursory seismicity can be taken into account. In addition, the classification of seismic events based on spectral characteristics may allow us to isolate individual types of signals which are responsible for certain types of unrest. In this way, we may be able to better forecast the type of eruption that may ensue, or at least some of its prevailing characteristics.

Review of complex networks application in hydroclimatic extremes with an implementation to characterize spatio-temporal drought propagation in continental USA

NASA Astrophysics Data System (ADS)

Konapala, Goutam; Mishra, Ashok

2017-12-01

The quantification of spatio-temporal hydroclimatic extreme events is a key variable in water resources planning, disaster mitigation, and preparing climate resilient society. However, quantification of these extreme events has always been a great challenge, which is further compounded by climate variability and change. Recently complex network theory was applied in earth science community to investigate spatial connections among hydrologic fluxes (e.g., rainfall and streamflow) in water cycle. However, there are limited applications of complex network theory for investigating hydroclimatic extreme events. This article attempts to provide an overview of complex networks and extreme events, event synchronization method, construction of networks, their statistical significance and the associated network evaluation metrics. For illustration purpose, we apply the complex network approach to study the spatio-temporal evolution of droughts in Continental USA (CONUS). A different drought threshold leads to a new drought event as well as different socio-economic implications. Therefore, it would be interesting to explore the role of thresholds on spatio-temporal evolution of drought through network analysis. In this study, long term (1900-2016) Palmer drought severity index (PDSI) was selected for spatio-temporal drought analysis using three network-based metrics (i.e., strength, direction and distance). The results indicate that the drought events propagate differently at different thresholds associated with initiation of drought events. The direction metrics indicated that onset of mild drought events usually propagate in a more spatially clustered and uniform approach compared to onsets of moderate droughts. The distance metric shows that the drought events propagate for longer distance in western part compared to eastern part of CONUS. We believe that the network-aided metrics utilized in this study can be an important tool in advancing our knowledge on drought propagation as well as other hydroclimatic extreme events. Although the propagation of droughts is investigated using the network approach, however process (physics) based approaches is essential to further understand the dynamics of hydroclimatic extreme events.

Significant events in psychotherapy: An update of research findings.

PubMed

Timulak, Ladislav

2010-11-01

Significant events research represents a specific approach to studying client-identified important moments in the therapy process. The current study provides an overview of the significant events research conducted, the methodology used together with findings and implications. PsychInfo database was searched with keywords such as significant events, important events, significant moments, important moments, and counselling or psychotherapy. The references of the selected studies were also searched. This process led to the identification of 41 primary studies that used client-identified significant event(s) as a main or secondary focus of the study. These were consequently reviewed with regard to their methodology and findings. The findings are presented according to type of study conducted. The impacts of helpful events reported by clients are focused on contributions to therapeutic relationship and to in-session outcomes. Hindering events focus on some client disappointment with the therapist or therapy. The group therapy modality highlighted additional helpful impacts (like learning from others). Perspectives on what is significant in therapy differ between clients and therapists. The intensive qualitative studies reviewed confirm that the processes involved in significant events are complex and ambiguous. Studies show that the helpful events may also contain many hindering elements and that specific events are deeply contextually embedded in the preceding events of therapy. Some studies suggest that helpful significant events are therapeutically productive although this may need to be established further. Specific intensive studies show that the clients' perceptions in therapy may differ dramatically from that of the therapist. Furthermore, the relational and emotional aspects of significant moments may be more important for the clients than the cognitive aspects of therapy which are frequently stressed by therapists. 2010 The British Psychological Society.

Frequency analysis of urban runoff quality in an urbanizing catchment of Shenzhen, China

NASA Astrophysics Data System (ADS)

Qin, Huapeng; Tan, Xiaolong; Fu, Guangtao; Zhang, Yingying; Huang, Yuefei

2013-07-01

This paper investigates the frequency distribution of urban runoff quality indicators using a long-term continuous simulation approach and evaluates the impacts of proposed runoff control schemes on runoff quality in an urbanizing catchment in Shenzhen, China. Four different indicators are considered to provide a comprehensive assessment of the potential impacts: total runoff depth, event pollutant load, Event Mean Concentration, and peak concentration during a rainfall event. The results obtained indicate that urban runoff quantity and quality in the catchment have significant variations in rainfall events and a very high rate of non-compliance with surface water quality regulations. Three runoff control schemes with the capacity to intercept an initial runoff depth of 5 mm, 10 mm, and 15 mm are evaluated, respectively, and diminishing marginal benefits are found with increasing interception levels in terms of water quality improvement. The effects of seasonal variation in rainfall events are investigated to provide a better understanding of the performance of the runoff control schemes. The pre-flood season has higher risk of poor water quality than other seasons after runoff control. This study demonstrates that frequency analysis of urban runoff quantity and quality provides a probabilistic evaluation of pollution control measures, and thus helps frame a risk-based decision making for urban runoff quality management in an urbanizing catchment.

Modeling eye gaze patterns in clinician-patient interaction with lag sequential analysis.

PubMed

Montague, Enid; Xu, Jie; Chen, Ping-Yu; Asan, Onur; Barrett, Bruce P; Chewning, Betty

2011-10-01

The aim of this study was to examine whether lag sequential analysis could be used to describe eye gaze orientation between clinicians and patients in the medical encounter. This topic is particularly important as new technologies are implemented into multiuser health care settings in which trust is critical and nonverbal cues are integral to achieving trust. This analysis method could lead to design guidelines for technologies and more effective assessments of interventions. Nonverbal communication patterns are important aspects of clinician-patient interactions and may affect patient outcomes. The eye gaze behaviors of clinicians and patients in 110 videotaped medical encounters were analyzed using the lag sequential method to identify significant behavior sequences. Lag sequential analysis included both event-based lag and time-based lag. Results from event-based lag analysis showed that the patient's gaze followed that of the clinician, whereas the clinician's gaze did not follow the patient's. Time-based sequential analysis showed that responses from the patient usually occurred within 2 s after the initial behavior of the clinician. Our data suggest that the clinician's gaze significantly affects the medical encounter but that the converse is not true. Findings from this research have implications for the design of clinical work systems and modeling interactions. Similar research methods could be used to identify different behavior patterns in clinical settings (physical layout, technology, etc.) to facilitate and evaluate clinical work system designs.

Modeling Eye Gaze Patterns in Clinician-Patient Interaction with Lag Sequential Analysis

PubMed Central

Montague, E; Xu, J; Asan, O; Chen, P; Chewning, B; Barrett, B

2011-01-01

Objective The aim of this study was to examine whether lag-sequential analysis could be used to describe eye gaze orientation between clinicians and patients in the medical encounter. This topic is particularly important as new technologies are implemented into multi-user health care settings where trust is critical and nonverbal cues are integral to achieving trust. This analysis method could lead to design guidelines for technologies and more effective assessments of interventions. Background Nonverbal communication patterns are important aspects of clinician-patient interactions and may impact patient outcomes. Method Eye gaze behaviors of clinicians and patients in 110-videotaped medical encounters were analyzed using the lag-sequential method to identify significant behavior sequences. Lag-sequential analysis included both event-based lag and time-based lag. Results Results from event-based lag analysis showed that the patients’ gaze followed that of clinicians, while clinicians did not follow patients. Time-based sequential analysis showed that responses from the patient usually occurred within two seconds after the initial behavior of the clinician. Conclusion Our data suggest that the clinician’s gaze significantly affects the medical encounter but not the converse. Application Findings from this research have implications for the design of clinical work systems and modeling interactions. Similar research methods could be used to identify different behavior patterns in clinical settings (physical layout, technology, etc.) to facilitate and evaluate clinical work system designs. PMID:22046723

Past climate variability inferred from statistical processing of documentary data: a case study on extreme meteorological events in western central France from 1500 to 2000 AD

NASA Astrophysics Data System (ADS)

Poirier, Clément; Chaumillon, Eric; Audé, Jean-Luc

2010-05-01

Recent human-induced climate changes are expected to have an impact on extreme events including shifts in storm tracks, heavier precipitations and more severe droughts (Planton, 2008). Although climate models successfully describe the past mean climate variability, they often fail to correctly reproduce such extreme events, mainly because of a low spatial and temporal resolution (Sánchez et al., 2004). Reports of extreme meteorological events gathered from documentary archives are be useful to fill this gap, and would also provide insights into local climatic variations (Leijonhufvud et al., 2008; Rodrigo, 2008; Wheeler, 2006). In this study, a local text book published by Audé (2006) was used as a source of climatic data. It consists of a list of extreme meteorological events recorded in historical archives (diaries mainly) in western central France, along the Bay of Biscay. From the book, 284 extreme meteorological events that occurred between 1500 and 2000 were selected. A presence-absence matrix was built, the events being classified in 7 distinct categories by Audé. A preliminary multivariate analysis (Principal Component Analysis) was used to group these categories into 4 classes of events. First axis (22.3% of explained variance) discriminated the events related to temperature, with frosts and snowfalls on one side, versus gales and storms on the other side. Second axis (18.5% of explained variance) discriminated the events related to precipitation, with floods and rainfalls on one side (humid), versus droughts on the other (dry). For each class, a 29-year running mean was computed to convert binary qualitative data to semi-quantitative curves. A spectral analysis was also performed on the same binary data to detect potential climatic cycles. Despite the randomness of the historical records reported in this book, that much relies on the subjective perception of meteorological events by past witnesses, the results obtained are consistent with existing data about past climate changes since 1500 AD. Temperature-related events show a significant negative correlation (R2 = -0.49, p = 0) with δ14C curve (Reimer et al., 2004), whereas precipitation-related events show a significant positive correlation (R2 = 0.66, p = 0) with the same curve. As an example, recurrent flood and rainfall events occurred from 1630 to 1720 and from 1800 to 1830, which corresponds to the Maunder and Dalton periods of minimum solar activity respectively. Spectral analysis carried out on the 4 classes of events revealed several cycles in the data, in particular a 11 year cycle that corresponds to the Schwabe cycle, and a 85 year cycle that might be related to Gleissberg cycle. The last 150 years display unusual conditions with increasing storms, gales and droughts. The documentary data analysed in the present study might provide interesting information about the consequences of human-induced global warming on extreme meteorological events. They would also be useful as a source of information about local climate variations. References: Audé J.L., 2006. Chronique du climat en Poitou-Charentes Vendée. Lonali Editions, France, 152 pp. Leijonhufvud L., Wilson R., Moberg A. 2008. The Holocene 18(2), 333-343 Planton S., Déqué M., Chauvin F., Terray L., 2008. Comptes Rendus Geosciences, 340 (9-10), 564-574. Reimer P.J. et al., 2004. Radiocarbon 46, 1029-1058. Rodrigo F.S., 2008. Climatic Change 87, 471-487. Sánchez E., Gallardo C., Gaertner M.A, Arribas A., Castro M., 2004. Global and Planetary Change 44, 163-180. Wheeler D., 2006. Archives 31, 119-132.

The relationship of lightning activity and short-duation rainfall events during warm seasons over the Beijing metropolitan region

NASA Astrophysics Data System (ADS)

Wu, F.; Cui, X.; Zhang, D. L.; Lin, Q.

2017-12-01

The relationship between lightning activity and rainfall associated with 2925 short-duration rainfall (SDR) events over the Beijing metropolitan region (BMR) is examined during the warm seasons of 2006-2007, using the cloud-to-ground (CG) and intracloud (IC) lightning data from Surveillance et Alerte Foudre par Interférometrie Radioélectrique (SAFIR)-3000 and 5-min rainfall data from automatic weather stations (AWSs). To facilitate the analysis of the rainfall-lightning correlations, the SDR events are categorized into six different intensity grades according to their hourly rainfall rates (HRRs), and an optimal radius of 10 km from individual AWSs for counting their associated lightning flashes is used. Results show that the lightning-rainfall correlations vary significantly with different intensity grades. Weak correlations (R 0.4) are found in the weak SDR events, and 40-50% of the events are no-flash ones. And moderate correlation (R 0.6) are found in the moderate SDR events, and > 10-20% of the events are no-flash ones. In contrast, high correlations (R 0.7) are obtained in the SDHR events, and < 10% of the events are no-flash ones. The results indicate that lightning activity is observed more frequently and correlated more robust with the rainfall in the SDHR events. Significant time lagged correlations between lightning and rainfall are also found. About 80% of the SDR events could reach their highest correlation coefficients when the associated lightning flashes shift at time lags of < 25 min before and after rainfall begins. The percentages of SDR events with CG or total lightning activity preceding, lagging or coinciding with rainfall shows that (i) in about 55% of the SDR events lightning flashes preceded rainfall; (ii) the SDR events with lightning flashes lagging behind rainfall accounted for about 30%; and (iii) the SDR events without any time shifts accounted for the remaining 15%. Better lightning-rainfall correlations can be attained when time lags are incorporated, with the use of total (CG and IC) lightning data. These results appear to have important implications to improving the nowcast of SDHR events.

Increasing cardiopulmonary emergency visits by long-range transported Asian dust storms in Taiwan.

PubMed

Chan, Chang-Chuan; Chuang, Kai-Jen; Chen, Wen-Jone; Chang, Wei-Tien; Lee, Chung-Te; Peng, Chi-Ming

2008-03-01

This study aims to explore whether Asian dust storms can affect health after 4000 km long-range transport from their origins to downwind areas. Asian dust storms reaching Taipei, Taiwan are tracked by satellite images and confirmed by backward trajectory analysis and ground air pollution monitoring between 1995 and 2002. Our outcome variables include emergency visits for ischaemic heart diseases (ICD-9-CM 410-411, 414), cerebrovascular diseases (ICD-9-CM 430-437), and chronic obstructive pulmonary diseases (COPD) (ICD-9-CM 493, 496) from the National Taiwan University Hospital (NTUH). We use simple paired t-test and Poisson regression models to compare difference in emergency visits, air pollution levels and meteorological conditions for the pairs of Asian dust events and pre-dust periods. There were 39 high dust events with PM(10) greater than 90 microg/m(3) and another 46 low dust events with PM(10) less than 90 microg/m(3). Compared to their pre-dust periods, PM(10) concentrations are significantly increased by 77 microg/m(3) per event for the high dust events. Asian dust storms increase cardiopulmonary emergency visits during storm-affecting periods in Taipei when ambient PM(10) concentrations are above 90 microg/m(3). Compared to their pre-dust periods, emergency visits for ischaemic heart diseases, cerebrovascular diseases, and COPD during high dust events are increased by 0.7 case (35%), 0.7 case (20%), and 0.9 case (20%) per event, respectively, by paired t-tests. By comparing the model-predicted to the observed emergency visits, we find emergency visits for cardiovascular diseases (ICD-9-CM 410-411, 414, 430-437) were significantly increased by 2.9 cases (67%) per event for the 39 high Asian dust events.

Evaluation of Precipitation Simulated by Seven SCMs against the ARM Observations at the SGP Site

NASA Technical Reports Server (NTRS)

Song, Hua; Lin, Wuyin; Lin, Yanluan; Wolf, Audrey B.; Neggers, Roel; Donner, Leo J.; Del Genio, Anthony D.; Liu, Yangang

2013-01-01

This study evaluates the performances of seven single-column models (SCMs) by comparing simulated surface precipitation with observations at the Atmospheric Radiation Measurement Program Southern Great Plains (SGP) site from January 1999 to December 2001. Results show that although most SCMs can reproduce the observed precipitation reasonably well, there are significant and interesting differences in their details. In the cold season, the model-observation differences in the frequency and mean intensity of rain events tend to compensate each other for most SCMs. In the warm season, most SCMs produce more rain events in daytime than in nighttime, whereas the observations have more rain events in nighttime. The mean intensities of rain events in these SCMs are much stronger in daytime, but weaker in nighttime, than the observations. The higher frequency of rain events during warm-season daytime in most SCMs is related to the fact that most SCMs produce a spurious precipitation peak around the regime of weak vertical motions but rich in moisture content. The models also show distinct biases between nighttime and daytime in simulating significant rain events. In nighttime, all the SCMs have a lower frequency of moderate-to-strong rain events than the observations for both seasons. In daytime, most SCMs have a higher frequency of moderate-to-strong rain events than the observations, especially in the warm season. Further analysis reveals distinct meteorological backgrounds for large underestimation and overestimation events. The former occur in the strong ascending regimes with negative low-level horizontal heat and moisture advection, whereas the latter occur in the weak or moderate ascending regimes with positive low-level horizontal heat and moisture advection.

Of Disasters and Dragon Kings: A Statistical Analysis of Nuclear Power Incidents and Accidents.

PubMed

Wheatley, Spencer; Sovacool, Benjamin; Sornette, Didier

2017-01-01

We perform a statistical study of risk in nuclear energy systems. This study provides and analyzes a data set that is twice the size of the previous best data set on nuclear incidents and accidents, comparing three measures of severity: the industry standard International Nuclear Event Scale, the Nuclear Accident Magnitude Scale of radiation release, and cost in U.S. dollars. The rate of nuclear accidents with cost above 20 MM 2013 USD, per reactor per year, has decreased from the 1970s until the present time. Along the way, the rate dropped significantly after Chernobyl (April 1986) and is expected to be roughly stable around a level of 0.003, suggesting an average of just over one event per year across the current global fleet. The distribution of costs appears to have changed following the Three Mile Island major accident (March 1979). The median cost became approximately 3.5 times smaller, but an extremely heavy tail emerged, being well described by a Pareto distribution with parameter α = 0.5-0.6. For instance, the cost of the two largest events, Chernobyl and Fukushima (March 2011), is equal to nearly five times the sum of the 173 other events. We also document a significant runaway disaster regime in both radiation release and cost data, which we associate with the "dragon-king" phenomenon. Since the major accident at Fukushima (March 2011) occurred recently, we are unable to quantify an impact of the industry response to this disaster. Excluding such improvements, in terms of costs, our range of models suggests that there is presently a 50% chance that (i) a Fukushima event (or larger) occurs every 60-150 years, and (ii) that a Three Mile Island event (or larger) occurs every 10-20 years. Further-even assuming that it is no longer possible to suffer an event more costly than Chernobyl or Fukushima-the expected annual cost and its standard error bracket the cost of a new plant. This highlights the importance of improvements not only immediately following Fukushima, but also deeper improvements to effectively exclude the possibility of "dragon-king" disasters. Finally, we find that the International Nuclear Event Scale (INES) is inconsistent in terms of both cost and radiation released. To be consistent with cost data, the Chernobyl and Fukushima disasters would need to have between an INES level of 10 and 11, rather than the maximum of 7. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Major adverse cardiac events and mortality in chronic obstructive pulmonary disease following percutaneous coronary intervention: a systematic review and meta-analysis.

PubMed

Bundhun, Pravesh Kumar; Gupta, Chakshu; Xu, Guang Ma

2017-07-17

We aimed to systematically compare Major Adverse Cardiac Events (MACEs) and mortality following Percutaneous Coronary Intervention (PCI) in patients with and without Chronic Obstructive Pulmonary Diseases (COPD) through a meta-analysis. Electronic databases (Cochrane library, EMBASE and Medline/PubMed) were searched for English publications comparing in-hospital and long-term MACEs and mortality following PCI in patients with a past medical history of COPD. Statistical analysis was carried out by Revman 5.3 whereby Odds Ratio (OR) and 95% Confidence Intervals (CI) were considered the relevant parameters. A total number of 72,969 patients were included (7518 patients with COPD and 65,451 patients without COPD). Results of this analysis showed that in-hospital MACEs were significantly higher in the COPD group with OR: 1.40, 95% CI: 1.19-1.65; P = 0.0001, I 2  = 0%. Long-term MACEs were still significantly higher in the COPD group with OR: 1.58, 95% CI: 1.38-1.81; P = 0.00001, I 2  = 29%. Similarly, in-hospital and long-term mortality were significantly higher in patients with COPD, with OR: 2.25, 95% CI: 1.78-2.85; P = 0.00001, I 2  = 0% and OR: 2.22, 95% CI: 1.33-3.71; P = 0.002, I 2  = 97% respectively. However, the result for the long-term death was highly heterogeneous. Since in-hospital and long-term MACEs and mortality were significantly higher following PCI in patients with versus without COPD, COPD should be considered a risk factor for the development of adverse clinical outcomes following PCI. However, the result for the long-term mortality was highly heterogeneous warranting further analysis.

The origins of multifractality in financial time series and the effect of extreme events

NASA Astrophysics Data System (ADS)

Green, Elena; Hanan, William; Heffernan, Daniel

2014-06-01

This paper presents the results of multifractal testing of two sets of financial data: daily data of the Dow Jones Industrial Average (DJIA) index and minutely data of the Euro Stoxx 50 index. Where multifractal scaling is found, the spectrum of scaling exponents is calculated via Multifractal Detrended Fluctuation Analysis. In both cases, further investigations reveal that the temporal correlations in the data are a more significant source of the multifractal scaling than are the distributions of the returns. It is also shown that the extreme events which make up the heavy tails of the distribution of the Euro Stoxx 50 log returns distort the scaling in the data set. The most extreme events are inimical to the scaling regime. This result is in contrast to previous findings that extreme events contribute to multifractality.

The Effects of Twitter Sentiment on Stock Price Returns.

PubMed

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

2015-01-01

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

Hepatic FDG uptake is associated with future cardiovascular events in asymptomatic individuals with non-alcoholic fatty liver disease.

PubMed

Moon, Seung Hwan; Hong, Sun-Pyo; Cho, Young Seok; Noh, Tae Soo; Choi, Joon Young; Kim, Byung-Tae; Lee, Kyung-Han

2017-06-01

Hepatic F-18 fluoro-2-deoxyglucose (FDG) uptake is associated with non-alcoholic fatty liver disease (NAFLD) which is an independent risk factor for cardiovascular disease. However, the value of hepatic FDG uptake for predicting future cardiovascular events has not been explored. Study participants were 815 consecutive asymptomatic participants who underwent a health screening program that included FDG positron emission tomography/computed tomography (PET/CT), abdominal ultrasonography, and carotid intima-media thickness (CIMT) measurements (age 51.8 ± 6.0 year; males 93.9%). We measured hepatic FDG uptake and assessed the prognostic significance of this parameter with other cardiovascular risk factors including Framingham risk score and CIMT. Multivariate Cox proportional hazards analyses including all study participants revealed that NAFLD with high-hepatic FDG uptake was the only independent predictor for future cardiovascular events [hazard ratio (HR) 4.23; 95% CI 1.05-17.04; P = .043). Subgroup analysis conducted in the NAFLD group showed that high-hepatic FDG uptake was a significant independent predictor of cardiovascular events (HR 9.29; 95% CI 1.05-81.04; P = .045). This exploratory study suggests that high-hepatic FDG uptake may be a useful prognostic factor for cardiovascular events in individuals with NAFLD.

Intracranial mapping of auditory perception: Event-related responses and electrocortical stimulation

PubMed Central

Sinai, A.; Crone, N.E.; Wied, H.M.; Franaszczuk, P.J.; Miglioretti, D.; Boatman-Reich, D.

2010-01-01

Objective We compared intracranial recordings of auditory event-related responses with electrocortical stimulation mapping (ESM) to determine their functional relationship. Methods Intracranial recordings and ESM were performed, using speech and tones, in adult epilepsy patients with subdural electrodes implanted over lateral left cortex. Evoked N1 responses and induced spectral power changes were obtained by trial averaging and time-frequency analysis. Results ESM impaired perception and comprehension of speech, not tones, at electrode sites in the posterior temporal lobe. There was high spatial concordance between ESM sites critical for speech perception and the largest spectral power (100% concordance) and N1 (83%) responses to speech. N1 responses showed good sensitivity (0.75) and specificity (0.82), but poor positive predictive value (0.32). Conversely, increased high-frequency power (>60 Hz) showed high specificity (0.98), but poorer sensitivity (0.67) and positive predictive value (0.67). Stimulus-related differences were observed in the spatial-temporal patterns of event-related responses. Conclusions Intracranial auditory event-related responses to speech were associated with cortical sites critical for auditory perception and comprehension of speech. Significance These results suggest that the distribution and magnitude of intracranial auditory event-related responses to speech reflect the functional significance of the underlying cortical regions and may be useful for pre-surgical functional mapping. PMID:19070540

Discrimination and Acculturative Stress among First-Generation Dominicans

ERIC Educational Resources Information Center

Dawson, Beverly Araujo; Panchanadeswaran, Subadra

2010-01-01

The present study examined the relationship between discriminatory experiences and acculturative stress levels among a sample of 283 Dominican immigrants. Findings from a linear regression analysis revealed that experiences of daily racial discrimination and major racist events were significant predictors of acculturative stress after controlling…

Development of collision avoidance for light vehicles : near-crash/crash event data recorders

DOT National Transportation Integrated Search

2006-12-01

This report presents the results of an analysis effort undertaken to address the following research question: What sensor(s) can be cost effectively added to vehicles on a wide scale to significantly improve the understanding and modeling of naturali...

The Use of Categorized Time-Trend Reporting of Radiation Oncology Incidents: A Proactive Analytical Approach to Improving Quality and Safety Over Time

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

Arnold, Anthony, E-mail: anthony.arnold@sesiahs.health.nsw.gov.a; Delaney, Geoff P.; Cassapi, Lynette

Purpose: Radiotherapy is a common treatment for cancer patients. Although incidence of error is low, errors can be severe or affect significant numbers of patients. In addition, errors will often not manifest until long periods after treatment. This study describes the development of an incident reporting tool that allows categorical analysis and time trend reporting, covering first 3 years of use. Methods and Materials: A radiotherapy-specific incident analysis system was established. Staff members were encouraged to report actual errors and near-miss events detected at prescription, simulation, planning, or treatment phases of radiotherapy delivery. Trend reporting was reviewed monthly. Results: Reportsmore » were analyzed for the first 3 years of operation (May 2004-2007). A total of 688 reports was received during the study period. The actual error rate was 0.2% per treatment episode. During the study period, the actual error rates reduced significantly from 1% per year to 0.3% per year (p < 0.001), as did the total event report rates (p < 0.0001). There were 3.5 times as many near misses reported compared with actual errors. Conclusions: This system has allowed real-time analysis of events within a radiation oncology department to a reduced error rate through focus on learning and prevention from the near-miss reports. Plans are underway to develop this reporting tool for Australia and New Zealand.« less

[Spatiotemporal pattern analysis of event-related potentials elicited by emotional Stroop task].

PubMed

Liu, Qi; Liu, Ling; He, Hui; Zhou, Shu

2007-05-01

To investigate the spatiotemporal pattern of event-related potentials (ERPs) induced by emotional Stroop task. The ERPs of 19 channels were recorded from 13 healthy subjects while performing emotional Stroop task by pressing the buttons representing the colors in which the words denoting different emotions were displayed. A repeated-measures factorial design was adopted with three levels (word valence: positive, neutral and negative). The result of ERP analysis was presented in the form of statistical parametric mapping (SPM) of F value. No significant difference was found in either reaction time or accuracy. The SPM of ERPs suggested significant emotional valence effects in the occipital region (200-220 ms), the left and central frontal regions (270-300 ms), and the bilateral temporal and parietal cortex (560-580 and 620-630 ms, respectively). Processing of task-irrelevant emotional valence information involves the dynamic operation of extensive brain regions. The ERPs are more sensitive than the behavioral indices in emotional evaluation.

Effect of first myocardial ischemic event on renal function.

PubMed

Eijkelkamp, Wouter B A; de Graeff, Pieter A; van Veldhuisen, Dirk J; van Dokkum, Richard P E; Gansevoort, Ronald T; de Jong, Paul E; de Zeeuw, Dick; Hillege, Hans L

2007-07-01

Effects of cardiovascular dysfunction on renal function have been poorly characterized. Therefore, we investigated the relation between a first ischemic cardiac event and long-term renal function changes in the general population from the PREVEND study. We studied 6,360 subjects with a total follow-up duration of 27.017 subject-years. The estimated mean proportional increase in serum creatinine after a first ischemic cardiac event was 3.1% compared with 0.4% per year of follow-up in subjects without such an event (p = 0.005). This represented a significantly larger decrease in estimated glomerular filtration rate after the event in subjects with an event versus the decrease in subjects without a first ischemic cardiac event (2.2 vs 0.5 ml/min/1.73 m(2)/year of follow-up, p = 0.006). In multivariate analysis with adjustment for renal risk factors, this event showed an independent association with serum creatinine change. In conclusion, a first ischemic cardiac event appears to enhance the natural decrease in renal function. Because even mild renal dysfunction should be considered a major cardiovascular risk factor after myocardial infarction, increased renal function loss after an ischemic cardiac event could add to the risk for subsequent cardiovascular morbidity, thus closing a vicious circle.

Event Congruency Enhances Episodic Memory Encoding through Semantic Elaboration and Relational Binding

PubMed Central

Staresina, Bernhard P.; Gray, James C.

2009-01-01

Behavioral research consistently shows that congruous events, that is, events whose constituent elements match along some specific dimension, are better remembered than incongruous events. Although it has been speculated that this “congruency subsequent memory effect” (cSME) results from enhanced semantic elaboration, empirical evidence for this account is lacking. Here, we report a set of behavioral and neuroimaging experiments demonstrating that congruous events engage regions along the left inferior frontal gyrus (LIFG)—consistently related to semantic elaboration—to a significantly greater degree than incongruous events, providing evidence in favor of this hypothesis. Critically, we additionally report 3 novel findings in relation to event congruency: First, congruous events yield superior memory not only for a given study item but also for associated source details. Second, the cSME is evident not only for events that matched a semantic context but also for those that matched a subjective aesthetic schema. Finally, functional magnetic resonance imaging brain/behavior correlation analysis reveals a strong link between 1) across-subject variation in the magnitude of the cSME and 2) differential right hippocampal activation, suggesting that episodic memory for congruous events is effectively bolstered by the extent to which semantic associations are generated and relationally integrated via LIFG-hippocampal–encoding mechanisms. PMID:18820289

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

Gorham, P. W.; Allison, P.; DuVernois, M.

The Antarctic Impulsive Transient Antenna (ANITA) completed its second Long Duration Balloon flight in January 2009, with 31 days aloft (28.5 live days) over Antarctica. ANITA searches for impulsive coherent radio Cherenkov emission from 200 to 1200 MHz, arising from the Askaryan charge excess in ultrahigh energy neutrino-induced cascades within Antarctic ice. This flight included significant improvements over the first flight in payload sensitivity, efficiency, and flight trajectory. Analysis of in-flight calibration pulses from surface and subsurface locations verifies the expected sensitivity. In a blind analysis, we find 2 surviving events on a background, mostly anthropogenic, of 0.97{+-}0.42 events. Wemore » set the strongest limit to date for 10{sup 18}-10{sup 21} eV cosmic neutrinos, excluding several current cosmogenic neutrino models.« less

Increased risk of adverse drug events secondary to bevacizumab treatment in patients with advanced or metastatic breast cancer: a meta-analysis of randomized controlled trials.

PubMed

Shin, Sooyoung; Noh, Yoojin

2018-01-01

Several clinical trials have shown an increased risk of hypertension with bevacizumab when added to chemotherapy in different types of malignancy; however, the risks of other significant adverse events besides hypertension, specifically in breast cancer, have not been completely elucidated. This study was conducted with the aim, primarily, to assess the overall incidence and risk of common toxicities associated with bevacizumab in patients with advanced or metastatic breast cancer and, secondarily, to descriptively review study results concerning a potential correlation between bevacizumab-induced hypertension and its efficacy for breast cancer treatment. We carried out a meta-analysis of relevant randomized controlled trials (RCTs) identified from a database search (Cochrane Library and PubMed) and, additionally, by reviewing previous reviews and meta-analyses. Overall incidence rates, odds ratios (ORs), and 95% confidence intervals (CIs) were assessed with the random- or fixed-effect models, depending on the level of heterogeneity across the included trials. The primary clinical outcomes were high-grade adverse events commonly reported with bevacizumab therapy. We included 6,260 patients with advanced-stage breast cancer from 12 RCTs in the meta-analysis. Five types of high-grade (Grade 3 or 4) adverse drug events were identified as being correlated with bevacizumab treatment versus alternative treatment with statistical significance: hypertension (OR 5.67, 95% CI 3.02-10.65), proteinuria (OR 10.09, 95% CI 4.79-21.27), bleeding (OR 3.45, 95% CI 2.25-5.30), cardiac toxicity (OR 2.15, 95% CI 1.29-3.59), and neutropenic fever (OR 1.51, 95% CI 1.15-2.00). The prognostic value of bevacizumab-induced hypertension for its antitumor efficacy among patients with breast cancer remains controversial, with mixed results presented in the five retrospective studies that were identified from our additional literature search. The addition of bevacizumab to anticancer therapy was associated with a significant increase in the risk of high-grade adverse events, including hypertension, proteinuria, bleeding, cardiac toxicity, and neutropenic fever among patients with advanced-stage breast cancer. Although several retrospective studies suggested a predictive importance of hypertension secondary to bevacizumab therapy, the role of elevated blood pressure as a prognostic biomarker for its antitumor efficacy remains controversial, and further prospective trials are required to confirm such a correlation.

Cinnarizine in refractory migraine prophylaxis: efficacy and tolerability. A comparison with sodium valproate.

PubMed

Togha, Mansoureh; Mansoureh, Togha; Rahmat Jirde, Masoud; Nilavari, Kiafar; Ashrafian, Hosein; Razeghi, Soodeh; Kohan, Leila

2008-04-01

This was a double-blind clinical trial designed to assess the efficacy and safety of the cinnarizine (CIN) in patients with migraine who were refractory to propranolol and tricyclic antidepressants in comparison with sodium valproate (SV) to investigate whether CIN could be at least as effective as SV. A total of 125 patients were treated in a treatment period of 12 weeks. All patients had at least one intake of trial medication and 2-week post baseline efficacy observation which all were included in the ITT analysis. Of the 125 subjects treated, 46 discontinued prematurely: 25 from the CIN and 21 from the SV group. The main reasons for premature discontinuation were: lost to follow up (25/46, 63.2%), insufficient response (16/46, 20%), and adverse events (5/46, 12.8%). No statistically significant inter-group differences in the number of discontinuation was observed (p > 0.05). In both groups, number of attacks, intensity, and duration of attacks significantly decreased (p < 0.05). No statistically significant inter-group differences were observed regarding the mean number of attacks, duration, and intensity of migraine attacks for any of the time intervals analysed, except for the mean reduction of third and fourth visits intensity from baseline which were significantly different in two groups (p < 0.05), with the CIN group showing more reduction. Analysis of the number of responders showed that in the CIN group 61.2% subjects were responders, and 63.8% in the SV group. No statistically significant differences between the treatment groups were found for any of the secondary parameters. Overall 26 subjects reported one or more adverse events during the study period: 13 subjects in each group. Five subjects discontinued prematurely due to adverse events; two in the CIN group with significant weight gain, and 3 in the SV group with significant weight gain and severe tremor. These results suggest that CIN is an effective and safe prophylactic agent even in severe migraine headache.

NASA's Meteoroid Environments Office's Response to Three Significant Bolide Events Over North America

NASA Technical Reports Server (NTRS)

Blaauw, Rhiannon C.; Cooke, William J.; Kingery, Aaron M.

2015-01-01

Being the only U.S. Government entity charged with monitoring the meteor environment, the Meteoroid Environment Office has deployed a network of all sky and wide field meteor cameras, along with the appropriate software tools to quickly analyze data from these systems. However, the coverage of this network is still quite limited, forcing the incorporation of data from other cameras posted to the internet in analyzing many of the fireballs reported by the public and media. A procedure has been developed that determines the analysis process for a given fireball event based on the types and amount of data available. The differences between these analysis process will be explained and outlined by looking at three bolide events, all of which were large enough to produce meteorites. The first example is an ideal event - a bright meteor that occurred over NASA's All Sky Camera Network on August 2, 2014. With clear video of the event from various angles, a high-accuracy trajectory, beginning and end heights, orbit and approximate brightness/size of the event are able to be found very quickly using custom software. The bolide had the potential to have dropped meteorites, so dark flight analysis and modeling was performed, allowing potential fall locations to be mapped as a function of meteorite mass. The second case study was a bright bolide that occurred November 3, 2014 over West Virginia. This was just north of the NASA southeastern all-sky network, and just south of the Ohio-Pennsylvania network. This case study showcases the MEO's ability to use social media and various internet sources to locate videos of the event from obscure sources (including the Washington Monument) for anything that will permit a determination of a basic trajectory and fireball light curve The third case study will highlight the ability to use doppler weather radar in helping locate meteorites, which enable a definitive classification of the impactor. The input data and analysis steps differ for each case study, but the goals remain the same - a trajectory, orbit, and mass estimate for the bolide within hours of the event, and, for events with a high probability of producing meteorites, a location of the strewn field within a day.

Data Albums: An Event Driven Search, Aggregation and Curation Tool for Earth Science

NASA Technical Reports Server (NTRS)

Ramachandran, Rahul; Kulkarni, Ajinkya; Maskey, Manil; Bakare, Rohan; Basyal, Sabin; Li, Xiang; Flynn, Shannon

2014-01-01

One of the largest continuing challenges in any Earth science investigation is the discovery and access of useful science content from the increasingly large volumes of Earth science data and related information available. Approaches used in Earth science research such as case study analysis and climatology studies involve gathering discovering and gathering diverse data sets and information to support the research goals. Research based on case studies involves a detailed description of specific weather events using data from different sources, to characterize physical processes in play for a specific event. Climatology-based research tends to focus on the representativeness of a given event, by studying the characteristics and distribution of a large number of events. This allows researchers to generalize characteristics such as spatio-temporal distribution, intensity, annual cycle, duration, etc. To gather relevant data and information for case studies and climatology analysis is both tedious and time consuming. Current Earth science data systems are designed with the assumption that researchers access data primarily by instrument or geophysical parameter. Those who know exactly the datasets of interest can obtain the specific files they need using these systems. However, in cases where researchers are interested in studying a significant event, they have to manually assemble a variety of datasets relevant to it by searching the different distributed data systems. In these cases, a search process needs to be organized around the event rather than observing instruments. In addition, the existing data systems assume users have sufficient knowledge regarding the domain vocabulary to be able to effectively utilize their catalogs. These systems do not support new or interdisciplinary researchers who may be unfamiliar with the domain terminology. This paper presents a specialized search, aggregation and curation tool for Earth science to address these existing challenges. The search tool automatically creates curated "Data Albums", aggregated collections of information related to a specific science topic or event, containing links to relevant data files (granules) from different instruments; tools and services for visualization and analysis; and information about the event contained in news reports, images or videos to supplement research analysis. Curation in the tool is driven via an ontology based relevancy ranking algorithm to filter out non-relevant information and data.

Event Networks and the Identification of Crime Pattern Motifs

PubMed Central

2015-01-01

In this paper we demonstrate the use of network analysis to characterise patterns of clustering in spatio-temporal events. Such clustering is of both theoretical and practical importance in the study of crime, and forms the basis for a number of preventative strategies. However, existing analytical methods show only that clustering is present in data, while offering little insight into the nature of the patterns present. Here, we show how the classification of pairs of events as close in space and time can be used to define a network, thereby generalising previous approaches. The application of graph-theoretic techniques to these networks can then offer significantly deeper insight into the structure of the data than previously possible. In particular, we focus on the identification of network motifs, which have clear interpretation in terms of spatio-temporal behaviour. Statistical analysis is complicated by the nature of the underlying data, and we provide a method by which appropriate randomised graphs can be generated. Two datasets are used as case studies: maritime piracy at the global scale, and residential burglary in an urban area. In both cases, the same significant 3-vertex motif is found; this result suggests that incidents tend to occur not just in pairs, but in fact in larger groups within a restricted spatio-temporal domain. In the 4-vertex case, different motifs are found to be significant in each case, suggesting that this technique is capable of discriminating between clustering patterns at a finer granularity than previously possible. PMID:26605544

Survival analysis: Part I — analysis of time-to-event

PubMed Central

2018-01-01

Length of time is a variable often encountered during data analysis. Survival analysis provides simple, intuitive results concerning time-to-event for events of interest, which are not confined to death. This review introduces methods of analyzing time-to-event. The Kaplan-Meier survival analysis, log-rank test, and Cox proportional hazards regression modeling method are described with examples of hypothetical data. PMID:29768911

Clopidogrel-Proton Pump Inhibitor Drug-Drug Interaction and Risk of Adverse Clinical Outcomes Among PCI-Treated ACS Patients: A Meta-analysis.

PubMed

Serbin, Michael A; Guzauskas, Gregory F; Veenstra, David L

2016-08-01

Uncertainty regarding clopidogrel effectiveness attenuation because of a drug-drug interaction with proton pump inhibitors (PPI) has led to conflicting guidelines on concomitant therapy. In particular, the effect of this interaction in patients who undergo a percutaneous coronary intervention (PCI), a population known to have increased risk of adverse cardiovascular events, has not been systematically evaluated. To synthesize the evidence of the effect of clopidogrel-PPI drug interaction on adverse cardiovascular outcomes in a PCI patient population. We conducted a systematic literature review for studies reporting clinical outcomes in patients who underwent a PCI and were initiated on clopidogrel with or without a PPI. Studies were included in the analysis if they reported at least 1 of the clinical outcomes of interest (major adverse cardiovascular event [MACE], cardiovascular death, all-cause death, myocardial infarction, stroke, stent thrombosis, and bleed events). We excluded studies that were not exclusive to PCI patients or had no PCI subgroup analysis and/or did not report at least a 6-month follow-up. Statistical and clinical heterogeneity were evaluated and HRs and 95% CIs for adverse clinical events were pooled using the DerSimonian and Laird random-effects meta-analysis method. We identified 12 studies comprising 50,277 PCI patients that met our inclusion and exclusion criteria. Our analysis included retrospective analyses of randomized controlled trials (2), health registries (3), claims databases (2), and institutional records (5); no prospective studies of PCI patients were identified. On average, patients were in their mid-60s, male, and had an array of comorbidities, including hyperlipidemia, diabetes, hypertension, and smoking history. Concomitant therapy following PCI resulted in statistically significant increases in composite MACE (HR = 1.28; 95% CI = 1.24-1.32), myocardial infarction (HR = 1.51; 95% CI = 1.40-1.62), and stroke (HR = 1.46; 95% CI = 1.15-1.86). However, concomitant therapy had no statistically significant effect on stent thrombosis, mortality measured by all-cause or cardiovascular death, or major bleeding before or after the grouping of studies that reported a major or minor bleed outcome. Only 1 study reported on gastrointestinal bleed, and pooled analysis could not be conducted. Statistical testing suggested heterogeneity among studies, but subgroup analysis did not reveal a clear source. Based on the results from this meta-analysis of retrospective analyses of randomized controlled trials and observational studies, concomitant clopidogrel-PPI therapy following PCI appears to be significantly associated with adverse cardiovascular events. Further research on the effect of individual PPIs is needed. Serbin, Guzauskas, and Veenstra were supported by the NIH Common Fund and NIA (1U01AG047109-01, Veenstra, PI) via the Personalized Medicine Economics Research (PriMER) project. The authors do not report any conflicting interests. All authors contributed to the study concept and design. Serbin took the lead in data collection; data interpretation was performed primarily by Serbin, with assistance from the other authors. The manuscript was written primarily by Serbin, along with Guzauskas, and revised by Guzauskas and Veenstra, with assistance from Serbin.

One-year atherothrombotic vascular events rates in outpatients with recent non-cardioembolic ischemic stroke: the EVEREST (Effective Vascular Event REduction after STroke) registry.

PubMed

Suzuki, Norihiro; Sato, Motoki; Houkin, Kiyohiro; Terayama, Yasuo; Uchiyama, Shinichiro; Daida, Hiroyuki; Shigematsu, Hiroshi; Goto, Shinya; Tanaka, Kortaro; Origasa, Hideki; Miyamoto, Susumu; Minematsu, Kazuo; Matsumoto, Masayasu; Okada, Yasushi

2012-05-01

Patients with recent ischemic stroke may have higher risk of atherothrombosis than stable patients with established vascular events. Our aims were to investigate 1-year atherothrombotic vascular event rates and to assess the risk factors for recurrent ischemic stroke in this population. This prospective cohort study was conducted between January 2007 and July 2009 at 313 hospitals in Japan. Outpatients who were at least 45 years of age and who had received oral antiplatelet therapy were enrolled within 2 weeks to 6 months from the last onset of noncardioembolic ischemic stroke. At 12 ± 3 months after enrollment, data on presence/absence of atherothrombotic vascular events were collected. The primary endpoint was the occurrence of fatal or nonfatal ischemic stroke. A total of 3452 patients were enrolled, and 3411 patients who had baseline data were included in the analysis. The 1-year event rate was 3.81% (95% confidence interval 3.15-4.48%) for fatal or nonfatal ischemic stroke and 0.84% (95% confidence interval 0.52-1.15%) for all-cause mortality. The annual rate of recurrent ischemic stroke was significantly higher in patients who had ischemic stroke at least twice than in patients who had first-ever ischemic stroke (5.02% vs 3.59%; P = .0313). In the multivariable Cox regression analysis, recurrent ischemic stroke was significantly associated with age (P = .0033), the presence of diabetes (P = .0129), and waist circumference ≥80 cm (P = .0056). Patients with recent ischemic stroke have a higher risk of stroke recurrence than stable patients enrolled in the REduction of Atherothrombosis for Continued Health (REACH) registry even though they received antiplatelet therapy. The rigorous management of risk factors is needed. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Formaldehyde Source Attribution in Houston during TexAQS II and TRAMP

NASA Astrophysics Data System (ADS)

Guven, B.; Olaguer, E. P.

2010-12-01

To determine the relative importance of primary vs secondary formaldehyde in Houston, source apportionment was performed on continuous online measurements of VOCs, formaldehyde (HCHO), CO, SO2, and HONO at one urban and two industrial sites. The results of source apportionment were used in conjunction with the meteorological, emission inventory, emission event, and back trajectory data catalogued in Air Research Information Infrastructure (ARII) to determine the dominant source regions and evaluate the accuracy of reported regular and upset emissions from industrial facilities. The contribution of industrial sources such as flares from petrochemical plants and refineries to total atmospheric formaldehyde concentrations at the urban site is estimated to be 17% compared to 23% for mobile sources, amounting to 40% for the total contribution of primary HCHO sources. The relative contribution of industrial sources to HCHO concentration at the urban site increased to about 66% on some mornings coinciding with the HCHO peak concentrations. Secondary formation of HCHO during the day and night resulted from the reactions of industrial olefins and other VOCs with OH or ozone was a significant contributor to HCHO concentrations at the urban site. An analysis of emission event, back trajectory and ambient concentration data in ARII showed that a large percentage of emission events were associated with trajectories that passed through the two industrial sites when peaks in concentrations were detected at those sites. Some peak HCHO concentrations can also be linked to emission events of other VOCs, while a significant portion remained unexplained by the reported events. It is likely, based on the results from the SHARP campaign and our analysis, that some episodic emission events containing HCHO are unreported to the TCEQ. Overlaid CPF plots for nighttime (green) and daytime (red) HCHO concentrations measured at three sites and the locations of the largest emitting point sources around the sites. Average contributions to formaldehyde concentrations.

Reduced risk of hypoglycemia with once-daily glargine versus twice-daily NPH and number needed to harm with NPH to demonstrate the risk of one additional hypoglycemic event in type 2 diabetes: Evidence from a long-term controlled trial

PubMed Central

Rosenstock, Julio; Fonseca, Vivian; Schinzel, Stefan; Dain, Marie-Paule; Mullins, Peter; Riddle, Matthew

2016-01-01

Aims This analysis evaluated HbA1c-adjusted hypoglycemia risk with glargine versus neutral protamine Hagedorn (NPH) over a 5-year study in patients with Type 2 diabetes mellitus (T2DM). Clinical significance was assessed using number needed to harm (NNH) to demonstrate the risk of one additional patient experiencing at least one hypoglycemic event. Methods Individual patient-level data for symptomatic documented hypoglycemia and HbA1c values from a 5-year randomized study comparing once-daily glargine (n = 513) with twice-daily NPH (n = 504) were analyzed. Symptomatic hypoglycemia was categorized according to concurrent self-monitoring blood glucose levels and need for assistance. Hypoglycemic events per patient-year as a function of HbA1c were fitted by negative binomial regression using treatment and HbA1c at endpoint as independent variables. An estimate of NNH was derived from logistic regression models. Results The cumulative number of symptomatic hypoglycemia events was consistently lower with glargine compared with NPH over 5 years. Compared with twice-daily NPH, once-daily glargine treatment resulted in significantly lower adjusted odds ratios (OR) for all daytime hypoglycemia (OR 0.74; p = 0.030) and any severe event (OR 0.64; p = 0.035), representing a 26% and 36% reduction in the odds of daytime and severe hypoglycemia, respectively. Our model predicts that, if 25 patients were treated with NPH instead of glargine, then one additional patient would experience at least one severe hypoglycemic event. Conclusions This analysis of long-term insulin treatment confirms findings from short-term studies and demonstrates that glargine provides sustained, clinically meaningful reductions in risk of hypoglycemia compared with NPH in patients with T2DM. PMID:24856612

24-Hour Blood Pressure Variability Assessed by Average Real Variability: A Systematic Review and Meta-Analysis.

PubMed

Mena, Luis J; Felix, Vanessa G; Melgarejo, Jesus D; Maestre, Gladys E

2017-10-19

Although 24-hour blood pressure (BP) variability (BPV) is predictive of cardiovascular outcomes independent of absolute BP levels, it is not regularly assessed in clinical practice. One possible limitation to routine BPV assessment is the lack of standardized methods for accurately estimating 24-hour BPV. We conducted a systematic review to assess the predictive power of reported BPV indexes to address appropriate quantification of 24-hour BPV, including the average real variability (ARV) index. Studies chosen for review were those that presented data for 24-hour BPV in adults from meta-analysis, longitudinal or cross-sectional design, and examined BPV in terms of the following issues: (1) methods used to calculate and evaluate ARV; (2) assessment of 24-hour BPV determined using noninvasive ambulatory BP monitoring; (3) multivariate analysis adjusted for covariates, including some measure of BP; (4) association of 24-hour BPV with subclinical organ damage; and (5) the predictive value of 24-hour BPV on target organ damage and rate of cardiovascular events. Of the 19 assessed studies, 17 reported significant associations between high ARV and the presence and progression of subclinical organ damage, as well as the incidence of hard end points, such as cardiovascular events. In all these cases, ARV remained a significant independent predictor ( P <0.05) after adjustment for BP and other clinical factors. In addition, increased ARV in systolic BP was associated with risk of all cardiovascular events (hazard ratio, 1.18; 95% confidence interval, 1.09-1.27). Only 2 cross-sectional studies did not find that high ARV was a significant risk factor. Current evidence suggests that ARV index adds significant prognostic information to 24-hour ambulatory BP monitoring and is a useful approach for studying the clinical value of BPV. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Influence of Mountains on Arctic Tropospheric Ozone

NASA Astrophysics Data System (ADS)

Whiteway, J. A.; Seabrook, J.

2015-12-01

Tropospheric ozone was measured above Ellesmere Island in the Canadian Arctic during spring using a differential absorption lidar (DIAL). Analysis of the observations revealed that mountains had a significant effect on the vertical distribution of ozone. Ozone depletion events were observed when air that had spent significant time near to the frozen surface of the Arctic Ocean reached Eureka. This air arrived at Eureka by flowing over the surrounding mountains. Surface level ozone depletion events were not observed during periods when mountains blocked the flow of air from over the sea ice. In the case of blocking there was an enhancement in the amount of ozone near the surface as air from the mid troposphere descended in the lee of the mountains. Three case studies will be presented.

Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis

PubMed Central

Speyer, Helene; Gluud, Christian; Nordentoft, Merete

2017-01-01

Objectives To assess the benefits and harms of exercise in patients with depression. Design Systematic review Data sources Bibliographical databases were searched until 20 June 2017. Eligibility criteria and outcomes Eligible trials were randomised clinical trials assessing the effect of exercise in participants diagnosed with depression. Primary outcomes were depression severity, lack of remission and serious adverse events (eg, suicide) assessed at the end of the intervention. Secondary outcomes were quality of life and adverse events such as injuries, as well as assessment of depression severity and lack of remission during follow-up after the intervention. Results Thirty-five trials enrolling 2498 participants were included. The effect of exercise versus control on depression severity was −0.66 standardised mean difference (SMD) (95% CI −0.86 to −0.46; p<0.001; grading of recommendations assessment, development and evaluation (GRADE): very low quality). Restricting this analysis to the four trials that seemed less affected of bias, the effect vanished into −0.11 SMD (−0.41 to 0.18; p=0.45; GRADE: low quality). Exercise decreased the relative risk of no remission to 0.78 (0.68 to 0.90; p<0.001; GRADE: very low quality). Restricting this analysis to the two trials that seemed less affected of bias, the effect vanished into 0.95 (0.74 to 1.23; p=0.78). Trial sequential analysis excluded random error when all trials were analysed, but not if focusing on trials less affected of bias. Subgroup analyses found that trial size and intervention duration were inversely associated with effect size for both depression severity and lack of remission. There was no significant effect of exercise on secondary outcomes. Conclusions Trials with less risk of bias suggested no antidepressant effects of exercise and there were no significant effects of exercise on quality of life, depression severity or lack of remission during follow-up. Data for serious adverse events and adverse events were scarce not allowing conclusions for these outcomes. Systematic review registration The protocol was published in the journal Systematic Reviews: 2015; 4:40. PMID:28928174

Prognostic Value of Myocardial Perfusion Analysis in Patients with Coronary Artery Disease: A Meta-Analysis.

PubMed

Xiu, Jiancheng; Cui, Kai; Wang, Yuegang; Zheng, Hua; Chen, Gangbin; Feng, Qian; Bin, Jianping; Wu, Juefei; Porter, Thomas R

2017-03-01

Myocardial perfusion (MP) imaging during stress myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic value to predict cardiac events in patients with known or suspected CAD is still undefined. A search was conducted for single- or multicenter prospective studies that evaluated the prognostic value of stress MCE in patients with known or suspected CAD. A database search was performed through June 2015. Effect sizes of relative risk ratios (RRs) with their corresponding 95% CIs were used to evaluate the association between the occurrence of total cardiac events (cardiac death, nonfatal myocardial infarction, coronary revascularization) and hard cardiac events (cardiac death and nonfatal myocardial infarction) in subjects with normal and abnormal MP measured by MCE. The Cochran Q statistic and the I 2 statistic were used to assess heterogeneity. A comprehensive literature search of the MEDLINE, Google Scholar, Cochrane, and Embase databases identified 11 studies enrolling a total of 4,045 patients. The overall analysis of RRs revealed that patients with abnormal MP were at higher risk for total cardiac events compared with patients with normal MP (RR, 5.58; 95% CI, 3.64-8.57; P < .001), with low heterogeneity among trials (I 2  = 48.15%, Q = 7.71, P = .103). Similarly, patients with abnormal MP were at higher risk for hard cardiac events compared with patients with normal MP (RR, 4.99; 95% CI, 1.75-14.32; P = .003), with significant heterogeneity among trials (I 2  = 81.48%, Q = 21.59, P < .001). The results of this meta-analysis suggest that MP assessment using stress MCE is an effective prognostic tool for predicting the occurrence of cardiac events in patients with known or suspected CAD. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

In search for genetic determinants of clinically meaningful differential cardiovascular event reduction by pravastatin in the PHArmacogenetic study of Statins in the Elderly at risk (PHASE)/PROSPER study.

PubMed

Postmus, Iris; Johnson, Paul C D; Trompet, Stella; de Craen, Anton J M; Slagboom, P Eline; Devlin, James J; Shiffman, Dov; Sacks, Frank M; Kearney, Patricia M; Stott, David J; Buckley, Brendan M; Sattar, Naveed; Ford, Ian; Westendorp, Rudi G J; Jukema, J Wouter

2014-07-01

Statin therapy is widely used in the prevention and treatment of cardiovascular events and is associated with significant risk reductions. However, there is considerable variation in response to statin therapy both in terms of LDL cholesterol reduction and clinical outcomes. It has been hypothesized that genetic variation contributes importantly to this individual drug response. We investigated the interaction between genetic variants and pravastatin or placebo therapy on the incidence of cardiovascular events by performing a genome-wide association study in the participants of the PROspective Study of Pravastatin in the Elderly at Risk for vascular disease--PHArmacogenetic study of Statins in the Elderly at risk (PROSPER/PHASE) study (n = 5244). We did not observe genome-wide significant associations with a clinically meaningful differential cardiovascular event reduction by pravastatin therapy. In addition, SNPs with p-values lower than 1 × 10(-4) were assessed for replication in a case-only analysis within two randomized placebo controlled pravastatin trials, CARE (n = 711) and WOSCOPS (n = 522). rs7102569, on chromosome 11 near the ODZ4 gene, was replicated in the CARE study (p = 0.008), however the direction of effect was opposite. This SNP was not associated in WOSCOPS. In addition, none of the SNPs replicated significantly after correcting for multiple testing. We could not identify genetic variation that was significantly associated at genome-wide level with a clinically meaningful differential event reduction by pravastatin treatment in a large prospective study. We therefore assume that in daily practice the use of genetic characteristics to personalize pravastatin treatment to improve prevention of cardiovascular disease will be limited. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

OPERA neutrino oscillation search: Status and perspectives

NASA Astrophysics Data System (ADS)

Gornushkin, Yu.

2016-07-01

OPERA is a long-baseline neutrino experiment at the Gran Sasso laboratory (LNGS) designed to search for ν_{{μ}}^{} → ν_{{τ}}^{} oscillations in a direct appearance mode on an event by event basis. OPERA took data in 2008-2012 with the CNGS neutrino beam from CERN. The data analysis is ongoing, with the goal of establishing ν_{{τ}}^{} appearance with a high significance. Complementary studies of the ν_{{μ}}^{} → ν_{{e}}^{} oscillations and atmospheric muons fluxes were performed as well. Current results of the experiment are presented and perspectives discussed.

48 CFR 2152.210-71 - Notice of significant events.

Code of Federal Regulations, 2011 CFR

2011-10-01

... events. 2152.210-71 Section 2152.210-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL... events. As prescribed in 2110.7004(b), insert the following clause: Notice of Significant Events (OCT 2005) (a) The Contractor agrees to notify OPM of any significant event within 10 working days after the...

48 CFR 2152.210-71 - Notice of significant events.

Code of Federal Regulations, 2013 CFR

2013-10-01

... events. 2152.210-71 Section 2152.210-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL... events. As prescribed in 2110.7004(b), insert the following clause: Notice of Significant Events (OCT 2005) (a) The Contractor agrees to notify OPM of any significant event within 10 working days after the...

48 CFR 2152.210-71 - Notice of significant events.

Code of Federal Regulations, 2012 CFR

2012-10-01

... events. 2152.210-71 Section 2152.210-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL... events. As prescribed in 2110.7004(b), insert the following clause: Notice of Significant Events (OCT 2005) (a) The Contractor agrees to notify OPM of any significant event within 10 working days after the...

The Tendril Plot-a novel visual summary of the incidence, significance and temporal aspects of adverse events in clinical trials.

PubMed

Karpefors, Martin; Weatherall, James

2018-03-21

In contrast to efficacy, safety hypotheses of clinical trials are not always pre-specified, and therefore, the safety interpretation work of a trial tends to be more exploratory, often reactive, and the analysis more statistically and graphically challenging. We introduce a new means of visualizing the adverse event data across an entire clinical trial. The approach overcomes some of the current limitations of adverse event analysis and streamlines the way safety data can be explored, interpreted and analyzed. Using a phase II study, we describe and exemplify how the tendril plot effectively summarizes the time-resolved safety profile of two treatment arms in a single plot and how that can provide scientists with a trial safety overview that can support medical decision making. To our knowledge, the tendril plot is the only way to graphically show important treatment differences with preserved temporal information, across an entire clinical trial, in a single view.

Hydro-Geological Hazard Temporal Evolution during the last seven decades in the Solofrana River Basin—Southern Italy

NASA Astrophysics Data System (ADS)

Longobardi, Antonia; Diodato, Nazzareno; Mobilia, Mirka

2017-04-01

Extremes precipitation events are frequently associated to natural disasters falling within the broad spectrum of multiple damaging hydrological events (MDHEs), defined as the simultaneously triggering of different types of phenomena, such as landslides and floods. The power of the rainfall (duration, magnitude, intensity), named storm erosivity, is an important environmental indicator of multiple damaging hydrological phenomena. At the global scale, research interest is actually devoted to the investigation of non-stationary features of extreme events, and consequently of MDHEs, which appear to be increasing in frequency and severity. The Mediterranean basin appears among the most vulnerable regions with an expected increase in occurring damages of about 100% by the end of the century. A high concentration of high magnitude and short duration rainfall events are, in fact, responsible for the largest rainfall erosivity and erosivity density values within Europe. The aim of the reported work is to investigate the relationship between the temporal evolution of severe geomorphological events and combined precipitation indices as a tool to improve understanding the hydro-geological hazard at the catchment scale. The case study is the Solofrana river basin, Southern Italy, which has been seriously and consistently in time affected by natural disasters. Data for about 45 MDH events, spanning on a decadal scale 1951-2014, have been collected and analyzed for this purpose. A preliminary monthly scale analysis of event occurrences highlights a pronounced seasonal characterization of the phenomenon, as about 60% of the total number of reported events take place during the period from September to November. Following, a statistical analysis clearly indicates a significant increase in the frequency of occurrences of MDHEs during the last decades. Such an increase appears to be related to non-stationary features of an average catchment scale rainfall-runoff erosivity index, which combines maximum monthly, maximum daily, and a proxy of maximum hourly precipitation data. The main findings of the reported study relate to the fact that climate evolving tendencies do not appear significant in most of the cases and that MDHEs occurred within the studied catchment also for rainfall events of very moderate intensity and/or severity. The illustrated results seems to indicate that climate variability has not assumed the main role in the large number of damaging event, and that the relative increase hazardous hydro-geological events in the last decade, is instead most likely caused by incorrect urban planning policies.

Insecure attachment style and cumulative traumatic life events in patients with somatoform pain disorder: A cross-sectional study.

PubMed

Nacak, Yeliz; Morawa, Eva; Tuffner, Daniela; Erim, Yesim

2017-12-01

Current models assume somatoform pain disorder (SPD) to be the result of a complex interaction between bio- and psychosocial factors, but the etiology is still not well understood. This study aimed to investigate the distribution of attachment style and the frequency of traumatic life events, especially childhood adversities, in patients with SPD compared to healthy controls. We compared 65 patients with SPD (confirmed by Structured Clinical Interview, SCID-I) to 65 age- and gender-matched healthy controls. The following questionnaires were employed: Relationship Scale Questionnaire (RSQ), Essen Trauma Inventory (ETI), Childhood Trauma Questionnaire (CTQ) and Patient Health Questionnaire (PHQ-15). A logistic regression analysis was used to identify the association between SPD and psychological factors. Insecure attachment was significantly more prevalent (60%) in patients with SPD compared to healthy subjects (14%; p<0.001). Overall, 70.4% of patients with SPD reported three or more traumatic events in their life, compared with healthy subjects who reported predominantly one (40%). Patients with SPD scored significantly higher in all CTQ subscales compared to the healthy controls. The factor most strongly related with SPD was the insecure attachment style (OR=11.20, 95% CI: 1.32-94.86). Other significant predictive factors were depression (OR=3.35, 95% CI: 1.84-6.11) and number of traumatic events (OR=2.04, 95% CI: 1.06-3.92). Insecure attachment, depression symptoms and the number of traumatic events explained 86.2% of the variance. The high predictive value of insecure attachment style and cumulative traumatic events emphasize their importance as risk factors of SPD. Copyright © 2017 Elsevier Inc. All rights reserved.

Event-level relationship between methamphetamine use significantly associated with non-adherence to pharmacologic trial medications in event-level analyses.

PubMed

Hermanstyne, Keith A; Santos, Glenn-Milo; Vittinghoff, Eric; Santos, Deirdre; Colfax, Grant; Coffin, Phillip

2014-10-01

Methamphetamine use has been previously associated with poor medication adherence, but, to date, there have been no studies that have conducted event-level analyses on correlates of medication adherence in studies of pharmacologic agents for methamphetamine dependence. We pooled data from two previous, randomized controlled trials (using bupropion and mirtazapine, respectively) for methamphetamine dependence and used a mixed effects logistic model to examine correlates of daily opening of the medication event monitoring system (MEMS) cap as a repeated measure. We explored whether periods of observed methamphetamine use via urine testing were associated with study medication adherence based on MEMS cap openings. We found a significant negative association between methamphetamine-urine positivity and event-level study medication adherence as measured by MEMS cap openings (AOR: 0.69; 95% CI: 0.49-0.98). In addition, age (AOR: 1.07; 95% CI: 1.02-1.11) and depressive symptoms (AOR: 0.78; 95% CI: 0.64-0.90) were significantly associated with adherence. Finally, participants were more likely to open their study medication bottles on days when they presented for in-person urine testing. Our event-level analysis shows that methamphetamine use can be associated with reduced medication adherence as measured by MEMS cap openings in pharmacologic trials, which corroborates prior research. These findings may suggest that medication adherence support in pharmacologic trials among methamphetamine users may be needed to improve study compliance and could be targeted towards periods of time when there are more likely to not open their study medication pill bottles. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Patient safety culture in Norwegian nursing homes.

PubMed

Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

2017-06-20

Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values <0.05 were considered to be significant. Out of the 463 employees invited, 288 (62.2%) answered the questionnaire. Response rates varied between 56.9% and 72.2% across the five nursing homes. In multiple linear regression analysis, we found that increasing age and job position among the healthcare providers were associated with significantly increased mean scores for the patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the occurrence of adverse events in nursing homes.

Making adjustments to event annotations for improved biological event extraction.

PubMed

Baek, Seung-Cheol; Park, Jong C

2016-09-16

Current state-of-the-art approaches to biological event extraction train statistical models in a supervised manner on corpora annotated with event triggers and event-argument relations. Inspecting such corpora, we observe that there is ambiguity in the span of event triggers (e.g., "transcriptional activity" vs. 'transcriptional'), leading to inconsistencies across event trigger annotations. Such inconsistencies make it quite likely that similar phrases are annotated with different spans of event triggers, suggesting the possibility that a statistical learning algorithm misses an opportunity for generalizing from such event triggers. We anticipate that adjustments to the span of event triggers to reduce these inconsistencies would meaningfully improve the present performance of event extraction systems. In this study, we look into this possibility with the corpora provided by the 2009 BioNLP shared task as a proof of concept. We propose an Informed Expectation-Maximization (EM) algorithm, which trains models using the EM algorithm with a posterior regularization technique, which consults the gold-standard event trigger annotations in a form of constraints. We further propose four constraints on the possible event trigger annotations to be explored by the EM algorithm. The algorithm is shown to outperform the state-of-the-art algorithm on the development corpus in a statistically significant manner and on the test corpus by a narrow margin. The analysis of the annotations generated by the algorithm shows that there are various types of ambiguity in event annotations, even though they could be small in number.

Natural hazard events and social capital: the social impact of natural disasters.

PubMed

Albrecht, Frederike

2018-04-01

This study investigates if and to what extent natural disasters affect social capital. Twelve different events in Europe are examined in a quantitative analysis, using data derived from the European Social Survey and the EM-DAT International Disaster Database. The study uses social trust as an indicator of social capital and offers evidence that a change in social trust is a possible occurrence during or after a disaster, but that it is not an inevitable consequence of it. The results reveal that social trust decreases after a disaster with a death toll of at least nine. Changes in social capital, therefore, are found to be more probable as the severity of the event increases. National, rather than regional, disasters lead more frequently to significant shifts in social trust. This evaluation of 12 separate cases pinpoints several disasters that have had an effect on social trust, but it does not identify any general patterns, underlining the significance of contextual dependency. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Contrasting environments associated with storm prediction center tornado outbreak forecasts using synoptic-scale composite analysis

NASA Astrophysics Data System (ADS)

Bates, Alyssa Victoria

Tornado outbreaks have significant human impact, so it is imperative forecasts of these phenomena are accurate. As a synoptic setup lays the foundation for a forecast, synoptic-scale aspects of Storm Prediction Center (SPC) outbreak forecasts of varying accuracy were assessed. The percentages of the number of tornado outbreaks within SPC 10% tornado probability polygons were calculated. False alarm events were separately considered. The outbreaks were separated into quartiles using a point-in-polygon algorithm. Statistical composite fields were created to represent the synoptic conditions of these groups and facilitate comparison. Overall, temperature advection had the greatest differences between the groups. Additionally, there were significant differences in the jet streak strengths and amounts of vertical wind shear. The events forecasted with low accuracy consisted of the weakest synoptic-scale setups. These results suggest it is possible that events with weak synoptic setups should be regarded as areas of concern by tornado outbreak forecasters.

Foot and ankle injuries during the Athens 2004 Olympic Games

PubMed Central

Badekas, Thanos; Papadakis, Stamatios A; Vergados, Nikolaos; Galanakos, Spyros P; Siapkara, Angeliki; Forgrave, Mike; Romansky, Nick; Mirones, Steven; Trnka, Hans-Jeorg; Delmi, Marino

2009-01-01

Background Major, rare and complex incidents can occur at any mass-gathering sporting event and team medical staff should be appropriately prepared for these. One such event, the Athens Olympic Games in 2004, presented a significant sporting and medical challenge. This study concerns an epidemiological analysis of foot and ankle injuries during the Games. Methods An observational, epidemiological survey was used to analyse injuries in all sport tournaments (men's and women's) over the period of the Games. Results A total of 624 injuries (525 soft tissue injuries and 99 bony injuries) were reported. The most frequent diagnoses were contusions, sprains, fractures, dislocations and lacerations. Significantly more injuries in male (58%) versus female athletes (42%) were recorded. The incidence, diagnosis and cause of injuries differed substantially between the team sports. Conclusion Our experience from the Athens Olympic Games will inform the development of public health surveillance systems for future Olympic Games, as well as other similar mass events. PMID:19361341

Analysis of MEG Auditory 40-Hz Response by Event-Related Coherence

NASA Astrophysics Data System (ADS)

Tanaka, Keita; Kawakatsu, Masaki; Yunokuchi, Kazutomo

We examined the event-related coherence of magnetoencephalography (auditory 40-Hz response) while the subjects were presented click acoustic stimuli at repetition rate 40Hz in the ‘Attend' and ‘Reading' conditions. MEG signals were recorded of 5 healthy males using the whole-head SQUID system. The event-related coherence was used to provide a measurement of short synchronization which occurs in response to a stimulus. The results showed that the peak value of coherence in auditory 40-Hz response between right and left temporal regions was significantly larger when subjects paid attention to stimuli (‘Attend' condition) rather than it was when the subject ignored them (‘Reading' condition). Moreover, the latency of coherence in auditory 40-Hz response was significantly shorter when the subjects paid attention to stimuli (‘Attend' condition). These results suggest that the phase synchronization between right and left temporal region in auditory 40-Hz response correlate closely with selective attention.

DrImpute: imputing dropout events in single cell RNA sequencing data.

PubMed

Gong, Wuming; Kwak, Il-Youp; Pota, Pruthvi; Koyano-Nakagawa, Naoko; Garry, Daniel J

2018-06-08

The single cell RNA sequencing (scRNA-seq) technique begin a new era by allowing the observation of gene expression at the single cell level. However, there is also a large amount of technical and biological noise. Because of the low number of RNA transcriptomes and the stochastic nature of the gene expression pattern, there is a high chance of missing nonzero entries as zero, which are called dropout events. We develop DrImpute to impute dropout events in scRNA-seq data. We show that DrImpute has significantly better performance on the separation of the dropout zeros from true zeros than existing imputation algorithms. We also demonstrate that DrImpute can significantly improve the performance of existing tools for clustering, visualization and lineage reconstruction of nine published scRNA-seq datasets. DrImpute can serve as a very useful addition to the currently existing statistical tools for single cell RNA-seq analysis. DrImpute is implemented in R and is available at https://github.com/gongx030/DrImpute .

IMPACT fragmentation model developments

NASA Astrophysics Data System (ADS)

Sorge, Marlon E.; Mains, Deanna L.

2016-09-01

The IMPACT fragmentation model has been used by The Aerospace Corporation for more than 25 years to analyze orbital altitude explosions and hypervelocity collisions. The model is semi-empirical, combining mass, energy and momentum conservation laws with empirically derived relationships for fragment characteristics such as number, mass, area-to-mass ratio, and spreading velocity as well as event energy distribution. Model results are used for several types of analysis including assessment of short-term risks to satellites from orbital altitude fragmentations, prediction of the long-term evolution of the orbital debris environment and forensic assessments of breakup events. A new version of IMPACT, version 6, has been completed and incorporates a number of advancements enabled by a multi-year long effort to characterize more than 11,000 debris fragments from more than three dozen historical on-orbit breakup events. These events involved a wide range of causes, energies, and fragmenting objects. Special focus was placed on the explosion model, as the majority of events examined were explosions. Revisions were made to the mass distribution used for explosion events, increasing the number of smaller fragments generated. The algorithm for modeling upper stage large fragment generation was updated. A momentum conserving asymmetric spreading velocity distribution algorithm was implemented to better represent sub-catastrophic events. An approach was developed for modeling sub-catastrophic explosions, those where the majority of the parent object remains intact, based on estimated event energy. Finally, significant modifications were made to the area-to-mass ratio distribution to incorporate the tendencies of different materials to fragment into different shapes. This ability enabled better matches between the observed area-to-mass ratios and those generated by the model. It also opened up additional possibilities for post-event analysis of breakups. The paper will discuss a number of the modifications that have been made to improve IMPACT and why these modifications were made. Comparisons between observational data and the IMPACT predictions will be discussed in the context of these model revisions and the overall behavior of model results. A number of future areas of investigation that were uncovered in the process of the analysis efforts will also be reviewed.

Association of computed tomography-derived left ventricular size with major cardiovascular events in the general population: the Heinz Nixdorf recall study.

PubMed

Dykun, Iryna; Geisel, Marie H; Kälsch, Hagen; Lehmann, Nils; Bauer, Marcus; Moebus, Susanne; Jöckel, Karl-Heinz; Möhlenkamp, Stefan; Erbel, Raimund; Mahabadi, Amir A

2015-05-01

To investigate the relationship between LV size as determined by non-contrast enhanced cardiac CT with incident cardiovascular disease in the general population free of clinical cardiovascular disease. LV axial area was quantified from non-contrast CT in axial, end-diastolic images at a mid-ventricular slice in participants from the population-based Heinz Nixdorf recall study, free of cardiovascular disease (n=3926, 59±8years, 53%female). LV size index (LVI) was defined as the quotient of LV area and body surface area. Major CV events (coronary events, stroke, CV death) were assessed during follow-up. Association of LVI with events was assessed using Cox regression analysis in unadjusted and multivariable adjusted models. During 8.0±1.5years of follow-up, 219 subjects developed a major CV event. Those with events had larger LVI at baseline (2258±352 vs. 2149±276 mm2/m2, p<0.0001). In univariate analysis, increase of LVI by 1 standard deviation was associated with 40% higher risk of events (HR(95%CI):1.41(1.26-1.59), p<0.0001). Associations remained statistically significant after adjustment for CV risk factors (1.24(1.10-1.40), p=0.0007) and when further adjusting for CAC (1.21(1.07-1.37), p=0.003). There was a trend towards stronger association for subjects with low CAC-score (CAC<100:1.41(1.16-1.71), p=0.0005, CAC≥100:1.24(1.06-1.44), p=0.006) in univariate analysis which persisted after multivariable adjustment (CAC<100: 1.41(1.14-1.73), p=0.001, CAC≥100: 1.12(0.96-1.31), p=0.16). CT-derived LV size is associated with incident major CV events independent of traditional risk factors and CAC-score in a population-based cohort and may improve the prediction of hard events especially in subjects with low CAC-scores. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Combining microseismic and geomechanical observations to interpret storage integrity at the In Salah CCS site

NASA Astrophysics Data System (ADS)

Goertz-Allmann, Bettina P.; Kühn, Daniela; Oye, Volker; Bohloli, Bahman; Aker, Eyvind

2014-07-01

We present results from microseismic monitoring and geomechanical analysis obtained at the industrial-scale CO2 sequestration site at the In Salah gas development project in Algeria. More than 5000 microseismic events have been detected at a pilot monitoring well using a master event cross-correlation method. The microseismic activity occurs in four distinct clusters and thereof three clearly correlate with injection rates and wellhead pressures. These event clusters are consistent with a location within the reservoir interval. However, due to insufficient network geometry there are large uncertainties on event location. We estimate a fracture pressure of 155 bar (at the wellhead) from the comparison of injection pressure and injection rate and conclude that reservoir fracture pressure of the injection horizon has most likely been exceeded occasionally, accompanied by increased microseismic activity. Our analysis of 3-D ray tracing for direct and converted phases suggests that one of the event clusters is located at a shallower depth than the reservoir injection interval. However, this event cluster is most likely unrelated to changes in the injection activity at a single well, as the event times do not correlate with the wellhead pressures. Furthermore, this event cluster shows b-values close to one, indicating re-activated natural or tectonic seismicity on pre-existing weakness zones rather than injection induced seismicity. Analysis of event azimuths and significant shear wave splitting of up to 5 per cent provide further valuable insight into fluid migration and fracture orientation at the reservoir level. Although only one geophone was available during the critical injection period, the microseismic monitoring of CO2 injection at In Salah is capable of addressing some of the most relevant questions about fluid migration and reservoir integrity. An improved monitoring array with larger aperture and higher sensitivity is highly recommended, as it could greatly enhance the value of this technique. As such, real-time microseismic monitoring can be used to guide the injection pressure below fracture pressure, thus providing a tool to mitigate the risk of inducing felt seismicity and compromising seal integrity.

Detection of Sleep Disordered Breathing and Its Central/Obstructive Character Using Nasal Cannula and Finger Pulse Oximeter

PubMed Central

Sommermeyer, Dirk; Zou, Ding; Grote, Ludger; Hedner, Jan

2012-01-01

Study Objective: To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Methods: Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHIauto) was calculated using both signals, and a respiratory disturbance index (RDIauto) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Results: Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m2) were included in the analysis. AHImanual (19.4 ± 18.5 events/h) correlated highly significantly with AHIauto (19.9 ± 16.5 events/h) and RDIauto (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p < 0.001) with a mean difference of −0.5 ± 6.6 and −1.0 ± 6.1 events/h. The automatic analysis of AHIauto and RDIauto detected sleep apnea (cutoff AHImanual ≥ 15 events/h) with a sensitivity/specificity of 0.90/0.97 and 0.86/0.94, respectively. The automated obstructive/central apnea indices correlated closely with manually scoring (r = 0.87 and 0.95, p < 0.001) with mean difference of −4.3 ± 7.9 and 0.3 ± 1.5 events/h, respectively. Conclusions: Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep. Citation: Sommermeyer D; Zou D; Grote L; Hedner J. Detection of sleep disordered breathing and its central/obstructive character using nasal cannula and finger pulse oximeter. J Clin Sleep Med 2012;8(5):527-533. PMID:23066364

Prescription-event monitoring in Japan (J-PEM).

PubMed

Kubota, Kiyoshi

2002-01-01

In prescription-event monitoring in Japan (J-PEM), patients are identified by prescriptions in individual pharmacies where drugs are dispensed. The methodology is somewhat different to that used by the Drug Safety Research Unit in the UK, in that two questionnaires, one to the pharmacist and the other to the doctor are sent for each patient and the method of concurrent control is employed in J-PEM. In the data analysis, the list of events reported as a suspected reaction or a reason for stopping the drug is made to generate a signal. In addition, a signal may be generated for some events with the statistically significant difference of crude rates followed by the regression analysis or a follow-up study. In J-PEM, Medical Dictionary for Regulatory Activities (MedDRA) terminology is used for data entry and data analysis. Lowest level terms (LLTs) in MedDRA are used in data entry while a signal is generated using preferred terms (PTs). However, to generate a signal effectively, some PTs may be grouped as one term. In addition, if two terms are so similar, it may be instructed that one of those two terms is normally selected in data entry to avoid confusion. Many more PEM studies could be undertaken to determine if MedDRA can be used for effective signal generation, but the usefulness of MedDRA in J-PEM is still to be determined.

Mesoscale data assimilation for a local severe rainfall event with the NHM-LETKF system

NASA Astrophysics Data System (ADS)

Kunii, M.

2013-12-01

This study aims to improve forecasts of local severe weather events through data assimilation and ensemble forecasting approaches. Here, the local ensemble transform Kalman filter (LETKF) is implemented with the Japan Meteorological Agency's nonhydrostatic model (NHM). The newly developed NHM-LETKF contains an adaptive inflation scheme and a spatial covariance localization scheme with physical distance. One-way nested analysis in which a finer-resolution LETKF is conducted by using the outputs of an outer model also becomes feasible. These new contents should enhance the potential of the LETKF for convective scale events. The NHM-LETKF is applied to a local severe rainfall event in Japan in 2012. Comparison of the root mean square errors between the model first guess and analysis reveals that the system assimilates observations appropriately. Analysis ensemble spreads indicate a significant increase around the time torrential rainfall occurred, which would imply an increase in the uncertainty of environmental fields. Forecasts initialized with LETKF analyses successfully capture intense rainfalls, suggesting that the system can work effectively for local severe weather. Investigation of probabilistic forecasts by ensemble forecasting indicates that this could become a reliable data source for decision making in the future. A one-way nested data assimilation scheme is also tested. The experiment results demonstrate that assimilation with a finer-resolution model provides an advantage in the quantitative precipitation forecasting of local severe weather conditions.

Integrative genome-wide analysis of the determinants of RNA splicing in kidney renal clear cell carcinoma.

PubMed

Lehmann, Kjong-Van; Kahles, André; Kandoth, Cyriac; Lee, William; Schultz, Nikolaus; Stegle, Oliver; Rätsch, Gunnar

2015-01-01

We present a genome-wide analysis of splicing patterns of 282 kidney renal clear cell carcinoma patients in which we integrate data from whole-exome sequencing of tumor and normal samples, RNA-seq and copy number variation. We proposed a scoring mechanism to compare splicing patterns in tumor samples to normal samples in order to rank and detect tumor-specific isoforms that have a potential for new biomarkers. We identified a subset of genes that show introns only observable in tumor but not in normal samples, ENCODE and GEUVADIS samples. In order to improve our understanding of the underlying genetic mechanisms of splicing variation we performed a large-scale association analysis to find links between somatic or germline variants with alternative splicing events. We identified 915 cis- and trans-splicing quantitative trait loci (sQTL) associated with changes in splicing patterns. Some of these sQTL have previously been associated with being susceptibility loci for cancer and other diseases. Our analysis also allowed us to identify the function of several COSMIC variants showing significant association with changes in alternative splicing. This demonstrates the potential significance of variants affecting alternative splicing events and yields insights into the mechanisms related to an array of disease phenotypes.

The use of historical information for regional frequency analysis of extreme skew surge

NASA Astrophysics Data System (ADS)

Frau, Roberto; Andreewsky, Marc; Bernardara, Pietro

2018-03-01

The design of effective coastal protections requires an adequate estimation of the annual occurrence probability of rare events associated with a return period up to 103 years. Regional frequency analysis (RFA) has been proven to be an applicable way to estimate extreme events by sorting regional data into large and spatially distributed datasets. Nowadays, historical data are available to provide new insight on past event estimation. The utilisation of historical information would increase the precision and the reliability of regional extreme's quantile estimation. However, historical data are from significant extreme events that are not recorded by tide gauge. They usually look like isolated data and they are different from continuous data from systematic measurements of tide gauges. This makes the definition of the duration of our observations period complicated. However, the duration of the observation period is crucial for the frequency estimation of extreme occurrences. For this reason, we introduced here the concept of credible duration. The proposed RFA method (hereinafter referenced as FAB, from the name of the authors) allows the use of historical data together with systematic data, which is a result of the use of the credible duration concept.

Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.

PubMed

Doyle, Frank; McGee, Hannah; Delaney, Mary; Motterlini, Nicola; Conroy, Ronán

2011-01-01

Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization. We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories. Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group. Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

[Violence and post-traumatic stress disorder in childhood].

PubMed

Ximenes, Liana Furtado; de Oliveira, Raquel de Vasconcelos Carvalhães; de Assis, Simone Gonçalves

2009-01-01

This study presents the prevalence of symptoms of Posttraumatic Stress Disorder (PTSD) in 500 schoolchildren (6-13 years old) in São Gonçalo, Rio de Janeiro. It also investigates the association between PTSD, violence and other adverse events in the lives of these children. The multi-stage cluster sampling strategy involved three selection stages. Parents were interviewed about their children's behavior. The instrument used to screen symptoms of PTSD was the Child Behavior Checklist-Posttraumatic Stress Disorder Scale (CBCL-PTSD). Conflict Tactics Scales (CTS) were applied to evaluate family violence and other scales to investigate the socioeconomic profile, familiar relationship, characteristics and adverse events in the lives of the children. Multivariate analysis was performed using a hierarchical model with a significance level of 5%. The prevalence of clinical symptoms of PTSD was of 6.5%. The multivariate analysis suggested an explanation model of PTSD characterized by 18 variables, such as the child's characteristics; specific life events; family violence; and other family factors. The results reveal that it is necessary to work with the child in particularly difficult moments of his/her life in order to prevent or minimize the impact of adverse events on their mental and social functioning.

Ground-based Parallax Confirmed by Spitzer: Binary Microlensing Event MOA-2015-BLG-020

NASA Astrophysics Data System (ADS)

Wang, Tianshu; Zhu, Wei; Mao, Shude; Bond, I. A.; Gould, A.; Udalski, A.; Sumi, T.; Bozza, V.; Ranc, C.; Cassan, A.; Yee, J. C.; Han, C.; Abe, F.; Asakura, Y.; Barry, R.; Bennett, D. P.; Bhattacharya, A.; Donachie, M.; Evans, P.; Fukui, A.; Hirao, Y.; Itow, Y.; Kawasaki, K.; Koshimoto, N.; Li, M. C. A.; Ling, C. H.; Masuda, K.; Matsubara, Y.; Miyazaki, S.; Muraki, Y.; Nagakane, M.; Ohnishi, K.; Rattenbury, N.; Saito, To.; Sharan, A.; Shibai, H.; Sullivan, D. J.; Suzuki, D.; Tristram, P. J.; Yamada, T.; Yonehara, A.; MOA Collaboration; KozŁowski, S.; Mróz, P.; Pawlak, M.; Pietrukowicz, P.; Poleski, R.; Skowron, J.; Soszyński, I.; Szymański, M. K.; Ulaczyk, K.; OGLE Collaboration; Beichman, C.; Bryden, G.; Calchi Novati, S.; Carey, S.; Fausnaugh, M.; Gaudi, B. S.; Henderson, C. B.; Shvartzvald, Y.; Wibking, B.; Spitzer Team; Albrow, M. D.; Chung, S.-J.; Hwang, K.-H.; Jung, Y. K.; Ryu, Y.-H.; Shin, I.-G.; Cha, S.-M.; Kim, D.-J.; Kim, H.-W.; Kim, S.-L.; Lee, C.-U.; Lee, Y.; Park, B.-G.; Pogge, R. W.; KMTNet Collaboration; Street, R. A.; Tsapras, Y.; Hundertmark, M.; Bachelet, E.; Dominik, M.; Horne, K.; Figuera Jaimes, R.; Wambsganss, J.; Bramich, D. M.; Schmidt, R.; Snodgrass, C.; Steele, I. A.; Menzies, J.; RoboNet Collaboration

2017-08-01

We present the analysis of the binary gravitational microlensing event MOA-2015-BLG-020. The event has a fairly long timescale (˜63 days) and thus the light curve deviates significantly from the lensing model that is based on the rectilinear lens-source relative motion. This enables us to measure the microlensing parallax through the annual parallax effect. The microlensing parallax parameters constrained by the ground-based data are confirmed by the Spitzer observations through the satellite parallax method. By additionally measuring the angular Einstein radius from the analysis of the resolved caustic crossing, the physical parameters of the lens are determined. It is found that the binary lens is composed of two dwarf stars with masses {M}1=0.606+/- 0.028 {M}⊙ and {M}2=0.125 +/- 0.006 {M}⊙ in the Galactic disk. Assuming that the source star is at the same distance as the bulge red clump stars, we find the lens is at a distance {D}L=2.44+/- 0.10 {kpc}. We also provide a summary and short discussion of all of the published microlensing events in which the annual parallax effect is confirmed by other independent observations.

Summertime ozone at Mount Washington: Meteorological controls at the highest peak in the northeast

NASA Astrophysics Data System (ADS)

Fischer, Emily V.; Talbot, Robert W.; Dibb, Jack E.; Moody, Jennie L.; Murray, Georgia L.

2004-12-01

This study examined the synoptic and regional-scale meteorological controls on summertime O3 at Mount Washington, the highest peak (1910 m) in the northeastern United States. Analysis of air mass transport to Mount Washington was conducted for the summers of 1998-2003 using backward trajectories. Distinct patterns in air mass history were revealed using this approach that helped explain extreme variations in O3 mixing ratios. Most enhanced (≥90th percentile) and depleted (≤10th percentile) O3 events were short-lived and spread out over the summer months. Enhanced O3 events at Mount Washington were generally associated with westerly transport, while depleted events corresponded to northwesterly transport. Periods of O3 greater than 80 ppbv during nighttime periods coincided with westerly (71%) and southwesterly (29%) transport. Periods of elevated O3 commonly occurred during regional warm sector flow or on the western edge of a surface anticyclone. Our analysis also identified a stratospheric contribution to a small percentage (˜5%) of extreme O3 events at the site, but more evidence is required to establish the significance of the contribution to background O3 levels in this region.

Compositional Solution Space Quantification for Probabilistic Software Analysis

NASA Technical Reports Server (NTRS)

Borges, Mateus; Pasareanu, Corina S.; Filieri, Antonio; d'Amorim, Marcelo; Visser, Willem

2014-01-01

Probabilistic software analysis aims at quantifying how likely a target event is to occur during program execution. Current approaches rely on symbolic execution to identify the conditions to reach the target event and try to quantify the fraction of the input domain satisfying these conditions. Precise quantification is usually limited to linear constraints, while only approximate solutions can be provided in general through statistical approaches. However, statistical approaches may fail to converge to an acceptable accuracy within a reasonable time. We present a compositional statistical approach for the efficient quantification of solution spaces for arbitrarily complex constraints over bounded floating-point domains. The approach leverages interval constraint propagation to improve the accuracy of the estimation by focusing the sampling on the regions of the input domain containing the sought solutions. Preliminary experiments show significant improvement on previous approaches both in results accuracy and analysis time.

Integration of modern statistical tools for the analysis of climate extremes into the web-GIS “CLIMATE”

NASA Astrophysics Data System (ADS)

Ryazanova, A. A.; Okladnikov, I. G.; Gordov, E. P.

2017-11-01

The frequency of occurrence and magnitude of precipitation and temperature extreme events show positive trends in several geographical regions. These events must be analyzed and studied in order to better understand their impact on the environment, predict their occurrences, and mitigate their effects. For this purpose, we augmented web-GIS called “CLIMATE” to include a dedicated statistical package developed in the R language. The web-GIS “CLIMATE” is a software platform for cloud storage processing and visualization of distributed archives of spatial datasets. It is based on a combined use of web and GIS technologies with reliable procedures for searching, extracting, processing, and visualizing the spatial data archives. The system provides a set of thematic online tools for the complex analysis of current and future climate changes and their effects on the environment. The package includes new powerful methods of time-dependent statistics of extremes, quantile regression and copula approach for the detailed analysis of various climate extreme events. Specifically, the very promising copula approach allows obtaining the structural connections between the extremes and the various environmental characteristics. The new statistical methods integrated into the web-GIS “CLIMATE” can significantly facilitate and accelerate the complex analysis of climate extremes using only a desktop PC connected to the Internet.

ANALYSIS OF INPATIENT HOSPITAL STAFF MENTAL WORKLOAD BY MEANS OF DISCRETE-EVENT SIMULATION

DTIC Science & Technology

2016-03-24

ANALYSIS OF INPATIENT HOSPITAL STAFF MENTAL WORKLOAD BY MEANS OF DISCRETE -EVENT SIMULATION...in the United States. AFIT-ENV-MS-16-M-166 ANALYSIS OF INPATIENT HOSPITAL STAFF MENTAL WORKLOAD BY MEANS OF DISCRETE -EVENT SIMULATION...UNLIMITED. AFIT-ENV-MS-16-M-166 ANALYSIS OF INPATIENT HOSPITAL STAFF MENTAL WORKLOAD BY MEANS OF DISCRETE -EVENT SIMULATION Erich W

Effect of Aspirin Coadministration on the Safety of Celecoxib, Naproxen, or Ibuprofen.

PubMed

Reed, Grant W; Abdallah, Mouin S; Shao, Mingyuan; Wolski, Kathy; Wisniewski, Lisa; Yeomans, Neville; Lüscher, Thomas F; Borer, Jeffrey S; Graham, David Y; Husni, M Elaine; Solomon, Daniel H; Libby, Peter; Menon, Venu; Lincoff, A Michael; Nissen, Steven E

2018-04-24

The safety of nonsteroidal anti-inflammatory drug (NSAID) and aspirin coadministration is uncertain. The aim of this study was to compare the safety of combining NSAIDs with low-dose aspirin. This analysis of the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen) trial included 23,953 patients with osteoarthritis or rheumatoid arthritis at increased cardiovascular risk randomized to celecoxib, ibuprofen, or naproxen. The on-treatment population was used for this study. Outcomes included composite major adverse cardiovascular events, noncardiovascular death, gastrointestinal or renal events, and components of the composite. Cox proportional hazards models compared outcomes among NSAIDs stratified by aspirin use following propensity score adjustment. Kaplan-Meier analysis was used to compare the cumulative probability of events. When taken without aspirin, naproxen or ibuprofen had greater risk for the primary composite endpoint compared with celecoxib (hazard ratio [HR]: 1.52; 95% confidence interval [CI]: 1.22 to 1.90, p <0.001; and HR: 1.81; 95% CI: 1.46 to 2.26; p <0.001, respectively). Compared with celecoxib, ibuprofen had more major adverse cardiovascular events (p < 0.05), and both ibuprofen and naproxen had more gastrointestinal (p < 0.001) and renal (p < 0.05) events. Taken with aspirin, ibuprofen had greater risk for the primary composite endpoint compared with celecoxib (HR: 1.27; 95% CI: 1.06 to 1.51; p < 0.01); this was not significantly higher with naproxen (HR: 1.18; 95% CI: 0.98 to 1.41; p = 0.08). Among patients on aspirin, major adverse cardiovascular events were similar among NSAIDs, and compared with celecoxib, ibuprofen had more gastrointestinal and renal events (p < 0.05), while naproxen had more gastrointestinal events (p < 0.05), without a difference in renal events. Similar results were seen on adjusted Kaplan-Meier analysis. Celecoxib has a more favorable overall safety profile than naproxen or ibuprofen when taken without aspirin. Adding aspirin attenuates the safety advantage of celecoxib, although celecoxib is still associated with fewer gastrointestinal events than ibuprofen or naproxen and fewer renal events than ibuprofen. (Prospective Randomized Evaluation of Celecoxib Integrated Safety vs Ibuprofen or Naproxen [PRECISION]; NCT00346216). Copyright © 2018 American College of Cardiology Foundation. All rights reserved.

Event coincidence analysis for quantifying statistical interrelationships between event time series. On the role of flood events as triggers of epidemic outbreaks

NASA Astrophysics Data System (ADS)

Donges, J. F.; Schleussner, C.-F.; Siegmund, J. F.; Donner, R. V.

2016-05-01

Studying event time series is a powerful approach for analyzing the dynamics of complex dynamical systems in many fields of science. In this paper, we describe the method of event coincidence analysis to provide a framework for quantifying the strength, directionality and time lag of statistical interrelationships between event series. Event coincidence analysis allows to formulate and test null hypotheses on the origin of the observed interrelationships including tests based on Poisson processes or, more generally, stochastic point processes with a prescribed inter-event time distribution and other higher-order properties. Applying the framework to country-level observational data yields evidence that flood events have acted as triggers of epidemic outbreaks globally since the 1950s. Facing projected future changes in the statistics of climatic extreme events, statistical techniques such as event coincidence analysis will be relevant for investigating the impacts of anthropogenic climate change on human societies and ecosystems worldwide.

Triggering Events and New Daily Persistent Headache: Age and Gender Differences and Insights on Pathogenesis-A Clinic-Based Study.

PubMed

Rozen, Todd D

2016-01-01

To define what are the age and gender differences for new daily persistent headache (NDPH) triggering events and how this may relate to the pathogenesis of NDPH. To describe several new triggering events for NDPH. All patients were diagnosed with primary NDPH at a headache specialty clinic during the time period of 01/2009 through 01/2013. This was a retrospective analysis of patient medical records utilizing an electronic medical record system. Ninety-seven patients were diagnosed with primary NDPH (65 women and 32 men). The mean average age of onset was younger in women than men 32.4 years vs 35.8 years. Fifty one of ninety seven NDPH patients (53%) did not recognize a triggering event while an infection or flu-like illness triggered NDPH in 22%, a stressful life event in 9%, a procedure (surgical) in 9%, and some "other" recognized trigger in 7%. All of the NDPH patients who developed new onset headache after an invasive surgical procedure were intubated. There was no significant difference in frequency for any of the triggering events between genders. The youngest age of onset was for a post stressful life event trigger while the oldest age of onset was in the post-surgical subgroup. Women developed NDPH at a younger age of onset for all recognized triggers, but there was no significant difference in ages of onset between the genders. There was no significant difference in the number of NDPH patients who had a history of migraine or no history and if they developed NDPH after any triggered event vs no triggering event. However, the majority of patients who developed NDPH after a stressful life event did have a precedent migraine history (67%). Newly noted triggers include: hormonal manipulation with progesterone, medication exposure, chemical/pesticide exposure, massage treatment, and immediately post a syncopal event. More than 50% of NDPH sufferers do not recognize a triggering event to their headaches. A key finding from the present study is the recognition that of those patients who developed NDPH after an invasive surgical procedure all required intubation and we speculate a cervicogenic origin to their headaches. The fact that both genders had an almost equal rate of occurrence for most NDPH triggers and almost the same age of onset suggests a common underlying pathogenesis for similar triggering events. A precedent history of migraine did not enhance the frequency of triggered vs nontriggered NDPH except possibly for a stressful life event. © 2015 American Headache Society.

Non-high-density lipoprotein cholesterol: an important predictor of stroke and diabetes-related mortality in Japanese elderly diabetic patients.

PubMed

Araki, Atsushi; Iimuro, Satoshi; Sakurai, Takashi; Umegaki, Hiroyuki; Iijima, Katsuya; Nakano, Hiroshi; Oba, Kenzo; Yokono, Koichi; Sone, Hirohito; Yamada, Nobuhiro; Ako, Junya; Kozaki, Koichi; Miura, Hisayuki; Kashiwagi, Atsunori; Kikkawa, Ryuichi; Yoshimura, Yukio; Nakano, Tadasumi; Ohashi, Yasuo; Ito, Hideki

2012-04-01

To evaluate the association of low-density lipoprotein, high-density lipoprotein and non-high-density lipoprotein cholesterol with the risk of stroke, diabetes-related vascular events and mortality in elderly diabetes patients. This study was carried out as a post-hoc landmark analysis of a randomized, controlled, multicenter, prospective intervention trial. We included 1173 elderly type 2 diabetes patients (aged ≥ 65 years) from 39 Japanese institutions who were enrolled in the Japanese elderly diabetes intervention trial study and who could be followed up for 1 year. A landmark survival analysis was carried out in which follow up was set to start 1 year after the initial time of entry. During 6 years of follow up, there were 38 cardiovascular events, 50 strokes, 21 diabetes-related deaths and 113 diabetes-related events. High low-density lipoprotein cholesterol was associated with incident cardiovascular events, and high glycated hemoglobin was associated with strokes. After adjustment for possible covariables, non-high-density lipoprotein cholesterol showed a significant association with increased risk of stroke, diabetes-related mortality and total events. The adjusted hazard ratios (95% confidence intervals) of non-high-density lipoprotein cholesterol were 1.010 (1.001-1.018, P = 0.029) for stroke, 1.019 (1.007-1.031, P < 0.001) for diabetes-related death and 1.008 (1.002-1.014; P < 0.001) for total diabetes-related events. Higher non-high-density lipoprotein cholesterol was associated with an increased risk of stroke, diabetes-related mortality and total events in elderly diabetes patients. © 2012 Japan Geriatrics Society.

Investigating the Origins of Two Extreme Solar Particle Events: Proton Source Profile and Associated Electromagnetic Emissions

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

Kocharov, Leon; Usoskin, Ilya; Pohjolainen, Silja

We analyze the high-energy particle emission from the Sun in two extreme solar particle events in which protons are accelerated to relativistic energies and can cause a significant signal even in the ground-based particle detectors. Analysis of a relativistic proton event is based on modeling of the particle transport and interaction, from a near-Sun source through the solar wind and the Earth’s magnetosphere and atmosphere to a detector on the ground. This allows us to deduce the time profile of the proton source at the Sun and compare it with observed electromagnetic emissions. The 1998 May 2 event is associatedmore » with a flare and a coronal mass ejection (CME), which were well observed by the Nançay Radioheliograph, thus the images of the radio sources are available. For the 2003 November 2 event, the low corona images of the CME liftoff obtained at the Mauna Loa Solar Observatory are available. Those complementary data sets are analyzed jointly with the broadband dynamic radio spectra, EUV images, and other data available for both events. We find a common scenario for both eruptions, including the flare’s dual impulsive phase, the CME-launch-associated decimetric-continuum burst, and the late, low-frequency type III radio bursts at the time of the relativistic proton injection into the interplanetary medium. The analysis supports the idea that the two considered events start with emission of relativistic protons previously accelerated during the flare and CME launch, then trapped in large-scale magnetic loops and later released by the expanding CME.« less

Association of aortic wall thickness on contrast-enhanced chest CT with major cerebro-cardiac events.

PubMed

Tresoldi, Silvia; Di Leo, Giovanni; Zoffoli, Elena; Munari, Alice; Primolevo, Alessandra; Cornalba, Gianpaolo; Sardanelli, Francesco

2014-11-01

There is a significant association between aortic atherosclerosis and previous major cardiovascular events. Particularly, thoracic aortic atherosclerosis is closely related to the degree of coronary and carotid artery disease. Thus, there is a rationale for screening the thoracic aorta in patients who undergo a chest computed tomography (CT) for any clinical question, in order to detect patients at increased risk of cerebro-cardiovascular (CCV) events. To estimate the association between either thoracic aortic wall thickness (AWT) or aortic total calcium score (ATCS) and CCV events. One hundred and forty-eight non-cardiac patients (78 men; 67 ± 12 years) underwent chest contrast-enhanced multidetector CT (MDCT). The AWT was measured at the level of the left atrium (AWTref) and at the maximum AWT (AWTmax). Correlation with clinical CCV patients' history was estimated. The value of AWTmax and of a semi-quantitative ATCS as a marker for CCV events was assessed using receiver-operating characteristic curve (ROC) analysis and multivariate regression analysis. Out of 148 patients, 59% reported sedentary lifestyle, 44% hypertension, 32% smoking, 23% hypercholesterolemia, 13% family history of cardiac disease, 12% diabetes, and 10% BMI ≥ 30 kg/m(2); 9% reported myocardial infarction, 8% aortic aneurism, 8% myocardial revascularization, and 2% ischemic stroke. Twenty-six percent of patients had a medium-to-high ATCS. Both AWTmax and AWTref correlated with hypertension and age (P < 0.002). At the ROC analysis, a 4.8 mm threshold was associated to a 90% specificity and an odds ratio of 6.3 (AUC = 0.735). Assuming as threshold the AWTmax median value (4.3 mm) of patients who suffered from at least one CCV event in their history, a negative predictive value of 90%, a RR of 3.6 and an OR of 6.3 were found. At the multivariate regression analysis, AWTmax was the only independent variable associated to the frequency of CCV events. Patients with increased thoracic AWTmax on chest MDCT could be considered at risk for CCV disease. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

TRANSIENT GALACTIC COSMIC-RAY MODULATION DURING SOLAR CYCLE 24: A COMPARATIVE STUDY OF TWO PROMINENT FORBUSH DECREASE EVENTS

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

Zhao, L.-L.; Zhang, H., E-mail: zhaolingling@ucas.edu.cn

Forbush decrease (FD) events are of great interest for transient galactic cosmic-ray (GCR) modulation study. In this study, we perform comparative analysis of two prominent Forbush events during cycle 24, occurring on 2012 March 8 (Event 1) and 2015 June 22 (Event 2), utilizing the measurements from the worldwide neutron monitor (NM) network. Despite their comparable magnitudes, the two Forbush events are distinctly different in terms of evolving GCR energy spectrum and energy dependence of the recovery time. The recovery time of Event 1 is strongly dependent on the median energy, compared to the nearly constant recovery time of Eventmore » 2 over the studied energy range. Additionally, while the evolutions of the energy spectra during the two FD events exhibit similar variation patterns, the spectrum of Event 2 is significantly harder, especially at the time of deepest depression. These difference are essentially related to their associated solar wind disturbances. Event 1 is associated with a complicated shock-associated interplanetary coronal mass ejection (ICME) disturbance with large radial extent, probably formed by the merging of multiple shocks and transient flows, and which delivered a glancing blow to Earth. Conversely, Event 2 is accompanied by a relatively simple halo ICME with small radial extent that hit Earth more head-on.« less

Probabilistic Approaches for Multi-Hazard Risk Assessment of Structures and Systems

NASA Astrophysics Data System (ADS)

Kwag, Shinyoung

Performance assessment of structures, systems, and components for multi-hazard scenarios has received significant attention in recent years. However, the concept of multi-hazard analysis is quite broad in nature and the focus of existing literature varies across a wide range of problems. In some cases, such studies focus on hazards that either occur simultaneously or are closely correlated with each other. For example, seismically induced flooding or seismically induced fires. In other cases, multi-hazard studies relate to hazards that are not dependent or correlated but have strong likelihood of occurrence at different times during the lifetime of a structure. The current approaches for risk assessment need enhancement to account for multi-hazard risks. It must be able to account for uncertainty propagation in a systems-level analysis, consider correlation among events or failure modes, and allow integration of newly available information from continually evolving simulation models, experimental observations, and field measurements. This dissertation presents a detailed study that proposes enhancements by incorporating Bayesian networks and Bayesian updating within a performance-based probabilistic framework. The performance-based framework allows propagation of risk as well as uncertainties in the risk estimates within a systems analysis. Unlike conventional risk assessment techniques such as a fault-tree analysis, a Bayesian network can account for statistical dependencies and correlations among events/hazards. The proposed approach is extended to develop a risk-informed framework for quantitative validation and verification of high fidelity system-level simulation tools. Validation of such simulations can be quite formidable within the context of a multi-hazard risk assessment in nuclear power plants. The efficiency of this approach lies in identification of critical events, components, and systems that contribute to the overall risk. Validation of any event or component on the critical path is relatively more important in a risk-informed environment. Significance of multi-hazard risk is also illustrated for uncorrelated hazards of earthquakes and high winds which may result in competing design objectives. It is also illustrated that the number of computationally intensive nonlinear simulations needed in performance-based risk assessment for external hazards can be significantly reduced by using the power of Bayesian updating in conjunction with the concept of equivalent limit-state.

Probabilistic tsunami hazard assessment for Makran considering recently suggested larger maximum magnitudes and sensitivity analysis for GNSS-based early warning

NASA Astrophysics Data System (ADS)

Zamora, N.; Hoechner, A.; Babeyko, A. Y.

2014-12-01

Iran and Pakistan are countries frequently affected by destructive earthquakes, as for instance, the magnitude 6.6 Bam earthquake in 2003 in Iran with about 30 000 casualties, or the magnitude 7.6 Kashmir earthquake 2005 in Pakistan with about 80'000 casualties. Both events took place inland, but in terms of magnitude, even significantly larger events can be expected to happen offshore, at the Makran subduction zone. This small subduction zone is seismically rather quiescent, nevertheless a tsunami caused by a thrust event in 1945 (Balochistan earthquake) led to about 4000 casualties. Nowadays, the coastal regions are more densely populated and vulnerable to similar events. Furthermore, some recent publications discuss the possiblity of rather rare huge magnitude 9 events at the Makran subduction zone. We analyze the seismicity at the subduction plate interface and generate various synthetic earthquake catalogs spanning 100000 years. All the events are projected onto the plate interface using scaling relations and a tsunami model is run for every scenario. The tsunami hazard along the coast is computed and presented in the form of annual probability of exceedance, probabilistic tsunami height for different time periods and other measures. We show how the hazard reacts to variation of the Gutenberg-Richter parameters and maximum magnitudes.We model the historic Balochistan event and its effect in terms of coastal wave heights. Finally, we show how an effective tsunami early warning could be achieved by using an array of high-precision real-time GNSS (Global Navigation Satellite System) receivers along the coast by applying it to the 1945 event and by performing a sensitivity analysis.

Negative Emotional Events that People Ruminate about Feel Closer in Time

PubMed Central

Siedlecka, Ewa; Capper, Miriam M.; Denson, Thomas F.

2015-01-01

Rumination is intrusive, perseverative cognition. We suggest that one psychological consequence of ruminating about negative emotional events is that the events feel as though they happened metaphorically “just yesterday”. Results from three studies showed that ruminating about real world anger provocations, guilt-inducing events, and sad times in the last year made these past events feel as though they happened more recently. The relationship between rumination and reduced temporal psychological distance persisted even when controlling for when the event occurred and the emotional intensity of the event. Moreover, angry rumination was correlated with enhanced approach motivation, which mediated the rumination-distance relationship. The relationship between guilty rumination and distance was mediated by enhanced vividness. Construal level and taking a 3rd person perspective contributed to the sense of distance when participants were prompted to think about less emotionally charged situations. A meta-analysis of the data showed that the relationship between rumination and reduced distance was significant and twice as large as the same relationship for neutral events. These findings have implications for understanding the role of emotional rumination on memory processes in clinical populations and people prone to rumination. This research suggests that rumination may be a critical mechanism that keeps negative events close in the heart, mind, and time. PMID:25714395

An Alternative Explanation for "Step-Like" Early VLF Event

NASA Astrophysics Data System (ADS)

Moore, R. C.

2016-12-01

A newly-deployed array of VLF receivers along the East Coast of the United States is ideally suited for detecting VLF scattering from lightning-induced disturbances to the lower ionosphere. The array was deployed in May 2016, and one VLF receiver was deployed only 20 km from the NAA transmitter (24.0 kHz) in Cutler, Maine. The phase of the NAA signal at this closest site varies significantly with time, due simply to the impedance match of the transmitter varying with time. Additionally, both the amplitude and phase exhibit periods of rapid shifts that could possibly explain at least some "step-like" VLF scattering events. Here, we distinguish between "step-like" VLF scattering events and other events in that "step-like" events are typically not closely associated with a detected causative lightning flash and also tend to exhibit little or no recovery to ambient conditions after the event onset. We present an analysis of VLF observations from the East Coast array that demonstrates interesting examples of step-like VLF events far from the transmitter that are associated with step-like events very close to the transmitter. We conclude that step-like VLF events should be treated with caution, unless definitively associated with a causative lightning flash and/or detected using observations of multiple transmitter signals.

[The analysis of negative life events, hopelessness and coping strategies among psychotic patients].

PubMed

Perczel Forintos, Dóra; Kiss, Zsófia

2008-01-01

Some theories explaining the background of suicidal attempts emphasise the role of depression, while others emphasise the role of hopelessness in the case of different psychological states, like psychosis. According to researches negative emotions, namely hopelessness predicts suicidal intentions more precisely than depression itself. In our study we measured the suicidal risk of our psychotic patients with hopelessness, depression and life event scales. Our results have implied that suicidal psychotic patient groups showed significantly more serious level of depression and hopelessness and had more negative life events than the non-suicidal group. Indeed, a sub-group could also be distinguished among suicidal psychotic patients in which the level of hopelessness predicts suicidal risk and not depression.

Incorporating oximeter analyses to investigate synchronies in heart rate while teaching and learning about race

NASA Astrophysics Data System (ADS)

Amat, Arnau; Zapata, Corinna; Alexakos, Konstantinos; Pride, Leah D.; Paylor-Smith, Christian; Hernandez, Matthew

2016-09-01

In this paper, we look closely at two events selected through event-oriented inquiry that were part of a classroom presentation on race. The first event was a provocative discussion about Mark Twain's ( Pudd'nhead Wilson, Harper, New York, 1899) and passing for being White. The other was a discussion on the use of the N-word. Grounded in authentic inquiry, we use ethnographic narrative, cogenerative dialogues, and video and oximeter data analyses as part of a multi-ontological approach for studying emotions. Statistical analysis of oximeter data shows statistically significant heart rate synchrony among two of the coteachers during their presentations, providing evidence of emotional synchrony, resonance, and social and emotional contagion.

Hyaluronic acid injection therapy for osteoarthritis of the knee: concordant efficacy and conflicting serious adverse events in two systematic reviews.

PubMed

O'Hanlon, Claire E; Newberry, Sydne J; Booth, Marika; Grant, Sean; Motala, Aneesa; Maglione, Margaret A; FitzGerald, John D; Shekelle, Paul G

2016-11-04

The prevalence of knee osteoarthritis (OA)/degenerative joint disease (DJD) is increasing in the USA. Systematic reviews of treatment efficacy and adverse events (AEs) of hyaluronic acid (HA) injections report conflicting evidence about the balance of benefits and harms. We review evidence on efficacy and AEs of intraarticular viscosupplementation with HA in older individuals with knee osteoarthritis and account for differences in these conclusions from another systematic review. We searched PubMed and eight other databases and gray literature sources from 1990 to December 12, 2014. Double-blind placebo-controlled randomized controlled trials (RCTs) reporting functional outcomes or quality-of-life; RCTs and observational studies on delay/avoidance of arthroplasty; RCTs, case reports, and large cohort studies and case series assessing safety; and systematic reviews reporting on knee pain were considered for inclusion. A standardized, pre-defined protocol was applied by two independent reviewers to screen titles and abstracts, review full text, and extract details on study design, interventions, outcomes, and quality. We compared our results with those of a prior systematic review and found them to be discrepant; our analysis of why this discrepancy occurred is the focus of this manuscript. Eighteen RCTs reported functional outcomes: pooled analysis of ten placebo-controlled, blinded trials showed a standardized mean difference of -0.23 (95 % confidence interval (CI) -0.45 to -0.01) favoring HA at 6 months. Studies reported few serious adverse events (SAEs) and no significant differences in non-serious adverse events (NSAEs) (relative risk (RR) [95 % CI] 1.03 [0.93-1.15] or SAEs (RR [95 % CI] 1.39 [0.78-2.47]). A recent prior systematic review reported similar functional outcomes, but significant SAE risk. Differences in SAE inclusion and synthesis accounted for the disparate conclusions. Trials show a small but significant effect of HA on function on which recent systematic reviews agree, but lack of AE synthesis standardization leads to opposite conclusions about the balance of benefits and harms. A limitation of the re-analysis of the prior systematic review is that it required imputation of missing data.

Defining Tsunami Magnitude as Measure of Potential Impact

NASA Astrophysics Data System (ADS)

Titov, V. V.; Tang, L.

2016-12-01

The goal of tsunami forecast, as a system for predicting potential impact of a tsunami at coastlines, requires quick estimate of a tsunami magnitude. This goal has been recognized since the beginning of tsunami research. The work of Kajiura, Soloviev, Abe, Murty, and many others discussed several scales for tsunami magnitude based on estimates of tsunami energy. However, difficulties of estimating tsunami energy based on available tsunami measurements at coastal sea-level stations has carried significant uncertainties and has been virtually impossible in real time, before tsunami impacts coastlines. The slow process of tsunami magnitude estimates, including collection of vast amount of available coastal sea-level data from affected coastlines, made it impractical to use any tsunami magnitude scales in tsunami warning operations. Uncertainties of estimates made tsunami magnitudes difficult to use as universal scale for tsunami analysis. Historically, the earthquake magnitude has been used as a proxy of tsunami impact estimates, since real-time seismic data is available of real-time processing and ample amount of seismic data is available for an elaborate post event analysis. This measure of tsunami impact carries significant uncertainties in quantitative tsunami impact estimates, since the relation between the earthquake and generated tsunami energy varies from case to case. In this work, we argue that current tsunami measurement capabilities and real-time modeling tools allow for establishing robust tsunami magnitude that will be useful for tsunami warning as a quick estimate for tsunami impact and for post-event analysis as a universal scale for tsunamis inter-comparison. We present a method for estimating the tsunami magnitude based on tsunami energy and present application of the magnitude analysis for several historical events for inter-comparison with existing methods.

Fifty Years of THERP and Human Reliability Analysis

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

Ronald L. Boring

2012-06-01

In 1962 at a Human Factors Society symposium, Alan Swain presented a paper introducing a Technique for Human Error Rate Prediction (THERP). This was followed in 1963 by a Sandia Laboratories monograph outlining basic human error quantification using THERP and, in 1964, by a special journal edition of Human Factors on quantification of human performance. Throughout the 1960s, Swain and his colleagues focused on collecting human performance data for the Sandia Human Error Rate Bank (SHERB), primarily in connection with supporting the reliability of nuclear weapons assembly in the US. In 1969, Swain met with Jens Rasmussen of Risø Nationalmore » Laboratory and discussed the applicability of THERP to nuclear power applications. By 1975, in WASH-1400, Swain had articulated the use of THERP for nuclear power applications, and the approach was finalized in the watershed publication of the NUREG/CR-1278 in 1983. THERP is now 50 years old, and remains the most well known and most widely used HRA method. In this paper, the author discusses the history of THERP, based on published reports and personal communication and interviews with Swain. The author also outlines the significance of THERP. The foundations of human reliability analysis are found in THERP: human failure events, task analysis, performance shaping factors, human error probabilities, dependence, event trees, recovery, and pre- and post-initiating events were all introduced in THERP. While THERP is not without its detractors, and it is showing signs of its age in the face of newer technological applications, the longevity of THERP is a testament of its tremendous significance. THERP started the field of human reliability analysis. This paper concludes with a discussion of THERP in the context of newer methods, which can be seen as extensions of or departures from Swain’s pioneering work.« less

Efficacy and Safety of Nitazoxanide, Albendazole, and Nitazoxanide-Albendazole against Trichuris trichiura Infection: A Randomized Controlled Trial

PubMed Central

Speich, Benjamin; Ame, Shaali M.; Ali, Said M.; Alles, Rainer; Hattendorf, Jan; Utzinger, Jürg; Albonico, Marco; Keiser, Jennifer

2012-01-01

Background The currently used anthelmintic drugs, in single oral application, have low efficacy against Trichuris trichiura infection, and hence novel anthelmintic drugs are needed. Nitazoxanide has been suggested as potential drug candidate. Methodology The efficacy and safety of a single oral dose of nitazoxanide (1,000 mg), or albendazole (400 mg), and a nitazoxanide-albendazole combination (1,000 mg–400 mg), with each drug administered separately on two consecutive days, were assessed in a double-blind, randomized, placebo-controlled trial in two schools on Pemba, Tanzania. Cure and egg reduction rates were calculated by per-protocol analysis and by available case analysis. Adverse events were assessed and graded before treatment and four times after treatment. Principal Findings Complete data for the per-protocol analysis were available from 533 T. trichiura-positive children. Cure rates against T. trichiura were low regardless of the treatment (nitazoxanide-albendazole, 16.0%; albendazole, 14.5%; and nitazoxanide, 6.6%). Egg reduction rates were 54.9% for the nitazoxanide-albendazole combination, 45.6% for single albendazole, and 13.4% for single nitazoxanide. Similar cure and egg reduction rates were calculated using the available case analysis. Children receiving nitazoxanide had significantly more adverse events compared to placebo recipients. Most of the adverse events were mild and had resolved within 24 hours posttreatment. Conclusions/Significance Nitazoxanide shows no effect on T. trichiura infection. The low efficacy of albendazole against T. trichiura in the current setting characterized by high anthelmintic drug pressure is confirmed. There is a pressing need to develop new anthelmintics against trichuriasis. Trial Registration Controlled-Trials.com ISRCTN08336605 PMID:22679525

Changes in the extreme wave heights over the Baltic Sea

NASA Astrophysics Data System (ADS)

Kudryavtseva, Nadia; Soomere, Tarmo

2017-04-01

Storms over the Baltic Sea and northwestern Europe have a large impact on the population, offshore industry, and shipping. The understanding of extreme events in sea wave heights and their change due to the climate change and variability is critical for assessment of flooding risks and coastal protection. The BACCII Assessment of Climate Change for the Baltic Sea Basin showed that the extreme events analysis of wind waves is currently not very well addressed, as well as satellite observations of the wave heights. Here we discuss the analysis of all existing satellite altimetry data over the Baltic Sea Basin regarding extremes in the wave heights. In this talk for the first time, we present an analysis of 100-yr return periods, fitted generalized Pareto and Weibull distributions, number, and frequency of extreme events in wave heights in the Baltic Sea measured by the multi-mission satellite altimetry. The data span more than 23 years and provide an excellent spatial coverage over the Baltic Sea, allowing to study in details spatial variations and changes in extreme wave heights. The analysis is based on an application of the Initial Distribution Method, Annual Maxima method and Peak-Over-Threshold approach to satellite altimetry data, all validated in comparison with in-situ wave height measurements. Here we show that the 100-yr return periods of wave heights show significant spatial changes over the Baltic Sea indicating a decrease in the southern part of the Baltic Sea and an increase in adjacent areas, which can significantly affect coast vulnerability. Here we compare the observed shift with storm track database data and discuss a spatial correlation and possible connection between the changes in the storm tracks over the Baltic Sea and the change in the extreme wave heights.

Research on Visual Analysis Methods of Terrorism Events

NASA Astrophysics Data System (ADS)

Guo, Wenyue; Liu, Haiyan; Yu, Anzhu; Li, Jing

2016-06-01

Under the situation that terrorism events occur more and more frequency throughout the world, improving the response capability of social security incidents has become an important aspect to test governments govern ability. Visual analysis has become an important method of event analysing for its advantage of intuitive and effective. To analyse events' spatio-temporal distribution characteristics, correlations among event items and the development trend, terrorism event's spatio-temporal characteristics are discussed. Suitable event data table structure based on "5W" theory is designed. Then, six types of visual analysis are purposed, and how to use thematic map and statistical charts to realize visual analysis on terrorism events is studied. Finally, experiments have been carried out by using the data provided by Global Terrorism Database, and the results of experiments proves the availability of the methods.

Colonization of hydrogel lenses with Streptococcus pneumoniae: risk of development of corneal infiltrates.

PubMed

Sankaridurg, P R; Sharma, S; Willcox, M; Sweeney, D F; Naduvilath, T J; Holden, B A; Rao, G N

1999-05-01

To report the association between colonization of contact lenses with Streptococcus pneumoniae and the observation of corneal infiltrative events in a group of patients wearing disposable hydrogel lenses on an extended-wear schedule. In a prospective clinical trial, 330 patients wore disposable hydrogels on a 6-night extended-wear and replacement schedule. The contact lens, lid, and conjunctival microbiota of these subjects was analyzed at frequent intervals and at the time of an adverse event. Streptococcus pneumoniae was an uncommon isolate and was recovered from only one of the 3,763 conjunctival samples, five (0.1%) of the 3,764 lid samples, and 33 (0.8%) of the 4,315 contact lens samples. Of the 33 lens samples, 10 (30%) were associated with corneal infiltrative events. Many of the events were mild inflammatory responses and resolved rapidly on discontinuation of lens wear. The presence of S. pneumoniae on the contact lens was associated with a significant risk of development of corneal infiltrates (odds ratio, 3.0; p = 0.0227, logistic-regression analysis). Presence of S. pneumoniae on hydrogel lenses is a significant risk factor for the development of corneal infiltrates.