Trends in chronic diseases among the oldest-old in China

NASA Astrophysics Data System (ADS)

Teh, Jane K. L.; Tey, Nai Peng

2015-12-01

This study examined the prevalence of several chronic diseases among the oldest-old in China. Data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) of 4 waves collected in 2002, 2005, 2008 and 2011, filtered to include individuals aged 80 and above. Bivariate and logistic regression methods were used in analyses. There were significant differences in the prevalence of hypertension, diabetes, chronic heart diseases, stroke/cardiovascular diseases, cancer and dementia, which generally saw an increase across the 4 waves. By contrast, prevalence of Parkinson was not significantly different over the 4 waves. Logistic regression results revealed that since 2002, hypertension had been significantly higher in subsequent waves in 2005, 2008 and 2011. Stroke had also shown significant increase in the 2008 and 2011 waves. Other chronic diseases such as diabetes, heart disease, cancer, Parkinson and dementia were only found to be significantly higher in the recent 2011 wave compared to the initial wave in 2002. Arthritis, which initially increased in earlier waves, had dropped significantly in the recent 2011 wave. However, respiratory conditions had been significantly lower since the initial wave in 2002. Generally, findings confirmed the increasing trend of chronic morbidity in recent years among the oldest-old in China. Long life expectancy coupled with chronic morbidity in very late age will duly have societal and economic implications.

The relationship between the dietary inflammatory index and prevalence of radiographic symptomatic osteoarthritis: data from the Osteoarthritis Initiative.

PubMed

Veronese, Nicola; Shivappa, Nitin; Stubbs, Brendon; Smith, Toby; Hébert, James R; Cooper, Cyrus; Guglielmi, Giuseppe; Reginster, Jean-Yves; Rizzoli, Renè; Maggi, Stefania

2017-12-05

To investigate whether higher dietary inflammatory index (DII ® ) scores were associated with higher prevalence of radiographic symptomatic knee osteoarthritis in a large cohort of North American people from the Osteoarthritis Initiative database. A total of 4358 community-dwelling participants (2527 females; mean age 61.2 years) from the Osteoarthritis Initiative were identified. DII ® scores were calculated using the validated Block Brief 2000 Food-Frequency Questionnaire and scores were categorized into quartiles. Knee radiographic symptomatic osteoarthritis was diagnosed clinically and radiologically. The strength of association between divided into quartiles (DII ® ) and knee osteoarthritis was investigated through a logistic regression analysis, which adjusted for potential confounders, and results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Participants with a higher DII ® score, indicating a more pro-inflammatory diet, had a significantly higher prevalence of radiographic symptomatic knee osteoarthritis compared to those with lower DII ® score (quartile 4: 35.4% vs. quartile 1: 24.0%; p < 0.0001). Using a logistic regression analysis, adjusting for 11 potential confounders, participants with the highest DII ® score (quartile 4) had a significantly higher probability of experiencing radiographic symptomatic knee osteoarthritis (OR 1.40; 95% CI 1.14-1.72; p = 0.002) compared to participants with the lowest DII ® score (quartile 1). Higher DII ® values are associated with higher prevalence of radiographic symptomatic knee osteoarthritis.

No Significant Difference in Service Learning Online

ERIC Educational Resources Information Center

McGorry, Sue Y.

2012-01-01

Institutions of higher education are realizing the importance of service learning initiatives in developing awareness of students' civic responsibilities, leadership and management skills, and social responsibility. These skills and responsibilities are the foundation of program outcomes in accredited higher education business programs at…

Intrathecal Baclofen Dosing Regimens: A Retrospective Chart Review.

PubMed

Clearfield, Jacob S; Nelson, Mary Elizabeth S; McGuire, John; Rein, Lisa E; Tarima, Sergey

2016-08-01

To examine dosing patterns in patients receiving baclofen via intrathecal baclofen pumps to assess for common patterns by diagnosis, ambulation ability, and affected limbs distribution. This trial study included 25 patients with baclofen pumps selected from the 356 patients enrolled in our center's baclofen pump program. Selection was done by splitting all patients into diagnostic categories of stroke, multiple sclerosis, traumatic/anoxic brain injury, cerebral palsy, and spinal cord injury, and then, five patients were randomly selected from each diagnosis.A systematic chart review was then conducted for each patient from Jan 1, 2008, through September 16, 2013, to look at factors including mean daily dose at end of study, and among those implanted during the study mean initial stable dose and time to initial stable dose. Analysis of mean daily dose across diagnoses found significant differences, with brain injury, cerebral palsy, and spinal cord injury patients having higher doses while multiple sclerosis and stroke patients required lower doses. Nonambulatory patients strongly trended to have higher daily doses than ambulatory patients. Similar trends of mean initial stable dose being higher in a similar pattern as that of end mean daily dose were seen according to diagnoses and ambulatory status, although statistical significance could not be achieved with the small sample size. Significant differences in dosing were found between diagnoses and trended to differ by ambulatory status at the end of the study, and similar trends could be observed in achieving initial stable dose. © 2015 International Neuromodulation Society.

Effect of initial moisture content on the in-vessel composting under air pressure of organic fraction of municipal solid waste in Morocco.

PubMed

Makan, Abdelhadi; Assobhei, Omar; Mountadar, Mohammed

2013-01-03

This study aimed to evaluate the effect of initial moisture content on the in-vessel composting under air pressure of organic fraction of municipal solid waste in Morocco in terms of internal temperature, produced gases quantity, organic matter conversion rate, and the quality of the final composts.For this purpose, in-vessel bioreactor was designed and used to evaluate both appropriate initial air pressure and appropriate initial moisture content for the composting process. Moreover, 5 experiments were carried out within initial moisture content of 55%, 65%, 70%, 75% and 85%. The initial air pressure and the initial moisture content of the mixture showed a significant effect on the aerobic composting. The experimental results demonstrated that for composting organic waste, relatively high moisture contents are better at achieving higher temperatures and retaining them for longer times.This study suggested that an initial moisture content of around 75%, under 0.6 bar, can be considered as being suitable for efficient composting of organic fraction of municipal solid waste. These last conditions, allowed maximum value of temperature and final composting product with good physicochemical properties as well as higher organic matter degradation and higher gas production. Moreover, final compost obtained showed good maturity levels and can be used for agricultural applications.

Selective sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer: results of the GEICAM 2005-07 study.

PubMed

Piñero-Madrona, Antonio; Escudero-Barea, María J; Fernández-Robayna, Francisco; Alberro-Adúriz, José A; García-Fernández, Antonio; Vicente-García, Francisco; Dueñas-Rodriguez, Basilio; Lorenzo-Campos, Miguel; Caparrós, Xavier; Cansado-Martínez, María P; Ramos-Boyero, Manuel; Rojo-Blanco, Roberto; Serra-Genís, Constantí

2015-01-01

A controversial aspect of breast cancer management is the use of sentinel lymph node biopsy (SLNB) in patients requiring neoadjuvant chemotherapy (NCT). This paper discusses the detection rate (DT) and false negatives (FN) of SLNB after NCT to investigate the influence of initial nodal disease and the protocols applied. Prospective observational multicenter study in women with breast cancer, treated with NCT and SLNB post-NCT with subsequent lymphadenectomy. DT and FN rates were calculated, both overall and depending on the initial nodal status or the use of diagnostic protocols pre-SLNB. No differences in DT between initial node-negative cases and positive cases were found (89.8 vs. 84.4%, P=.437). Significant differences were found (94.1 vs. 56.5%, P=0,002) in the negative predictive value, which was lower when there was initial lymph node positivity, and a higher rate of FN, not significant (18.2 vs. 43.5%, P=.252) in the same cases. The axillary study before SLNB and after the NCT, significantly decreased the rate of FN in patients with initial involvement (55.6 vs 12.5, P=0,009). NCT means less DT and a higher rate of FN in subsequent SLNB, especially if there is initial nodal involvement. The use of protocols in axillary evaluation after administering the NCT and before BSGC, decreases the FN rate in these patients. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Depressive Symptoms Moderate Dating Violence Prevention Outcomes Among Adolescent Girls.

PubMed

Collibee, Charlene; Rizzo, Christie J; Kemp, Kathleen; Hood, Erik; Doucette, Hannah; Gittins Stone, Daniel I; DeJesus, Brett

2018-04-01

Few dating violence prevention programs assess how variations in initial violence risk affects responsiveness. This study examines the efficacy of Date SMART, a dating violence and sexual risk prevention program designed to target high-risk adolescent girls, in preventing dating violence in the context of varying initial levels of depressive symptoms. A diverse sample of N = 109 female adolescents with a history of physical dating violence participated in a randomized controlled trial of the Date SMART program and a knowledge only (KO) comparison. Using baseline depression level as a primary risk factor, a series of multilevel models revealed significant main effects of baseline depression such that higher baseline depression was associated with greater physical dating violence perpetration and victimization. Results also showed a three-way interaction for assessment point, depressive symptoms, and condition for physical dating violence perpetration. Specifically, those with higher baseline depression in Date SMART showed significantly less physical dating violence perpetration at follow-ups compared with those with higher baseline depression in the KO group. This difference in violence reduction between conditions was not observed for those with lower baseline depression. Date SMART appears to effectively reduce physical dating violence perpetration in those with higher levels of initial risk. Current findings support that adolescents with different risk profiles respond differently to violence prevention programs.

Preoperative fat-free mass: a predictive factor of weight loss after gastric bypass.

PubMed

Robert, Maud; Pelascini, Elise; Disse, Emmanuel; Espalieu, Philippe; Poncet, Gilles; Laville, Martine; Gouillat, Christian

2013-04-01

Weight loss failure occurs in 8% to 40% of patients after gastric bypass (GBP). The aim of our study was to analyse the predictive factors of weight loss at 1 year so as to select the best candidates for this surgery and reduce the failures. We included 73 patients treated by laparoscopic GBP. We retrospectively analysed the predictive factors of weight loss in kilograms as well as excess weight loss in percentage (EWL%) at 1 year. The population was divided into tertiles so as to compare the sub-group with the highest weight loss with the sub-group with the least satisfactory results. The significantly predictive factors of a better weight loss in kilograms were male, higher initial weight (144 versus 118 kg, p = 0.002), a significant early weight loss and a higher preoperative percentage of fat-free mass (FFM%; p = 0.03). A higher FFM% was also associated with a better EWL% (p = 0.004). The preoperative FFM (in kilograms) was the principal factor accounting for the weight loss at 1 year regardless of age, gender, height and initial body mass index (BMI; p < 0.0001). There was a better correlation between FFM and weight loss (Spearman test, p = 0.0001) than between initial BMI and weight loss (p = 0.016). We estimated weight loss at 1 year according to initial FFM using the formula: 0.5 kg of lost weight per kilogram of initial FFM. The initial FFM appears to be a decisive factor in the success of GBP. Thus, the sarcopoenic patients would appear to be less suitable candidates for this surgery.

Outsourcing in Higher Education: An Empirical Examination

ERIC Educational Resources Information Center

Gupta, Atul; Herath, S. Kanthi; Mikouiza, Nathalie C.

2005-01-01

Purpose: To measure the degree of implementation and satisfaction level with the outsourcing initiatives from higher education institutions. Design/methodology/approach: Uses a survey questionnaire to measure the levels of satisfaction with the institutions' services and the questionnaire was based on six factors that are deemed significant in…

Two-year outcomes in initial survivors with acute liver failure: results from a prospective, multicentre study.

PubMed

Fontana, Robert J; Ellerbe, Caitlyn; Durkalski, Valerie E; Rangnekar, Amol; Reddy, Rajender K; Stravitz, Todd; McGuire, Brendan; Davern, Timothy; Reuben, Adrian; Liou, Iris; Fix, Oren; Ganger, Daniel R; Chung, Raymond T; Schilsky, Mike; Han, Steven; Hynan, Linda S; Sanders, Corron; Lee, William M

2015-02-01

The long-term clinical outcomes in initial survivors with acute liver failure (ALF) are not well known. The aim of this study was to provide an overview of the 2-year clinical outcomes among initial survivors and liver transplant (LT) recipients that were alive 3 weeks after enrolment in the Acute Liver Failure Study Group (ALFSG). Outcomes in adult ALFSG patients that were enrolled between 1998 and 2010 were reviewed. Two-year patient survival was significantly higher in the 262 LT recipients (92.4%) compared to the 306 acetaminophen (APAP) spontaneous survivors (SS) (89.5%) and 200 non-APAP SS (75.5%) (P < 0.0001). The causes of death were similar in the three groups but the time to death was significantly longer in the LT recipients (P < 0.0001). Independent predictors of 2-year mortality in the APAP group were a high serum phosphate level and patient age (c-statistic = 0.65 (0.54, 0.76)), patient age and days from jaundice to ALF onset in the non-APAP group (c-statistic = 0.69 (0.60, 0.78)), and patient age, days from jaundice, and higher coma grade in the LT recipients (c-statistic = 0.74 (0.61, 0.87)). The LT recipients were significantly more likely to be employed and have a higher educational level (P < 0.05). Two-year outcomes in initial survivors of ALF are generally good but non-APAP patients have a significantly lower survival which may relate to pre-existing medical comorbidities. Spontaneous survivors with APAP overdose experience substantial morbidity during follow-up from ongoing psychiatric and substance abuse issues. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Drug resistance characteristics of Mycobacterium tuberculosis isolates to four first-line antituberculous drugs from tuberculosis patients with AIDS in Beijing, China.

PubMed

Gao, Gui-ju; Lian, Lulu; Sun, Yue; Wei, Jianhao; Xiao, Jiang; Wang, Xiaoying; Zhang, Ling; Zhao, Xiuqin; Yang, Di; Zhao, Hong-xin; Zhao, Hui; Wang, Hui-zhu; Wan, Kang-lin; Li, Xing-wang

2015-02-01

The objective of this study was to investigate the drug resistance characteristics of Mycobacterium tuberculosis isolates to four first-line antituberculous drugs (ATDs) from tuberculosis (TB) patients with AIDS in Beijing, China. All M. tuberculosis strains were isolated from specimens from TB patients with AIDS hospitalised between April 2010 and October 2012. Isolates were cultured by mycobacterial culture methods and were identified by multilocus PCR. Drug sensitivity testing was performed by the proportion method with the following first-line ATDs: isoniazid; rifampicin; streptomycin; and ethambutol. Results were compared with the drug resistance status of M. tuberculosis strains isolated from TB patients without HIV infection in Beijing. Among 41 M. tuberculosis isolates from TB patients with AIDS, the rates of total drug resistance (58.5%), initial drug resistance (46.7%) and acquired drug resistance (90.9%) were significantly higher than in TB patients without HIV infection (34.1%, 24.5% and 48.5%, respectively; P<0.05). In TB patients with AIDS, the rates of acquired drug resistance (90.9%) and acquired multidrug-resistant TB (MDR-TB) (54.5%) were significantly higher than the rates of initial drug resistance (46.7%) and initial MDR-TB (10.0%) (P<0.05). In patients with TB without HIV infection, the rate of acquired drug resistance (48.5%) was significantly higher than the rate of initial drug resistance (24.5%) (P<0.05). M. tuberculosis drug resistance in TB patients with AIDS is significantly more serious than in TB patients without HIV infection. These results showed that more attention should be paid to M. tuberculosis drug resistance in AIDS patients. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States.

PubMed

Henry, Kevin A; Swiecki-Sikora, Allison L; Stroup, Antoinette M; Warner, Echo L; Kepka, Deanna

2017-07-14

This study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.). Data from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately. In 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of  HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32)  than Hispanic boys in  low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas. Higher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with high poverty may be attributable to factors such as vaccine acceptance, health-care practices, and their access to HPV vaccines through the Vaccines for Children Program, which provides free vaccines to uninsured and under-insured children. Given the low HPV vaccination rates among boys in the U.S., these results provide important evidence to inform public health interventions to increase HPV vaccination.

Comparative treatment patterns, healthcare resource utilization and costs of atomoxetine and long-acting methylphenidate among children and adolescents with attention-deficit/hyperactivity disorder in Germany.

PubMed

Greven, Peter; Sikirica, Vanja; Chen, Yaozhu J; Curtice, Tammy G; Makin, Charles

2017-09-01

Attention-deficit/hyperactivity disorder (ADHD) imposes a substantial burden on patients and their families. A retrospective, propensity score-matched cohort study compared treatment patterns, healthcare resource utilization (HRU) and costs among children/adolescents with ADHD aged 6-17 years at treatment initiation (index) in Germany who received atomoxetine (ATX) or long-acting methylphenidate (LA-MPH) monotherapy. Patients received at least one prescription for their index medication (ATX/LA-MPH) during 2006-2010; the first prescription marked the index date. ATX- and LA-MPH-indexed cohorts were matched 1:1 (n = 737); a patient subset was identified that had not received ADHD-indicated medications in 12 months prior to index (novel initiators: ATX, n = 486; LA-MPH, n = 488). Treatment patterns were evaluated among novel initiators, and HRU and costs among the matched cohorts in the 12 months after index. No significant differences in baseline characteristics were found between the novel initiator patient subsets. ATX-indexed novel initiators had significantly longer persistence to index medication [mean (standard deviation; SD) days: 222.0 (133.9) vs 203.2 (135.0), P = 0.029) but higher switching rates (8.8 vs 5.5 %, P = 0.045) than LA-MPH-indexed novel initiators. The total ATX-indexed cohort required more prescriptions [any medication; mean (SD): 20.9 (11.5) vs 15.7 (9.0), P < 0.001] and outpatient visits [mean (SD): 10.1 (6.3) vs 8.3 (5.3), P < 0.001], and incurred significantly higher total median healthcare costs (€1144 vs €541, P < 0.001) versus matched LA-MPH patients. These real-world data indicate that, among children/adolescents with ADHD in Germany, ATX-indexed patients may require more prescriptions and physician visits, and incur higher total healthcare costs, than matched LA-MPH patients.

Student Retention in Higher Education: Some Conceptual and Programmatic Perspectives.

ERIC Educational Resources Information Center

Lang, Marvel

2002-01-01

Provides a review of conceptual perspectives on the salient issues affecting student retention in higher education generally, and minority student retention in particular, over the past few decades. Also summarizes programmatic strategies implemented at institutions as examples of student retention initiatives that have had significant impacts.…

Corticosterone levels and behavioral changes induced by simultaneous exposure to chronic social stress and enriched environments in NMRI male mice.

PubMed

Mesa-Gresa, Patricia; Ramos-Campos, Marta; Redolat, Rosa

2016-05-01

Environmental enrichment (EE) is an experimental model which is believed to counteract some of the effects induced by stressors, although few studies have exposed rodents simultaneously to EE and stress. Our aim was to compare the short- and long-term effects of different housing conditions in mice submitted to chronic stress. 128 NMRI male mice arrived at our laboratory on postnatal day (PND) 21. During Phase I (PND 28), animals were randomly assigned to four experimental conditions: 1) EE+STRESS: mice housed in EE and submitted to social stress (n=32); 2) EE+NO STRESS: mice housed in EE without stress (n=32); 3) SE+STRESS: mice maintained in standard conditions (SE) and submitted to social stress (n=32); and 4) SE+NO STRESS (n=32). At the end of Phase I (PND 77), one cohort of 32 animals was used for behavioral assessment whereas another cohort of 32 was sacrificed for corticosterone analysis. Results indicated that EE animals showed less body weight, higher water and food intake, diminished anxiety response and decreased motor and exploratory behavior than SE mice. Mice exposed to stress gained less body weight, showed higher food and fluid intake and displayed decreased exploratory behavior than non-stressed mice. Furthermore, EE+STRESS group displayed significantly higher corticosterone levels than EE+NO STRESS group whereas EE+NO STRESS group showed lower levels than SE+NO STRESS. On PND 83, Phase II of the study began. Animals (n=96) were assigned to two different housing conditions: EE (n=48) and SE (n=48). On PND 112, corticosterone analysis (n=32) and behavioral study (n=64) were done. The factor "Housing Phase II" reached statistical significance. Results indicated that EE animals showed lower body weight and higher fluid intake than SE group, as well as decreased anxiety. No clear effects on motor and exploratory behavior or learning were observed. When long-term effects were analyzed, results indicated that "Initial Housing" condition was significant: animals allocated in EE during Phase I of the study showed higher corticosterone levels, lower body weight and higher fluid intake than SE mice. "Initial Stress" had significant long-term actions on food intake and exploratory behavior: animals initially reared under stress conditions displayed higher food intake and lower exploration levels on the hole-board test than non-stressed mice. In the elevated plus-maze, there were significant interactions between factors "Initial Housing" and "Initial Stress". These factors did not reach statistical significance for motor activity or learning task. We can conclude that both short- and long-term effects of housing conditions are evident for corticosterone levels, body weight and fluid intake. Social stress induced short-term effects on body weight, food and fluid intake and exploratory behavior whereas long-acting effects were reflected on food intake and exploratory behavior. Further studies are needed in order to explore more in depth behavioral and physiological consequences of social stress and environmental enrichment. Copyright © 2016. Published by Elsevier Inc.

Effect of initial moisture content on the in-vessel composting under air pressure of organic fraction of municipal solid waste in Morocco

PubMed Central

2013-01-01

This study aimed to evaluate the effect of initial moisture content on the in-vessel composting under air pressure of organic fraction of municipal solid waste in Morocco in terms of internal temperature, produced gases quantity, organic matter conversion rate, and the quality of the final composts. For this purpose, in-vessel bioreactor was designed and used to evaluate both appropriate initial air pressure and appropriate initial moisture content for the composting process. Moreover, 5 experiments were carried out within initial moisture content of 55%, 65%, 70%, 75% and 85%. The initial air pressure and the initial moisture content of the mixture showed a significant effect on the aerobic composting. The experimental results demonstrated that for composting organic waste, relatively high moisture contents are better at achieving higher temperatures and retaining them for longer times. This study suggested that an initial moisture content of around 75%, under 0.6 bar, can be considered as being suitable for efficient composting of organic fraction of municipal solid waste. These last conditions, allowed maximum value of temperature and final composting product with good physicochemical properties as well as higher organic matter degradation and higher gas production. Moreover, final compost obtained showed good maturity levels and can be used for agricultural applications. PMID:23369502

Gender differences in salary and practice ownership expectations of matriculating veterinary students.

PubMed

Bristol, David G

2011-08-01

To examine gender differences in initial and long-term salary and practice ownership expectations among first-year veterinary students. Survey. First-year veterinary students at the North Carolina State University College of Veterinary Medicine during 2000 through 2003 and 2005 through 2009. A 1-page survey was distributed to students during orientation exercises or on the first day of a first-year course on ethics and jurisprudence. Students were asked to indicate their expected salary at graduation and in 5-year increments after graduation and to indicate whether they expected to own a practice after graduation. Responses were obtained from 567 female and 120 male students. There was no significant difference in initial salary expectations between male and female students. However, men had higher expectations for salary increases over the course of their career, so that expected salary was significantly higher for men than for women 5 years after graduation and beyond. A significantly greater percentage of men (69/93 [74.2%]) than women (242/499 [48.5%]) indicated they expected to own a practice. Although male and female veterinary students had similar expectations with regard to initial salaries, the male students had higher long-term salary expectations and were more likely to indicate an expectation to become a practice owner. Differences in expectations may lead to differences in behavior when those expectations are or are not met.

Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection

PubMed Central

Swordy, Alice; Mori, Luisa; Laker, Leana; Muenchhoff, Maximilian; Matthews, Philippa C.; Tudor-Williams, Gareth; Lavandier, Nora; van Zyl, Anriette; Hurst, Jacob; Walker, Bruce D.; Ndung’u, Thumbi; Prendergast, Andrew; Goulder, Philip; Jooste, Pieter

2015-01-01

The incidence and severity of infections in childhood is typically greater in males. The basis for these observed sex differences is not well understood, and potentially may facilitate novel approaches to reducing disease from a range of conditions. We here investigated sex differences in HIV-infected children in relation to antiretroviral therapy (ART) initiation and post-treatment outcome. In a South African cohort of 2,101 HIV-infected children, we observed that absolute CD4+ count and CD4% were significantly higher in ART-naïve female, compared to age-matched male, HIV-infected children. Absolute CD4 count and CD4% were also significantly higher in HIV-uninfected female versus male neonates. We next showed that significantly more male than female children were initiated on ART (47% female); and children not meeting criteria to start ART by >5yrs were more frequently female (59%; p<0.001). Among ART-treated children, immune reconstitution of CD4 T-cells was more rapid and more complete in female children, even after adjustment for pre-ART absolute CD4 count or CD4% (p=0.011, p=0.030, respectively). However, while ART was initiated as a result of meeting CD4 criteria less often in females (45%), ART initiation as a result of clinical disease in children whose CD4 counts were above treatment thresholds occurred more often in females (57%, p<0.001). The main sex difference in morbidity observed in children initiating ART above CD4 thresholds, above that of TB disease, was as a result of wasting and stunting observed in females with above-threshold CD4 counts (p=0.002). These findings suggest the possibility that optimal treatment of HIV-infected children might incorporate differential CD4 treatment thresholds for ART initiation according to sex. PMID:26151555

Evaluation of the Missouri WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) breast-feeding peer counselling programme.

PubMed

Yun, Shumei; Liu, Qian; Mertzlufft, Kathy; Kruse, Catherine; White, Maggie; Fuller, Phyllis; Zhu, Bao-Ping

2010-02-01

To evaluate the effectiveness of the peer counselling (PC) programme on breast-feeding initiation among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Missouri, and to identify factors that facilitate breast-feeding initiation. We used the data from the 2006 Missouri Pregnancy Nutrition Surveillance System, Missouri Live Birth Records and the Missouri WIC programme to compare breast-feeding initiation rates between PC and non-PC agencies. We used multilevel logistic regression, with individual participants being nested within agencies, to control for individual- and agency-level characteristics. The breast-feeding initiation rate in PC agencies was significantly higher than in non-PC agencies among prenatal participants, but the difference was not significant among postpartum participants. After controlling for maternal sociodemographic characteristics, compared with prenatal cases in non-PC agencies, prenatal cases in PC agencies were more likely to initiate breast-feeding (OR = 1.21; 95 % CI 1.03, 1.43), whereas postpartum cases were less likely to initiate breast-feeding. Among prenatal participants in PC agencies, longer duration of prenatal WIC enrolment was associated with a higher rate of breast-feeding initiation. After adjusting for maternal sociodemographic characteristics and other agency-level characteristics, participants of PC agencies with an international board-certified lactation consultant were more likely to initiate breast-feeding than participants of PC agencies without such a consultant (OR = 1.21; 95 % CI 1.01, 1.45). Prenatal participation in the WIC breast-feeding PC programme (especially participation early during pregnancy) was associated with an increased rate of breast-feeding initiation in Missouri.

Low prevalence of renal dysfunction in HIV-infected pregnant women: implications for guidelines for the prevention of mother-to-child transmission of HIV.

PubMed

Myer, Landon; Kamkuemah, Monika; Kaplan, Richard; Bekker, Linda-Gail

2013-11-01

Emerging international guidelines for the prevention of mother-to-child transmission of HIV infection across sub-Saharan Africa call for the initiation of a triple-drug antiretroviral regimen containing tenofovir, a potentially nephrotoxic agent, in all HIV-infected pregnant women at the first antenatal clinic visit. While there are significant benefits to the rapid initiation of antiretroviral therapy (ART) in pregnancy, there are few data on the prevalence of pre-existing renal disease in HIV-infected pregnant women and in turn, the potential risks of this approach are not well understood. We analysed data on renal function in consecutive patients eligible for ART at a large primary healthcare clinic in Cape Town. All individuals were screened for renal dysfunction via serum creatinine and estimation of creatinine clearance via the Cockroft-Gault equation. Over a 2-year period, 238 pregnant women, 1014 non-pregnant women and 609 men were screened to initiate ART. Pregnant women eligible were significantly younger, in earlier stages of HIV disease, had higher CD4 cell counts and lower HIV viral loads, than non-pregnant adults. The median serum creatinine in pregnant women (46 µmol/L) was significantly lower and the median creatinine clearance (163 ml/min/1.73 m(2) ) was significantly higher than other groups (P < 0.001 and P = 0.004, respectively). Fewer than 1% of pregnant women had moderate renal dysfunction before ART initiation, with no instances of severe dysfunction observed, compared to 7% moderate or severe renal dysfunction in non-pregnant women or men (P < 0.001). Renal dysfunction in HIV-infected pregnant women is significantly less common than in other HIV-infected adults eligible for ART. The risks associated with initiating tenofovir immediately in pregnant women before reviewing serum creatinine results may be limited, and the benefits of rapid ART initiation in pregnancy may outweigh possible risks of nephrotoxicity. © 2013 John Wiley & Sons Ltd.

The increased cost of ventral hernia recurrence: a cost analysis.

PubMed

Davila, D G; Parikh, N; Frelich, M J; Goldblatt, M I

2016-12-01

Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p < 0.0001). However, for index laparoscopic repairs, both the adjusted total hospital cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

Higher Education for Sustainable Development in China

ERIC Educational Resources Information Center

Niu, Dongjie; Jiang, Dahe; Li, Fengting

2010-01-01

Purpose: The purpose of this paper is to analyse the significance of developments across Chinese higher education in the field of education and learning for sustainable development (SD) and to assess the relative impact of these initiatives. Design/methodology/approach: This is a review of policy and practice to examine developments, challenges,…

Effect of long-term training and acute physical exercise on red cell 2,3-diphosphoglycerate.

PubMed

Remes, K; Vuopio, P; Härkönen, M

1979-11-01

A statistically significant 10% increase (p less than 0.005) in mean red cell 2,3-diphosphoglycerate (2,3-DPG) concentration, concomitantly with a mean 16% increase (p less than 0.001) in the predicted maximal oxygen uptake (VO2max) was observed in 29 recruits, who were studied during 6 months of physical training in military service. The increase in 2,3-DPG was higher, the lower the initial 2,3-DPG and VO2max levels. The mean initial 2,3-DPG level was higher in the subjects with a higher initial VO2max. A strenuous but highly aerobic 21-km marching exercise elicited a mean 9% increase (p less than 0.005) in red cell 2,3-DPG concentration. A significantly greater response of 2,3-DPG to marching exercise was observed in subjects with a lower pre-test VO2max than in those with a higher pre-test VO2max. During another more competitive march 2,3-DPG remained almost unchanged and was associated with a tendency towards a negative correlation with the acccompanying lactate response (r = -0.60, p less than 0.05). Red cell 2,3-DPG response to a standardized exercise is considered to be a suitable indicator for evaluating the effect of training on an individual.

Triggers of sustained monomorphic ventricular tachycardia differ among patients with varying etiologies of left ventricular dysfunction.

PubMed

Rosman, Jonathan; Hanon, Sam; Shapiro, Michael; Evans, Steven J; Schweitzer, Paul

2006-04-01

The mechanisms underlying the initiation of sustained ventricular tachycardia (VT) have not been fully elucidated. The extent to which reentry, abnormal automaticity, and triggered activity play a role in VT differs depending on the etiology of left ventricular dysfunction. By analyzing electrograms from implantable cardioverter defibrillator (ICD), we sought to determine whether there were differences in VT initiation patterns between patients with ischemic and nonischemic cardiomyopathy. We analyzed ICD electrograms in patients with ejection fractions < 40% who had sustained VT over a 27-month period. The trigger for VT onset was classified as a ventricular premature beat (VPB), supraventricular tachycardia, or of "sudden onset." The baseline cycle length, VT cycle length, coupling interval, and prematurity ratio were recorded for each event. The prematurity ratio was calculated as the coupling interval of the VT initiator divided by the baseline cycle length. Sixty-three VT events in 14 patients met the inclusion criteria. A VPB initiated the VT in 58 episodes (92%), 1 episode (2%) was initiated by a supraventricular tachycardia, and 4 episodes (6%) were sudden onset. The prematurity ratio was significantly higher (P < 0.05) in patients with ischemic cardiomyopathy (0.751 +/- 0.068) as compared to patients with nonischemic cardiomyopathy (0.604 +/- 0.139). VPBs initiated most sustained VT episodes. A significantly higher prematurity ratio was observed in the ischemic heart disease group. This may represent different mechanisms of VT initiation in patients with ischemic versus nonischemic heart disease.

Knowing Me, Knowing You: Building Strengths Awareness, Belonging, and Persistence in Higher Education

ERIC Educational Resources Information Center

Soria, Krista M.; Stubblefield, Robin

2015-01-01

This goal of this study was to examine the benefits of a campus-wide initiative to build first-year students' strengths awareness. The results of a survey of the first-year class (n?=?1,421) suggest a positive and significant relationship between students' strengths awareness and their belief that the strengths initiatives on campus positively…

The personal costs of citizenship behavior: the relationship between individual initiative and role overload, job stress, and work-family conflict.

PubMed

Bolino, Mark C; Turnley, William H

2005-07-01

By and large, prior research has focused on the positive aspects of organizational citizenship behavior (OCB). D. W. Organ and K. Ryan (1995), though, suggest that individuals who engage in high levels of OCB may become overloaded. This research explores the relationship between a specific type of OCB--namely, individual initiative--and role overload, job stress, and work-family conflict. Results from a sample of 98 couples indicate that higher levels of individual initiative (as assessed by the spouse or significant other) are associated with higher levels of employee role overload, job stress, and work-family conflict. The findings also suggest that the relationship between individual initiative and work-family conflict is moderated by gender, such that the relationship is stronger among women than among men. Some implications of this work and directions for future research are discussed as well. Copyright 2005 APA, all rights reserved.

Patient-derived Mammosphere and Xenograft Tumour Initiation Correlates with Progression to Metastasis.

PubMed

Eyre, Rachel; Alférez, Denis G; Spence, Kath; Kamal, Mohamed; Shaw, Frances L; Simões, Bruno M; Santiago-Gómez, Angélica; Sarmiento-Castro, Aida; Bramley, Maria; Absar, Mohammed; Saad, Zahida; Chatterjee, Sumohan; Kirwan, Cliona; Gandhi, Ashu; Armstrong, Anne C; Wardley, Andrew M; O'Brien, Ciara S; Farnie, Gillian; Howell, Sacha J; Clarke, Robert B

2016-12-01

Breast cancer specific mortality results from tumour cell dissemination and metastatic colonisation. Identification of the cells and processes responsible for metastasis will enable better prevention and control of metastatic disease, thus reducing relapse and mortality. To better understand these processes, we prospectively collected 307 patient-derived breast cancer samples (n = 195 early breast cancers (EBC) and n = 112 metastatic samples (MBC)). We assessed colony-forming activity in vitro by growing isolated cells in both primary (formation) and secondary (self-renewal) mammosphere culture, and tumour initiating activity in vivo through subcutaneous transplantation of fragments or cells into mice. Metastatic samples formed primary mammosphere colonies significantly more frequently than early breast cancers and had significantly higher primary mammosphere colony formation efficiency (0.9 % vs. 0.6 %; p < 0.0001). Tumour initiation in vivo was significantly higher in metastatic than early breast cancer samples (63 % vs. 38 %, p = 0.04). Of 144 breast cancer samples implanted in vivo, we established 20 stable patient-derived xenograft (PDX) models at passage 2 or greater. Lung metastases were detected in mice from 14 PDX models. Mammosphere colony formation in vitro significantly correlated with the ability of a tumour to metastasise to the lungs in vivo (p = 0.05), but not with subcutaneous tumour initiation. In summary, the breast cancer stem cell activities of colony formation and tumour initiation are increased in metastatic compared to early samples, and predict metastasis in vivo. These results suggest that breast stem cell activity will predict for poor outcome tumours, and therapy targeting this activity will improve outcomes for patients with metastatic disease.

Steroid plus antiviral treatment for Bell's palsy.

PubMed

Kang, H M; Jung, S Y; Byun, J Y; Park, M S; Yeo, S G

2015-05-01

The effectiveness of antiviral agents for the treatment of Bell's palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bell's palsy. A total of 1342 patients diagnosed with Bell's palsy who visited the Kyung Hee Medical Center in Seoul, Korea, from 2002 to 2012 were included in this study. Patients in the S + A group were treated with prednisolone and antiviral agents (n = 569) and those in the S group with prednisolone alone (n = 773). Outcomes were measured using the House-Brackmann (HB) scale according to age, initial disease severity, electroneurography (ENoG) findings and underlying comorbidities. The rate of recovery (HB grades I and II) with initially severe Bell's palsy (HB grades V and VI) was higher in the S + A than in the S group (P = 0.001). However, the rates of recovery were similar with initially moderate palsy (HB grades II-IV) (P = 0.502). In patients classified according to age and ENoG-determined severity of palsy, the overall recovery rate was higher in the S + A than in the S group, but the differences were not statistically significant (P > 0.05 for both). The recovery rate without diabetes mellitus (DM) and hypertension (HTN) was higher in the S + A group than in the S group (P = 0.031). But in the patients with HTN and DM, the difference in recovery rates between the S + A and S groups was not statistically significant (P = 0.805). Treatment with a steroid plus antiviral agent resulted in significantly higher recovery rates than steroid therapy alone in patients with initially severe Bell's palsy and without either HTN or DM, and a nonsignificant trend towards higher recovery rates in all patients with Bell's palsy in this study. Antiviral agents may therefore help in the treatment of Bell's palsy. © 2014 The Association for the Publication of the Journal of Internal Medicine.

Radiation or chemoradiation: initial utility study of selected therapy for local advanced stadium cervical cancer

NASA Astrophysics Data System (ADS)

Pramitasari, D. A.; Gondhowiardjo, S.; Nuranna, L.

2017-08-01

This study aimed to compare radiation only or chemo radiation treatment of local advanced cervical cancers by examining the initial response of tumors and acute side effects. An initial assessment employed value based medicine (VBM) by obtaining utility values for both types of therapy. The incidences of acute lower gastrointestinal, genitourinary, and hematology side effects in patients undergoing chemoradiation did not differ significantly from those undergoing radiation alone. Utility values for patients who underwent radiation alone were higher compared to those who underwent chemoradiation. It was concluded that the complete response of patients who underwent chemoradiation did not differ significantly from those who underwent radiation alone.

Left-handers look before they leap: handedness influences reactivity to novel Tower of Hanoi tasks

PubMed Central

Wright, Lynn; Hardie, Scott M.

2015-01-01

A sample of 203 task naïve left- and right-handed participants were asked to complete a combination of the 3- and 4-disk Towers of Hanoi (ToH), manipulating novelty and complexity. Self-reported state anxiety and latency to respond (initiation time) were recorded before each ToH. Novelty had a major effect on initiation time, particularly for left-handers. Left-handers had a longer latency to start and this was significantly longer on the first trial. Irrespective of hand-preference, initiation time reduced on the second trial, however, this was greatest for left-handers. Condition of task did not systematically influence initiation time for right handers, but did for left-handers. State anxiety was influenced by task novelty and complexity in a more complicated way. During the first trial, there was a significant handedness × number of disks interaction with left-handers having significantly higher state anxiety levels before the 3-disk ToH. This suggests that the initial reaction to this task for left-handers was not simply due to perceived difficulty. On their second trial, participants completing a novel ToH had higher state anxiety scores than those completing a repeated version. Overall, left-handers had a larger reduction in their state anxiety across trials. Relating to this, the expected strong positive correlation between state and trait anxiety was absent for left-handed females in their first tower presentation, but appeared on their second. This was driven by low trait anxiety individuals showing a higher state anxiety response in the first (novel) trial, supporting the idea that left-handed females respond to novelty in a way that is not directly a consequence of their trait anxiety. A possible explanation may be stereotype threat influencing the behavior of left-handed females. PMID:25691878

Persistence of Graduate Students at an Urban Research Institution in the Southeastern Region of the United States

ERIC Educational Resources Information Center

Gibbs, Lakeisha Nicole

2012-01-01

Attrition rates have remained at the breadth of significant concerns for higher education institutions. During the progression toward a graduate degree, countless students lose focus and "stop-out." An unsuccessful practice in higher education is the lack of concentrated initiatives to retain graduate students and assist in providing…

Linear and non-linear flow mode in Pb-Pb collisions at √{sNN} = 2.76 TeV

NASA Astrophysics Data System (ADS)

Acharya, S.; Adamová, D.; Adolfsson, J.; Aggarwal, M. M.; Aglieri Rinella, G.; Agnello, M.; Agrawal, N.; Ahammed, Z.; Ahmad, N.; Ahn, S. U.; Aiola, S.; Akindinov, A.; Alam, S. N.; Alba, J. L. B.; Albuquerque, D. S. D.; Aleksandrov, D.; Alessandro, B.; Alfaro Molina, R.; Alici, A.; Alkin, A.; Alme, J.; Alt, T.; Altenkamper, L.; Altsybeev, I.; Alves Garcia Prado, C.; An, M.; Andrei, C.; Andreou, D.; Andrews, H. A.; Andronic, A.; Anguelov, V.; Anson, C.; Antičić, T.; Antinori, F.; Antonioli, P.; Anwar, R.; Aphecetche, L.; Appelshäuser, H.; Arcelli, S.; Arnaldi, R.; Arnold, O. W.; Arsene, I. C.; Arslandok, M.; Audurier, B.; Augustinus, A.; Averbeck, R.; Azmi, M. D.; Badalà, A.; Baek, Y. W.; Bagnasco, S.; Bailhache, R.; Bala, R.; Baldisseri, A.; Ball, M.; Baral, R. C.; Barbano, A. M.; Barbera, R.; Barile, F.; Barioglio, L.; Barnaföldi, G. G.; Barnby, L. S.; Barret, V.; Bartalini, P.; Barth, K.; Bartsch, E.; Basile, M.; Bastid, N.; Basu, S.; Bathen, B.; Batigne, G.; Batista Camejo, A.; Batyunya, B.; Batzing, P. C.; Bearden, I. G.; Beck, H.; Bedda, C.; Behera, N. K.; Belikov, I.; Bellini, F.; Bello Martinez, H.; Bellwied, R.; Beltran, L. G. E.; Belyaev, V.; Bencedi, G.; Beole, S.; Bercuci, A.; Berdnikov, Y.; Berenyi, D.; Bertens, R. A.; Berzano, D.; Betev, L.; Bhasin, A.; Bhat, I. R.; Bhati, A. K.; Bhattacharjee, B.; Bhom, J.; Bianchi, L.; Bianchi, N.; Bianchin, C.; Bielčík, J.; Bielčíková, J.; Bilandzic, A.; Biro, G.; Biswas, R.; Biswas, S.; Blair, J. T.; Blau, D.; Blume, C.; Boca, G.; Bock, F.; Bogdanov, A.; Boldizsár, L.; Bombara, M.; Bonomi, G.; Bonora, M.; Book, J.; Borel, H.; Borissov, A.; Borri, M.; Botta, E.; Bourjau, C.; Braun-Munzinger, P.; Bregant, M.; Broker, T. A.; Browning, T. A.; Broz, M.; Brucken, E. J.; Bruna, E.; Bruno, G. E.; Budnikov, D.; Buesching, H.; Bufalino, S.; Buhler, P.; Buncic, P.; Busch, O.; Buthelezi, Z.; Butt, J. B.; Buxton, J. T.; Cabala, J.; Caffarri, D.; Caines, H.; Caliva, A.; Calvo Villar, E.; Camerini, P.; Capon, A. A.; Carena, F.; Carena, W.; Carnesecchi, F.; Castillo Castellanos, J.; Castro, A. J.; Casula, E. A. R.; Ceballos Sanchez, C.; Cerello, P.; Chandra, S.; Chang, B.; Chapeland, S.; Chartier, M.; Charvet, J. L.; Chattopadhyay, S.; Chattopadhyay, S.; Chauvin, A.; Cherney, M.; Cheshkov, C.; Cheynis, B.; Chibante Barroso, V.; Chinellato, D. D.; Cho, S.; Chochula, P.; Choi, K.; Chojnacki, M.; Choudhury, S.; Chowdhury, T.; Christakoglou, P.; Christensen, C. H.; Christiansen, P.; Chujo, T.; Chung, S. U.; Cicalo, C.; Cifarelli, L.; Cindolo, F.; Cleymans, J.; Colamaria, F.; Colella, D.; Collu, A.; Colocci, M.; Concas, M.; Conesa Balbastre, G.; Conesa Del Valle, Z.; Connors, M. E.; Contreras, J. G.; Cormier, T. M.; Corrales Morales, Y.; Cortés Maldonado, I.; Cortese, P.; Cosentino, M. R.; Costa, F.; Costanza, S.; Crkovská, J.; Crochet, P.; Cuautle, E.; Cunqueiro, L.; Dahms, T.; Dainese, A.; Danisch, M. C.; Danu, A.; Das, D.; Das, I.; Das, S.; Dash, A.; Dash, S.; de, S.; de Caro, A.; de Cataldo, G.; de Conti, C.; de Cuveland, J.; de Falco, A.; de Gruttola, D.; De Marco, N.; de Pasquale, S.; de Souza, R. D.; Degenhardt, H. F.; Deisting, A.; Deloff, A.; Deplano, C.; Dhankher, P.; di Bari, D.; di Mauro, A.; di Nezza, P.; di Ruzza, B.; Diaz Corchero, M. A.; Dietel, T.; Dillenseger, P.; Divià, R.; Djuvsland, Ø.; Dobrin, A.; Domenicis Gimenez, D.; Dönigus, B.; Dordic, O.; Doremalen, L. V. V.; Drozhzhova, T.; Dubey, A. K.; Dubla, A.; Ducroux, L.; Duggal, A. K.; Dupieux, P.; Ehlers, R. J.; Elia, D.; Endress, E.; Engel, H.; Epple, E.; Erazmus, B.; Erhardt, F.; Espagnon, B.; Esumi, S.; Eulisse, G.; Eum, J.; Evans, D.; Evdokimov, S.; Fabbietti, L.; Faivre, J.; Fantoni, A.; Fasel, M.; Feldkamp, L.; Feliciello, A.; Feofilov, G.; Ferencei, J.; Fernández Téllez, A.; Ferreiro, E. G.; Ferretti, A.; Festanti, A.; Feuillard, V. J. G.; Figiel, J.; Figueredo, M. A. S.; Filchagin, S.; Finogeev, D.; Fionda, F. M.; Fiore, E. M.; Floris, M.; Foertsch, S.; Foka, P.; Fokin, S.; Fragiacomo, E.; Francescon, A.; Francisco, A.; Frankenfeld, U.; Fronze, G. G.; Fuchs, U.; Furget, C.; Furs, A.; Fusco Girard, M.; Gaardhøje, J. J.; Gagliardi, M.; Gago, A. M.; Gajdosova, K.; Gallio, M.; Galvan, C. D.; Ganoti, P.; Gao, C.; Garabatos, C.; Garcia-Solis, E.; Garg, K.; Garg, P.; Gargiulo, C.; Gasik, P.; Gauger, E. F.; Gay Ducati, M. B.; Germain, M.; Ghosh, J.; Ghosh, P.; Ghosh, S. K.; Gianotti, P.; Giubellino, P.; Giubilato, P.; Gladysz-Dziadus, E.; Glässel, P.; Goméz Coral, D. M.; Gomez Ramirez, A.; Gonzalez, A. S.; Gonzalez, V.; González-Zamora, P.; Gorbunov, S.; Görlich, L.; Gotovac, S.; Grabski, V.; Graczykowski, L. K.; Graham, K. L.; Greiner, L.; Grelli, A.; Grigoras, C.; Grigoriev, V.; Grigoryan, A.; Grigoryan, S.; Grion, N.; Gronefeld, J. M.; Grosa, F.; Grosse-Oetringhaus, J. F.; Grosso, R.; Gruber, L.; Guber, F.; Guernane, R.; Guerzoni, B.; Gulbrandsen, K.; Gunji, T.; Gupta, A.; Gupta, R.; Guzman, I. B.; Haake, R.; Hadjidakis, C.; Hamagaki, H.; Hamar, G.; Hamon, J. C.; Harris, J. W.; Harton, A.; Hassan, H.; Hatzifotiadou, D.; Hayashi, S.; Heckel, S. T.; Hellbär, E.; Helstrup, H.; Herghelegiu, A.; Herrera Corral, G.; Herrmann, F.; Hess, B. A.; Hetland, K. F.; Hillemanns, H.; Hills, C.; Hippolyte, B.; Hladky, J.; Hohlweger, B.; Horak, D.; Hornung, S.; Hosokawa, R.; Hristov, P.; Hughes, C.; Humanic, T. J.; Hussain, N.; Hussain, T.; Hutter, D.; Hwang, D. S.; Iga Buitron, S. A.; Ilkaev, R.; Inaba, M.; Ippolitov, M.; Irfan, M.; Isakov, V.; Ivanov, M.; Ivanov, V.; Izucheev, V.; Jacak, B.; Jacazio, N.; Jacobs, P. M.; Jadhav, M. B.; Jadlovska, S.; Jadlovsky, J.; Jaelani, S.; Jahnke, C.; Jakubowska, M. J.; Janik, M. A.; Jayarathna, P. H. S. Y.; Jena, C.; Jena, S.; Jercic, M.; Jimenez Bustamante, R. T.; Jones, P. G.; Jusko, A.; Kalinak, P.; Kalweit, A.; Kang, J. H.; Kaplin, V.; Kar, S.; Karasu Uysal, A.; Karavichev, O.; Karavicheva, T.; Karayan, L.; Karpechev, E.; Kebschull, U.; Keidel, R.; Keijdener, D. L. D.; Keil, M.; Ketzer, B.; Khabanova, Z.; Khan, P.; Khan, S. A.; Khanzadeev, A.; Kharlov, Y.; Khatun, A.; Khuntia, A.; Kielbowicz, M. M.; Kileng, B.; Kim, D.; Kim, D. W.; Kim, D. J.; Kim, H.; Kim, J. S.; Kim, J.; Kim, M.; Kim, M.; Kim, S.; Kim, T.; Kirsch, S.; Kisel, I.; Kiselev, S.; Kisiel, A.; Kiss, G.; Klay, J. L.; Klein, C.; Klein, J.; Klein-Bösing, C.; Klewin, S.; Kluge, A.; Knichel, M. L.; Knospe, A. G.; Kobdaj, C.; Kofarago, M.; Kollegger, T.; Kolojvari, A.; Kondratiev, V.; Kondratyeva, N.; Kondratyuk, E.; Konevskikh, A.; Konyushikhin, M.; Kopcik, M.; Kour, M.; Kouzinopoulos, C.; Kovalenko, O.; Kovalenko, V.; Kowalski, M.; Koyithatta Meethaleveedu, G.; Králik, I.; Kravčáková, A.; Krivda, M.; Krizek, F.; Kryshen, E.; Krzewicki, M.; Kubera, A. M.; Kučera, V.; Kuhn, C.; Kuijer, P. G.; Kumar, A.; Kumar, J.; Kumar, L.; Kumar, S.; Kundu, S.; Kurashvili, P.; Kurepin, A.; Kurepin, A. B.; Kuryakin, A.; Kushpil, S.; Kweon, M. J.; Kwon, Y.; La Pointe, S. L.; La Rocca, P.; Lagana Fernandes, C.; Lai, Y. S.; Lakomov, I.; Langoy, R.; Lapidus, K.; Lara, C.; Lardeux, A.; Lattuca, A.; Laudi, E.; Lavicka, R.; Lazaridis, L.; Lea, R.; Leardini, L.; Lee, S.; Lehas, F.; Lehner, S.; Lehrbach, J.; Lemmon, R. C.; Lenti, V.; Leogrande, E.; León Monzón, I.; Lévai, P.; Li, S.; Li, X.; Lien, J.; Lietava, R.; Lim, B.; Lindal, S.; Lindenstruth, V.; Lindsay, S. W.; Lippmann, C.; Lisa, M. A.; Litichevskyi, V.; Ljunggren, H. M.; Llope, W. J.; Lodato, D. F.; Loenne, P. I.; Loginov, V.; Loizides, C.; Loncar, P.; Lopez, X.; López Torres, E.; Lowe, A.; Luettig, P.; Lunardon, M.; Luparello, G.; Lupi, M.; Lutz, T. H.; Maevskaya, A.; Mager, M.; Mahajan, S.; Mahmood, S. M.; Maire, A.; Majka, R. D.; Malaev, M.; Malinina, L.; Mal'Kevich, D.; Malzacher, P.; Mamonov, A.; Manko, V.; Manso, F.; Manzari, V.; Mao, Y.; Marchisone, M.; Mareš, J.; Margagliotti, G. V.; Margotti, A.; Margutti, J.; Marín, A.; Markert, C.; Marquard, M.; Martin, N. A.; Martinengo, P.; Martinez, J. A. L.; Martínez, M. I.; Martínez García, G.; Martinez Pedreira, M.; Mas, A.; Masciocchi, S.; Masera, M.; Masoni, A.; Masson, E.; Mastroserio, A.; Mathis, A. M.; Matyja, A.; Mayer, C.; Mazer, J.; Mazzilli, M.; Mazzoni, M. A.; Meddi, F.; Melikyan, Y.; Menchaca-Rocha, A.; Meninno, E.; Mercado Pérez, J.; Meres, M.; Mhlanga, S.; Miake, Y.; Mieskolainen, M. M.; Mihaylov, D.; Mihaylov, D. L.; Mikhaylov, K.; Milano, L.; Milosevic, J.; Mischke, A.; Mishra, A. N.; Miśkowiec, D.; Mitra, J.; Mitu, C. M.; Mohammadi, N.; Mohanty, B.; Mohisin Khan, M.; Montes, E.; Moreira de Godoy, D. A.; Moreno, L. A. P.; Moretto, S.; Morreale, A.; Morsch, A.; Muccifora, V.; Mudnic, E.; Mühlheim, D.; Muhuri, S.; Mukherjee, M.; Mulligan, J. D.; Munhoz, M. G.; Münning, K.; Munzer, R. H.; Murakami, H.; Murray, S.; Musa, L.; Musinsky, J.; Myers, C. J.; Myrcha, J. W.; Naik, B.; Nair, R.; Nandi, B. K.; Nania, R.; Nappi, E.; Narayan, A.; Naru, M. U.; Natal da Luz, H.; Nattrass, C.; Navarro, S. R.; Nayak, K.; Nayak, R.; Nayak, T. K.; Nazarenko, S.; Nedosekin, A.; Negrao de Oliveira, R. A.; Nellen, L.; Nesbo, S. V.; Ng, F.; Nicassio, M.; Niculescu, M.; Niedziela, J.; Nielsen, B. S.; Nikolaev, S.; Nikulin, S.; Nikulin, V.; Nobuhiro, A.; Noferini, F.; Nomokonov, P.; Nooren, G.; Noris, J. C. C.; Norman, J.; Nyanin, A.; Nystrand, J.; Oeschler, H.; Oh, S.; Ohlson, A.; Okubo, T.; Olah, L.; Oleniacz, J.; Oliveira da Silva, A. C.; Oliver, M. H.; Onderwaater, J.; Oppedisano, C.; Orava, R.; Oravec, M.; Ortiz Velasquez, A.; Oskarsson, A.; Otwinowski, J.; Oyama, K.; Pachmayer, Y.; Pacik, V.; Pagano, D.; Pagano, P.; Paić, G.; Palni, P.; Pan, J.; Pandey, A. K.; Panebianco, S.; Papikyan, V.; Pappalardo, G. S.; Pareek, P.; Park, J.; Parmar, S.; Passfeld, A.; Pathak, S. P.; Paticchio, V.; Patra, R. N.; Paul, B.; Pei, H.; Peitzmann, T.; Peng, X.; Pereira, L. G.; Pereira da Costa, H.; Peresunko, D.; Perez Lezama, E.; Peskov, V.; Pestov, Y.; Petráček, V.; Petrov, V.; Petrovici, M.; Petta, C.; Pezzi, R. P.; Piano, S.; Pikna, M.; Pillot, P.; Pimentel, L. O. D. L.; Pinazza, O.; Pinsky, L.; Piyarathna, D. B.; Płoskoń, M.; Planinic, M.; Pliquett, F.; Pluta, J.; Pochybova, S.; Podesta-Lerma, P. L. M.; Poghosyan, M. G.; Polichtchouk, B.; Poljak, N.; Poonsawat, W.; Pop, A.; Poppenborg, H.; Porteboeuf-Houssais, S.; Porter, J.; Pozdniakov, V.; Prasad, S. K.; Preghenella, R.; Prino, F.; Pruneau, C. A.; Pshenichnov, I.; Puccio, M.; Puddu, G.; Pujahari, P.; Punin, V.; Putschke, J.; Rachevski, A.; Raha, S.; Rajput, S.; Rak, J.; Rakotozafindrabe, A.; Ramello, L.; Rami, F.; Rana, D. B.; Raniwala, R.; Raniwala, S.; Räsänen, S. S.; Rascanu, B. T.; Rathee, D.; Ratza, V.; Ravasenga, I.; Read, K. F.; Redlich, K.; Rehman, A.; Reichelt, P.; Reidt, F.; Ren, X.; Renfordt, R.; Reolon, A. R.; Reshetin, A.; Reygers, K.; Riabov, V.; Ricci, R. A.; Richert, T.; Richter, M.; Riedler, P.; Riegler, W.; Riggi, F.; Ristea, C.; Rodríguez Cahuantzi, M.; Røed, K.; Rogochaya, E.; Rohr, D.; Röhrich, D.; Rokita, P. S.; Ronchetti, F.; Rosas, E. D.; Rosnet, P.; Rossi, A.; Rotondi, A.; Roukoutakis, F.; Roy, A.; Roy, C.; Roy, P.; Rubio Montero, A. J.; Rueda, O. V.; Rui, R.; Russo, R.; Rustamov, A.; Ryabinkin, E.; Ryabov, Y.; Rybicki, A.; Saarinen, S.; Sadhu, S.; Sadovsky, S.; Šafařík, K.; Saha, S. K.; Sahlmuller, B.; Sahoo, B.; Sahoo, P.; Sahoo, R.; Sahoo, S.; Sahu, P. K.; Saini, J.; Sakai, S.; Saleh, M. A.; Salzwedel, J.; Sambyal, S.; Samsonov, V.; Sandoval, A.; Sarkar, D.; Sarkar, N.; Sarma, P.; Sas, M. H. P.; Scapparone, E.; Scarlassara, F.; Scharenberg, R. P.; Scheid, H. S.; Schiaua, C.; Schicker, R.; Schmidt, C.; Schmidt, H. R.; Schmidt, M. O.; Schmidt, M.; Schuchmann, S.; Schukraft, J.; Schutz, Y.; Schwarz, K.; Schweda, K.; Scioli, G.; Scomparin, E.; Scott, R.; Šefčík, M.; Seger, J. E.; Sekiguchi, Y.; Sekihata, D.; Selyuzhenkov, I.; Senosi, K.; Senyukov, S.; Serradilla, E.; Sett, P.; Sevcenco, A.; Shabanov, A.; Shabetai, A.; Shahoyan, R.; Shaikh, W.; Shangaraev, A.; Sharma, A.; Sharma, A.; Sharma, M.; Sharma, M.; Sharma, N.; Sheikh, A. I.; Shigaki, K.; Shou, Q.; Shtejer, K.; Sibiriak, Y.; Siddhanta, S.; Sielewicz, K. M.; Siemiarczuk, T.; Silvermyr, D.; Silvestre, C.; Simatovic, G.; Simonetti, G.; Singaraju, R.; Singh, R.; Singhal, V.; Sinha, T.; Sitar, B.; Sitta, M.; Skaali, T. B.; Slupecki, M.; Smirnov, N.; Snellings, R. J. M.; Snellman, T. W.; Song, J.; Song, M.; Soramel, F.; Sorensen, S.; Sozzi, F.; Spiriti, E.; Sputowska, I.; Srivastava, B. K.; Stachel, J.; Stan, I.; Stankus, P.; Stenlund, E.; Stocco, D.; Strmen, P.; Suaide, A. A. P.; Sugitate, T.; Suire, C.; Suleymanov, M.; Suljic, M.; Sultanov, R.; Šumbera, M.; Sumowidagdo, S.; Suzuki, K.; Swain, S.; Szabo, A.; Szarka, I.; Szczepankiewicz, A.; Tabassam, U.; Takahashi, J.; Tambave, G. J.; Tanaka, N.; Tarhini, M.; Tariq, M.; Tarzila, M. G.; Tauro, A.; Tejeda Muñoz, G.; Telesca, A.; Terasaki, K.; Terrevoli, C.; Teyssier, B.; Thakur, D.; Thakur, S.; Thomas, D.; Tieulent, R.; Tikhonov, A.; Timmins, A. R.; Toia, A.; Tripathy, S.; Trogolo, S.; Trombetta, G.; Tropp, L.; Trubnikov, V.; Trzaska, W. H.; Trzeciak, B. A.; Tsuji, T.; Tumkin, A.; Turrisi, R.; Tveter, T. S.; Ullaland, K.; Umaka, E. N.; Uras, A.; Usai, G. L.; Utrobicic, A.; Vala, M.; van der Maarel, J.; van Hoorne, J. W.; van Leeuwen, M.; Vanat, T.; Vande Vyvre, P.; Varga, D.; Vargas, A.; Vargyas, M.; Varma, R.; Vasileiou, M.; Vasiliev, A.; Vauthier, A.; Vázquez Doce, O.; Vechernin, V.; Veen, A. M.; Velure, A.; Vercellin, E.; Vergara Limón, S.; Vernet, R.; Vértesi, R.; Vickovic, L.; Vigolo, S.; Viinikainen, J.; Vilakazi, Z.; Villalobos Baillie, O.; Villatoro Tello, A.; Vinogradov, A.; Vinogradov, L.; Virgili, T.; Vislavicius, V.; Vodopyanov, A.; Völkl, M. A.; Voloshin, K.; Voloshin, S. A.; Volpe, G.; von Haller, B.; Vorobyev, I.; Voscek, D.; Vranic, D.; Vrláková, J.; Wagner, B.; Wagner, J.; Wang, H.; Wang, M.; Watanabe, D.; Watanabe, Y.; Weber, M.; Weber, S. G.; Weiser, D. F.; Wenzel, S. C.; Wessels, J. P.; Westerhoff, U.; Whitehead, A. M.; Wiechula, J.; Wikne, J.; Wilk, G.; Wilkinson, J.; Willems, G. A.; Williams, M. C. S.; Willsher, E.; Windelband, B.; Witt, W. E.; Yalcin, S.; Yamakawa, K.; Yang, P.; Yano, S.; Yin, Z.; Yokoyama, H.; Yoo, I.-K.; Yoon, J. H.; Yurchenko, V.; Zaccolo, V.; Zaman, A.; Zampolli, C.; Zanoli, H. J. C.; Zardoshti, N.; Zarochentsev, A.; Závada, P.; Zaviyalov, N.; Zbroszczyk, H.; Zhalov, M.; Zhang, H.; Zhang, X.; Zhang, Y.; Zhang, C.; Zhang, Z.; Zhao, C.; Zhigareva, N.; Zhou, D.; Zhou, Y.; Zhou, Z.; Zhu, H.; Zhu, J.; Zhu, X.; Zichichi, A.; Zimmermann, A.; Zimmermann, M. B.; Zinovjev, G.; Zmeskal, J.; Zou, S.; Alice Collaboration

2017-10-01

The second and the third order anisotropic flow, V2 and V3, are mostly determined by the corresponding initial spatial anisotropy coefficients, ε2 and ε3, in the initial density distribution. In addition to their dependence on the same order initial anisotropy coefficient, higher order anisotropic flow, Vn (n > 3), can also have a significant contribution from lower order initial anisotropy coefficients, which leads to mode-coupling effects. In this Letter we investigate the linear and non-linear modes in higher order anisotropic flow Vn for n = 4, 5, 6 with the ALICE detector at the Large Hadron Collider. The measurements are done for particles in the pseudorapidity range | η | < 0.8 and the transverse momentum range 0.2

Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department.

PubMed

Taylor, Jennifer A; Barnes, Brittany; Davis, Andrea L; Wright, Jasmine; Widman, Shannon; LeVasseur, Michael

2016-02-01

Struck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient-initiated violence. A convergent parallel mixed methods design was employed. Using a linked injury dataset, patient-initiated violence estimates were calculated comparing genders. Semi-structured interviews and a focus group were conducted with injured EMS responders. Paramedics had significantly higher odds for patient-initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2-22.2, P < 0.001). Females reported increased odds of patient-initiated violence injuries compared to males (OR = 6.25, 95%CI 3.8-10.2), but this relationship was entirely mediated through occupation (AOR = 1.64, 95%CI 0.94-2.85). Qualitative data illuminated the impact of patient-initiated violence and highlighted important organizational opportunities for intervention. Mixed methods greatly enhanced the assessment of EMS responder patient-initiated violence prevention. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Linear and non-linear flow mode in Pb–Pb collisions at s NN = 2.76  TeV

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

Acharya, S.; Adamová, D.; Adolfsson, J.

The second and the third order anisotropic flow, V 2 and V 3, are mostly determined by the corresponding initial spatial anisotropy coefficients, and , in the initial density distribution. In addition to their dependence on the same order initial anisotropy coefficient, higher order anisotropic flow, V n (n > 3), can also have a significant contribution from lower order initial anisotropy coefficients, which leads to mode-coupling effects. In this Letter we investigate the linear and non-linear modes in higher order anisotropic flow V n for n = 4, 5, 6 with the ALICE detector at the Large Hadron Collider.more » The measurements are done for particles in the pseudorapidity range |η| < 0.8 and the transverse momentum range 0.2 < p T < 5.0 GeV/c as a function of collision centrality. The results are compared with theoretical calculations and provide important constraints on the initial conditions, including initial spatial geometry and its fluctuations, as well as the ratio of the shear viscosity to entropy density of the produced system.« less

Linear and non-linear flow mode in Pb–Pb collisions at s NN = 2.76  TeV

DOE PAGES

Acharya, S.; Adamová, D.; Adolfsson, J.; ...

2017-08-04

The second and the third order anisotropic flow, V 2 and V 3, are mostly determined by the corresponding initial spatial anisotropy coefficients, and , in the initial density distribution. In addition to their dependence on the same order initial anisotropy coefficient, higher order anisotropic flow, V n (n > 3), can also have a significant contribution from lower order initial anisotropy coefficients, which leads to mode-coupling effects. In this Letter we investigate the linear and non-linear modes in higher order anisotropic flow V n for n = 4, 5, 6 with the ALICE detector at the Large Hadron Collider.more » The measurements are done for particles in the pseudorapidity range |η| < 0.8 and the transverse momentum range 0.2 < p T < 5.0 GeV/c as a function of collision centrality. The results are compared with theoretical calculations and provide important constraints on the initial conditions, including initial spatial geometry and its fluctuations, as well as the ratio of the shear viscosity to entropy density of the produced system.« less

Comparison of acyclovir and famciclovir for the treatment of Bell's palsy.

PubMed

Kim, Ho Joong; Kim, Sang Hoon; Jung, Junyang; Kim, Sung Su; Byun, Jae Yong; Park, Moon Suh; Yeo, Seung Geun

2016-10-01

The relative effectiveness of acyclovir and famciclovir in the treatment of Bell's palsy is unclear. This study therefore compared recovery outcomes in patients with Bell's palsy treated with acyclovir and famciclovir. The study cohort consisted of patients with facial palsy who visited the outpatient clinic between January 2006 and January 2014. Patients were treated with prednisolone plus either acyclovir (n = 457) or famciclovir (n = 245). Patient outcomes were measured using the House-Brackmann scale according to initial severity of disease and underlying disease. The overall recovery rate tended to be higher in the famciclovir than in the acyclovir group. The rate of recovery in patients with initially severe facial palsy (grades V and VI) was significantly higher in the famciclovir than in the acyclovir group (p = 0.01), whereas the rates of recovery in patients with initially moderate palsy (grade III-IV) were similar in the two groups. The overall recovery rates in patients without hypertension or diabetes mellitus were higher in the famciclovir than in the acyclovir group, but the difference was not statistically significant. Treatment with steroid plus famciclovir was more effective than treatment with steroid plus acyclovir in patients with severe facial palsy. Famciclovir may be the antiviral agent of choice in the treatment of patients with severe facial palsy.

Clinical significance of quantitative analysis of facial nerve enhancement on MRI in Bell's palsy.

PubMed

Song, Mee Hyun; Kim, Jinna; Jeon, Ju Hyun; Cho, Chang Il; Yoo, Eun Hye; Lee, Won-Sang; Lee, Ho-Ki

2008-11-01

Quantitative analysis of the facial nerve on the lesion side as well as the normal side, which allowed for more accurate measurement of facial nerve enhancement in patients with facial palsy, showed statistically significant correlation with the initial severity of facial nerve inflammation, although little prognostic significance was shown. This study investigated the clinical significance of quantitative measurement of facial nerve enhancement in patients with Bell's palsy by analyzing the enhancement pattern and correlating MRI findings with initial severity of facial palsy and clinical outcome. Facial nerve enhancement was measured quantitatively by using the region of interest on pre- and postcontrast T1-weighted images in 44 patients diagnosed with Bell's palsy. The signal intensity increase on the lesion side was first compared with that of the contralateral side and then correlated with the initial degree of facial palsy and prognosis. The lesion side showed significantly higher signal intensity increase compared with the normal side in all of the segments except for the mastoid segment. Signal intensity increase at the internal auditory canal and labyrinthine segments showed correlation with the initial degree of facial palsy but no significant difference was found between different prognostic groups.

Comparison of patient-controlled intravenous analgesia with sufentanil versus tramadol in post-cesarean section pain management and lactation after general anesthesia - a prospective, randomized, double-blind, controlled study.

PubMed

Chi, Xiaohui; Li, Man; Mei, Wei; Liao, Mingfeng

2017-01-01

Acute pain is a common complication following cesarean section under general anesthesia. Post-cesarean section pain management is important for both the mother and the newborn. This study compared the effects of patient-controlled intravenous analgesia (PCIA) using sufentanil or tramadol on postoperative pain control and initiation time of lactation in patients who underwent cesarean section under general anesthesia. Primiparas (n=146) scheduled for cesarean section under general anesthesia were randomized to receive PCIA with sufentanil or tramadol. Movement-evoked and rest-pain intensity were assessed by the Numerical Rating Scale (NRS) postoperatively. The number of PCIA attempts, amount of drug consumed, initiation time of lactation, and Quality of Recovery Score 40 (QoR-40) were recorded at 4, 8, 12, and 24 h postoperatively. Pre- and postoperative serum prolactin levels were recorded. No between-group difference existed in the NRS at rest at any time point postoperatively. Patients on sufentanil had more movement-evoked pain and a higher sedation score at 4, 8, and 12 h postoperatively, as compared with the tramadol group. At 24 h, the QoR-40 was higher in the tramadol group compared with the sufentanil group. No significant between-group differences were present in patient satisfaction and nausea/vomiting scores. Postpartum prolactin levels were significantly higher in the tramadol group versus the sufentanil group, corresponding with a significant delay in initiation of lactation in the latter. PCIA with tramadol may be preferred due to lower movement-evoked pain, higher quality of recovery, and earlier lactation in patients following cesarean section under general anesthesia.

Effects of pill burden on discontinuation of the initial HAART regimen in minority female patients prescribed 1 pill/day versus any other pill burden.

PubMed

Hill, Seth; Kavookjian, Jan; Qian, Jingjing; Chung, Allison; Vandewaa, John

2014-01-01

Highly active antiretroviral therapy (HAART) is a mainstay of treatment for patients with Human Immunodeficiency Virus (HIV). Since second line HAART therapies can be costlier and less effective, it is essential to understand the duration of initial HAART therapies. The overall aim of this study was to estimate the effects of daily pill burden on the time to discontinuation of the initial HAART regimen. Patients were initially identified through the clinic's CAREWARE database. A chart review was conducted for data collection, where only adult, female, HIV-positive patients initiating therapy at the study clinic between 1 January 2001 and 31 December 2011 were included. All study subjects were followed up from the initiation of HAART to treatment discontinuation. A Kaplan-Meier curve was generated to describe time to discontinuation by regimens, and a Cox proportional hazards model was developed to assess the impact of different regimen and patient demographic characteristics on the hazard of discontinuation of the initial regimen. A total of 498 charts were initially reviewed. After assessment of these patients for inclusion criteria, a cohort of 115 adult female patients who initiated HAART at the study clinic was included. Patients treated with 1 pill/day regimen had a significantly longer time to discontinuation than regimens of >1 pills/day (mean duration of initial therapy was 1062.56 days vs. 631.70 days, respectively, p = 0.003). Compared to 1 pill/day regimens, >1 pills/day regimens were associated with a higher hazard of discontinuation (hazard ratio (HR) =3.44 with 95% confidence interval (CI) = 1.25, 9.48). A higher viral load and patients without insurance were also found to be significantly associated with increased hazards of discontinuation. Overall, female HIV patients initiating therapy with the 1 pill/day HAART regimen were less likely to discontinue their treatment compared to patients initiating with >1 pills/day HAART regimen.

The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study.

PubMed

Nglazi, Mweete D; Bekker, Linda-Gail; Wood, Robin; Kaplan, Richard

2015-11-19

The implementation of collaborative TB-HIV services is challenging. We, therefore, assessed TB treatment outcomes in relation to HIV infection and antiretroviral therapy (ART) among TB patients attending a primary care service with co-located ART and TB clinics in Cape Town, South Africa. In this retrospective cohort study, all new TB patients aged ≥ 15 years who registered and initiated TB treatment between 1 October 2009 and 30 June 2011 were identified from an electronic database. The effects of HIV-infection and ART on TB treatment outcomes were analysed using a multinomial logistic regression model, in which treatment success was the reference outcome. The 797 new TB patients included in the analysis were categorized as follows: HIV- negative, in 325 patients (40.8 %); HIV-positive on ART, in 339 patients (42.5 %) and HIV-positive not on ART, in 133 patients (16.7 %). Overall, bivariate analyses showed no significant difference in death and default rates between HIV-positive TB patients on ART and HIV-negative patients. Statistically significant higher mortality rates were found among HIV-positive patients not on ART compared to HIV-negative patients (unadjusted odds ratio (OR) 3.25; 95 % confidence interval (CI) 1.53-6.91). When multivariate analyses were conducted, the only significant difference between the patient categories on TB treatment outcomes was that HIV-positive TB patients not on ART had significantly higher mortality rates than HIV-negative patients (adjusted OR 4.12; 95 % CI 1.76-9.66). Among HIV-positive TB patients (n = 472), 28.2 % deemed eligible did not initiate ART in spite of the co-location of TB and ART services. When multivariate analyses were restricted to HIV-positive patients in the cohort, we found that being HIV-positive not on ART was associated with higher mortality (adjusted OR 7.12; 95 % CI 2.95-18.47) and higher default rates (adjusted OR 2.27; 95 % CI 1.15-4.47). There was no significant difference in death and default rates between HIV-positive TB patients on ART and HIV negative TB patients. Despite the co-location of services 28.2 % of 472 HIV-positive TB patients deemed eligible did not initiate ART. These patients had a significantly higher death and default rates.

A History of Ashes: An 80 Year Comparative Portrait of Smoking Initiation in American Indians and Non-Hispanic Whites—the Strong Heart Study

PubMed Central

Orr, Raymond; Calhoun, Darren; Noonan, Carolyn; Whitener, Ron; Henderson, Jeff; Goldberg, Jack; Henderson, Patrica Nez

2013-01-01

The consequences of starting smoking by age 18 are significant. Early smoking initiation is associated with higher tobacco dependence, increased difficulty in smoking cessation and more negative health outcomes. The purpose of this study is to examine how closely smoking initiation in a well-defined population of American Indians (AI) resembles a group of Non-Hispanic white (NHW) populations born over an 80 year period. We obtained data on age of smoking initiation among 7,073 AIs who were members of 13 tribes in Arizona, Oklahoma and North and South Dakota from the 1988 Strong Heart Study (SHS) and the 2001 Strong Heart Family Study (SHFS) and 19,747 NHW participants in the 2003 National Health Interview Survey. The participants were born as early as 1904 and as late as 1985. We classified participants according to birth cohort by decade, sex, and for AIs, according to location. We estimated the cumulative incidence of smoking initiation by age 18 in each sex and birth cohort group in both AIs and NHWs and used Cox regression to estimate hazard ratios for the association of birth cohort, sex and region with the age at smoking initiation. We found that the cumulative incidence of smoking initiation by age 18 was higher in males than females in all SHS regions and in NHWs (p < 0.001). Our results show regional variation of age of initiation significant in the SHS (p < 0.001). Our data showed that not all AIs (in this sample) showed similar trends toward increased earlier smoking. For instance, Oklahoma SHS male participants born in the 1980s initiated smoking before age 18 less often than those born before 1920 by a ratio of 0.7. The results showed significant variation in age of initiation across sex, birth cohort, and location. Our preliminary analyses suggest that AI smoking trends are not uniform across region or gender but are likely shaped by local context. If tobacco prevention and control programs depend in part on addressing the origin of AI smoking it may be helpful to increase the awareness in regional differences. PMID:23644825

Long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for low-birth-weight (LBW) infants in Madagascar.

PubMed

Nagai, Shuko; Yonemoto, Naohiro; Rabesandratana, Norotiana; Andrianarimanana, Diavolana; Nakayama, Takeo; Mori, Rintaro

2011-12-01

To examine the long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. A randomized controlled trial with long-term follow-up was performed in LBW infants in Madagascar. Earlier continuous KMC (intervention group) was initiated as soon as possible within 24 h postbirth, and later continuous KMC (control group: conventional care) was initiated after complete stabilization. Outcome measures were mortality or readmission, nutritional indicators at 6-12 months postbirth and feeding condition at 6 months postbirth (ClinicalTrials.gov, NCT00531492). A total of 72 infants were followed for mortality or readmission at 6-12 months postbirth. There was no difference between the two groups (7/36 vs. 7/36, Risk ratio (RR), 1.00; 95% CIs, 0.39-2.56; p = 1.00). The proportion of exclusive breast feeding (EBF) at 6 months postbirth was significantly higher with earlier KMC than later KMC (12/29 vs. 4/26; RR 2.69; 95% CIs, 1.00-7.31; p = 0.04). There were no differences in nutritional indicators between the two groups at 6-12 months postbirth. Earlier initiated continuous KMC results in a significantly higher proportion of EBF at 6 months postbirth. Further larger-scale long-term evaluations of earlier initiated continuous KMC for LBW infants are needed. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

pH and Organic Carbon Dose Rates Control Microbially Driven Bioremediation Efficacy in Alkaline Bauxite Residue.

PubMed

Santini, Talitha C; Malcolm, Laura I; Tyson, Gene W; Warren, Lesley A

2016-10-18

Bioremediation of alkaline tailings, based on fermentative microbial metabolisms, is a novel strategy for achieving rapid pH neutralization and thus improving environmental outcomes associated with mining and refining activities. Laboratory-scale bioreactors containing bauxite residue (an alkaline, saline tailings material generated as a byproduct of alumina refining), to which a diverse microbial inoculum was added, were used in this study to identify key factors (pH, salinity, organic carbon supply) controlling the rates and extent of microbially driven pH neutralization (bioremediation) in alkaline tailings. Initial tailings pH and organic carbon dose rates both significantly affected bioremediation extent and efficiency with lower minimum pHs and higher extents of pH neutralization occurring under low initial pH or high organic carbon conditions. Rates of pH neutralization (up to 0.13 mM H + produced per day with pH decreasing from 9.5 to ≤6.5 in three days) were significantly higher in low initial pH treatments. Representatives of the Bacillaceae and Enterobacteriaceae, which contain many known facultative anaerobes and fermenters, were identified as key contributors to 2,3-butanediol and/or mixed acid fermentation as the major mechanism(s) of pH neutralization. Initial pH and salinity significantly influenced microbial community successional trajectories, and microbial community structure was significantly related to markers of fermentation activity. This study provides the first experimental demonstration of bioremediation in bauxite residue, identifying pH and organic carbon dose rates as key controls on bioremediation efficacy, and will enable future development of bioreactor technologies at full field scale.

Impact of Including Higher Actinides in Fast Reactor Transmutation Analyses

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

B. Forget; M. Asgari; R. Ferrer

2007-09-01

Previous fast reactor transmutation studies generally disregarded higher mass minor actinides beyond Cm-246 due to various considerations including deficiencies in nuclear cross-section data. Although omission of these higher mass actinides does not significantly impact the neutronic calculations and fuel cycle performance parameters follow-on neutron dose calculations related to fuel recycling, transportation and handling are significantly impacted. This report shows that including the minor actinides in the equilibrium fast reactor calculations will increase the predicted neutron emission by about 30%. In addition a sensitivity study was initiated by comparing the impact of different cross-section evaluation file for representing these minor actinides.

DNA Damage Levels Determine Cyclobutyl Pyrimidine Dimer Repair Mechanisms in Alfalfa Seedlings.

PubMed Central

Quaite, F. E.; Takayanagi, S.; Ruffini, J.; Sutherland, J. C.; Sutherland, B. M.

1994-01-01

Ultraviolet radiation in sunlight damages DNA in plants, but little is understood about the types, lesion capacity, and coordination of repair pathways. We challenged intact alfalfa seedlings with UV doses that induced different initial levels of cyclobutyl pyrimidine dimers and measured repair by excision and photoreactivation. By using alkaline gel electrophoresis of nonradioactive DNAs treated with a cyclobutyl pyrimidine dimer-specific UV endonuclease, we quantitated ethidium-stained DNA by electronic imaging and calculated lesion frequencies from the number average molecular lengths. At low initial dimer frequencies (less than ~30 dimers per million bases), the seedlings used only photoreactivation to repair dimers; excision repair was not significant. At higher damage levels, both excision and photorepair contributed significantly. This strategy would allow plants with low damage levels to use error-free repair requiring only an external light energy source, whereas seedlings subjected to higher damage frequencies could call on additional repair processes requiring cellular energy. Characterization of repair in plants thus requires an investigation of a range of conditions, including the level of initial damage. PMID:12244228

Dose-response relationship of robot-assisted stroke motor rehabilitation: the impact of initial motor status.

PubMed

Hsieh, Yu-wei; Wu, Ching-yi; Lin, Keh-chung; Yao, Grace; Wu, Kuen-yuh; Chang, Ya-ju

2012-10-01

The increasing availability of robot-assisted therapy (RT), which provides quantifiable, reproducible, interactive, and intensive practice, holds promise for stroke rehabilitation, but data on its dose-response relation are scanty. This study used 2 different intensities of RT to examine the treatment effects of RT and the effect on outcomes of the severity of initial motor deficits. Fifty-four patients with stroke were randomized to a 4-week intervention of higher-intensity RT, lower-intensity RT, or control treatment. The primary outcome, the Fugl-Meyer Assessment, was administered at baseline, midterm, and posttreatment. Secondary outcomes included the Medical Research Council scale, the Motor Activity Log, and the physical domains of the Stroke Impact Scale. The higher-intensity RT group showed significantly greater improvements on the Fugl-Meyer Assessment than the lower-intensity RT and control treatment groups at midterm (P=0.003 and P=0.02) and at posttreatment (P=0.04 and P=0.02). Within-group gains on the secondary outcomes were significant, but the differences among the 3 groups did not reach significance. Recovery rates of the higher-intensity RT group were higher than those of the lower-intensity RT group, particularly on the Fugl-Meyer Assessment. Scatterplots with curve fitting showed that patients with moderate motor deficits gained more improvements than those with severe or mild deficits after the higher-intensity RT. This study demonstrated the higher treatment intensity provided by RT was associated with better motor outcome for patients with stroke, which may shape further stroke rehabilitation. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00917605.

The Role of Engineering Laboratories in the Establishment of a Quality Culture in Higher Education in Greece

ERIC Educational Resources Information Center

Stamatelos, G. M.; Stamatelos, A. M.

2009-01-01

An academic legislative reform of the public university sector was recently initiated in Greece (since 2005). It was designed to respond to the requirements of convergence to a common frame of the European Space of Higher Education. This reform found significant resistance from university personnel and students, resulting in a very slow degree of…

Why Are There so Few Female Leaders in Higher Education: A Case of Structure or Agency?

ERIC Educational Resources Information Center

Shepherd, Sue

2017-01-01

A significant gender imbalance remains at executive management level within higher education despite a number of initiatives to increase the number of women in the leadership pipeline and ensure they are better prepared for these roles. This article presents findings from a recent study on the appointment of deputy and pro vice-chancellors in…

Universal test and treat is not associated with sub-optimal antiretroviral therapy adherence in rural South Africa: the ANRS 12249 TasP trial.

PubMed

Iwuji, Collins; McGrath, Nuala; Calmy, Alexandra; Dabis, Francois; Pillay, Deenan; Newell, Marie-Louise; Baisley, Kathy; Porter, Kholoud

2018-06-01

HIV treatment guidelines now recommend antiretroviral therapy (ART) initiation regardless of CD4 count to maximize benefit both for the individual and society. It is unknown whether the initiation of ART at higher CD4 counts would affect adherence levels. We investigated whether initiating ART at higher CD4 counts was associated with sub-optimal adherence (<95%) during the first 12 months of ART. A prospective cohort study nested within a two-arm cluster-randomized trial of universal test and treat was implemented from March 2012 to June 2016 to measure the impact of ART on HIV incidence in rural KwaZulu-Natal. ART was initiated regardless of CD4 count in the intervention arm and according to national guidelines in the control arm. ART adherence was measured monthly using a visual analogue scale (VAS) and pill counts (PC). HIV viral load was measured at ART initiation, three and six months, and six-monthly thereafter. We pooled data from participants in both arms and used random-effects logistic regression models to examine the association between CD4 count at ART initiation and sub-optimal adherence, and assessed if adherence levels were associated with virological suppression. Among 900 individuals who initiated ART ≥12 months before study end, median (IQR) CD4 at ART initiation was 350 cells/mm 3 (234, 503); median age was 34.6 years (IQR 27.4 to 46.4) and 71.7% were female. Adherence was sub-optimal in 14.7% of visits as measured by VAS and 20.7% by PC. In both the crude analyses and after adjusting for potential confounders, adherence was not significantly associated with CD4 count at ART initiation (adjusted OR for linear trend in sub-optimal adherence with every 100 cells/mm 3 increase in CD4 count: 1.00, 95% CI 0.95 to 1.05, for VAS, and 1.03, 95% CI 0.99 to 1.07, for PC). Virological suppression at 12 months was 97%. Optimal adherence by both measures was significantly associated with virological suppression (p < 0.001 for VAS; p = 0.006 for PC). We found no evidence that higher CD4 counts at ART initiation were associated with sub-optimal ART adherence in the first 12 months. Our findings should alleviate concerns about adherence in individuals initiating ART at higher CD4 counts, however long-term outcomes are needed. ClinicalTrials.gov NCT01509508. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Learning and memory performance in breast cancer survivors 2 to 6 years post-treatment: the role of encoding versus forgetting.

PubMed

Root, James C; Andreotti, Charissa; Tsu, Loretta; Ellmore, Timothy M; Ahles, Tim A

2016-06-01

Our previous retrospective analysis of clinically referred breast cancer survivors' performance on learning and memory measures found a primary weakness in initial encoding of information into working memory with intact retention and recall of this same information at a delay. This suggests that survivors may misinterpret cognitive lapses as being due to forgetting when, in actuality, they were not able to properly encode this information at the time of initial exposure. Our objective in this study was to replicate and extend this pattern of performance to a research sample to increase the generalizability of this finding in a sample in which subjects were not clinically referred for cognitive issues. We contrasted learning and memory performance between breast cancer survivors on endocrine therapy 2 to 6 years post-treatment with age- and education-matched healthy controls. We then stratified lower- and higher-performing breast cancer survivors to examine specific patterns of learning and memory performance. Contrasts were generated for four aggregate visual and verbal memory variables from the California Verbal Learning Test-2 (CVLT-2) and the Brown Location Test (BLT): Single-trial Learning: Trial 1 performance, Multiple-trial Learning: Trial 5 performance, Delayed Recall: Long-delay Recall performance, and Memory Errors: False-positive errors. As predicted, breast cancer survivors' performance as a whole was significantly lower on Single-trial Learning than the healthy control group but exhibited no significant difference in Delayed Recall. In the secondary analysis contrasting lower- and higher-performing survivors on cognitive measures, the same pattern of lower Single-trial Learning performance was exhibited in both groups, with the additional finding of significantly weaker Multiple-trial Learning performance in the lower-performing breast cancer group and intact Delayed Recall performance in both groups. As with our earlier finding of weaker initial encoding with intact recall in a cohort of clinically referred breast cancer survivors, our results indicate this same profile in a research sample of breast cancer survivors. Further, when the breast cancer group was stratified by lower and higher performance, both groups exhibited significantly lower performance on initial encoding, with more pronounced encoding weakness in the lower-performing group. As in our previous research, survivors did not lose successfully encoded information over longer delays, either in the lower- or higher-performing group, again arguing against memory decay in survivors. The finding of weaker initial encoding of information together with intact delayed recall in survivors points to specific treatment interventions in rehabilitation of cognitive dysfunction. The finding of weaker initial encoding of information together with intact delayed recall in survivors points to specific treatment interventions in rehabilitation of cognitive dysfunction and is discussed.

A First Look at Higher Performing High Schools: School Qualities that Educators Believe Contribute Most to College and Career Readiness

ERIC Educational Resources Information Center

ACT, Inc., 2012

2012-01-01

The Common Core State Standards Initiative represents one of the most significant reforms to US education in recent history. As of June 2012, 45 states and the District of Columbia have adopted the Standards. ACT is pleased to have played a leading role in the development of the Standards. Not only did the initiative draw on its longitudinal…

Prolonged Culture of Aligned Skeletal Myotubes on Micromolded Gelatin Hydrogels

PubMed Central

Bettadapur, Archana; Suh, Gio C.; Geisse, Nicholas A.; Wang, Evelyn R.; Hua, Clara; Huber, Holly A.; Viscio, Alyssa A.; Kim, Joon Young; Strickland, Julie B.; McCain, Megan L.

2016-01-01

In vitro models of skeletal muscle are critically needed to elucidate disease mechanisms, identify therapeutic targets, and test drugs pre-clinically. However, culturing skeletal muscle has been challenging due to myotube delamination from synthetic culture substrates approximately one week after initiating differentiation from myoblasts. In this study, we successfully maintained aligned skeletal myotubes differentiated from C2C12 mouse skeletal myoblasts for three weeks by utilizing micromolded (μmolded) gelatin hydrogels as culture substrates, which we thoroughly characterized using atomic force microscopy (AFM). Compared to polydimethylsiloxane (PDMS) microcontact printed (μprinted) with fibronectin (FN), cell adhesion on gelatin hydrogel constructs was significantly higher one week and three weeks after initiating differentiation. Delamination from FN-μprinted PDMS precluded robust detection of myotubes. Compared to a softer blend of PDMS μprinted with FN, myogenic index, myotube width, and myotube length on μmolded gelatin hydrogels was similar one week after initiating differentiation. However, three weeks after initiating differentiation, these parameters were significantly higher on μmolded gelatin hydrogels compared to FN-μprinted soft PDMS constructs. Similar results were observed on isotropic versions of each substrate, suggesting that these findings are independent of substrate patterning. Our platform enables novel studies into skeletal muscle development and disease and chronic drug testing in vitro. PMID:27350122

Determinants of regular smoking onset in South Africa using duration analysis.

PubMed

Vellios, Nicole; van Walbeek, Corné

2016-07-18

South Africa has achieved significant success with its tobacco control policy. Between 1994 and 2012, the real price of cigarettes increased by 229%, while regular smoking prevalence decreased from about 31% to 18.2%. Cigarette prices and socioeconomic variables are used to examine the determinants of regular smoking onset. We apply duration analysis techniques to the National Income Dynamics Study, a nationally representative survey of South Africa. We find that an increase in cigarette prices significantly reduces regular smoking initiation among males, but not among females. Regular smoking among parents is positively correlated with smoking initiation among children. Children with more educated parents are less likely to initiate regular smoking than those with less educated parents. Africans initiate later and at lower rates than other race groups. As the tobacco epidemic is shifting towards low-income and middle-income countries, there is an increasing urgency to perform studies in these countries to influence policy. Higher cigarette excise taxes, which lead to higher retail prices, reduce smoking prevalence by encouraging smokers to quit and by discouraging young people from starting smoking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Controlled ultrasound tissue erosion: The role of dynamic interaction between insonation and microbubble activity

PubMed Central

Xu, Zhen; Fowlkes, J. Brian; Rothman, Edward D.; Levin, Albert M.; Cain, Charles A.

2009-01-01

Previous studies showed that ultrasound can mechanically remove tissue in a localized, controlled manner. Moreover, enhanced acoustic backscatter is highly correlated with the erosion process. “Initiation” and “extinction” of this highly backscattering environment were studied in this paper. The relationship between initiation and erosion, variability of initiation and extinction, and effects of pulse intensity and gas saturation on time to initiation (initiation delay time) were investigated. A 788-kHz single-element transducer was used. Multiple pulses at a 3-cycle pulse duration and a 20-kHz pulse repetition frequency were applied. ISPPA values between 1000 and 9000 W/cm2 and gas saturation ranges of 24%–28%, 39%–49%, and 77%–81% were tested. Results show the following: (1) without initiation, erosion was never observed; (2) initiation and extinction of the highly backscattering environment were stochastic in nature and dependent on acoustic parameters; (3) initiation delay times were shorter with higher intensity and higher gas saturation (e.g., the mean initiation delay time was 66.9 s at ISPPA of 4000 W/cm2 and 3.6 ms at ISPPA of 9000 W/cm2); and (4) once initiated by high-intensity pulses, the highly backscattering environment and erosion can be sustained using a significantly lower intensity than that required to initiate the process. PMID:15704435

Racial/ethnic differences in the influence of cultural values, alcohol resistance self-efficacy, and alcohol expectancies on risk for alcohol initiation.

PubMed

Shih, Regina A; Miles, Jeremy N V; Tucker, Joan S; Zhou, Annie J; D'Amico, Elizabeth J

2012-09-01

Prior research has reported racial/ethnic differences in the early initiation of alcohol use, suggesting that cultural values that are central to specific racial/ethnic groups may be influencing these differences. This 1-year longitudinal study examines associations between two types of cultural values, parental respect (honor for one's parents) and familism (connectedness with family), both measured at baseline, and subsequent alcohol initiation in a sample of 6,054 (approximately 49% male, 57% Hispanic, 22% Asian, 18% non-Hispanic White, and 4% non-Hispanic Black) middle school students in Southern California. We tested whether the associations of cultural values with alcohol initiation could be explained by baseline measures of alcohol resistance self-efficacy (RSE) and alcohol expectancies. We also explored whether these pathways differed by race/ethnicity. In the full sample, adolescents with higher parental respect were less likely to initiate alcohol use, an association that was partially explained by higher RSE and fewer positive alcohol expectancies. Familism was not significantly related to alcohol initiation. Comparing racial/ethnic groups, higher parental respect was protective against alcohol initiation for Whites and Asians, but not Blacks or Hispanics. There were no racial/ethnic differences in the association between familism and alcohol initiation. Results suggest that cultural values are important factors in the decision to use alcohol and these values appear to operate in part, by influencing alcohol positive expectancies and RSE. Interventions that focus on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Information literacy needs in graduate-level health sciences education.

PubMed

Kleyman, Emily Z; Tabaei, Sara

2012-01-01

To determine whether incorporating information literacy education through workshops led by library faculty improves students' information literacy skills. A series of information literacy initiatives were incorporated into the curriculum of a physician assistant program. Initiatives included two library workshops, class instruction, and a research paper. Assessment included subjective and objective measures of students' information literacy skills and research competencies. Students' ratings of their skills were significantly higher on the postmeasure (t37 = 2.85, P = .007). The objective measures of these skills revealed an increase from 25% to 65% of the class scoring above 70% correct. Class assignments also revealed an improvement from 10% of the class citing and referencing material correctly at the beginning of the initiative to 80% at the end of the initiative. Engaging academic library faculty and providing students with guided instruction has a significant positive effect on objective as well as subjective measures of students' skills.

Model Forecast Skill and Sensitivity to Initial Conditions in the Seasonal Sea Ice Outlook

NASA Technical Reports Server (NTRS)

Blanchard-Wrigglesworth, E.; Cullather, R. I.; Wang, W.; Zhang, J.; Bitz, C. M.

2015-01-01

We explore the skill of predictions of September Arctic sea ice extent from dynamical models participating in the Sea Ice Outlook (SIO). Forecasts submitted in August, at roughly 2 month lead times, are skillful. However, skill is lower in forecasts submitted to SIO, which began in 2008, than in hindcasts (retrospective forecasts) of the last few decades. The multimodel mean SIO predictions offer slightly higher skill than the single-model SIO predictions, but neither beats a damped persistence forecast at longer than 2 month lead times. The models are largely unsuccessful at predicting each other, indicating a large difference in model physics and/or initial conditions. Motivated by this, we perform an initial condition sensitivity experiment with four SIO models, applying a fixed -1 m perturbation to the initial sea ice thickness. The significant range of the response among the models suggests that different model physics make a significant contribution to forecast uncertainty.

Atomistic simulations of shock-induced alloying reactions in Ni /Al nanolaminates

NASA Astrophysics Data System (ADS)

Zhao, Shijin; Germann, Timothy C.; Strachan, Alejandro

2006-10-01

We employ molecular dynamics simulations with a first principles-based many body potential to characterize the exothermic alloying reactions of nanostructured Ni /Al multilayers induced by shock loading. We introduce a novel technique that captures both the initial shock transit as well as the subsequent longer-time-scale Ni3Al alloy formation. Initially, the softer Al layers are shock heated to a higher temperature than the harder Ni layers as a result of a series of shock reflections from the impedance-mismatched interfaces. Once initiated, the highly exothermic alloying reactions can propagate in a self-sustained manner by mass and thermal diffusion. We also characterize the role of voids on the initiation of alloying. The interaction of the shock wave with the voids leads not only to significant local heating (hot spots) but also directly aids the intermixing between Al and Ni; both of these phenomena contribute to a significant acceleration of the alloying reactions.

Up for Debate: Congress to Consider Future of Workforce Investment Act

ERIC Educational Resources Information Center

Hermes, James

2010-01-01

Community colleges have seen significant legislative developments in the last few years, including reauthorization of the Higher Education Act in 2008, the stimulus legislation earlier this year, and, of course, the American Graduation Initiative (AGI), which should be passed by the end of the year. But there is one significant piece of the puzzle…

Experimental Study of Thermal Runaway Process of 18650 Lithium-Ion Battery

PubMed Central

Liu, Jingjing; Wang, Zhirong; Gong, Junhui; Liu, Kai; Wang, Hao; Guo, Linsheng

2017-01-01

This study addresses the effects of the SOC (State of Charge) and the charging–discharging process on the thermal runaway of 18650 lithium-ion batteries. A series of experiments were conducted on an electric heating and testing apparatus. The experimental results indicate that 6 W is the critical heating power for 40% SOC. With a 20 W constant heating rate, the thermal runaway initial temperature of the lithium-ion battery decreases with the increasing SOC. The final thermal runaway temperature increases with the SOC when the SOC is lower than 80%. However, a contrary conclusion was obtained when the SOC was higher than 80%. Significant mass loss, accompanied by an intense exothermic reaction, took place under a higher SOC. The critical charging current, beyond which the thermal runaway occurs, was found to be 2.6 A. The thermal runaway initial temperature decreases with the increasing charging current, while the intensity of the exothermic reaction varies inversely. Mass ejection of gas and electrolytes exists during thermal runaway when the charging current is higher than 10.4 A, below which only a large amount of gas is released. The thermal runaway initial temperature of discharging is higher than that of non-discharging. PMID:28772588

Experimental Study of Thermal Runaway Process of 18650 Lithium-Ion Battery.

PubMed

Liu, Jingjing; Wang, Zhirong; Gong, Junhui; Liu, Kai; Wang, Hao; Guo, Linsheng

2017-02-25

This study addresses the effects of the SOC (State of Charge) and the charging-discharging process on the thermal runaway of 18650 lithium-ion batteries. A series of experiments were conducted on an electric heating and testing apparatus. The experimental results indicate that 6 W is the critical heating power for 40% SOC. With a 20 W constant heating rate, the thermal runaway initial temperature of the lithium-ion battery decreases with the increasing SOC. The final thermal runaway temperature increases with the SOC when the SOC is lower than 80%. However, a contrary conclusion was obtained when the SOC was higher than 80%. Significant mass loss, accompanied by an intense exothermic reaction, took place under a higher SOC. The critical charging current, beyond which the thermal runaway occurs, was found to be 2.6 A. The thermal runaway initial temperature decreases with the increasing charging current, while the intensity of the exothermic reaction varies inversely. Mass ejection of gas and electrolytes exists during thermal runaway when the charging current is higher than 10.4 A, below which only a large amount of gas is released. The thermal runaway initial temperature of discharging is higher than that of non-discharging.

Managing and Resourcing a Program of Social Integration Initiatives for International University Students: What Are the Benefits?

ERIC Educational Resources Information Center

Owens, Alison R.; Loomes, Susan L.

2010-01-01

There has been much concern in the higher education sector recently about the well-being and the safety of slightly more than 200,000 international students studying in higher education in Australia. In recognition of the economic and socio-cultural value of the international student cohort, as well as the significant challenge and risk of…

Promoting Social Change Amongst Students in Higher Education: A Reflection on the Listen, Live and Learn Senior Student Housing Initiative at Stellenbosch University

ERIC Educational Resources Information Center

Dunn-Coetzee, Munita; Fourie-Malherbe, Magda

2017-01-01

Twenty-two years after apartheid South African higher education is still struggling with challenges around access, success and transformation. Stellenbosch University (SU), as a historically white university, is striving to become significantly better and different in terms of relevance and active role-playing. SU wants to prepare students to…

Higher Education Institutions and Work-Based Learning in the UK: Employer Engagement within a Tripartite Relationship

ERIC Educational Resources Information Center

Basit, Tehmina N.; Eardley, Alan; Borup, Rosemary; Shah, Hanifa; Slack, Kim; Hughes, Amanda

2015-01-01

Higher education institutions (HEIs) in the UK are increasingly engaging in work-based learning. The tripartite relationship between the HEI, the employer and the employee is viewed to be of great significance in work-based learning, not only in the initial stages of procurement of a contract, but also in designing and delivering the programme to…

Medical Services at an International Summer Camp Event Under Hot and Humid Conditions: Experiences From the 23rd World Scout Jamboree, Japan.

PubMed

Watanabe, Takemasa; Mizutani, Keiji; Iwai, Toshiyasu; Nakashima, Hiroshi

2018-06-01

The 23rd World Scout Jamboree (WSJ) was a 10-day summer camp held in Japan in 2015 under hot and humid conditions. The attendees comprised 33,628 people from 155 countries and territories. The aim of this study was to examine the provision of medical services under such conditions and to identify preventive factors for major diseases among long-term campers. Data were obtained from WSJ medical center records and examined to clarify the effects of age, sex, and period on visit frequencies and rates. Medical records from 3215 patients were examined. Daytime temperatures were 31.5±3.2°C and relative humidity was 61±13% (mean±SD). The initial visit rates among scouts and adults were 72.2 and 77.2 per 1000 persons, respectively. No significant age difference was observed in the initial visit rate; however, it was significantly higher among female patients than male patients. Significant differences were also seen in the adjusted odds ratios by age, sex, and period for disease distributions of initial visit frequencies. In addition, a higher initial visit frequency for heat strain-related diseases was seen among the scouts. Initial visit frequencies for heatstroke and/or dehydration increased just after opening day and persisted until closing day. Our findings suggest the importance of taking effective countermeasures against heat strain, fatigue, and unsanitary conditions at the WSJ. Medical services staff should take attendees' age, sex, and period into consideration to prevent heat strain-related diseases during such camps under hot and humid conditions. Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Temperature-dependent elimination efficiency on Phaeocystis globosa by different initial population sizes of rotifer Brachionus plicatilis.

PubMed

Sun, Yunfei; Wang, Yuanyuan; Lei, Jin; Qian, Chenchen; Zhu, Xuexia; Akbar, Siddiq; Huang, Yuan; Yang, Zhou

2018-07-01

Due to sea water eutrophication and global warming, the harmful Phaeocystis blooms outbreak frequently in coastal waters, which cause a serious threat to marine ecosystem. The application of rotifer to control the harmful alga is a promising way. To investigate the influence of initial rotifer density and temperature on the ability of rotifer Brachionus plicatilis to eliminate Phaeocystis globosa population, we cultured P. globosa with different initial rotifer densities (1, 3, 5 inds mL -1 ) at 19, 22, 25, 28, and 31 °C for 9-16 d. Results showed that the population of rotifer feeding on Phaeocystis increased rapidly and higher temperatures favored the growth of P. globosa and B. plicatilis. With increased initial rotifer density and temperature, both the clearance rate of rotifer and the reduction rate of P. globosa increased, and thus P. globosa were eliminated earlier. Both temperature and initial rotifer density had significant effects on clearance rate of rotifer and the time to Phaeocystis extinction, and there was a significant interaction between the two factors on the two parameters, i.e., the effect of initial rotifer density on eliminating Phaeocystis decreased with increasing temperature. The rotifer in 5 inds mL -1 at 28 °C eliminated P. globosa in 4 d, whereas the rotifer in 1 ind mL -1 at 19 °C spent about 16 d on eliminating P. globosa. In conclusion, higher temperature and bigger initial rotifer density promote rotifer to eliminate the harmful P. globosa, and the optimal temperature for rotifer to clear P. globosa is 28 °C. Copyright © 2018 Elsevier Ltd. All rights reserved.

Early Initiation of Substance Use as an Indicator of Problematic Substance Use Among Young Men Who Have Sex with Men (YMSM).

PubMed

Kecojevic, Aleksandar; Basch, Corey H; Lankenau, Stephen E

2018-01-02

Much research has documented that young men who have sex with men (YMSM) are at higher risk for substance use-related problems. This study examined the age of substance use initiation and it's relationship to current substance use-related problems among substance-using YMSM. A cross-sectional survey of 191 YMSM (aged 18 to 29) with recent histories of prescription drug misuse was conducted in Philadelphia in 2012-13. Participants were surveyed about age of initiation of cigarette smoking, alcohol use to the point of intoxication, marijuana, prescription, and illicit drugs, and about alternate modes of prescription drug administration. The severity of participants' current substance use related problems was measured using the Drug Abuse Screening Test (DAST-10). Mean age of initiation was 14.6 years for cigarette smoking, 15.3 years for alcohol use to the point of intoxication, 15.2 years for marijuana, 16.8 years for prescription drugs, and 17.9 years for illicit drugs. Use of 2 or more substances by the age of 15 was reported by 56% of the participants. Odds of substance-related problems were significantly greater among those who reported earlier initiation of alcohol, prescription drugs, or polysubstance use. Odds of prescription drug misuse via altered routes of administration were significantly greater among participants with earlier onset of alcohol, marijuana, prescription, illicit drugs, or polysubstance use. This study demonstrates that earlier initiation of substance use is associated with higher risk of substance-related problems among substance-using YMSM. Early interventions addressing substance use initiation could benefit this population.

Differential uptake of recent Papanicolaou testing by HPV vaccination status among young women in the United States, 2008-2013.

PubMed

Sauer, Ann Goding; Jemal, Ahmedin; Simard, Edgar P; Fedewa, Stacey A

2015-08-01

A positive association between recent Papanicolaou (Pap) test uptake and initiation of HPV vaccination among U.S. women has been reported. However, it is unknown whether recent Pap testing by HPV vaccination status varies by race/ethnicity. Discerning racial/ethnic variations is important given the higher prevalence of HPV types other than 16 and 18 in some racial/ethnic groups. We assessed whether uptake of recent Pap testing differed among women aged 21-30 years who had not initiated the HPV vaccination series versus those who had and whether this pattern differed by sociodemographic factors. 2008, 2010, and 2013 National Health Interview Survey data were used to generate weighted prevalence estimates and 95% confidence intervals (CIs) (n=7095). Adjusted predicted marginal models were used to generate adjusted prevalence ratios (aPRs) to assess the relationship between recent Pap test uptake and HPV vaccination series initiation by race/ethnicity. The uptake of recent Pap testing among those who had not initiated the HPV vaccination series was significantly lower (81.0%) compared to those who had initiated vaccination (90.5%) (aPR=0.93, 95% CI: 0.90-0.96). This finding was consistent across most sociodemographic factors, though not statistically significant for Blacks, Hispanics, those with lower levels of education, or those with higher levels of income. Young women who had not initiated HPV vaccination were less likely to have had a recent Pap test compared to women who had initiated vaccination. Concerted efforts are needed to increase uptake of recommended cervical cancer screening and HPV vaccination among young women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implications of infiltrating immune cells within bone marrow of patients with diffuse large B-cell lymphoma.

PubMed

Jeong, Juhyeon; Oh, Eun Ji; Yang, Woo Ick; Kim, Soo Jeong; Yoon, Sun Och

2017-06-01

The implications of infiltrating immune cells, especially T cells and macrophages, in the bone marrow (BM) microenvironment of patients with diffuse large B-cell lymphoma (DLBCL) have rarely been studied. We aimed to investigate the significance of infiltrating immune cells in the BM microenvironment as a prognostic factor for DLBCL patients. Using the initial pretreatment BM biopsy obtained from 198 DLBCL patients, we semiquantitatively evaluated CD3+ T cells, CD8+ T cells, and CD163+ macrophages that infiltrate into the paratrabecular and interstitial areas of BM by immunohistochemistry and analyzed their clinicopathological and prognostic implications. Levels of infiltrating CD3+ T cells, CD8+ T cells, and CD163+ macrophages were significantly higher in BM with DLBCL involvement (BMI-positive group) than in that without DLBCL involvement (BMI-negative group). Infiltration of CD8+ T cells significantly increased in cases with advanced Ann Arbor stage, elevated lactate dehydrogenase level, extranodal site involvement ≥2 sites, higher Eastern Cooperative Oncology Group performance status, and higher International Prognostic Index (IPI) risk. High levels of CD3+ T cells were significantly associated with age ≤60, and high levels of CD163+ macrophages were associated with advanced Ann Arbor stage and higher IPI risk. High infiltration of CD8+ T cells was significantly related to inferior overall and recurrence-free survival rate, even in the BMI-negative group. High infiltration of CD8+ T cells within the pretreatment BM was related to poor prognosis, and might be a useful prognostic factor of DLBCL patients. Therefore, evaluation of CD8+ T cells is helpful for predicting prognosis in initial pretreatment BM biopsy of DLBCL patients. Copyright © 2017 Elsevier Inc. All rights reserved.

How doctors communicate the initial diagnosis of cancer matters: cancer disclosure and its relationship with Patients' hope and trust.

PubMed

Cao, Weidan; Qi, Xiaona; Yao, Ting; Han, Xuanye; Feng, Xujing

2017-05-01

The study is to examine the relationships between perceived initial cancer disclosure communication with doctors, levels of hope, and levels of trust in doctors among cancer patients in China. A total number of 192 cancer inpatients in a cancer hospital in China were surveyed. Perceived disclosure strategies, levels of hope, levels of trust in their doctors, as well as the demographic information were obtained from the participants. In addition to age, patients who had higher levels of perceived emotional support from doctors, or higher levels of perceived personalized disclosure from doctors, or higher levels of perceived discussion of multiple treatment plans with doctors were more likely to have higher levels of trust in doctors. In addition to perceived health status, perceived emotional support from doctors significantly predicted participants' levels of hope. That is, patients who had higher higher levels of perceived doctors' emotional support were more likely to have higher levels of hope. Key disclosure person was a marginally significant variable, that is, patients who were mainly disclosed by family members might have higher levels of hope compared with patients who were mainly disclosed by doctors. When communicating with a cancer patient, doctors might not ignore the importance of emotional support during cancer diagnosis communication. Doctors might want to involve family and collaborate with family to find out ways of personalized disclosure. During the communication process, doctors could provide their patients with multiple treatment options and discuss the benefits and side effects of each treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A First Look at Higher Performing High Schools: School Qualities That Educators Believe Contribute Most to College and Career Readiness. Executive Summary

ERIC Educational Resources Information Center

ACT, Inc., 2012

2012-01-01

The Common Core State Standards Initiative represents one of the most significant reforms to US education in recent history. As of June 2012, 45 states and the District of Columbia have adopted the Standards. ACT is pleased to have played a leading role in the development of the Standards. Not only did the initiative draw on its longitudinal…

Determinants of Paramedic Response Readiness for CBRNE Threats

PubMed Central

Jones, Alison; Smith, George; Nelson, Jenny; Agho, Kingsley; Taylor, Melanie; Raphael, Beverley

2010-01-01

Paramedics play a pivotal role in the response to major emergencies. Recent evidence indicates that their confidence and willingness to respond to chemical, biological, radiological, nuclear, and explosives-related (CBRNE) incidents differs from that relating to their “routine” emergency work. To further investigate the factors underpinning their readiness to respond to CBRNE incidents, paramedics in New South Wales (NSW), Australia, were asked to complete a validated online survey instrument. Univariate and multivariate analyses were performed to examine associated factors determining readiness. The sample of 663 respondents was weighted to reflect the NSW paramedic population as a whole. The univariate analysis indicated that gender, length of service, deployment concern, perceived personal resilience, CBRNE training, and incident experience were significantly associated with perceived CBRNE response readiness. In the initial multivariate analysis, significantly higher response readiness was associated with male gender, university education, and greater length of service (10-15 years). In the final multivariate model, the combined effect of training/incident experience negated the significant effects observed in the initial model and, importantly, showed that those with recent training reported higher readiness, irrespective of incident experience. Those with lower concern regarding CBRNE deployment and those with higher personal resilience were significantly more likely to report higher readiness (Adjusted Relative Risk [ARR] = 0.91, 95% CI: 0.84-0.99; ARR = 1.40, 95% CI: 1.11-1.72, respectively). These findings will assist emergency medical planners in recognizing occupational and dispositional factors associated with enhanced CBRNE readiness and highlight the important role of training in redressing potential readiness differences associated with these factors. PMID:20569060

Evaluation of Pharmacist-Initiated Interventions on Vaccination Rates in Patients with Asthma or COPD.

PubMed

Klassing, Haley M; Ruisinger, Janelle F; Prohaska, Emily S; Melton, Brittany L

2018-04-01

To determine if pharmacy-initiated interventions improved the rate of influenza and pneumococcal vaccinations in adult patients with asthma and/or chronic obstructive pulmonary disease (COPD). Adult patients who filled prescriptions at one of three community pharmacies, who had a dispensing history indicative of an asthma and/or COPD diagnosis were randomized to receive a personal phone call or standardized mailed letter recommending influenza and pneumococcal vaccinations, or control with no vaccination information. The rate of influenza and pneumococcal vaccinations was measured for each group and measured using Chi square. Of 831 eligible participants, 210 patients completed the study, and self-reported a diagnosis of asthma and/or COPD. The influenza vaccine was administered to 56 (72.7%), 55 (87.3%), and 62 (88.6%) patients (p = 0.019); pneumococcal vaccine was administered to 46 (59.7%), 39 (61.9%), and 39 (55.7%) patients in the phone call, letter, and control groups, respectively. While the control group had significantly more influenza vaccinations, between the interventions the letter showed a higher rate of influenza vaccination over the phone call. Reviewing patients under age 65, the letter had a significantly higher rate of influenza vaccination than the phone call (p = 0.021). No significant improvement was found for the pneumococcal vaccination. Patients under age 65 who received a mailed letter had a significantly higher rate of influenza vaccination than those who received a phone call, and had a higher rate of pneumococcal vaccination. A standardized, mailed letter may help community pharmacists improve vaccination rates in patients with asthma and/or COPD.

A microcosting study of microsurgery, LINAC radiosurgery, and gamma knife radiosurgery in meningioma patients

PubMed Central

van Putten, Erik; Nijdam, Wideke M.; Hanssens, Patrick; Beute, Guus N.; Nowak, Peter J.; Dirven, Clemens M.; Hakkaart-van Roijen, Leona

2010-01-01

The aim of the present study is to determine and compare initial treatment costs of microsurgery, linear accelerator (LINAC) radiosurgery, and gamma knife radiosurgery in meningioma patients. Additionally, the follow-up costs in the first year after initial treatment were assessed. Cost analyses were performed at two neurosurgical departments in The Netherlands from the healthcare providers’ perspective. A total of 59 patients were included, of whom 18 underwent microsurgery, 15 underwent LINAC radiosurgery, and 26 underwent gamma knife radiosurgery. A standardized microcosting methodology was employed to ensure that the identified cost differences would reflect only actual cost differences. Initial treatment costs, using equipment costs per fraction, were €12,288 for microsurgery, €1,547 for LINAC radiosurgery, and €2,412 for gamma knife radiosurgery. Higher initial treatment costs for microsurgery were predominantly due to inpatient stay (€5,321) and indirect costs (€4,350). LINAC and gamma knife radiosurgery were equally expensive when equipment was valued per treatment (€2,198 and €2,412, respectively). Follow-up costs were slightly, but not significantly, higher for microsurgery compared with LINAC and gamma knife radiosurgery. Even though initial treatment costs were over five times higher for microsurgery compared with both radiosurgical treatments, our study gives indications that the relative cost difference may decrease when follow-up costs occurring during the first year after initial treatment are incorporated. This reinforces the need to consider follow-up costs after initial treatment when examining the relative costs of alternative treatments. PMID:20526795

A non-randomized [corrected] controlled trial of the active music engagement (AME) intervention on children with cancer.

PubMed

Robb, Sheri L; Clair, Alicia A; Watanabe, Masayo; Monahan, Patrick O; Azzouz, Faouzi; Stouffer, Janice W; Ebberts, Allison; Darsie, Emily; Whitmer, Courtney; Walker, Joey; Nelson, Kirsten; Hanson-Abromeit, Deanna; Lane, Deforia; Hannan, Ann

2008-07-01

Coping theorists argue that environmental factors affect how children perceive and respond to stressful events such as cancer. However, few studies have investigated how particular interventions can change coping behaviors. The active music engagement (AME) intervention was designed to counter stressful qualities of the in-patient hospital environment by introducing three forms of environmental support. The purpose of this multi-site randomized controlled trial was to determine the efficacy of the AME intervention on three coping-related behaviors (i.e. positive facial affect, active engagement, and initiation). Eighty-three participants, ages 4-7, were randomly assigned to one of three conditions: AME (n = 27), music listening (ML; n = 28), or audio storybooks (ASB; n = 28). Conditions were videotaped to facilitate behavioral data collection using time-sampling procedures. After adjusting for baseline differences, repeated measure analyses indicated that AME participants had a significantly higher frequency of coping-related behaviors compared with ML or ASB. Positive facial affect and active engagement were significantly higher during AME compared with ML and ASB (p<0.0001). Initiation was significantly higher during AME than ASB (p<0.05). This study supports the use of the AME intervention to encourage coping-related behaviors in hospitalized children aged 4-7 receiving cancer treatment. (c) 2007 John Wiley & Sons, Ltd.

Effect of initiator concentration to low-density polyethylene production in a tubular reactor

NASA Astrophysics Data System (ADS)

Azmi, A.; Aziz, N.

2016-11-01

Low-density polyethylene (LDPE) is one of the most widely used polymers in the world, which is produced in high-capacity tubular and autoclave reactors. As the LDPE industry turn into more competitive and its market profit margins become tighter, manufacturers have to develop solutions to debottleneck the reactor output while abiding to the stringent product specification. A single polyolefin plant producing ten to forty grades of LDPE with various melt flow index (MFI), therefore understanding the reaction mechanism, the operating conditions as well as the dynamic behavior of tubular reactor is essential before any improvement can take place. In the present work, a steady state mathematical model representing a tubular reactor for the production of LDPE is simulated using MATLAB R2015a®. The model developed is a function of feed inlet, reactor jacket, single initiator injector and outlet stream. Analysis on the effect of initiator concentration (CI) shows sudden declining trend of initiator's concentration which indicates that all of the initiators are exhausted after polymerization reaction and no further reaction occur from this point onwards. Furthermore, the results demonstrate that the concentration of initiator gives significant impact on reactor temperature's profile and monomer conversion rate, since higher initiator concentration promotes greater polymerization rate, and therefore leads to higher monomer conversion throughput.

Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings.

PubMed

Malfait, Bart; Dingenen, Bart; Smeets, Annemie; Staes, Filip; Pataky, Todd; Robinson, Mark A; Vanrenterghem, Jos; Verschueren, Sabine

2016-01-01

The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ). Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping. The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001). This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior neuromuscular activation (dominant hamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase.

Ethnic differences in the initiation and duration of breast feeding--results from the born in Bradford Birth Cohort Study.

PubMed

Santorelli, Gillian; Petherick, Emily; Waiblinger, Dagmar; Cabieses, Baltica; Fairley, Lesley

2013-07-01

Initiation of breast feeding and duration of any breast feeding are known to differ by ethnic group, but there are limited data on differences in exclusive breast feeding. This study aimed to determine if there are ethnic differences in the initiation and duration of any and exclusive breast feeding. Breast-feeding data were obtained from a subsample of 1365 women recruited to a multi-ethnic cohort study (Born in Bradford) between August 2008 and March 2009. Poisson regression was used to investigate the impact of socio-economic, life style and birth factors on ethnic differences in the prevalence of breast feeding. Compared with white British mothers, initiation of breast feeding was significantly higher in all ethnic groups and this persisted after adjustment for socio-economic, life style and birth factors [Pakistani: prevalence rate ratio (PRR) = 1.19 (95% confidence interval 1.10, 1.29); Other South Asian: PRR = 1.29 (1.18, 1.42); Other ethnicities: PRR = 1.33 (1.21, 1.46)]. There were no differences in exclusive breast feeding at 4 months [Pakistani: PRR = 0.77 (0.54, 1.09); Other South Asian: PRR = 1.55 (0.99, 2.43); Other ethnicities: PRR = 1.50 (0.88, 2.56)]. Any breast feeding at 4 months was significantly higher in mothers of all non-white British ethnicities [Pakistani: PRR = 1.27 (1.02, 1.58); Other South Asian: PRR = 1.99 (1.52, 2.62); Other ethnicities: 2.45 (1.86, 3.21)]. Whilst women of ethnic minority groups were significantly more likely to initiate breast feeding and continue any breast feeding for 4 months compared with white British women, the rates of exclusive breast feeding at 4 months were not significantly different once socio-economic, life style and birth factors were accounted for. © 2013 John Wiley & Sons Ltd.

Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation Among Adolescent Girls in the United States

PubMed Central

Henry, Kevin A.; Stroup, Antoinette M.; Warner, Echo L; Kepka, Deanna

2015-01-01

Background This study is among the first to explore geographic factors that may be associated with HPV vaccine uptake in the United States. Methods Data from the 2011 and 2012 National Immunization Survey-Teen for 20,565 female adolescents aged 13-17 years were analyzed to examine associations of HPV vaccine initiation (receipt of at least one dose) with ZIP code-level geographic factors. Logistic regression including individual and geographic factors was used to estimate the odds of HPV vaccine initiation. Results Approximately 53% of girls initiated the HPV vaccine in both years. Girls in high poverty communities had higher HPV vaccine initiation compared to those in low poverty communities (61.1% vs .52.4%; Adjusted Odds Ratio [AOR] 1.18,95%CI 1.04-1.33). Initiation was higher among girls in communities where the majority of the population was Hispanic (69.0% vs. 49.9%;AOR 1.64, 95%CI 1.43-1.87) or non-Hispanic mixed race (60.4% vs. 49.9%; AOR 1.30, 95%CI 1.17-1.44) compared to majority non-Hispanic white communities. Interactions between individual-level race/ethnicity and community racial–ethnic composition indicated significantly higher odds of initiation among Hispanic girls living in Hispanic communities compared to Hispanic girls living in predominately NHW (AOR 2.23;95%CI 1.87-2.65) or NHB (AOR 1.90; 95%CI 1.20-3.04)communities, respectively Conclusion Initiation rates of HPV vaccination among teen girls were highest in the poorest communities and among Hispanics living in communities where the racial–ethnic composition was predominantly Hispanic or mixed race. Impact Given low HPV vaccination rates in the United States, these results provide important evidence to inform public health interventions to increase HPV vaccination. PMID:26768989

Influence of initial vaccination with 13-valent pneumococcal conjugate vaccine or 23-valent pneumococcal polysaccharide vaccine on anti-pneumococcal responses following subsequent pneumococcal vaccination in adults 50 years and older.

PubMed

Jackson, Lisa A; Gurtman, Alejandra; van Cleeff, Martin; Frenck, Robert W; Treanor, John; Jansen, Kathrin U; Scott, Daniel A; Emini, Emilio A; Gruber, William C; Schmoele-Thoma, Beate

2013-08-02

Unlike free polysaccharide vaccines, pneumococcal polysaccharide conjugate vaccines (PCVs) induce a T cell-dependent immune response and have the potential to provide an extended duration of protection with repeated vaccinations. This was an extension of a previous study in pneumococcal vaccine-naïve adults aged 50-64 years in which adults 60-64 years of age were given 13-valent PCV (PCV13) or 23-valent pneumococcal polysaccharide vaccine (PPSV23) and adults aged 50-59 were given PCV13. In this follow up study conducted about 4 years later, the 60-64 year olds initially given PCV13 received PCV13 or PPSV23, and those initially given PPSV23 received another PPSV23. All adults aged 50-59 years were re-vaccinated with PCV13. Anti-pneumococcal opsonophagocytic activity (OPA) titers were measured before and 1 month after vaccination. A second PCV13 given about 4 years after a first vaccination induced OPA titers that were significantly higher than those following the initial vaccination for 7 of 13 serotypes in the older group, and 6 of 13 serotypes in the younger group, and responses to the remaining serotypes were largely non-inferior. In contrast, OPA titers following revaccination with PPSV23 were statistically significantly lower for 9 of the 13 serotypes, and non-inferior for the remaining serotypes, when compared to the responses to the first PPSV23. OPA titers in the older adults who received PPSV23 after initial PCV13 were significantly higher than those following a first PPSV23 for 10 of the 13 serotypes. In adults 50 to 64 years of age, initial vaccination with PCV13 establishes an immune state that results in recall anti-pneumococcal responses upon subsequent vaccination with either conjugated or free polysaccharide vaccine. In contrast, initial vaccination with PPSV23 results in an immune state in which subsequent PPSV23 administration yields generally lower responses compared with the initial responses. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improvements in survival of the uncemented Nottingham Total Shoulder prosthesis: a prospective comparative study

PubMed Central

Rosenberg, Nahum; Neumann, Lars; Modi, Amit; Mersich, Istvan J; Wallace, Angus W

2007-01-01

Background The uncemented Nottingham Total Shoulder Replacement prosthesis system (Nottingham TSR) was developed from the previous BioModular® shoulder prosthesis taking into consideration the causes of the initial implant's failure. We investigated the impact of changes in the design of Nottingham TSR prosthesis on its survivorship rate. Methods Survivorship analyses of three types of uncemented total shoulder arthroplasty prostheses (BioModular®, initial Nottingham TSR and current Nottingham TSR systems with 11, 8 and 4 year survivorship data respectively) were compared. All these prostheses were implanted for the treatment of disabling pain in the shoulder due to primary and secondary osteoarthritis or rheumatoid arthritis. Each type of the prosthesis studied was implanted in consecutive group of patients – 90 patients with BioModular® system, 103 with the initial Nottingham TSR and 34 patients with the current Nottingham TSR system. The comparison of the annual cumulative survivorship values in the compatible time range between the three groups was done according to the paired t test. Results The 8-year and 11-year survivorship rates for the initially used modified BioModular® uncemented prosthesis were relatively low (75.6% and 71.7% respectively) comparing to the reported survivorship of the conventional cemented implants. The 8-year survivorship for the uncemented Nottingham TSR prosthesis was significantly higher (81.8%), but still not in the desired range of above 90%, that is found in other cemented designs. Glenoid component loosening was the main factor of prosthesis failure in both prostheses and mainly occurred in the first 4 postoperative years. The 4-year survivorship of the currently re-designed Nottingham TSR prosthesis, with hydroxylapatite coating of the glenoid baseplate, was significantly higher, 93.1% as compared to 85.1% of the previous Nottingham TSR. Conclusion The initial Nottingham shoulder prosthesis showed significantly higher survivorship than the BioModular® uncemented prosthesis, but lower than expected. Subsequently re-designed Nottingham TSR system presented a high short term survivorship rate that encourages its ongoing use PMID:17683577

Fever as an initial manifestation of spondyloarthritis: A retrospective study.

PubMed

Byun, Se Jin; Bae, William Han; Jung, Seung Min; Lee, Sang-Won; Park, Yong-Beom; Song, Jason Jungsik

2017-01-01

We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA) whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea) with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic. Clinical features and laboratory findings were compared in two patient groups. There were 26 patients who had fever as initial presentation of SpA (reactive arthritis 50%, undifferentiated SpA 26.9%, ankylosing spondylitis 15.4%, enteropathic arthritis 3.8%, psoriatic arthritis 3.8%). Peripheral SpA was more common in febrile SpA patients than in control SpA patients (65.4% vs 24.0%, p<0.001). Febrile SpA patients were less frequently HLA-B27 positive than control SpA patients (52.2% vs 77.0%, p<0.05). At baseline, systemic inflammatory markers were significantly higher in the febrile SpA patients (white blood cell count, 11.57 vs 7.81 cells/μL, p<0.001; erythrocyte sedimentation rate, 69.2 vs 41.0 mm/h, p<0.001; C-reactive protein, 109.6 vs 15.3 mg/L, p<0.001). The proportion of patients treated with systemic steroids was significantly higher in febrile SpA patients (57.7% vs. 11.0%, p<0.001). The proportion of patients who visited rheumatology specialty was significantly lower in febrile SpA patients than in control SpA patients (7.7% vs 59.0%, p<0.001). Various subgroups of SpA can be presented with fever as an initial manifestation. Febrile SpA patients demonstrated higher systemic inflammation and a lower chance to visit rheumatology in early stage. When evaluating febrile patients with any clinical features of SpA, clinicians are advised to consider performing SpA-focused evaluation including HLA-B27 or a simple sacroiliac joint radiograph.

GFR at Initiation of Dialysis and Mortality in CKD: A Meta-analysis

PubMed Central

Susantitaphong, Paweena; Altamimi, Sarah; Ashkar, Motaz; Balk, Ethan M.; Stel, Vianda S.; Wright, Seth; Jaber, Bertrand L.

2012-01-01

Background The proportion of patients with advanced chronic kidney disease (CKD) initiating dialysis at higher glomerular filtration rate (GFR) has increased over the past decade. Recent data suggest that higher GFR may be associated with increased mortality. Study Design A meta-analysis of cohort studies and trials. Setting & Population Patients with advanced CKD. Selection Criteria for Studies We performed a systematic literature search in MEDLINE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, American Society of Nephrology abstracts, and bibliographies of retrieved articles to identify studies reporting on GFR at dialysis initiation and mortality. Predictor estimated or calculated GFR at dialysis initiation. Outcome Pooled adjusted hazard ratio (HR) of continuous GFR for all-cause mortality. Results Sixteen cohort studies and one randomized controlled trial were identified (n=1,081,116). By meta-analysis, restricted to the 15 cohorts (n=1,079,917), higher GFR at dialysis initiation was associated with a higher pooled adjusted HR for all-cause mortality (1.04; 95% CI, 1.03–1.05; P<0.001). However, there was significant heterogeneity (I2=97%; P<0.001). The association persisted among the 9 cohorts that adjusted analytically for nutritional covariates (HR 1.03; 95% CI 1.02, 1.04; P<0.001; residual I2=97%). The highest mortality risk was observed in hemodialysis cohorts (HR 1.05; 95% CI 1.02, 1.08; P<0.001) whereas there was no association between GFR and mortality in peritoneal dialysis cohorts (HR 1.04; 95% CI 0.99, 1.08, P=0.11; residual I2=98%). Finally, higher GFR was associated with a lower mortality risk in cohorts that calculated GFR (HR 0.80; 95% CI 0.71, 0.91; P=0.003), contrasting with a higher mortality risk in cohorts that estimated GFR (HR 1.04; 95% CI 1.03, 1.05; P<0.001; residual I2=97%). Limitations Paucity of randomized controlled trials; different methods for determining GFR; and substantial heterogeneity. Conclusions Higher estimated rather than calculated GFR at dialysis initiation is associated with a higher mortality risk among patients with advanced CKD, independent of nutritional status. Although there was substantial heterogeneity of effect size estimates across studies, this observation requires further study. PMID:22465328

Pretreatment costs of care and time to initial treatment for patients with cancer of unknown primary.

PubMed

Walker, Mark S; Weinstein, Laura; Luo, Roger; Marino, Ingrid

2018-06-01

Time to treatment and pretreatment costs may be affected by unknown primary tumor site. This retrospective study used electronic medical record data from patients in ten US community oncology practices. Eligible patients were ≥18 years, diagnosed with cancer of unknown primary (CUP) or known metastatic solid tumor, and presented between 1 January 2012 and 30 June 2014. Patients with CUP (n = 294) had a longer interval than non-CUP patients (n = 92) from presentation to treatment initiation (1.18 vs 0.49 months, p < 0.0001), and had higher pretreatment costs (US$27,882 vs US$20,449, p = 0.0075). When analyzed as monthly cost, the difference between groups in log-cost per month was nonsignificant. Higher pretreatment costs in CUP patients appeared attributable to significantly longer time to initiation of therapy.

Use of HL cells for improved isolation and passage of Chlamydia pneumoniae.

PubMed Central

Cles, L D; Stamm, W E

1990-01-01

We compared growth of the recently discovered respiratory pathogen Chlamydia pneumoniae in McCoy, HeLa 229, BHK-21, and HL cells. When cells were not pretreated with DEAE-dextran, HL cells had significantly higher mean numbers of inclusion-forming units (IFUs) on initial inoculation than the other cell lines. When cells were pretreated with DEAE-dextran, HeLa 229 and HL cells had equivalent mean numbers of IFUs on initial inoculation. HL cells had strikingly higher mean numbers of IFUs in passage than HeLa 229, BHK-21, or McCoy cells. In addition, HL cells did not require pretreatment with DEAE-dextran and could be used from 2 to 4 days after seeding. We conclude that HL cells are an excellent cell culture system for laboratory propagation of C. pneumoniae and may be a more sensitive cell line for initial isolation. PMID:2191013

Decision Guidance for Sustainable Manufacturing

ERIC Educational Resources Information Center

Shao, Guodong

2013-01-01

Sustainable manufacturing has significant impacts on a company's business performance and competitiveness in today's world. A growing number of manufacturing industries are initiating efforts to address sustainability issues; however, to achieve a higher level of sustainability, manufacturers need methodologies for formally describing, analyzing,…

On the effects of higher convection modes on the thermal evolution of small planetary bodies

NASA Technical Reports Server (NTRS)

Arkani-Hamed, J.

1979-01-01

The effects of higher modes of convection on the thermal evolution of a small planetary body is investigated. Three sets of models are designed to specify an initially cold and differentiated, an initially hot and differentiated, and an initially cold and undifferentiated Moon-type body. The strong temperature dependence of viscosity enhances the thickening of lithosphere so that a lithosphere of about 400 km thickness is developed within the first billion years of the evolution of a Moon-type body. The thermally isolating effect of such a lithosphere hampers the heat flux out of the body and increases the temperature of the interior, causing the solid-state convection to occur with high velocity so that even the lower modes of convection can maintain an adiabatic temperature gradient there. It is demonstrated that the effect of solid-state convection on the thermal evolution of the models may be adequately determined by a combination of convection modes up to the third or the fourth order harmonic. The inclusion of higher modes does not affect the results significantly.

Educational attainment and hippocampal atrophy in the Alzheimer's disease neuroimaging initiative cohort.

PubMed

Shpanskaya, Katie S; Choudhury, Kingshuk Roy; Hostage, Christopher; Murphy, Kelly R; Petrella, Jeffrey R; Doraiswamy, P Murali

2014-12-01

Subjects with higher cognitive reserve (CR) may be at a lower risk for Alzheimer's disease (AD), but the neural mechanisms underlying this are not known. Hippocampal volume loss is an early event in AD that triggers cognitive decline. Regression analyses of the effects of education on MRI-measured baseline HV in 675 subjects (201 normal, 329 with mild cognitive impairment (MCI), and 146 subjects with mild AD), adjusting for age, gender, APOE ɛ4 status and intracranial volume (ICV). Subjects were derived from the Alzheimer's Disease Neuroimaging Initiative (ADNI), a large US national biomarker study. The association between higher education and larger HV was significant in AD (P=0.014) but not in cognitively normal or MCI subjects. In AD, HV was about 8% larger in a person with 20 years of education relative to someone with 6 years of education. There was also a trend for the interaction between education and APOE ɛ4 to be significant in AD (P=0.056). A potential protective association between higher education and lower hippocampal atrophy in patients with AD appears consistent with prior epidemiologic data linking higher education levels with lower rates of incident dementia. Longitudinal studies are warranted to confirm these findings. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

All-Cause, Stroke/Systemic Embolism-, and Major Bleeding-Related Health-Care Costs Among Elderly Patients With Nonvalvular Atrial Fibrillation Treated With Oral Anticoagulants.

PubMed

Deitelzweig, Steve; Luo, Xuemei; Gupta, Kiran; Trocio, Jeffrey; Mardekian, Jack; Curtice, Tammy; Hlavacek, Patrick; Lingohr-Smith, Melissa; Menges, Brandy; Lin, Jay

2018-05-01

In this study, all-cause, stroke/systemic embolism (SE)-related, and major bleeding (MB)-related health-care costs among elderly patients with nonvalvular atrial fibrillation (NVAF) initiating treatment with different oral anticoagulants (OACs) were compared. Patients ≥65 years of age initiating OACs, including apixaban, rivaroxaban, dabigatran, and warfarin, were identified from the Humana Research Database between January 1, 2013, and September 30, 2015. Propensity score matching was used to separately match the different OAC cohorts with the apixaban cohort. All-cause health-care costs and stroke/SE-related and MB-related medical costs per patient per month (PPPM) were compared using generalized linear or 2-part regression models. Compared to apixaban, rivaroxaban was associated with significantly higher all-cause health-care costs (US$2234 vs US$1846 PPPM, P < .001) and MB-related medical costs (US$106 vs US$47 PPPM, P < .001), dabigatran was associated with significantly higher all-cause health-care costs (US$1980 vs US$1801 PPPM, P = .007), and warfarin was associated with significantly higher all-cause health-care costs (US$2386 vs US$1929 PPPM, P < .001), stroke/SE-related medical costs (US$42 vs US$18 PPPM, P < .001), and MB-related medical costs (US$132 vs US$51 PPPM, P < .001). Among elderly patients with NVAF, other OACs were associated with higher all-cause health-care costs than apixaban.

Effect of tetrastarch (hydroxyethyl starch 130/0.4) on plasma creatinine concentration in cats: a retrospective analysis (2010-2015).

PubMed

Yozova, Ivayla D; Howard, Judith; Adamik, Katja N

2017-10-01

Objectives The objective was to determine survival and changes in creatinine concentrations after administration of 6% tetrastarch (hydroxyethyl starch [HES] 130/0.4) vs crystalloids in critically ill cats. Methods The medical records were reviewed for cats admitted to the intensive care unit with at least two plasma creatinine measurements and initial concentrations not exceeding the upper reference interval. Cats were excluded if they had received HES prior to admission or if they had received fluid therapy for <24 h between initial and subsequent measurements. Changes in creatinine concentrations were evaluated as the percentage change from initial values to the maximum subsequent measurements. Cats receiving only crystalloids were assigned to the crystalloid group; cats receiving only HES or HES and crystalloids were assigned to the HES group. Results Ninety-three cats were included in the study (62 in the crystalloid group, 31 in the HES group). The total median cumulative HES dose was 94 ml/kg (range 26-422 ml/kg) and 24 ml/kg/day (range 16-42 ml/kg/day). No difference was detected between the groups for age, sex, body weight or mortality. The HES group had a significantly longer length of hospitalisation ( P = 0.012), lower albumin concentrations ( P <0.001), higher Acute Patient Physiologic and Laboratory Evaluation scores ( P = 0.037) and higher incidence of systemic inflammatory response syndrome ( P = 0.009) and sepsis ( P = 0.013). There was no significant difference in initial, maximum or maximum change in creatinine concentrations between the groups. Moreover, there was no significant difference in maximum change in creatinine concentrations in the subgroups of cats with systemic inflammatory response syndrome or sepsis. Conclusions and relevance In this population of cats, the administration of HES did not result in a significantly greater increase in creatinine from values measured on admission or higher mortality compared with administration of crystalloids. Further prospective studies are needed to assess both safety and efficacy of HES in cats before recommendations can be made.

Monomer-to-polymer conversion and micro-tensile bond strength to dentine of experimental and commercial adhesives containing diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide or a camphorquinone/amine photo-initiator system.

PubMed

Miletic, Vesna; Pongprueksa, Pong; De Munck, Jan; Brooks, Neil R; Van Meerbeek, Bart

2013-10-01

To compare the degree of conversion (DC) of adhesives initiated by diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO) or a camphorquinone/tertiary amine system (CQ/Amine) as well as their 'immediate' micro-tensile bond strength (μTBS) to bur-cut dentine. DC of Scotchbond Universal ('SBU'; 3M ESPE), its experimental counterpart containing TPO as photo-initiator system, an experimental G-aenial Bond ('Ga-B'; GC) adhesive formulation, and an experimental LUB-102 adhesive formulation ('LUB', Kuraray Noritake), containing as photo-initiatior system either 2wt% CQ along with 2wt% tertiary amine ('SBU_CQ/Amine'; 'Ga-B_CQ/Amine'; 'LUB_CQ/Amine'), or 2wt% TPO ('SBU_TPO'; 'Ga-B_TPO'; 'LUB_TPO'), was determined using Fourier-transform infrared spectroscopy (FTIR), after being cured with a dual-wavelength light-curing unit (bluephase 20i, Ivoclar Vivadent). The same adhesive formulations were applied to bur-cut mid-coronal dentine of intact human molars, and subjected to a μTBS test after 1-week water storage. Besides being applied following a self-etch (SE) application mode, the adhesive formulations SBU_CQ/Amine and SBU_TPO were also applied following an etch-and-rinse (E&R) mode, this both for DS and μTBS measurement. No significant difference in DC was found for any of the adhesive formulations, except for SBU_CQ/Amine_SE and SBU_TPO_SE. For both SBU formulations, a significantly higher DC was reached for the E&R than the SE approach. Regarding μTBS, no significant differences were recorded, except for the significantly higher μTBS measured for SBU_CQ/Amine_E&R and SBU_TPO_E&R. In self-etch adhesives, the photo-initiator TPO may be used instead of CQ/Amine. The curing and 'immediate' bonding efficiency depended on the application protocol (E&R versus SE), but not on the photo-initiator system. The photo-initiator TPO may be used in self-etch adhesives instead of CQ/Amine with similar curing and 'immediate' bonding efficiency. Copyright © 2013 Elsevier Ltd. All rights reserved.

Early Complications and Outcomes in Combat Injury Related Invasive Fungal Wound Infections: A Case-Control Analysis

PubMed Central

Lewandowski, Louis R.; Weintrob, Amy C.; Tribble, David R.; Rodriguez, Carlos J.; Petfield, Joseph; Lloyd, Bradley A.; Murray, Clinton K.; Stinner, Daniel; Aggarwal, Deepak; Shaikh, Faraz; Potter, Benjamin K.

2015-01-01

Objective Clinicians have anecdotally noted that combat-related invasive fungal wound infections (IFIs) lead to residual limb shortening, additional days and operative procedures prior to initial wound closure, and high early complication rates. We evaluated the validity of these observations and identified risk factors that may impact time to initial wound closure. Design Retrospective review and case-control analysis. Setting Military hospitals. Patients/Participants United States military personnel injured during combat operations (2009–2011). The IFI cases were identified based upon the presence of recurrent, necrotic extremity wounds with mold growth in culture and/or histopathologic fungal evidence. Non-IFI controls were matched on injury pattern and severity. In a supplemental matching analysis, non-IFI controls were also matched by blood volume transfused within 24 hours of injury. Intervention None. Main Outcome Measurements Amputation revision rate and loss of functional levels. Results Seventy-one IFI cases (112 fungal-infected extremity wounds) were identified and matched to 160 control patients (315 non-IFI extremity wounds). The IFI wounds resulted in significantly more changes in amputation level (p<0.001). Additionally, significantly (p<0.001) higher number of operative procedures and longer duration to initial wound closure was associated with IFI. A shorter duration to initial wound closure was significantly associated with wounds lacking IFIs (Hazard ratio: 1.53; 95% CI: 1.17, 2.01). The supplemental matching analysis found similar results. Conclusions Our analysis indicates that IFIs adversely impact wound healing and patient recovery, requiring more frequent proximal amputation revisions and leading to higher early complication rates. PMID:26360542

Correction of deformational plagiocephaly in early infancy using the plagio cradle orthotic.

PubMed

Seruya, Mitchel; Oh, Albert K; Sauerhammer, Tina M; Taylor, Jonathan H; Rogers, Gary F

2013-03-01

The purpose of this study was to assess early treatment of deformational plagiocephaly using the Plagio Cradle, a modifiable cranial orthotic. Infants were included if they had treatment of deformational plagiocephaly with the Plagio Cradle beginning at 4 months or younger. Patients were prospectively stratified by the age treatment was initiated: group 1: under 10 weeks (n = 50); group 2: 10 to 20 weeks (n = 113). Pretreatment and posttreatment calvarial asymmetry was measured using direct anthropometry and reported as a transcranial difference (TCD). The end point for therapy was a TCD of 5 mm or less, falling within 2 SDs of published normative data. One hundred sixty-three infants were included. Initial TCD was significantly higher for group 1 as compared with group 2 (initial TCD: 11.0 vs 9.0 mm; P < 0.05). Duration of therapy was significantly longer for group 1 as compared with group 2 (6.9 vs 5.7 week; P < 0.05). Following cradle use, group 1 infants demonstrated a significantly larger change in TCD in comparison to group 2 (change in TCD: 6.0 vs 4.0 mm; P < 0.001). At the conclusion of therapy, group 1 infants trended toward greater calvarial symmetry than group 2 patients (final TCD: 4.5 vs 5.0 mm; P = 0.06) and a higher frequency of cases with full correction of asymmetry (62.4% vs 52.2%; P = 0.16). The Plagio Cradle can fully correct deformational plagiocephaly early in life. Nevertheless, treatment is more effective if initiated before 10 weeks of age.

Renal Function in De Novo Liver Transplant Recipients Receiving Different Prolonged-Release Tacrolimus Regimens-The DIAMOND Study.

PubMed

TruneČka, P; Klempnauer, J; Bechstein, W O; Pirenne, J; Friman, S; Zhao, A; Isoniemi, H; Rostaing, L; Settmacher, U; Mönch, C; Brown, M; Undre, N; Tisone, G

2015-07-01

DIAMOND: multicenter, 24-week, randomized trial investigating the effect of different once-daily, prolonged-release tacrolimus dosing regimens on renal function after de novo liver transplantation. Arm 1: prolonged-release tacrolimus (initial dose 0.2mg/kg/day); Arm 2: prolonged-release tacrolimus (0.15-0.175mg/kg/day) plus basiliximab; Arm 3: prolonged-release tacrolimus (0.2mg/kg/day delayed until Day 5) plus basiliximab. All patients received MMF plus a bolus of corticosteroid (no maintenance steroids). eGFR (MDRD4) at Week 24. Secondary endpoints: composite efficacy failure, BCAR and AEs. Baseline characteristics were comparable. Tacrolimus trough levels were readily achieved posttransplant; initially lower in Arm 2 versus 1 with delayed initiation in Arm 3. eGFR (MDRD4) was higher in Arms 2 and 3 versus 1 (p = 0.001, p = 0.047). Kaplan-Meier estimates of composite efficacy failure-free survival were 72.0%, 77.6%, 73.9% in Arms 1-3. BCAR incidence was significantly lower in Arm 2 versus 1 and 3 (p = 0.016, p = 0.039). AEs were comparable. Prolonged-release tacrolimus (0.15-0.175mg/kg/day) immediately posttransplant plus basiliximab and MMF (without maintenance corticosteroids) was associated with lower tacrolimus exposure, and significantly reduced renal function impairment and BCAR incidence versus prolonged-release tacrolimus (0.2mg/kg/day) administered immediately posttransplant. Delayed higher-dose prolonged-release tacrolimus initiation significantly reduced renal function impairment compared with immediate posttransplant administration, but BCAR incidence was comparable. © 2015 The Authors. American Journal of Transplantation published by Wiley Periodicals Inc.

Impact of sacubitril/valsartan on heart failure admissions: insights from real-world patient prescriptions.

PubMed

Martens, Pieter; Lambeets, Seppe; Lau, Chirikwah; Dupont, Matthias; Mullens, Wilfried

2018-06-17

Sacubitril/valsartan reduced heart failure (HF)-admissions and cardiovascular mortality in the PARADIGM-HF-trial. However, real-world patients are often frailer and less able to tolerate high doses of sacubitril/valsartan. We performed a retrospective analysis of consecutive patients prescribed sacubitril/valsartan in a single tertiary HF-clinic between December 2016 and January 2018. HF-admissions were assessed in a paired fashion, comparing the amount of antecedent HF-episodes with incident HF-episodes after the initiation. Baseline risk for adverse events was assessed by the EMPHASIS-HF-risk-score Results: A total of 201-HF-patients were retrospectively identified (age = 68 ± 11 years, ejection fraction = 29 ± 8%). Real world patients were older, had higher serum creatinine and a higher New-York Heart-Association (NYHA)-class (p < .05 for all) than in the PARADIGM-HF trial. Over a mean duration of 221 ± 114 days after initiation of sacubitril/valsartan a total of 23-individual patients experienced at least one HF-episodes. Over the same time period preceding initiation of sacubitril/valsartan, 51 individual patients experienced a HF-episodes (p < .001). Sacubitril/valsartan significantly reduced the rate of incident vs. antecedent HF-admissions, in patients with low or high baseline NYHA-class (II vs. III and IV; p value = 0.019 respectively p = .004) or patients with an EMPHASIS-HF risk score below or above the mean (p = .002 respectively p = .016). Patients older than 75-years exhibited a trend towards HF-reduction. Higher doses of sacubitril/valsartan were associated with more reduction in incident versus antecedent HF-episodes. Despite being frailer and older, real-world patients exhibit a significant and early reduction in incident HF-hospitalisations following initiation of sacubitril/valsartan. Higher doses might be associated with more reduction in HF-admissions, underscoring the importance of dose uptitration.

Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease.

PubMed

Jung, Young Ho; Lee, Doh Young; Kim, Dong Wook; Park, Sung Soo; Heo, Eun Young; Chung, Hee Soon; Kim, Deog Kyeom

2015-01-01

Although chronic obstructive pulmonary disease (COPD) is closely associated with gastroesophageal reflux disease (GERD), the clinical significance of laryngopharyngeal reflux (LPR) is not fully understood in COPD. Prospective cohorts were established among 118 patients with COPD from March 2013 to July 2014. Thirty-two age-matched and sex-matched normal controls, who had routine health check-ups during the study period, were included. Laryngopharyngeal reflux finding scores (RFS) and reflux symptom index (RSI) for LPR were subjected to association analysis with severity and acute exacerbation of COPD during the 1-year follow-up. The mean age of patients enrolled in the study was 69.2±8.8 years, with 93.2% being male. Positive RFS (>7) and RSI (>13) were observed in 51 (42.5%) and six patients (5.0%), respectively. RFS and RSI were significantly higher in patients with COPD than in normal, healthy patients (P<0.001). RFS was significantly correlated with residual volume/total lung capacity (%, P=0.048). Scores for diffuse laryngeal edema, erythema, and hyperemia were significantly higher in the high-risk group (Global Initiative for Chronic Obstructive Lung Disease classification C and D; P=0.025 and P=0.049, respectively), while RSI was significantly higher in the more symptomatic group (Global Initiative for Chronic Obstructive Lung Disease classification B and D; P=0.047). RSI and RFS were significant predictors for severe acute exacerbation of COPD (P=0.03 and P=0.047, respectively), while only RSI was associated with severity of dyspnea. Laryngeal examination and evaluation of laryngeal reflux symptom could be a surrogate clinical indicator related to severe acute exacerbation of COPD. Further studies of LPR in COPD patients should be considered.

Delay and refusal of human papillomavirus vaccine for girls, national immunization survey-teen, 2010.

PubMed

Dorell, Christina; Yankey, David; Jeyarajah, Jenny; Stokley, Shannon; Fisher, Allison; Markowitz, Lauri; Smith, Philip J

2014-03-01

Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine's effectiveness, and believing the vaccine is not needed.

Taking the Initiative: Risk-Reduction Strategies and Decreased Malpractice Costs.

PubMed

Raper, Steven E; Rose, Deborah; Nepps, Mary Ellen; Drebin, Jeffrey A

2017-11-01

To heighten awareness of attending and resident surgeons regarding strategies for defense against malpractice claims, a series of risk reduction initiatives have been carried out in our Department of Surgery. We hypothesized that emphasis on certain aspects of risk might be associated with decreased malpractice costs. The relative impact of Department of Surgery initiatives was assessed when compared with malpractice experience for the rest of the Clinical Practices of the University of Pennsylvania (CPUP). Surgery and CPUP malpractice claims, indemnity, and expenses were obtained from the Office of General Counsel. Malpractice premium data were obtained from CPUP finance. The Department of Surgery was assessed in comparison with all other CPUP departments. Cost data (yearly indemnity and expenses), and malpractice premiums (total and per physician) were expressed as a percentage of the 5-year mean value preceding implementation of the initiative program. Surgery implemented 38 risk reduction initiatives. Faculty participated in 27 initiatives; house staff participated in 10 initiatives; and advanced practitioners in 1 initiative. Department of Surgery claims were significantly less than CPUP (74.07% vs 81.07%; p < 0.05). The mean yearly indemnity paid by the Department of Surgery was significantly less than that of the other CPUP departments (84.08% vs 122.14%; p < 0.05). Department of Surgery-paid expenses were also significantly less (83.17% vs 104.96%; p < 0.05), and surgical malpractice premiums declined from baseline, but remained significantly higher than CPUP premiums. The data suggest that educating surgeons on malpractice and risk reduction may play a role in decreasing malpractice costs. Additional extrinsic factors may also affect cost data. Emphasis on risk reduction appears to be cumulative and should be part of an ongoing program. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Predictors of scoring at least 600 on COMLEX-USA Level 1: successful preparation strategies.

PubMed

Vora, Aditya; Maltezos, Nathan; Alfonzo, Lauren; Hernandez, Nilda; Calix, Erica; Fernandez, M Isabel

2013-02-01

Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores are an important criterion used by residency directors to make residency placement decisions. To explore the association between scoring at least 600 on COMLEX-USA Level 1 and grade point average (GPA), scores on the Medical College Admission Test (MCAT), and different test preparation strategies. Third-year osteopathic medical students at Nova Southeastern University were invited to complete a self-administered survey regarding their COMLEX-USA preparation strategies and to provide consent for the researchers to access their preclinical GPA and their MCAT and COMLEX-USA scores. Descriptive analyses were conducted to understand examination preparation procedures and resources used, and bivariate analyses were conducted to identify the statisically significant predictors of scoring 600 or higher. Two separate logistic regressions were also run. The first included all of the statisically significant factors that emerged from the bivariate analyses, and the second examined which candidate predictors remained statistically significant once the effects of GPA and MCAT scores were removed. One hundred twenty-two students completed the survey, and 113 (93%) provided informed consent to access their preclinical GPA and their MCAT and COMLEX-USA scores. In the first regression, scoring 600 or higher was associated with a higher GPA (P<.02), a higher MCAT score (P<.05), earlier preparation initiation (P<.05), and not ranking the Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) as the most helpful practice examination (P<.04). In the second regression, scoring 600 or higher was associated with earlier initiation of examination preparation (P<.01) and not ranking COMBANK (question bank for COMLEX-USA) as the most helpful question bank (P<.03). Among the different examination preparation methods, the specific resources ranked as most helpful were First Aid for the USMLE (United States Medical Licensing Examination) (review book), the COMSAE (practice examination); COMBANK (question bank); and Kaplan USMLE (lecture videos). Preclinical GPA and MCAT scores continue to be important predictors of scoring at least 600 on COMLEX-USA Level 1. However, the findings underscore the importance of maintaining a high GPA during the first 2 years of medical school and initiating COMLEX-USA preparation early.

The Effects of Hot Corrosion Pits on the Fatigue Resistance of a Disk Superalloy

NASA Technical Reports Server (NTRS)

Gabb, Timothy P.; Telesman, Jack; Hazel, Brian; Mourer, David P.

2009-01-01

The effects of hot corrosion pits on low cycle fatigue life and failure modes of the disk superalloy ME3 were investigated. Low cycle fatigue specimens were subjected to hot corrosion exposures producing pits, then tested at low and high temperatures. Fatigue lives and failure initiation points were compared to those of specimens without corrosion pits. Several tests were interrupted to estimate the fraction of fatigue life that fatigue cracks initiated at pits. Corrosion pits significantly reduced fatigue life by 60 to 98 percent. Fatigue cracks initiated at a very small fraction of life for high temperature tests, but initiated at higher fractions in tests at low temperature. Critical pit sizes required to promote fatigue cracking were estimated, based on measurements of pits initiating cracks on fracture surfaces.

Direction of an initial saccade depends on radiological expertise

NASA Astrophysics Data System (ADS)

Pietrzyk, Mariusz W.; McEntee, Mark F.; Evanoff, Michael E.; Brennan, Patrick C.; Mello-Thoms, Claudia R.

2014-03-01

Purpose: To evaluate the role of radiographic details in global impression of chest x-ray images viewed by experts in thoracic and non-thoracic domains. Materials and Methods: The study was approved by IRB. Five thoracic and five non-thoracic radiologists participated in two tachistoscopic (one low pass and one with the entire frequency spectrum, each lasting 270 ms) each containing 50 PA chest radiographs with 50% prevalence of pulmonary nodule. Eye movements were monitored in order to evaluate a pre-saccade shift of visual attention, saccade latency, decision time and the time to first fixation on a pulmonary nodule. Results: Thoracic radiologists showed significantly higher pre-saccadic shift of visual attention towards pulmonary nodules once using the full frequency spectrum (p < 0.05). An initial saccade orientation made by these radiologists on full resolution images correlated at significant level with their confidence ranking of pulmonary nodules (ρ = -0.387, p < 0.001). Conclusions: Thoracic radiologists benefited from high spatial frequency appearance during a rapid presentation of chest radiograph by allocating pre-saccade attention towards pulmonary nodules. This behavior correlated with a higher number of correct decisions, followed by higher confidence in the decisions made, and briefer reaction times.

Impact of asthma, exposure period, and filters on human responses during exposures to ozone and its initiated chemistry products.

PubMed

Fadeyi, M O; Tham, K W; Wu, W Y

2015-10-01

The impact of asthma, exposure period, and filter condition downstream of the mixing box of air-conditioning system on building occupants' perceptual response, work performance, and salivary α-amylase secretion during exposures to ozone and its initiated chemistry products is studied. The experiments were conducted in a field environmental chamber (FEC) (240 m(3)) simulating an office environment. Experiments were conducted during periods when the air-handling system operated with new or used pleated panel filters at constant recirculation (7/h) and ventilation (1/h) rates. Average ozone and secondary organic aerosols (ozone-initiated chemistry products) measured during non-asthmatic and asthmatic subjects' 3-h exposures in the FEC were in the ranges approximately 20-37 ppb and approximately 1.6-3 μg/m(3), respectively. Asthmatic subjects' perceived odor intensity and sensory (eye, nose, and throat) irritation ratings were generally lower than those of non-asthmatic subjects, possibly explaining why asthmatic subjects accept perceived air quality more than non-asthmatic subjects. However, asthmatic subjects' perceived physiological-like symptom ratings (flu, chest tightness, and headache) and concentrations of secreted salivary α-amylase were generally higher than those of non-asthmatic subjects. Asthmatic subjects had significantly lower accuracy than non-asthmatic subjects in a task that required higher concentration although they had higher work speed. Filter condition did not make any significant difference for subjects' responses. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia.

PubMed

Brekke, John S; Hoe, Maanse; Long, Jeffrey; Green, Michael F

2007-09-01

The purpose of this study was to assess how neurocognition and social cognition were associated with initial functional level and with rates of functional change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant functional change for individuals diagnosed with schizophrenia. We also examined how service intensity was associated with rates of change and whether it served as a moderator of the relationship between functional change and both neurocognition and social cognition. The sample consisted of 125 individuals diagnosed with schizophrenia or schizoaffective disorder who were recruited upon admission to 1 of 4 community-based psychosocial rehabilitation facilities and were followed prospectively for 12 months. One hundred and two subjects completed the 12-month protocol. The findings suggested that (i) the initial level of psychosocial functioning was related to both social cognition and neurocognition at baseline, (ii) when significant rehabilitative change occurs, higher neurocognition and social cognition scores at baseline predicted higher rates of functional change over the subsequent 12 months, (iii) greater service intensity was related to higher rates of improvement in functional outcome over time, and (iv) service intensity moderated the relationship between neurocognition and initial functional level and moderated the relationship between social cognition and the rates of functional change at a trend level. These findings have relevance to our understanding of the heterogeneity in functional rehabilitative outcomes, to our understanding of the conditions of rehabilitative change and for the design of psychosocial interventions in the community.

Oxygen Transport Changes in Canine Subjects Transfused with Stored Blood from Chronically Anemic Donors.

DTIC Science & Technology

diphosphoglycerate , and adenosine triphosphate occurred with storage in both sets. 2,3 diphosphoglycerate levels were slightly higher initially in...Adenosine triphosphate levels increased significantly and remained high 24 hr after transfusion. Red cell survival decreased with storage for both

HPV literacy and its link to initiation and completion of HPV vaccine among young adults in Minnesota.

PubMed

Lee, H Y; Lee, J; Henning-Smith, C; Choi, J

2017-11-01

This study identifies whether, and how, human papillomavirus (HPV) literacy and predisposing, enabling, and need factors are associated with HPV vaccine initiation and completion among young adults in Minnesota. Cross-sectional survey design. Using a sample of 170 young adults (aged 18-26 years), we used logistic regression models to identify factors associated with HPV vaccination initiation and completion, including HPV literacy, adjusting for relevant predisposing, enabling, and need factors. Consistent with national estimates, we found relatively low rates of HPV vaccination initiation (46%) and completion (36%). Better HPV literacy was significantly associated with higher rates of both initiation and completion, as was being female and having an annual check-up. Being married/partnered was significantly associated with lower odds of HPV vaccination. Public health programs, policy-makers, and healthcare providers can use these results to increase HPV vaccination rates by making concerted efforts to improve HPV vaccination literacy through individual and public education campaigns and by improving access to annual check-ups. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Stability of Multi-Planet Systems Orbiting in the Alpha Centauri AB System

NASA Astrophysics Data System (ADS)

Lissauer, Jack

2018-04-01

We evaluate how closely-spaced planetary orbits in multiple planet systems can be and still survive for billion-year timescales within the alpha Centauri AB system. Although individual planets on nearly circular, coplanar orbits can survive throughout the habitable zones of both stars, perturbations from the companion star imply that the spacing of such planets in multi-planet systems must be significantly larger than the spacing of similar systems orbiting single stars in order to be long-lived. Because the binary companion induces a forced eccentricity upon circumstellar planets, stable orbits with small initial eccentricities aligned with the binary orbit are possible to slightly larger initial semimajor axes than are initially circular orbits. Initial eccentricities close to the appropriate forced eccentricity can have a much larger affect on how closely planetary orbits can be spaced, on how many planets may remain in the habitable zones, although the required spacing remains significantly higher than for planets orbiting single stars.

Hemodynamic vascular biomarkers for initiation of paraclinoid internal carotid artery aneurysms using patient-specific computational fluid dynamic simulation based on magnetic resonance imaging.

PubMed

Watanabe, Tomoya; Isoda, Haruo; Takehara, Yasuo; Terada, Masaki; Naito, Takehiro; Kosugi, Takafumi; Onishi, Yuki; Tanoi, Chiharu; Izumi, Takashi

2018-05-01

We performed computational fluid dynamics (CFD) for patients with and without paraclinoid internal carotid artery (ICA) aneurysms to evaluate the distribution of vascular biomarkers at the aneurysm initiation sites of the paraclinoid ICA. This study included 35 patients who were followed up for aneurysms using 3D time of flight (TOF) magnetic resonance angiography (MRA) and 3D cine phase-contrast MR imaging. Fifteen affected ICAs were included in group A with the 15 unaffected contralateral ICAs in group B. Thirty-three out of 40 paraclinoid ICAs free of aneurysms and arteriosclerotic lesions were included in group C. We deleted the aneurysms in group A based on the 3D TOF MRA dataset. We performed CFD based on MR data set and obtained wall shear stress (WSS), its derivatives, and streamlines. We qualitatively evaluated their distributions at and near the intracranial aneurysm initiation site among three groups. We also calculated and compared the normalized highest (nh-) WSS and nh-spatial WSS gradient (SWSSG) around the paraclinoid ICA among three groups. High WSS and SWSSG distribution were observed at and near the aneurysm initiation site in group A. High WSS and SWSSG were also observed at similar locations in group B and group C. However, nh-WSS and nh-SWSSG were significantly higher in group A than in group C, and nh-SWSSG was significantly higher in group A than in group B. Our findings indicated that nh-WSS and nh-SWSSG were good biomarkers for aneurysm initiation in the paraclinoid ICA.

Breast-feeding initiation time and neonatal mortality risk among newborns in South India.

PubMed

Garcia, C R; Mullany, L C; Rahmathullah, L; Katz, J; Thulasiraj, R D; Sheeladevi, S; Coles, C; Tielsch, J M

2011-06-01

To examine the association between breast-feeding initiation time and neonatal mortality in India, where breast-feeding initiation varies widely from region to region. Data were collected as part of a community-based, randomized, placebo-controlled trial of the impact of vitamin A supplementation in rural villages of Tamil Nadu, India. Multivariate binomial regression analysis was used to estimate the association between neonatal mortality and breast-feeding initiation time (<12 h, 12 to 24 h, >24 h) among infants surviving a minimum of 48 h. Among 10 464 newborns, 82.1% were first breast-fed before 12 h, 13.8% were breast-fed between 12 and 24 h, and 4.1% were breast-fed after 24 h. After adjusting for birth weight, gestational age and other covariates, late initiators (>24 h) were at ∼78% higher risk of death (relative risk=1.78 (95% confidence interval (CI)=1.03 to 3.10)). There was no difference in mortality risk when comparing babies fed in the first 12 h compared with the second 1  h after birth. Late (>24 h) initiation of breast-feeding is associated with a higher risk of neonatal mortality in Tamil Nadu. Emphasis on breast-feeding promotion programs in low-resource settings of India where early initiation is low could significantly reduce neonatal mortality.

Steel Foil Improves Performance Of Blasting Caps

NASA Technical Reports Server (NTRS)

Bement, Laurence J.; Perry, Ronnie; Schimmel, Morry L.

1990-01-01

Blasting caps, which commonly include deep-drawn aluminum cups, give significantly higher initiation performance by application of steel foils on output faces. Steel closures 0.005 in. (0.13 mm) thick more effective than aluminum. Caps with directly bonded steel foil produce fragment velocities of 9,300 ft/s (2.8 km/s) with large craters and unpredictable patterns to such degree that no attempts made to initiate explosions. Useful in military and aerospace applications and in specialized industries as mining and exploration for oil.

Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia.

PubMed

Perez, Maria E; Coley, Brian; Crandall, Wallace; Di Lorenzo, Carlo; Bravender, Terrill

2013-09-01

To examine gastric function, as well as the presence of somatic complaints, anxiety symptoms, and functional gastrointestinal disorders (FGIDs), in adolescents with anorexia nervosa (AN) before and after nutritional rehabilitation. Sixteen females with AN and 22 healthy controls with similar demographic profiles were included. Gastric emptying (measured as residual gastric volume) and gastric accommodation (measured as postprandial antral diameter) were assessed with abdominal ultrasonography. Participants completed the Children's Somatization Inventory (CSI), the Screen for Child Anxiety-Related Emotional Disorders, and the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version. All testing was repeated 3-4 months later. Body mass index in the AN group improved over time (P = .012). Fasting gastric parameters were similar in the 2 groups. Maximum postprandial antral diameter was significantly greater in controls compared with the AN group (P = .008). Only adolescents with AN demonstrated a significant increase in maximum postprandial diameter at repeat testing (P = .009). There was no difference in residual gastric volume between the 2 groups. Initial CSI scores were higher in adolescents with AN (P < .0001), including higher scores for nausea and abdominal pain. CSI scores were significantly lower in adolescents with AN (P = .035). Initial scores on the Screen for Child Anxiety-Related Emotional Disorders were significantly higher in adolescents with AN (P = .0005), but did not change over time. Adolescents with AN met significantly more criteria for FGIDs (P = .003). Adolescents with AN have impaired gastric accommodation that improves after nutritional rehabilitation, have significantly more somatic complaints, and meet more criteria for anxiety disorders and FGIDs. After nutritional rehabilitation, somatization improves and FGIDs become less common, but symptoms of anxiety persist. Copyright © 2013 Mosby, Inc. All rights reserved.

Drug Authorization for Sofosbuvir/Ledipasvir (Harvoni) for Chronic HCV Infection in a Real-World Cohort: A New Barrier in the HCV Care Cascade

PubMed Central

Liapakis, AnnMarie; Cohen, Elizabeth; Chau, Hong; Bertuccio, Claudia; Sapir, Dana; Wright, Jessica; Eggers, Carol; Drozd, Kristine; Ciarleglio, Maria; Deng, Yanhong; Lim, Joseph K.

2015-01-01

Background New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. Materials and Methods We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times. Results Of 174 patients prescribed HCV therapy during this period, 129 requests were made for SOF/LED, of whom 100 (77.5%) received initial approval, and an additional 17 patients (13.9%) ultimately received approval through the appeals process. Faster approval times were seen in patients with Child-Pugh Class B disease (14.4 vs. 24.7 days, p = 0.048). A higher proportion of patients were initially approved in those with Medicare/Medicaid coverage (92.2% vs. 71.4%, p = 0.002) and those with baseline viral load ≥6 million IU/mL (84.1% vs. 62.5%, p = 0.040). Linear regression modeling identified advanced fibrosis, high Model of End Stage Liver Disease (MELD) score, and female gender as significant predictors of shorter decision and approval times. On logistic regression, Medicare/Medicaid coverage (OR 5.96, 95% CI 1.66–21.48) and high viral load (OR 4.52, 95% CI 1.08–19.08) were significant predictors for initial approval. Conclusions Early analysis of real-world drug authorization outcomes between October-December 2014 reveals that nearly one in four patients are initially denied access to SOF/LED upon initial prescription, although most patients are eventually approved through appeal, which delays treatment initiation. Having Medicare/Medicaid and advanced liver disease resulted in a higher likelihood of approval as well as earlier decision and approval times. More studies are needed to determine factors resulting in higher likelihood of denial and to evaluate approval rates and times after implementation of restrictive prior authorization guidelines. PMID:26312999

Drug Authorization for Sofosbuvir/Ledipasvir (Harvoni) for Chronic HCV Infection in a Real-World Cohort: A New Barrier in the HCV Care Cascade.

PubMed

Do, Albert; Mittal, Yash; Liapakis, AnnMarie; Cohen, Elizabeth; Chau, Hong; Bertuccio, Claudia; Sapir, Dana; Wright, Jessica; Eggers, Carol; Drozd, Kristine; Ciarleglio, Maria; Deng, Yanhong; Lim, Joseph K

2015-01-01

New treatments for hepatitis C (HCV) infection hold great promise for cure, but numerous challenges to diagnosing, establishing care, and receiving therapy exist. There are limited data on insurance authorization for these medications. We performed a retrospective chart review of patients receiving sofosbuvir/ledipasvir (SOF/LED) from October 11-December 31, 2014 to determine rates and timing of drug authorization. We also determined predictors of approval, and those factors associated with faster decision and approval times. Of 174 patients prescribed HCV therapy during this period, 129 requests were made for SOF/LED, of whom 100 (77.5%) received initial approval, and an additional 17 patients (13.9%) ultimately received approval through the appeals process. Faster approval times were seen in patients with Child-Pugh Class B disease (14.4 vs. 24.7 days, p = 0.048). A higher proportion of patients were initially approved in those with Medicare/Medicaid coverage (92.2% vs. 71.4%, p = 0.002) and those with baseline viral load ≥ 6 million IU/mL (84.1% vs. 62.5%, p = 0.040). Linear regression modeling identified advanced fibrosis, high Model of End Stage Liver Disease (MELD) score, and female gender as significant predictors of shorter decision and approval times. On logistic regression, Medicare/Medicaid coverage (OR 5.96, 95% CI 1.66-21.48) and high viral load (OR 4.52, 95% CI 1.08-19.08) were significant predictors for initial approval. Early analysis of real-world drug authorization outcomes between October-December 2014 reveals that nearly one in four patients are initially denied access to SOF/LED upon initial prescription, although most patients are eventually approved through appeal, which delays treatment initiation. Having Medicare/Medicaid and advanced liver disease resulted in a higher likelihood of approval as well as earlier decision and approval times. More studies are needed to determine factors resulting in higher likelihood of denial and to evaluate approval rates and times after implementation of restrictive prior authorization guidelines.

Aerothermal modeling. Executive summary

NASA Technical Reports Server (NTRS)

Kenworthy, M. K.; Correa, S. M.; Burrus, D. L.

1983-01-01

One of the significant ways in which the performance level of aircraft turbine engines has been improved is by the use of advanced materials and cooling concepts that allow a significant increase in turbine inlet temperature level, with attendant thermodynamic cycle benefits. Further cycle improvements have been achieved with higher pressure ratio compressors. The higher turbine inlet temperatures and compressor pressure ratios with corresponding higher temperature cooling air has created a very hostile environment for the hot section components. To provide the technology needed to reduce the hot section maintenance costs, NASA has initiated the Hot Section Technology (HOST) program. One key element of this overall program is the Aerothermal Modeling Program. The overall objective of his program is to evolve and validate improved analysis methods for use in the design of aircraft turbine engine combustors. The use of such combustor analysis capabilities can be expected to provide significant improvement in the life and durability characteristics of both combustor and turbine components.

The power of engagement: implementation of a career ladder program.

PubMed

Bourgeault, Robert; Newmark, Jason

2012-01-01

At Baystate Health in Massachusetts, the development and implementation of a career ladder program was implemented to reduce turnover and to improve employee satisfaction, morale, and recruitment efforts. There was significant initial expenditure in the program, as a result of promoting the large number of employees with significant experience and seniority. A smaller number of staff are expected to apply for advancement during successive cycles, allowing for decreased incremental expense going forward. Critical to the success of the program was understanding the time commitment, getting senior organizational support and staff buy-in, and justifying the associated expenses. The development and initiation of the program has done much to support a positive work environment with increased morale and higher performance among significant numbers of staff at all levels.

Breastfeeding Initiation and Continuation by Employment Status among Korean Women.

PubMed

Kang, Nam Mi; Lee, Jung Eun; Bai, Yeon; Van Achterberg, Theo; Hyun, Taisun

2015-04-01

The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

Not all Beta-Blockers are Equal in the Management of Long QT Syndrome Types 1 and 2: Higher Recurrence of Events under Metoprolol

PubMed Central

Chockalingam, Priya; Crotti, Lia; Girardengo, Giulia; Johnson, Jonathan N.; Harris, Katy M.; van der Heijden, Jeroen F.; Hauer, Richard N.W.; Beckmann, Britt M.; Spazzolini, Carla; Rordorf, Roberto; Rydberg, Annika; Clur, Sally-Ann B.; Fischer, Markus; van den Heuvel, Freek; Kääb, Stefan; Blom, Nico A.; Ackerman, Michael J.; Schwartz, Peter J.; Wilde, Arthur A.M.

2012-01-01

Objectives To compare the efficacy of beta-blockers (BB) in congenital long QT syndrome (LQTS). Background BB are the mainstay in managing LQTS. Studies comparing the efficacy of commonly-used BB are lacking and clinicians generally assume they are equally effective. Methods ECG and clinical parameters of 382 LQT1/LQT2 patients initiated on propranolol (n=134), metoprolol (n=147), and nadolol (n=101) were analyzed, excluding patients aged <1 year at BB initiation. Symptoms prior to therapy and the first breakthrough cardiac events (BCEs) were documented. Results Patients (56% females, 27% symptomatic, HR 76±16 bpm, QTc 472±46 ms) were started on BB therapy at a median age of 14 years (IQR 8–32 years). QTc-shortening with propranolol was significantly greater than with other BB in the total cohort and in the subset with QTc >480 ms. None of the asymptomatic patients had BCEs. Among symptomatic patients (n=101), 15 had BCEs (all syncopes). QTc-shortening was significantly less-pronounced among patients with BCEs. There was a greater risk of BCEs for symptomatic patients initiated on metoprolol compared to users of other two BB combined, after adjustment for genotype (OR 3.95, 95% CI 1.2–13.1, p=0.025). Kaplan-Meier analysis showed a significantly lower event-free survival for symptomatic patients on metoprolol compared to propranolol/nadolol. Conclusions Propranolol has a significantly better QTc-shortening effect compared to metoprolol and nadolol, especially in patients with prolonged QTc. Propranolol and nadolol are equally effective whereas symptomatic patients started on metoprolol are at a significantly higher risk for BCEs. Metoprolol should not be used in symptomatic LQT1 and LQT2 patients. PMID:23083782

Development of a Scale to Assess Faculty Motivation for Internationalising Their Curriculum

ERIC Educational Resources Information Center

Francois, Emmanuel Jean

2014-01-01

Faculty members are instrumental in internationalising the curriculum in a higher education institution. Their favourable or unfavourable orientation toward global education initiatives might significantly affect their engagement in internationalising the curriculum. The purpose of this study was to develop the Motivation for Internationalizing…

Sex differences in creative perceptions of Malaysian students.

PubMed

Palaniappan, A K

2000-12-01

Scores for creative perception of 101 boys and 69 girls on What Kind of Person Are You and Something About Myself were not significant for overall scores on both measures, but boys obtained somewhat higher means on Initiative than girls. Further replications on similar samples are needed.

Building Organizational Capacity: Strategic Management in Higher Education

ERIC Educational Resources Information Center

Toma, J. Douglas

2010-01-01

Every university or college president envisions bold initiatives--big projects intended to change the nature of an institution with significant implications across all sectors. How can leaders and senior managers charged with implementing reforms effectively frame their work and anticipate potential pitfalls? No organization can maximize its…

Metabolic and respiratory derangements associated with death in cold-stunned Kemp's ridley turtles (Lepidochelys kempii): 32 cases (2005-2009).

PubMed

Keller, Krista A; Innis, Charles J; Tlusty, Michael F; Kennedy, Adam E; Bean, Sarah B; Cavin, Julie M; Merigo, Constance

2012-02-01

To assess selected clinicopathologic variables at hospital admission (day 1) for cold-stunned Kemp's ridley turtles (Lepidochelys kempii) that died during the first 3 days after admission (nonsurvivors) and turtles that survived (survivors) and to determine the percentage change of each variable from day 1 to day of death (nonsurvivors) or to day 2 or 3 of hospitalization (survivors). Retrospective case-control study. Animals-64 stranded, cold-stunned Kemp's ridley turtles hospitalized from October 2005 through December 2009. Blood gas, pH, Hct, and selected biochemical values in blood samples determined on day 1 and day of death (nonsurvivors; n = 32) or day 2 or 3 of hospitalization (survivors; 32) were obtained from medical records. For each variable, initial values and percentage changes (from initial values to values at the day of death or day 2 or 3 of hospitalization) were compared between survivors and nonsurvivors. Compared with blood analysis findings for survivors, nonsurvivors initially had significantly higher potassium concentration and Pco(2) and significantly lower Po(2), pH, and bicarbonate concentration than did survivors. For the first 2 or 3 days of hospitalization, percentage changes in potassium, lactate, and ionized calcium concentrations were significantly higher and percentage changes in pH and plasma glucose and bicarbonate concentrations were significantly lower in nonsurvivors. At hospital admission, cold-stunned Kemp's ridley turtles were affected by metabolic and respiratory derangements; severe derangements were associated with death. Evaluation of blood gas, pH, Hct, and selected clinicopathologic variables provided useful clinical and prognostic information during rehabilitation of cold-stunned Kemp's ridley turtles.

Neutral-depletion-induced axially asymmetric density in a helicon source and imparted thrust

NASA Astrophysics Data System (ADS)

Takahashi, Kazunori; Takao, Yoshinori; Ando, Akira

2016-02-01

The high plasma density downstream of the source is observed to be sustained only for a few hundreds of microsecond at the initial phase of the discharge, when pulsing the radiofrequency power of a helicon plasma thruster. Measured relative density of argon neutrals inside the source implies that the neutrals are significantly depleted there. A position giving a maximum plasma density temporally moves to the upstream side of the source due to the neutral depletion and then the exhausted plasma density significantly decreases. The direct thrust measurement demonstrates that the higher thrust-to-power ratio is obtained by using only the initial phase of the high density plasma, compared with the steady-state operation.

Ethanol-reinforced responding by AA and ANA rats following the sucrose-substitution initiation procedure.

PubMed

Files, F J; Denning, C E; Hyytia, P; Kiianmaa, K; Samson, H H

1997-06-01

Ethanol-reinforced responding was initiated in male AA and ANA rats using the sucrose-substitution procedure. Before the initiation procedure, a homecage, two-bottle preference test was conducted. The rats were then trained to respond on an Fixed-Ratio 1 schedule with sucrose reinforcement. Over sessions, ethanol was added gradually to the sucrose solution as the concentration of sucrose was reduced until 10% ethanol (v/v) alone functioned as the reinforcer for lever pressing. The schedule of reinforcement was then increased to Fixed-Ratio 4. Next, the ethanol concentration presented as the reinforcer was increased over weeks to 15%, 20%, 30%, and then returned to 10%. A second homecage test was then performed. The results showed that the AA and ANA lines differed significantly on preference and intake (g/kg) during the homecage preference tests. There was a significant increase in preference during the second homecage test. During sucrose substitution, initial large differences in responding were observed between the lines. When the ethanol concentration was increased, intake (grams per kilogram) increased for the AA line but not for the ANA line. These effects were a function of no change in responding by the AA rats as concentration was increased and a decrease in responding by the ANA rats at the higher concentrations (20% and 30%). Taken together, data indicate that ethanol can function as a positive reinforcer for the behavior of AA and ANA rats. Even though 10% ethanol functioned as a reinforcer similarly for the two lines, ethanol intake in the AA line was significantly greater at the higher concentrations of ethanol, suggesting that ethanol functioned as a qualitatively different reinforcer for the AA rats, compared with the ANA rats.

Effect of C/N ratio, aeration rate and moisture content on ammonia and greenhouse gas emission during the composting.

PubMed

Jiang, Tao; Schuchardt, Frank; Li, Guoxue; Guo, Rui; Zhao, Yuanqiu

2011-01-01

Gaseous emission (N2O, CH4 and NH3) from composting can be an important source of anthropogenic greenhouse gas and air pollution. A laboratory scale orthogonal experiment was conducted to estimate the effects of C/N ratio, aeration rate and initial moisture content on gaseous emission during the composting of pig faeces from Chinese Ganqinfen system. The results showed that about 23.9% to 45.6% of total organic carbon (TOC) was lost in the form of CO2 and 0.8% to 7.5% of TOC emitted as CH4. Most of the nitrogen was lost in the form of NH3, which account for 9.6% to 32.4% of initial nitrogen. N2O was also an important way of nitrogen losses and 1.5% to 7.3% of initial total nitrogen was lost as it. Statistic analysis showed that the aeration rate is the most important factor which could affect the NH3 (p = 0.0189), CH4 (p = 0.0113) and N2O (p = 0.0493) emissions significantly. Higher aeration rates reduce the CH4 emission but increase the NH3 and N2O losses. C/N ratio could affect the NH3 (p = 0.0442) and CH4 (p = 0.0246) emissions significantly, but not the N2O. Lower C/N ratio caused higher NH3 and CH4 emissions. The initial moisture content can not influence the gaseous emission significantly. Most treatments were matured after 37 days, except a trial with high moisture content and a low C/N ratio.

Elevated urinary neutrophil gelatinase-associated lipocalcin after acute heart failure treatment is associated with worsening renal function and adverse events

PubMed Central

Collins, Sean P.; Hart, Kimberly W.; Lindsell, Christopher J.; Fermann, Gregory J.; Weintraub, Neal L.; Miller, Karen F.; Roll, Susan N.; Sperling, Matthew I.; Sawyer, Douglas B.; Storrow, Alan B.

2012-01-01

Aims Reliable detectors of worsening renal function (WRF) in Emergency Department (ED) patients with acute heart failure (AHF) are limited. We hypothesized that initial urinary neutrophil gelatinase-associated lipocalcin (NGAL) levels, and changes in urinary NGAL levels after initial ED AHF therapy, would be associated with WRF and adverse events. Methods and results Urinary NGAL upon ED presentation and 12–24 h after ED treatment was measured in a cohort of ED patients with AHF. NGAL was corrected for urinary creatinine (uCr). WRF was defined as RIFLE stages 1, 2, or 3, or a creatinine increase of ≥0.3 mg/dL. Patients were prospectively followed for 5- and 30-day adverse cardiovascular events. The 399 patients had a median age of 63 years, 50% were Caucasian, and 62% were male. Those with WRF at 72–96 h were more likely to have a higher initial NGAL value (71 vs. 32 ng NGAL/mg uCr) (P = 0.005), and a higher NGAL level at 12–24 h after ED therapy (107 vs. 25ng NGAL/mg uCr, P < 0.001). In a multivariable model, NGAL at 12–24 h remained a significant predictor of WRF (P = 0.012). Of all variables available 12–24 h after initial therapy, the only significant predictor of 30-day events was an elevated urinary NGAL level (P = 0.02). Conclusions Urinary NGAL levels determined 12–24 h after ED therapy are significantly associated with both WRF at 72–96 h and 30-day adverse events. This suggests that early management strategies may have an impact on subsequent WRF and outcomes. If confirmed, NGAL may have a role for guiding therapeutic decisions. PMID:22733980

Drying kinetic of industrial cassava flour: Experimental data in view.

PubMed

Odetunmibi, Oluwole A; Adejumo, Oluyemisi A; Oguntunde, Pelumi E; Okagbue, Hilary I; Adejumo, Adebowale O; Suleiman, Esivue A

2017-12-01

In this data article, laboratory experimental investigation results on drying kinetic properties: the drying temperature ( T ), drying air velocity ( V ) and dewatering time (Te), each of the factors has five levels, and the experiment was replicated three times and the output: drying rate and drying time obtained, were observed. The experiment was conducted at National Centre for Agricultural Mechanization (NCAM) for a period of eight months, in 2014. Analysis of variance was carried out using randomized complete block design with factorial experiment on each of the outputs: drying rate and drying times of the industrial cassava flour. A clear picture on each of these outputs was provided separately using tables and figures. It was observed that all the main factors as well as two and three ways interactions are significant at 5% level for both drying time and rate. This also implies that the rate of drying grated unfermented cassava mash, to produce industrial cassava flour, depend on the dewatering time (the initial moisture content), temperature of drying, velocity of drying air as well as the combinations of these factors altogether. It was also discovered that all the levels of each of these factors are significantly difference from one another. In summary, the time of drying is a function of the dewatering time which was responsible for the initial moisture content. The higher the initial moisture content the longer the time of drying, and the lower the initial moisture content, the lower the time of drying. Also, the higher the temperature of drying the shorter the time of drying and vice versa. Also, the air velocity effect on the drying process was significant. As velocity increases, rate of drying also increases and vice versa. Finally, it can be deduced that the drying kinetics are influenced by these processing factors.

Healthcare Quality Improvement and 'work engagement'; concluding results from a national, longitudinal, cross-sectional study of the 'Productive Ward-Releasing Time to Care' Programme.

PubMed

White, Mark; Butterworth, Tony; Wells, John Sg

2017-08-01

Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care. The main objective of this study was to explore whether PW sustains the 'engagement' of ward-based teams by examining the longitudinal effect that the national QI programme had on the 'work-engagement' of ward-based teams in Ireland. Utilising the Utrecht Work Engagement Scale questionnaire (UWES-17), we surveyed nine PW (intervention) sites from typical acute Medical/Surgical, Rehabilitation and Elderly services (representing the entire cohort of a national phase of PW implementation in Ireland) and a cohort of matched control sites. The numbers surveyed from the PW group at T1 (up to 3 months after commencing the programme) totalled 253 ward-team members and 249 from the control group. At T2 (12 months later), the survey was repeated with 233 ward-team members from the PW sites and 236 from the control group. Overall findings demonstrated that those involved in the QI initiative had higher 'engagement' scores at T1 and T2 in comparison to the control group. Total 'engagement' score (TES), and its 3 dimensions, were all significantly higher in the PW group at T1, but only the Vigour dimension remained significantly higher at T2 (p = 0.006). Our results lend some support to the assertions of the PW initiative itself and suggest that when compared to a control group, ward-based teams involved in the QI programme are more likely to be 'engaged' by it and its associated improvement activities and that this is maintained over time. However, only the Vigour dimension of 'engagement' remained significantly higher in the PW over time.

Clinical Analysis of 61 Systemic Lupus Erythematosus Patients With Intestinal Pseudo-Obstruction and/or Ureterohydronephrosis

PubMed Central

Xu, Na; Zhao, Jiuliang; Liu, Jinjing; Wu, Di; Zhao, Lidan; Wang, Qian; Hou, Yong; Li, Mengtao; Zhang, Wen; Zeng, Xuejun; Fang, Weigang; Huang, Xiaoming; Zhang, Xuan; Tian, Xinping; Zhao, Yan; Zeng, Xiaofeng; Zhang, Fengchun

2015-01-01

Abstract The objective of this article is to investigate the clinical features of intestinal pseudo-obstruction (IPO) and/or ureterohydronephrosis in systemic lupus erythematosus (SLE). Sixty-one SLE patients with IPO and/or ureterohydronephrosis were analyzed retrospectively. A total of 183 cases were randomly selected as controls from 3840 SLE inpatients without IPO and ureterohydronephrosis during the same period. Patients were assigned to 1 of the 3 groups (SLE with IPO and ureterohydronephrosis, SLE with IPO, and SLE with ureterohydronephrosis). The clinical characteristics, treatments, and prognosis were compared between the 3 groups. There were 57 females and 4 males, with a mean age of 32.0 years. IPO was the initial manifestation of SLE in 49.1% of the cases, whereas ureterohydronephrosis in 32.5%. All patients were initially treated with a high-dose steroid. Thirty-one of these patients (50.8%) also received intravenous methylprednisolone pulse therapy. Two patients died of bowel perforation and lupus encephalopathy, and the other 59 patients (96.7%) achieved remission after treatment. The incidences of fever, glomerulonephritis, nervous system involvement, serositis, erythrocyte sedimentation rate elevation, hypoalbuminemia, hypocomplementemia, and anti-SSA antibody positivity were significantly higher in patients with IPO and/or ureterohydronephrosis than in the control group (without IPO and ureterohydronephrosis). Also, patients with IPO and/or ureterohydronephrosis had higher SLE Disease Activity Index scores than control patients. Compared with SLE patients with IPO, the patients with IPO and ureterohydronephrosis had a significantly higher incidence of gallbladder wall thickening, biliary tract dilatation, and serositis, whereas the patients with ureterohydronephrosis had less mucocutaneous involvement and serositis. Eight of the 47 IPO patients who initially responded well to immunotherapy relapsed; however, all responded well to retreatment with adequate immunotherapy. Of these 8 patients, 4 relapsed following poor compliance and self-discontinuation of steroid or immunosuppressant therapy. The rate of poor compliance with immunotherapy and the number of organ systems involved in patients in the recurrent IPO group were significantly higher than those in the nonrecurrent IPO group. IPO and ureterohydronephrosis are severe complications of SLE. As patients usually respond readily to early optimal steroid treatment, early diagnosis and timely initiation of glucocorticoid are important to relieve symptoms, prevent complications, and improve prognosis. PMID:25634172

Non-Caking Freeze Dried Applesauce

DTIC Science & Technology

A study was initiated to develop an applesauce which resists caking when subjected to elevated temperatures such as 37.7C. for two weeks and/or 57C...following results were obtained: (1) The degree of caking of the freeze dried applesauce powder was correlated with the amount of juice extracted. (2... applesauce powders. (3) Reducing sugars appear to be the factor contributing most significantly to the caking with the higher reducing sugar levels producing the higher degrees of caking.

The moderating effect of leadership on the relationship between personality and performance.

PubMed

Yeh, Shu-Chuan Jennifer; Yuan, Kuo-Shu; Chen, Shih-Hua Sarah; Lo, Ying-Ying; Chou, Hsueh-Chih; Huang, Shan; Chiu, Herng-Chia; Wan, Thomas T H

2016-10-01

To examine how personality and leadership influence efficiency in the nursing service environment. Leadership and personality contribute to the success and failure of a unit. However, how they interact to influence performance is still understudied. We used matched pairs sample design to survey 135 head nurses and 1353 registered nurses on validated instruments of demographic characteristics, leadership styles and personality during June and July of 2014. Efficiency was calculated using Data Envelopment Analysis. Tobit regression was used for analysis. High conscientiousness and low neuroticism were significantly associated with higher efficiency. Particularly, under the initiating structure leadership style, high conscientiousness, high extraversion, high agreeableness, high openness and low neuroticism were related to higher efficiency. Openness would improve efficiency under a low consideration leadership style. Most personality traits were related to higher efficiency under the initiating leadership style. Only openness would improve leaders' efficiency under a high initiating structure and a low consideration leadership style. Considering personality as one factor of selecting head nurses, selecting the right person can improve the fit between individuals and organisations, which in turn, improves job performance. Training head nurses to develop better leadership styles in nurses is another way to enhance efficiency. © 2016 John Wiley & Sons Ltd.

The effect of transforming care at the bedside initiative on healthcare teams' work environments.

PubMed

Lavoie-Tremblay, Mélanie; O'Conner, Patricia; Harripaul, Anastasia; Biron, Alain; Ritchie, Judith; Lavigne, Genevieve L; Baillargeon, Sophie; Ringer, Justin; Macgibbon, Brenda; Taylor-Ducharme, Sharon; Sourdif, Jacynthe

2014-02-01

Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments. The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments. A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units. Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant. TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support. © 2013 Sigma Theta Tau International.

Outcome and prognostic factors in patients with brain metastases from small-cell lung cancer treated with whole brain radiotherapy.

PubMed

Bernhardt, Denise; Adeberg, Sebastian; Bozorgmehr, Farastuk; Opfermann, Nils; Hoerner-Rieber, Juliane; König, Laila; Kappes, Jutta; Thomas, Michael; Herth, Felix; Heußel, Claus Peter; Warth, Arne; Debus, Jürgen; Steins, Martin; Rieken, Stefan

2017-08-01

The purpose of this study was to evaluate prognostic factors associated with overall survival (OS) and neurological progression free survival (nPFS) in small-cell lung cancer (SCLC) patients with brain metastases who received whole-brain radiotherapy (WBRT). From 2003 to 2015, 229 SCLC patients diagnosed with brain metastases who received WBRT were analyzed retrospectively. In this cohort 219 patients (95%) received a total photon dose of 30 Gy in 10 fractions. The prognostic factors evaluated for OS and nPFS were: age, Karnofsky Performance Status (KPS), number of brain metastases, synchronous versus metachronous disease, initial response to chemotherapy, the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) class and thoracic radiation. Median OS after WBRT was 6 months and the median nPFS after WBRT was 11 months. Patients with synchronous cerebral metastases had a significantly better median OS with 8 months compared to patients with metachronous metastases with a median survival of 3 months (p < 0.0001; HR 0.46; 95% CI 0.31-0.67). Based on RPA classification median survival after WBRT was 17 months in RPA class I, 7 months in class II and 3 months in class III (p < 0.0001). Karnofsky performance status scale (KPS < 70%) was significantly associated with OS in both univariate (HR 2.84; p < 0.001) and multivariate analyses (HR 2.56; p = 0.011). Further, metachronous brain metastases (HR 1.8; p < 0.001), initial response to first-line chemotherapy (HR 0.51, p < 0.001) and RPA class III (HR 2.74; p < 0.001) were significantly associated with OS in univariate analysis. In multivariate analysis metachronous disease (HR 1.89; p < 0.001) and initial response to chemotherapy (HR 0.61; p < 0.001) were further identified as significant prognostic factors. NPFS was negatively significantly influenced by poor KPS (HR 2.56; p = 0.011), higher number of brain metastases (HR 1.97; p = 0.02), and higher RPA class (HR 2.26; p = 0.03) in univariate analysis. In this series, the main prognostic factors associated with OS were performance status, time of appearance of intracranial disease (synchronous vs. metachronous), initial response to chemotherapy and higher RPA class. NPFS was negatively influenced by poor KPS, multiplicity of brain metastases, and higher RPA class in univariate analysis. For patients with low performance status, metachronous disease or RPA class III, WBRT should be weighed against supportive therapy with steroids alone or palliative chemotherapy.

The evaluation of anxiety and panic agarophobia scores in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit.

PubMed

Kahraman, Serif Samil; Arli, Cengiz; Copoglu, Umit Sertan; Kokacya, Mehmet Hanifi; Colak, Sait

2017-05-01

Patients with BPPV experienced short but intense anxiety and/or panic disorder, especially at the initial visit, but most patients recovered without medication with successful treatment. Recent studies have shown that people with dizziness report some psychological problems such as panic and agoraphobia and anxiety. The aim of this study was to evaluate anxiety and panic agorophobia levels in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit and compare the scores with the control group. All the 32 patients in the study had a diagnosis of BPPV confirmed by their history, typical subjective symptom reports, and characteristic positional nystagmus during the Dix-Hallpike test and/or Roll test. The patients were instructed to complete the standard forms of Beck anxiety inventory and panic agoraphobia scale questionnaire before and at 7 and 14 days after the canalith repositioning treatment. The validity scores of panic agoraphobia were statistically significantly higher in patients with BPPV than in the control group in each period (p < .001) and the validity scores of the Beck anxiety inventory were statistically significantly higher in patients with BPPV than in the control group at the first and second evaluation (p < .001).

Comparative efficacy of tilmicosin versus tulathromycin as a metaphylactic antimicrobial in feedlot calves at moderate risk for respiratory disease.

PubMed

Van Donkersgoed, Joyce; Merrill, John; Hendrick, Steven

2008-01-01

The purpose of this study was to compare the efficacy and cost-effectiveness of tilmicosin (MIC) versus tulathromycin (DRAX) as a metaphylactic antimicrobial in feedlot calves at moderate risk for bovine respiratory disease (BRD). Calves that received DRAX had significantly (P < or = .05) lower initial BRD treatment rates compared with calves that received MIC. However, there were no significant differences in the BRD relapse rate, railer rate, total mortality rate, BRD mortality rate, average daily gain, and dry matter conversion between the two groups. The economic advantage of the MIC group was Can$8.29/animal. Based on these results, while DRAX was more efficacious in reducing initial treatments for BRD in feedlot calves at moderate risk for disease, MIC was more cost-effective. The lower initial BRD treatment costs in the DRAX group did not offset the higher metaphylactic cost of DRAX.

Factors influencing the development of a biostimulant for the in-situ anaerobic dechlorination of polychlorinated biphenyls in Fox River, Wisconsin sediments

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

Hollifield, M.B.; Park, J.K.; Boyle, W.C.

1995-12-31

Polychlorinated biphenyl (PCB) contaminated sediments were collected from the Fox River, Wisconsin, and analyzed for the possible occurrence of reductive dechlorination. Evidence of in-situ dechlorination was observed. However, the extent of this in-situ dechlorination was less than that typically reported in the literature, suggesting that stimulation of further dechlorination was possible. The use of nutrients and surfactants was explored for stimulating additional dechlorination. The nutrient amendment reported here was found to be inhibitory. Surfactants had varying effect, but non significantly improved dechlorination over control treatments. The most significant factors were observed to be the initial extent of dechlorination and PCBmore » concentration. Additional dechlorination was most likely to be observed in sediments with higher PCB concentration and less initial dechlorination. All sediments converged on a common dechlorination level regardless of the initial state of the sediments.« less

Determinants of Willingness to Enroll in Opioid Agonist Treatment among Opioid Dependent People Who Inject Drugs in Ukraine

PubMed Central

Makarenko, Iuliia; Mazhnaya, Alyona; Polonsky, Maxim; Marcus, Ruthanne; Bojko, Martha J.; Filippovich, Sergii; Springer, Sandra; Dvoriak, Sergii; Altice, Frederick L.

2016-01-01

Background Coverage with opioid agonist treatments (OAT) is low (N=8,400, 2.7%) for the 310,000 people who inject drugs (PWID) in Ukraine. In the context of widespread negative attitudes toward OAT in the region, patient-level interventions targeting the barriers and willingness to initiate OAT are urgently needed. Methods A sample of 1,179 opioid dependent PWID not currently on OAT from five regions in Ukraine was assessed using multivariable logistic regression for independent factors related to willingness to initiate OAT, stratified by their past OAT experience. Results Overall, 421 (36%) PWID were willing to initiate OAT. Significant adjusted odds ratios (aOR) for covariates associated with the willingness to initiate OAT common for both groups included: higher injection frequency (previously on OAT: aOR=2.7; never on OAT: aOR=1.8), social and family support (previously on OAT: aOR=2.0; never on OAT: aOR=2.0), positive attitude towards OAT (previously on OAT: aOR=1.3; never on OAT: aOR=1.4). Among participants previously on OAT, significant correlates also included: HIV-negative status (aOR=2.6) and depression (aOR=2.7). Among participants never on OAT, however, living in Kyiv (aOR=4.8) or Lviv (aOR=2.7), previous imprisonment (aOR=1.5), registration at a Narcology service (aOR=1.5) and recent overdose (aOR=2.6) were significantly correlated with willingness to initiate OAT. Conclusions These findings emphasize the need for developing interventions aimed to eliminate existing negative preconceptions regarding OAT among opioid dependent PWID in Ukraine, which should be tailored to the needs of specific characteristics of PWID in geographically distinct setting, higher injection frequency, prior incarceration, and psychiatric and HIV status. PMID:27370527

Smoking in movies and smoking initiation in adolescents: systematic review and meta-analysis.

PubMed

Leonardi-Bee, Jo; Nderi, Maryanne; Britton, John

2016-10-01

Preventing young people from initiating smoking is a vital public health objective. There is strong evidence that exposure to smoking imagery in movies is associated with an increased risk of smoking uptake. However, the estimate of the magnitude of effect is not clear, as previous reviews have synthesized estimates of cross-sectional and longitudinal associations. Therefore, we have performed a systematic review to quantify cross-sectional and longitudinal associations between exposure to smoking in movies and initiating smoking in adolescents. Four electronic databases (MEDLINE, EMBASE, PsycINFO and International Bibliography of the Social Sciences, IBSS) and grey literature were searched from inception to May 2015 for comparative epidemiological studies (cross-sectional and cohort studies) that reported the relation between exposure to smoking in movies and smoking initiation in adolescence (10-19 years). Reference lists of studies and previous reviews were also screened. Two authors screened papers and extracted data independently. Seventeen studies met our inclusion criteria. Random-effects meta-analysis of nine cross-sectional studies demonstrated higher exposure (typically highest versus lowest quantile) to smoking in movies was associated significantly with a doubling in risk of ever trying smoking [relative risk (RR) = 1.93, 95% confidence interval (CI) = 1.66-2.25]. In eight longitudinal studies (all deemed high quality), higher exposure to smoking in movies was associated significantly with a 46% increased risk of initiating smoking (RR = 1.46; 95% CI = 1.23-1.73). These pooled estimates were significantly different from each other (P = 0.02). Moderate levels of heterogeneity were seen in the meta-analyses. The cross-sectional association between young people reporting having seen smoking imagery in films and smoking status is greater than the prospective association. Both associations are substantial, but it is not clear whether or not they are causal. © 2016 Society for the Study of Addiction.

[The effects of increased dietary calcium intake on bone mineral density in long-term lactating women, and recovery of bone loss caused by long-term lactation with low calcium diet].

PubMed

Yoneyama, Kyoko; Ikeda, Junko

2004-12-01

The purpose of this study was to examine the efficacy of an increased calcium (Ca) diet for preventing bone mineral loss in long-term lactating women, considering bone metabolism, and recovery of bone loss caused by long-term lactation with low dietary Ca intake. Two groups of long-term (> 12 mon.) lactating women ... one with an enhanced Ca intake (Group M, n = 22) and the other with diet feeding no cow's milk and no milk products (Group N, n = 16) ... and a control group of 21 non-lactating postpartum women (Group C) were studied. Bone mineral density (BMD) was measured by ultrasonic bone densitometry. Stiffness calculated from the combined value of speed of sound and broadband ultrasound attenuation was used as an index of BMD. BMD and bone metabolic markers in urine and serum (only M and C groups) were assessed from 1 approximately 12 weeks postpartum (initial) at six-month intervals for a maximum of two years and changes were compared among the groups. 1. The mean (+/- SD) dietary Ca intake was 1032 (209) mg/day in the M group. 2. After lactating for one year, the N group demonstrated significant decrease in BMD, with both 1 and 2 babies, whereas the M group had no significant change. 3. The BMD in the N group returned to initial levels at 0.5 approximately 1 year post-weaning, 4. In the N group, compared with the M group, the urinary Hydroxyproline/creatinine ratio was significantly higher at the initial measurement and half a year thereafter, while urinary Ca/ creatinine ratio was significantly lower after a year. However, there were no significant differences between the M and C groups. 5. Serum bone alkaline phosphatase was significantly higher in the M group compared with the C group. Bone loss during long-term lactation can be prevented with adequate dietary Ca intake. Once lost, recovery to initial levels occurs 0.5 approximately 1 year post-weaning.

Effect of traffic density on drivers' lane change and overtaking maneuvers in freeway situation - A driving simulator based study.

PubMed

Yang, Liu; Li, Xiaomeng; Guan, Wei; Zhang, H Michael; Fan, Lingling

2018-05-14

The aim of this study is to examine the effect of traffic density on drivers' lane change and overtaking maneuvers. The differences between drivers' left and right lane-changing/overtaking maneuvers were also investigated. A driving simulator experiment was conducted and 24 participants took part in this experiment. Based on the driving simulation data, lane change frequency, time duration, average speed and acceleration were extracted as key variables of lane change maneuvers; overtaking frequency, overtaking duration, initial overtaking distance and headway, instantaneous speed and acceleration before overtaking were analyzed as the key overtaking variables. One-way repeated measures ANOVA, Friedman test and Wilcoxon signed-rank test were adopted for hypothesis tests with significance level of 0.05. Further pairwise comparisons were performed with a Bonferroni correction for multiple comparisons. Some significant differences in lane change and overtake behaviors were observed among different traffic densities: 1) both lane change and overtaking frequencies significantly increase with traffic density; 2) the average lane change acceleration and instantaneous overtaking acceleration significantly increase with traffic density; 3) as the traffic density increases, the initial overtaking distance and headway decrease. As for the effect of the directions of maneuvers: 1) the time duration of lane change and overtaking from right side was significantly shorter than that from left side; 2) the right initial overtaking distance/headway was smaller than that of left side; 3) the right instantaneous overtaking acceleration was significantly higher than the left instantaneous acceleration. The results showed that as traffic density increases, drivers' intention for lane change and overtaking is enhanced. Both initial overtaking distance and headway decrease with traffic density, which might influence road safety. In addition, drivers do not show a preference on the directions of lane change or overtaking according to the frequency. However, drivers tend to be more decisive and reckless when conducting the right overtaking because of a smaller distance/headway before overtaking, higher instantaneous acceleration and also a more restricted field of view compared with left overtaking.

R-rated movies, bedroom televisions, and initiation of smoking by white and black adolescents.

PubMed

Jackson, Christine; Brown, Jane D; L'Engle, Kelly L

2007-03-01

To test movie exposure and television use as predictors of smoking initiation among white and black adolescents who had never smoked cigarettes. Survey research using audio computer-assisted self-interviews at baseline and at 2-year follow-up (2002-2004). Participants' homes located in central North Carolina. A sample of 735 12- to 14-year-old adolescents drawn from 14 public middle schools. Frequency of exposure to movies rated R, PG-13, PG, or G; frequency, location, and parental oversight of television viewing. Initiation of smoking, indicated by the first occasion of puffing on a cigarette. Among white adolescents, high relative exposure to R-rated movies predicted a significantly greater likelihood of smoking initiation at follow-up, and private access to television during early adolescence, indicated by having a bedroom television, was also a significant independent predictor of smoking initiation at follow-up. No significant associations were observed between any movie-exposure or television-use variables and likelihood of smoking among black adolescents. Indicators of risky media use were associated with a significantly greater likelihood of smoking for white but not for black adolescents. These results diverge strongly from past results, which have indicated that all adolescents, regardless of race or place of residence, have a higher risk of smoking initiation as their exposure to movie smoking increases. Research is needed to identify the antecedents of risky media use and to understand how audience attributes, including race and other factors, moderate the effects of risky media use on health-related behaviors.

[Usefulness of galectin-3 expression in the clinical behavior of differentiated thyroid carcinoma].

PubMed

López Mondéjar, Pedro; Picó, Antonio; Seguí, Javier; López Maciá, Alicia

2008-02-16

Our objective was to quantify the galectin-3 (gal-3) expression in differentiated thyroid carcinoma and study its relation with the clinical behavior of these tumors. We investigated the immunohistochemical reaction of gal-3 in patients with papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) and performed a retrospective study in order to find correlations with clinical features. Gal-3 expression was studied in 53 differentiated tyroid carcinomas (42 PTC and 11 FTC), and was related with clinical features: metastases, extrathyroid invasion and initial stage in the diagnosis and persistence disease and relapses in the follow up. Gal-3 expression positivity in PTC had a median of 60% (percentil 25 [p25], 17.5%; percentil 75 [p75], 100%), and was significantly higher (p < 0.0001) than in FTC (median, 0%; p25, 0%; p75, 15%). In PTC, gal-3 expression was significantly higher in advanced stages at the time of initial diagnosis (p = 0.014), persistent disease (p = 0.012) and relapses (p = 0.012) during the follow up. We did not find any significant association between gal-3 expression and clinical features of FTC. Gal-3 is a negative prognosis marker in PTC but not in FTC.

Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000-2011.

PubMed

Bui, Quyen Thi-Tu; Lee, Hwa-Young; Le, Anh Thi-Kim; Van Dung, Do; Vu, Lan Thi-Hoang

2016-01-01

There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes - early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02-1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88-1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02-1.13), and those who delivered by Caesarean section were less likely to initiate early BF. Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices.

Visualising the Future: Surfacing Student Perspectives on Post-Graduation Prospects Using Rich Pictures

ERIC Educational Resources Information Center

Berg, Tessa; Bowen, Tracey; Smith, Colin; Smith, Sally

2017-01-01

The gradual commodification of higher education in the context of an increased focus on graduate employability attributes together with evolving labour markets is creating challenges for universities and students alike. For universities, there has been significant investment in careers services and, through institution-wide initiatives,…

Suicide and Its Prevention on College Campuses

ERIC Educational Resources Information Center

Keyes, Lee

2012-01-01

Suicide is a significant issue facing higher education institutions. Many campuses are involved in a variety of procedures, programs, and initiatives that seek to reduce or prevent suicide and the impact of suicide-related behavior. This article offers examples of campus prevention efforts, important resources on suicide prevention for college…

Exploring the Ethical Implications of MOOCs

ERIC Educational Resources Information Center

Marshall, Stephen

2014-01-01

Massive open online courses (MOOCs) represent a potentially exciting opportunity to use technology to realise many of the long-promised benefits of universal higher education. While there are many positive aspects to the MOOCs on offer and in development, there are also significant ethical concerns arising from various initiatives. These include…

Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.

PubMed

Lemburg, Stefan P; Peters, Soeren A; Roggenland, Daniela; Nicolas, Volkmar; Heyer, Christoph M

2010-12-01

The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries. At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries. The significance level was set at 5%. Imaging studies of 72 patients (32 with multiple injuries; average age, 17.5 years) entailed a median cumulative effective dose of 18.89 mSv. Patients with multiple injuries had a significantly higher total cumulative effective dose (29.70 versus 10.86 mSv, p < 0.001) mainly owing to the significantly higher CT-related cumulative effective dose to multiple injury patients during the initial evaluation (18.39 versus 2.83 mSv, p < 0.001). Overall, CT accounted for 86% of the total cumulative effective dose. Adolescents with spinal injuries receive a cumulative effective dose equal to that of adult trauma patients and nearly three times that of pediatric trauma patients. Areas of focus in lowering cumulative effective dose should be appropriate initial estimation of trauma severity and careful selection of CT scan parameters.

Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation among Adolescent Girls in the United States.

PubMed

Henry, Kevin A; Stroup, Antoinette M; Warner, Echo L; Kepka, Deanna

2016-02-01

This study is among the first to explore geographic factors that may be associated with human papillomavirus (HPV) vaccine uptake in the United States. Data from the 2011 and 2012 National Immunization Survey-Teen for 20,565 female adolescents aged 13 to 17 years were analyzed to examine associations of HPV vaccine initiation (receipt of at least one dose) with ZIP code-level geographic factors. Logistic regression including individual and geographic factors was used to estimate the odds of HPV vaccine initiation. Approximately 53% of girls initiated the HPV vaccine in both years. Girls in high poverty communities had higher HPV vaccine initiation compared with those in low poverty communities [61.1% vs. 52.4%; adjusted OR (AOR), 1.18; 95% confidence intervals (CI), 1.04-1.33]. Initiation was higher among girls in communities where the majority of the population was Hispanic (69.0% vs. 49.9%; AOR, 1.64; 95% CI, 1.43-1.87) or non-Hispanic mixed race (60.4% vs. 49.9%; AOR, 1.30; 95% CI, 1.17-1.44) compared with majority non-Hispanic white communities. Interactions between individual-level race/ethnicity and community racial-ethnic composition indicated significantly higher odds of initiation among Hispanic girls living in Hispanic communities compared with Hispanic girls living in predominantly non-Hispanic White (NHW) (AOR, 2.23; 95% CI, 1.87-2.65) or non-Hispanic Black (NHB) (AOR, 1.90; 95% CI, 1.20-3.04) communities, respectively. Initiation rates of HPV vaccination among teen girls were highest in the poorest communities and among Hispanics living in communities where the racial-ethnic composition was predominantly Hispanic or mixed race. Given low HPV vaccination rates in the United States, these results provide important evidence to inform public health interventions to increase HPV vaccination. ©2016 American Association for Cancer Research.

Verbal marking of affect by children with Asperger Syndrome and high functioning autism during spontaneous interactions with family members.

PubMed

Müller, Eve; Schuler, Adriana

2006-11-01

Verbal marking of affect by older children with Asperger Syndrome (AS) and high functioning autism (HFA) during spontaneous interactions is described. Discourse analysis of AS and HFA and typically developing children included frequency of affective utterances, affective initiations, affective labels and affective explanations, attribution of affective responses to self and others, and positive and negative markers of affect. Findings indicate that children with AS and HFA engaged in a higher proportion of affect marking and provided a higher proportion of affective explanations than typically developing children, yet were less likely to initiate affect marking sequences or talk about the affective responses of others. No significant differences were found between groups in terms of the marking of positive and negative affect.

Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings

PubMed Central

Malfait, Bart; Dingenen, Bart; Smeets, Annemie; Staes, Filip; Pataky, Todd; Robinson, Mark A.; Vanrenterghem, Jos; Verschueren, Sabine

2016-01-01

Purpose The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ). Methods Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping. Results The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001). Conclusion This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior neuromuscular activation (dominant hamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase. PMID:27101130

Pre-ESRD Changes in Body Weight and Survival in Nursing Home Residents Starting Dialysis

PubMed Central

Stack, Shobha; Chertow, Glenn M.; Johansen, Kirsten L.; Si, Yan

2013-01-01

Summary Background and objectives Among patients receiving maintenance dialysis, weight loss at any body mass index is associated with mortality. However, it is not known whether weight changes before dialysis initiation are associated with mortality and if so, what risks are associated with weight gain or loss. Design, setting, participants, and measurements Linking data from the US Renal Data System to a national registry of nursing home residents, this study identified 11,090 patients who started dialysis between January of 2000 and December of 2006. Patients were categorized according to weight measured between 3 and 6 months before dialysis initiation and the percentage change in body weight before dialysis initiation (divided into quintiles). The outcome was mortality within 1 year of starting dialysis. Results There were 361 patients (3.3%) who were underweight (Quételet’s [body mass] index<18.5 kg/m2) and 4046 patients (36.5%) who were obese (body mass index≥30 kg/m2) before dialysis initiation. The median percentage change in body weight before dialysis initiation was −6% (interquartile range=−13% to 1%). There were 6063 deaths (54.7%) over 1 year of follow-up. Compared with patients with minimal weight changes (−3% to 3%, quintile 4), patients with weight loss ≥15% (quintile 1) had 35% higher risk for mortality (95% confidence interval, 1.25 to 1.47), whereas those patients with weight gain≥4% (quintile 5) had a 24% higher risk for mortality (95% confidence interval, 1.14 to 1.35) adjusted for baseline body mass index and other confounders. Conclusions Among nursing home residents, changes in body weight in advance of dialysis initiation are associated with significantly higher 1-year mortality. PMID:24009221

Boys' and girls' involvement in science learning and their self-efficacy in Taiwan.

PubMed

Hong, Zuway-R; Lin, Huann-shyang

2013-01-01

This cross-sectional study investigated the significant differences in students' self-efficacy and their involvement in learning science. Nine hundred and twenty-two elementary school fifth graders, 499 junior high school eighth graders, and 1455 senior or vocational high school eleventh graders completed the students' questionnaire. Analyses of variance (ANOVAs) and independent t-tests compared the significant similarities and differences across school levels and genders. The initial findings were as follows: A sharp decline in boys' and girls' self-efficacy scores from elementary to secondary school levels; boys have significantly higher self-efficacy scores than girls at vocational and senior high school levels; students with more involvement in science learning presented significantly higher self-efficacy scores than those with less involvement. The significant discrepancies in terms of gender and age in students' self-efficacy and involvement in learning science need to be addressed. Implications and limitations are provided.

Injection-salting of pre rigor fillets of Atlantic salmon (Salmo salar).

PubMed

Birkeland, Sveinung; Akse, Leif; Joensen, Sjurdur; Tobiassen, Torbjørn; Skåra, Torstein

2007-01-01

The effects of temperature (-1, 4, and 10 degrees C), brine concentration (12% and 25% NaCl), injection volumes, and needle densities were investigated on fillet weight gain (%), salt content (%), fillet contraction (%), and muscle gaping in pre rigor brine-injected fillets of Atlantic salmon (Salmo salar). Increased brine concentration (12% to 25%) significantly increased the initial (< 5 min after injection) and final contraction (24 h after injection) of pre rigor fillets. Increased brine concentration significantly reduced weight gain and increased salt content but had no significant effect on muscle gaping. The temperatures tested did not significantly affect weight gain, fillet contraction, or gaping score. Significant regressions (P < 0.01) between the injection volume and weight gain (range: 2.5% to 15.5%) and salt content (range: 1.7% to 6.5%) were observed for injections of pre rigor fillets. Double injections significantly increased the weight gain and salt content compared to single injections. Initial fillet contraction measured 30 min after brine injection increased significantly (P < 0.01) with increasing brine injection volume but no significant difference in the fillet contraction was observed 12 h after brine injection (range: 7.9% to 8.9%). Brine-injected post rigor control fillets obtained higher weight gain, higher salt content, more muscle gaping, and significantly lower fillet contraction compared to the pre rigor injected fillets. Injection-salting is an applicable technology as a means to obtain satisfactory salt contents and homogenously distribute the salt into the muscle of pre rigor fillets of Atlantic salmon before further processing steps such as drying and smoking.

Outcomes by sex following treatment initiation with atazanavir plus ritonavir or efavirenz with abacavir/lamivudine or tenofovir/emtricitabine.

PubMed

Smith, Kimberly Y; Tierney, Camlin; Mollan, Katie; Venuto, Charles S; Budhathoki, Chakra; Ma, Qing; Morse, Gene D; Sax, Paul; Katzenstein, David; Godfrey, Catherine; Fischl, Margaret; Daar, Eric S; Collier, Ann C

2014-02-01

We aimed to evaluate treatment responses to atazanavir plus ritonavir (ATV/r) or efavirenz (EFV) in initial antiretroviral regimens among women and men, and determine if treatment outcomes differ by sex. We performed a randomized trial of open-label ATV/r or EFV combined with abacavir/lamivudine (ABC/3TC) or tenofovir/emtricitabine (TDF/FTC) in 1857 human immunodeficiency virus type 1-infected, treatment-naive persons enrolled between September 2005 and November 2007 at 59 sites in the United States and Puerto Rico. Associations of sex with 3 primary study endpoints of time to virologic failure, safety, and tolerability events were analyzed using Cox proportional hazards models. Model-based population pharmacokinetic analysis was performed using nonlinear mixed effects modeling (NONMEM version VII). Of 1857 participants, 322 were women. Women assigned to ATV/r had a higher risk of virologic failure with either nucleoside reverse transcriptase inhibitor backbone than women assigned to EFV, or men assigned to ATV/r. The effects of ATV/r and EFV upon safety and tolerability risk did not differ significantly by sex. With ABC/3TC, women had a significantly higher (32%) safety risk compared to men; with TDF/FTC, the safety risk was 20% larger for women compared to men, but not statistically significant. Women had slower ATV clearance and higher predose levels of ATV compared to men. Self-reported adherence did not differ significantly by sex. This is the first randomized clinical trial to identify a significantly earlier time to virologic failure in women randomized to ATV/r compared to women randomized to EFV. This finding has important clinical implications given that boosted protease inhibitors are often favored over EFV in women of childbearing potential. NCT00118898.

The Impact of Personal Gender-Typicality and Partner Gender-Traditionality on Taking Sexual Initiative: Investigating a Social Tuning Hypothesis.

PubMed

Emmerink, Peggy M J; Van Den Eijnden, Regina J J M; Ter Bogt, Tom F M; Vanwesenbeeck, Ine

2017-01-01

Sexual assertiveness is an issue of interest in the context of gender equality and sexual health. This study investigated the social tuning hypothesis that encountering a gender-traditional partner would lead to stronger gender-typical behavior, i.e., respectively, higher and lower levels of taking sexual initiative among men and women. Participants ( N = 271) read a vignette describing a romantic partner, who was either presented as gender-traditional or not, followed by a sexual scenario. Subsequently, participants were asked about their expectations toward their own sexual initiative taking. Results showed a significant 'target gender-traditionality × participant gender × participant gender-typicality (masculinity/femininity)' interaction meaning that less gender-typical men were more likely to initiate sexual contact in the experimental, compared to the control condition. Men low in masculine characteristics showed higher initiative taking in response to a gender-traditional target female. We conclude that less gender-typical men seem to employ more social tuning toward their sexual partner, whereas more gender-typical men seem to adhere to their gender-typical behavior regardless of perceived partner characteristics. These results were not seen among the women in the sample. These findings are a starting point for the further development of experimental investigations regarding the gendered nature of both sexual initiative taking and sexual assertiveness in general.

The Impact of Personal Gender-Typicality and Partner Gender-Traditionality on Taking Sexual Initiative: Investigating a Social Tuning Hypothesis

PubMed Central

Emmerink, Peggy M. J.; Van Den Eijnden, Regina J. J. M.; Ter Bogt, Tom F. M.; Vanwesenbeeck, Ine

2017-01-01

Sexual assertiveness is an issue of interest in the context of gender equality and sexual health. This study investigated the social tuning hypothesis that encountering a gender-traditional partner would lead to stronger gender-typical behavior, i.e., respectively, higher and lower levels of taking sexual initiative among men and women. Participants (N = 271) read a vignette describing a romantic partner, who was either presented as gender-traditional or not, followed by a sexual scenario. Subsequently, participants were asked about their expectations toward their own sexual initiative taking. Results showed a significant ‘target gender-traditionality × participant gender × participant gender-typicality (masculinity/femininity)’ interaction meaning that less gender-typical men were more likely to initiate sexual contact in the experimental, compared to the control condition. Men low in masculine characteristics showed higher initiative taking in response to a gender-traditional target female. We conclude that less gender-typical men seem to employ more social tuning toward their sexual partner, whereas more gender-typical men seem to adhere to their gender-typical behavior regardless of perceived partner characteristics. These results were not seen among the women in the sample. These findings are a starting point for the further development of experimental investigations regarding the gendered nature of both sexual initiative taking and sexual assertiveness in general. PMID:28203216

A Multicenter Real-Life Study on the Effect of Flash Glucose Monitoring on Glycemic Control in Patients with Type 1 and Type 2 Diabetes.

PubMed

Anjana, Ranjit Mohan; Kesavadev, Jothydev; Neeta, Deshpande; Tiwaskar, Mangesh; Pradeepa, Rajendra; Jebarani, Saravanan; Thangamani, Suresh; Sastry, Nadiminty Ganapathi; Brijendra Kumar, Srivastava; Ramu, Muthu; Gupta, Pokal Prasanna Kumar; Vignesh, Jayaprakash; Chandru, Sundramoorthy; Kayalvizhi, Sengottuvel; Jagdish, Padoor Sethuraman; Uthra, Subash Chandra Bose; Lovelena, Munawar; Jyoti, Sah; Suguna Priya, Sengodan; Kannan, Alagarsamy; Mohan, Viswanathan; Unnikrishnan, Ranjit

2017-09-01

To assess the efficacy of ambulatory glucose profiling (AGP) generated by FreeStyle LibrePro ™ flash glucose monitoring (FCGM) on glycemic control in patients with uncontrolled type 1 diabetes (T1D) and type 2 diabetes (T2D). Clinical and biochemical data were obtained from 5072 patients with diabetes who had an A1c ≥7% (2536 who had been initiated on FCGM-based AGP between March 2015 and October 2016 [cases] and 2536 age-, gender-, A1c-, site- and time-matched controls who were not initiated on AGP) across seven diabetes clinics in India. Anthropometric and clinical measurements were obtained through standardized techniques. Fasting and postprandial plasma glucose and glycated hemoglobin(A1c) were estimated before and after initiation of AGP. Overall, there was a significant decrease in A1c both in cases and controls; however, the magnitude of reduction was higher among cases (1% vs.0.7%; P < 0.001).The overall reduction in A1c among cases was higher in T2D (9.2% to 8.3%) compared with T1D (9.6% to 9.4%); however, the absolute difference in A1c reduction between cases and controls was higher among T1D (0.5% vs. 0.2%) patients. The reduction in glycemic parameters was irrespective of age or gender (P for trend <0.001) across all study sites. The greatest reductions in A1c were noted within 6 months of AGP initiation. Multiple logistic regression showed that those who did not use AGP had a 1.42 higher risk (95% CI: 1.24-1.64) of not achieving even 0.1% reduction in A1c compared with those who were initiated on AGP even after adjusting for age, gender, body-mass index, systolic blood pressure, time to follow-up A1c, and medication use. This study shows that FCGM-based AGP with FreeStyle LibrePro is associated with significant reductions in A1c levels in both T1D and T2D. In addition, improvement in A1c levels was maintained across all age groups and in patients enrolled at different diabetes clinics in India.

Association of low non-invasive near-infrared spectroscopic measurements during initial trauma resuscitation with future development of multiple organ dysfunction.

PubMed

Nicks, Bret A; Campons, Kevin M; Bozeman, William P

2015-01-01

Near-infrared spectroscopy (NIRS) non-invasively monitors muscle tissue oxygen saturation (StO2). It may provide a continuous noninvasive measurement to identify occult hypoperfusion, guide resuscitation, and predict the development of multiple organ dysfunction (MOD) after severe trauma. We evaluated the correlation between initial StO2 and the development of MOD in multi-trauma patients. Patients presenting to our urban, academic, Level I Trauma Center/Emergency Department and meeting standardized trauma-team activation criteria were enrolled in this prospective trial. NIRS monitoring was initiated immediately on arrival with collection of StO2 at the thenar eminence and continued up to 24 hours for those admitted to the Trauma Intensive Care Unit (TICU). Standardized resuscitation laboratory measures and clinical evaluation tools were collected. The primary outcome was the association between initial StO2 and the development of MOD within the first 24 hours based on a MOD score of 6 or greater. Descriptive statistical analyses were performed; numeric means, multivariate regression and rank sum comparisons were utilized. Clinicians were blinded from the StO2 values. Over a 14 month period, 78 patients were enrolled. Mean age was 40.9 years (SD 18.2), 84.4% were male, 76.9% had a blunt trauma mechanism and mean injury severity score (ISS) was 18.5 (SD 12.9). Of the 78 patients, 26 (33.3%) developed MOD within the first 24 hours. The MOD patients had mean initial StO2 values of 53.3 (SD 10.3), significantly lower than those of non-MOD patients 61.1 (SD 10.0); P=0.002. The mean ISS among MOD patients was 29.9 (SD 11.5), significantly higher than that of non-MODS patients, 12.1 (SD 9.1) (P<0.0001). The mean shock index (SI) among MOD patients was 0.92 (SD 0.28), also significantly higher than that of non-MODS patients, 0.73 (SD 0.19) (P=0.0007). Lactate values were not significantly different between groups. Non-invasive, continuous StO2 near-infrared spectroscopy values during initial trauma resuscitation correlate with the later development of multiple organ dysfunction in this patient population.

Timing of First Antenatal Care (ANC) and Inequalities in Early Initiation of ANC in Nepal.

PubMed

Paudel, Yuba Raj; Jha, Trishna; Mehata, Suresh

2017-01-01

The provision and uptake of quality and timely antenatal care (ANC) is an essential element of efforts to improve health outcomes for women and newborn babies. Antenatal consultations assist in early identification and treatment of complications during pregnancy. This study aimed to provide an information on distribution and inequalities in early initiation of ANC in Nepal. The distribution and inequalities in the early initiation of ANC were examined using Nepal Demographic and Health Surveys 2011. Bivariate and multivariate logistic regression was used to assess inequalities. Overall, 70% of the women had started their first ANC at 4 month or earlier. Among participants who had never attended school, just more than half (52%) received first ANC at 4 months or earlier, while majority of participants (97%) who had received higher education received first ANC at recommended time. Similarly, 89% of those from richest quintile and 48% of those from poorest quintile received first ANC at recommended time. In adjusted analysis, women from richest wealth quintile were significantly more likely to initiate ANC early (AOR: 3.74, 95% CI: 2.31-6.05) compared to the poorest. Similarly, women with higher level education were significantly more likely (AOR: 11.40, 95% CI: 5.05-25.73) to initiate ANC early compared to women who had never attended school. A significantly lower odds of early ANC take up was observed among madhesi other caste (AOR: 0.56, 95% CI: 0.35-0.90) compared to brahmin/chhetri women. Women whose pregnancy was unwanted were significantly less likely to attend first ANC at 4 months or early (AOR: 0.73, 95% CI: 0.58-0.93) in comparison to women whose pregnancy was wanted. The differences in the recommended timing of initiation of ANC were evident among women with different educational, economic levels, and caste/ethnic groups. Rural women were less likely to have checkups as per guidelines. The findings suggest to a need of interventions to raise female education and improve economic status of households. Targeted interventions suitable to local context and culture are equally important. Increasing access to family planning methods and reduction of unwanted pregnancy can promote early ANC take up.

Freeze-drying of tert-butyl alcohol/water cosolvent systems: effects of formulation and process variables on residual solvents.

PubMed

Wittaya-Areekul, S; Nail, S L

1998-04-01

The objective of this study was to identify significant formulation and processing variables affecting levels of tert-butyl alcohol (TBA) and isopropyl alcohol (IPA) in freeze-dried solids prepared from TBA/water cosolvent systems. The variables examined were the physical state of the solute (crystalline vs amorphous), initial TBA concentration, freezing rate, cake thickness, and the temperature and duration of secondary drying. Sucrose and glycine were used as models for noncrystallizing and crystallizing solutes, respectively. The TBA concentration above which eutectic crystallization takes place was determined by differential scanning calorimetry. Model formulations were subjected to extremes of freezing rate by either dipping in liquid nitrogen or by slowly freezing on the shelf of a freeze-dryer. Dynamics of solvent loss during secondary drying was determined by withdrawing samples as a function of time at different shelf temperatures using a thief system. On the basis of these studies, the most important determinant of residual TBA level is the physical state of the solute. Freeze-dried glycine contained very low levels of residual TBA (0.01-0.03%) regardless of freezing rate or initial TBA concentration. For freeze-dried sucrose, residual TBA levels were approximately 2 orders of magnitude higher and were significantly affected by initial TBA concentration and freezing rate. For the sucrose/TBA/water system, relatively low residual TBA levels were obtained when the initial TBA level was above the threshold concentration for eutectic crystallization of TBA, whereas samples freeze-dried from solutions containing TBA concentrations below this threshold contained significantly higher levels of TBA. Residual IPA levels increased continuously with initial concentration of TBA in the sucrose/TBA/water system. Formulations of sucrose/TBA/water which were frozen rapidly contained residual TBA levels which were approximately twice those measured in the same formulation after slow freezing and drying under the same conditions. For the sucrose/TBA/water system, the temperature and time of secondary drying had only minimal influence on residual TBA in the freeze-dried solid. At low initial TBA concentrations (2%), residual TBA increases with increased cake thickness, perhaps because of the influence of depth of fill on effective freezing rate.

Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia.

PubMed

Haile, Demewoz; Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

2016-01-01

Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73)].Similarly, lower CD4 count (<100 m3/dl) at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84).Bedridden [AHR = 5.02; 95% CI: (1.98-12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing treatment failure [AHR = 7.0, 95% CI: (3.19-15.37)]. Similarly having fair [AHR = 4.99 95% CI: (1.90-13.13)] and poor drug adherence [AHR = 2.56; 95% CI: (1.12-5.86)]were significantly associated with higher odds of treatment failure as compared to clients with good adherence. The rate of treatment failure in Bale zone hospitals needs attention. Prevention and control of TB and other opportunistic infections, promotion of ART initiation at higher CD4 level, and better functional status, improving drug adherence are important interventions to reduce treatment failure among ART clients in Southeastern Ethiopia.

Differences in Human Papillomavirus Vaccination Among Adolescent Girls in Metropolitan Versus Non-metropolitan Areas: Considering the Moderating Roles of Maternal Socioeconomic Status and Health Care Access.

PubMed

Monnat, Shannon M; Rhubart, Danielle C; Wallington, Sherrie Flynt

2016-02-01

This study is among the first to examine metropolitan status differences in human papillomavirus (HPV) vaccine initiation and completion among United States adolescent girls and is unique in its focus on how maternal socioeconomic status and health care access moderate metropolitan status differences in HPV vaccination. Using cross-sectional data from 3573 girls aged 12-17 in the U.S. from the 2008-2010 Behavioral Risk Factor Surveillance System, we estimate main and interaction effects from binary logistic regression models to identify subgroups of girls for which there are metropolitan versus non-metropolitan differences in HPV vaccination. Overall 34 % of girls initiated vaccination, and 19 % completed all three shots. On average, there were no metropolitan status differences in vaccination odds. However, there were important subgroup differences. Among low-income girls and girls whose mothers did not complete high school, those in non-metropolitan areas had significantly higher probability of vaccine initiation than those in metropolitan areas. Among high-income girls and girls whose mothers completed college, those in metropolitan areas had significantly higher odds of vaccine initiation than those in non-metropolitan areas. Moreover, among girls whose mothers experienced a medical cost barrier, non-metropolitan girls were less likely to initiate vaccination compared to metropolitan girls. Mothers remain essential targets for public health efforts to increase HPV vaccination and combat cervical cancer. Public health experts who study barriers to HPV vaccination and physicians who come into contact with mothers should be aware of group-specific barriers to vaccination and employ more tailored efforts to increase vaccination.

Late Antiretroviral Therapy (ART) Initiation Is Associated with Long-Term Persistence of Systemic Inflammation and Metabolic Abnormalities

PubMed Central

Ghislain, Mathilde; Bastard, Jean-Philippe; Meyer, Laurence; Capeau, Jacqueline; Fellahi, Soraya; Gérard, Laurence; May, Thierry; Simon, Anne; Vigouroux, Corinne; Goujard, Cécile

2015-01-01

Objectives HIV-induced immunodeficiency is associated with metabolic abnormalities and systemic inflammation. We investigated the effect of antiretroviral therapy (ART) on restoration of insulin sensitivity, markers of immune activation and inflammation. Methods Immunological, metabolic and inflammatory status was assessed at antiretroviral therapy initiation and three years later in 208 patients from the ANRS-COPANA cohort. Patients were compared according to their pre-ART CD4+ cell count (group 1: ≤ 200/mm3, n = 66 vs. group 2: > 200/mm3, n = 142). Results Median CD4+ cell count increased in both groups after 3 years of successful ART but remained significantly lower in group 1 than in group 2 (404 vs 572 cells/mm3). Triglyceride and insulin levels were higher or tended to be higher in group 1 than in group 2 at ART initiation (median: 1.32 vs 0.97 mmol/l, p = 0.04 and 7.6 vs 6.8 IU, p = 0.09, respectively) and remained higher after three years of ART (1.42 vs 1.16 mmol/L, p = 0.0009 and 8.9 vs 7.2 IU, p = 0.01). After adjustment for individual characteristics and antiretroviral therapy regimens (protease inhibitor (PI), zidovudine), insulin levels remained significantly higher in patients with low baseline CD4+ cell count. Baseline IL-6, sCD14 and sTNFR2 levels were higher in group 1 than in group 2. Most biomarkers of immune activation/inflammation declined during ART, but IL-6 and hsCRP levels remained higher in patients with low baseline CD4+ cell count than in the other patients (median are respectively 1.4 vs 1.1 pg/ml, p = 0.03 and 2.1 vs 1.3 mg/ml, p = 0.07). Conclusion After three years of successful ART, low pretreatment CD4+ T cell count remained associated with elevated insulin, triglyceride, IL-6 and hsCRP levels. These persistent metabolic and inflammatory abnormalities could contribute to an increased risk of cardiovascular and metabolic disease. PMID:26636578

Cleaning of Filtering Facepiece Respirators Contaminated with Mucin and Staphylococcus aureus

DTIC Science & Technology

2012-11-01

Journal of Infection Control. Document contains color images. Decontamination and reuse of filtering facepiece respirators (FFRs) has been proposed to...in the area of cleaning FFRs. This study evaluates the cleaning of three surgical N95 FFRs by three commercial wipe products as an initial exploration...significantly higher penetration than the other wipe products. The significance of these data to the concept of decontamination and reuse of FFRs will remain

Mechanics and Morphology of Silk Drawn from Anesthetized Spiders

NASA Astrophysics Data System (ADS)

Madsen, B.; Vollrath, F.

CO2 and N2 anesthetized Nephila spiders produced dragline silk with mechanical properties that differed from control silk as a function of time under anesthesia. Silk from CO2 spiders had a significantly lower breaking strain and breaking energy, significantly higher initial modulus, and marginally lower breaking stress. At the onset of anesthesia the silk diameter became highly variable. During deep anesthesia silk either became thinner or retained cross-section but fibrillated.

Impact of coil design on the contrast-to-noise ratio, precision, and consistency of quantitative cartilage morphometry at 3 Tesla: a pilot study for the osteoarthritis initiative.

PubMed

Eckstein, Felix; Kunz, Manuela; Hudelmaier, Martin; Jackson, Rebecca; Yu, Joseph; Eaton, Charles B; Schneider, Erika

2007-02-01

Phased-array (PA) coils generally provide higher signal-to-noise ratios (SNRs) than quadrature knee coils. In this pilot study for the Osteoarthritis Initiative (OAI) we compared these two types of coils in terms of contrast-to-noise ratio (CNR), precision, and consistency of quantitative femorotibial cartilage measurements. Test-retest measurements were acquired using coronal fast low-angle shot with water excitation (FLASHwe) and coronal multiplanar reconstruction (MPR) of sagittal double-echo steady state with water excitation (DESSwe) at 3T. The precision errors for cartilage volume and thickness were

Parental smoking, exposure to secondhand smoke at home, and smoking initiation among young children.

PubMed

Wang, Man Ping; Ho, Sai Yin; Lam, Tai Hing

2011-09-01

To investigate the associations of parental smoking and secondhand smoke (SHS) exposure at home with smoking initiation among young children in Hong Kong. A prospective school-based survey of Hong Kong primary 2-4 students was conducted at baseline in 2006 and followed up in 2008. Self-administered anonymous questionnaires were used to collect information about smoking, SHS exposure at home, parental smoking, and sociodemographic characteristics. Cross-sectional and prospective associations of SHS exposure at home and parental smoking with student smoking were analyzed using logistic regression adjusting for potential confounders. Cross-sectional association between parental smoking and ever smoking was significant with adjustment of sociodemographic characteristics but became insignificant after adjusting for home SHS exposure. Home SHS exposure mediated the association between parental smoking and students smoking (p = .03). Prospectively, parental smoking was not associated with smoking initiation after adjusting for home SHS exposure. Each day increase in home SHS exposure significantly predicted 16% excess risk of smoking initiation after adjusting for parental smoking. The prospective effect of parental smoking on smoking initiation was significantly mediated by baseline home SHS exposure (p < .01). Higher exposure to SHS at home predicted smoking initiation of young Chinese children in Hong Kong independent of parental smoking status. On the other hand, the effect of parental smoking on smoking initiation was mediated through SHS exposure at home. To prevent children from smoking as well as the harm of SHS exposure, parents and other family members should quit smoking or at least reduce smoking at home.

Enantioselective Pharmacokinetics of α-Lipoic Acid in Rats

PubMed Central

Uchida, Ryota; Okamoto, Hinako; Ikuta, Naoko; Terao, Keiji; Hirota, Takashi

2015-01-01

α-Lipoic acid (LA) is widely used for nutritional supplements as a racemic mixture, even though the R enantiomer is biologically active. After oral administration of the racemic mixture (R-α-lipoic acid (RLA) and S-α-lipoic acid (SLA) mixed at the ratio of 50:50) to rats, RLA showed higher plasma concentration than SLA, and its area under the plasma concentration-time curve from time zero to the last (AUC) was significantly about 1.26 times higher than that of SLA. However, after intravenous administration of the racemic mixture, the pharmacokinetic profiles, initial concentration (C0), AUC, and half-life (T1/2) of the enantiomers were not significantly different. After oral and intraduodenal administration of the racemic mixture to pyrolus-ligated rats, the AUCs of RLA were significantly about 1.24 and 1.32 times higher than that of SLA, respectively. In addition, after intraportal administration the AUC of RLA was significantly 1.16 times higher than that of SLA. In conclusion, the enantioselective pharmacokinetics of LA in rats arose from the fraction absorbed multiplied by gastrointestinal availability (FaFg) and hepatic availability (Fh), and not from the total clearance. PMID:26402669

Enantioselective Pharmacokinetics of α-Lipoic Acid in Rats.

PubMed

Uchida, Ryota; Okamoto, Hinako; Ikuta, Naoko; Terao, Keiji; Hirota, Takashi

2015-09-21

α-Lipoic acid (LA) is widely used for nutritional supplements as a racemic mixture, even though the R enantiomer is biologically active. After oral administration of the racemic mixture (R-α-lipoic acid (RLA) and S-α-lipoic acid (SLA) mixed at the ratio of 50:50) to rats, RLA showed higher plasma concentration than SLA, and its area under the plasma concentration-time curve from time zero to the last (AUC) was significantly about 1.26 times higher than that of SLA. However, after intravenous administration of the racemic mixture, the pharmacokinetic profiles, initial concentration (C₀), AUC, and half-life (T1/2) of the enantiomers were not significantly different. After oral and intraduodenal administration of the racemic mixture to pyrolus-ligated rats, the AUCs of RLA were significantly about 1.24 and 1.32 times higher than that of SLA, respectively. In addition, after intraportal administration the AUC of RLA was significantly 1.16 times higher than that of SLA. In conclusion, the enantioselective pharmacokinetics of LA in rats arose from the fraction absorbed multiplied by gastrointestinal availability (FaFg) and hepatic availability (Fh), and not from the total clearance.

Treatment of anaerobically digested swine wastewater by Rhodobacter blasticus and Rhodobacter capsulatus.

PubMed

Wen, Shan; Liu, Hongyu; He, Huijun; Luo, Le; Li, Xiang; Zeng, Guangming; Zhou, Zili; Lou, Wei; Yang, Chunping

2016-12-01

Two strains of photosynthetic bacteria, Rhodobacter blasticus and Rhodobacter capsulatus, were used in this work to investigate the feasibility of using photosynthetic bacteria for the treatment of anaerobically digested swine wastewater. The effects of crucial factors which influence the pollutants removal efficiency were also examined. Results showed that anaerobically digested swine wastewater could be treated effectively by photosynthetic bacteria. The treatment efficiency was significantly higher by the mixed photosynthetic bacteria than that by any unitary bacterium. The optimal treatment condition by mixed bacteria was inoculation of 10.0%(v/v) of the two bacteria by 1:1, initial pH of 7.0 and initial chemical oxygen demand of 4800mgL -1 . Under these conditions, the removal rate of chemical oxygen demand was 83.3%, which was 19.3% higher than when using Rhodobacter blasticus or 10.6% higher than when using Rhodobacter capsulatus separately. This mixed photosynthetic bacteria achieved high chemical oxygen demand removal and cell yields. Copyright © 2016 Elsevier Ltd. All rights reserved.

Synthetic versus serum-based medium for corneal preservation in organ culture: a comparative study between 2 different media.

PubMed

Parekh, Mohit; Ferrari, Stefano; Salvalaio, Gianni; Ponzin, Diego

2015-01-01

To study the effect of a synthetic medium and compare it with a serum-based medium for corneal preservation in organ culture using an overall quality assessment system. A randomized study with blinded observers was performed comparing parameters such as thickness, transparency, viable endothelial cell density (VECD), morphology, and overall quality (OQ) of the corneal tissues preserved in synthetic and a serum-based medium, respectively. Seven human paired corneas were randomly selected and assessed at day 0 (initial), day 2 (before organ culture), day 30 (before deturgescence/deswelling storage), and 48 hours post deswelling. Thickness was determined with optical coherence tomography and transparency with a validated, custom device. The morphology and VECD were observed after treating the tissues with trypan blue and sucrose. Data were compared using paired t tests with p<0.05 deemed significant. Parameters were similar at the initial stage between the groups with no statistically significant difference. However, after preservation in the deturgescent medium, the corneas stored in a serum-based medium showed a higher and statistically significant OQ value (p = 0.0317). The OQ of a serum-based medium was higher than that of the synthetic medium. A higher rate of transparency and reduction in thickness was observed in the serum-based medium at the end of the storage. Although complete synthetic media may have distinct advantages of being serum/animal-free, the quality of the cornea is of a reasonable concern when it is deemed for transplantation.

Evaluation and optimization of ethanol production from carob pod extract by Zymomonas mobilis using response surface methodology.

PubMed

Vaheed, Hossein; Shojaosadati, Seyed Abbas; Galip, Hasan

2011-01-01

In this research, ethanol production from carob pod extract (extract) using Zymomonas mobilis with medium optimized by Plackett-Burman (P-B) and response surface methodologies (RSM) was studied. Z. mobilis was recognized as useful for ethanol production from carob pod extract. The effects of initial concentrations of sugar, peptone, and yeast extract as well as agitation rate (rpm), pH, and culture time in nonhydrolyzed carob pod extract were investigated. Significantly affecting variables (P = 0.05) in the model obtained from RSM studies were: weights of bacterial inoculum, initial sugar, peptone, and yeast extract. Acid hydrolysis was useful to complete conversion of sugars to glucose and fructose. Nonhydrolyzed extract showed higher ethanol yield and residual sugar compared with hydrolyzed extract. Ethanol produced (g g(-1) initial sugar, as the response) was not significantly different (P = 0.05) when Z. mobilis performance was compared in hydrolyzed and nonhydrolyzed extract. The maximum ethanol of 0.34 ± 0.02 g g(-1) initial sugar was obtained at 30°C, initial pH 5.2, and 80 rpm, using concentrations (g per 50 mL culture media) of: inoculum bacterial dry weight, 0.017; initial sugar, 5.78; peptone, 0.43; yeast extract, 0.43; and culture time of 36 h.

Metformin selectively affects human glioblastoma tumor-initiating cell viability

PubMed Central

Würth, Roberto; Pattarozzi, Alessandra; Gatti, Monica; Bajetto, Adirana; Corsaro, Alessandro; Parodi, Alessia; Sirito, Rodolfo; Massollo, Michela; Marini, Cecilia; Zona, Gianluigi; Fenoglio, Daniela; Sambuceti, Gianmario; Filaci, Gilberto; Daga, Antonio; Barbieri, Federica; Florio, Tullio

2013-01-01

Cancer stem cell theory postulates that a small population of tumor-initiating cells is responsible for the development, progression and recurrence of several malignancies, including glioblastoma. In this perspective, tumor-initiating cells represent the most relevant target to obtain effective cancer treatment. Metformin, a first-line drug for type II diabetes, was reported to possess anticancer properties affecting the survival of cancer stem cells in breast cancer models. We report that metformin treatment reduced the proliferation rate of tumor-initiating cell-enriched cultures isolated from four human glioblastomas. Metformin also impairs tumor-initiating cell spherogenesis, indicating a direct effect on self-renewal mechanisms. Interestingly, analyzing by FACS the antiproliferative effects of metformin on CD133-expressing subpopulation, a component of glioblastoma cancer stem cells, a higher reduction of proliferation was observed as compared with CD133-negative cells, suggesting a certain degree of cancer stem cell selectivity in its effects. In fact, glioblastoma cell differentiation strongly reduced sensitivity to metformin treatment. Metformin effects in tumor-initiating cell-enriched cultures were associated with a powerful inhibition of Akt-dependent cell survival pathway, while this pathway was not affected in differentiated cells. The specificity of metformin antiproliferative effects toward glioblastoma tumor-initiating cells was confirmed by the lack of significant inhibition of normal human stem cells (umbilical cord-derived mesenchymal stem cells) in vitro proliferation after metformin exposure. Altogether, these data clearly suggest that metformin exerts antiproliferative activity on glioblastoma cells, showing a higher specificity toward tumor-initiating cells, and that the inhibition of Akt pathway may represent a possible intracellular target of this effect. PMID:23255107

[Gender based violence in the Spanish Parliamentary Agenda (1979-2004)].

PubMed

Vives-Cases, Carmen; Gil-González, Diana; Carrasco-Portiño, Mercedes; Alvarez-Dardet, Carlos

2006-01-01

To systematically examine the characteristics of the processes of formulating and taking decisions on gender-based violence in the Spanish Parliament. A search was performed for all parliamentary initiatives on gender-based violence in the Spanish parliament (1979-2004) and their qualitative content was analyzed. The ratio between initiatives on gender-based violence and those on other issues was calculated by years and legislatures. The probability of presenting initiatives on gender-based violence was analyzed by sex and political group (government vs. opposition) (odds ratio, 95% CI and statistical significance using the Mantel-Haenszel method). In the 26 years studied, there were 322,187 initiatives, of which 569 concerned gender-based violence. Initiatives on this issue increased in 1998 (4.12 per 1,000), 2001 (4.49 per 1,000) and 2004 (9.19 per 1,000). Sixty-seven percent were questions to the government. The majority of the initiatives were registered without agreement or decision (81%). Men had a higher probability of asking questions (OR = 17.08; 95%CI, 5.91-55.62), but women instigated 60% of the initiatives. Parliamentary groups in government showed a higher probability of asking questions (OR = 2.63; 95%CI, 1.32-5.31), but 88% of the initiatives were promoted by the opposition. The process of policy construction has been started in Spain, which could lead to the development of true policies on gender-based violence in the future. Parliamentary activity on this issue should be maintained in the long-term, as the problem shows no sign of abating.

Effects of sales promotion on smoking among U.S. ninth graders.

PubMed

Redmond, W H

1999-03-01

The purpose of this study was to examine the association between tobacco marketing efforts and daily cigarette smoking by adolescents. This was a longitudinal study of uptake of smoking on a daily basis with smoking data from the Monitoring the Future project. Diffusion modeling was used to generate expected rates of daily smoking initiation, which were compared with actual rates. Study data were from a national survey, administered annually from 1978 through 1995. Between 4,416 and 6,099 high school seniors participated per year, for a total of 94,652. The main outcome measure was a deviation score based on expected rates from diffusion modeling vs actual rates of initiation of daily use of cigarettes by ninth graders. Annual data on cigarette marketing expenditures were reported by the Federal Trade Commission. The deviation scores of expected vs actual rates of smoking initiation for ninth graders were correlated with annual changes in marketing expenditures. The correlation between sales promotion expenditures and the deviation score in daily smoking initiation was large (r = 0. 769) and statistically significant (P = 0.009) in the 1983-1992 period. Correlations between sales promotion and smoking initiation were not statistically significant in 1978-1982. Correlations between advertising expenditures and smoking initiation were not significant in either period. In years of high promotional expenditures, the rate of daily smoking initiation among ninth graders was higher than expected from diffusion model predictions. Large promotional pushes by cigarette marketers in the 1980s and 1990s appear to be linked with increased levels of daily smoking initiation among ninth graders. Copyright 1999 American Health Foundation and Academic Press.

Motivational Interviewing Fidelity in a Community Corrections Setting: Treatment Initiation and Subsequent Drug Use.

PubMed

Spohr, Stephanie A; Taxman, Faye S; Rodriguez, Mayra; Walters, Scott T

2016-06-01

Although substance use is common among people in the U.S. criminal justice system, treatment initiation remains an ongoing problem. This study assessed the reliability and predictive validity of the Motivational Interviewing Treatment Integrity 3.1.1. (MITI) coding instrument in a community corrections sample. We used data from 80 substance-using clients who were participating in a clinical trial of MI in a probation setting. We analyzed 124 MI counseling sessions using the MITI, a coding system for documenting MI fidelity. Bivariate associations and logistic regression modeling were used to determine if MI-consistent behaviors predicted substance use or treatment initiation at a 2-month follow-up. We found a high level of agreement between coders on behavioral utterance counts. Counselors met at least beginning proficiency on most MITI summary scores. Probationers who initiated treatment at 2-month follow-up had significantly higher ratings of clinician empathy and MI spirit than clients who did not initiate treatment. Other MITI summary scores were not significantly different between clients who had initiated treatment and those who did not. MI spirit and empathy ratings were entered into a forward logistic regression in which MI spirit significantly predicted 2-month treatment initiation (χ(2) (1)=4.10, p<.05, R(2)=.05) but counselor empathy did not. MITI summary scores did not predict substance use at 2-month follow-up. Counselor MI-consistent relational skills were an important predictor of client treatment initiation. Counselor behaviors such as empathy and MI spirit may be important for developing client rapport with people in a probation setting. Copyright © 2015. Published by Elsevier Inc.

Cognitive inconsistency in bipolar patients is determined by increased intra-individual variability in initial phase of task performance.

PubMed

Krukow, Paweł; Szaniawska, Ola; Harciarek, Michał; Plechawska-Wójcik, Małgorzata; Jonak, Kamil

2017-03-01

Bipolar patients show high intra-individual variability during cognitive processing. However, it is not known whether there are a specific fluctuations of variability contributing to the overall high cognitive inconsistency. The objective was to compare dynamic profiles of patients and healthy controls to identify hypothetical differences and their associations with overall variability and processing speed. Changes of reaction times iSD during processing speed test performance over time was measured by dividing the iSD for whole task into four consecutive parts. Motor speed and cognitive effort were controlled. Patients with BD exhibited significantly lower results regarding processing speed and higher intra-individual variability comparing with HC. The profile of intra-individual variability changes over time of performance was significantly different in BD versus HC groups: F(3, 207)=8.60, p<0.0001, η p 2 =0.11. iSD of BD patients in the initial phase of performance was three times higher than in the last. There was no significant differences between four intervals in HC group. Inter-group difference in the initial part of the profiles was significant also after controlling for several cognitive and clinical variables. Applied computer version of Cognitive Speed Test was relatively new and, thus, replication studies are needed. Effect seen in the present study is driven mainly by the BD type I. Patients with BD exhibits problems with setting a stimulus-response association in starting phase of cognitive processing. This deficit may negatively interfere with the other cognitive functions, decreasing level of psychosocial functioning, therefore should be explored in future studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of a Synbiotic Yogurt on Levels of Fecal Bifidobacteria, Clostridia, and Enterobacteria

PubMed Central

Palaria, Amrita; Johnson-Kanda, Ivy

2012-01-01

While ingestion of synbiotic yogurts containing Bifidobacterium animalis subsp. lactis and inulin is increasing, their effect on certain microbial groups in the human intestine is unclear. To further investigate this, a large-scale, crossover-design, placebo-controlled study was utilized to evaluate the effect of a synbiotic yogurt containing B. animalis subsp. lactis Bb-12 and inulin on the human intestinal bifidobacteria, clostridia, and enterobacteria. Fecal samples were collected at 14 time points from 46 volunteers who completed the study, and changes in the intestinal bacterial levels were monitored using real-time PCR. Strain Bb-12 could not be detected in feces after 2 weeks of washout. A live/dead PCR procedure indicated that the Bb-12 strain detected in the fecal samples was alive. A significant increase (P < 0.001) in the total bifidobacterial numbers was seen in both groups of subjects during the final washout period compared to the prefeeding period. This increase in total bifidobacteria corresponded with a significant decrease (P < 0.05) in numbers of clostridia but not enterobacteria. No significant differences in numbers of bifidobacteria, clostridia, or enterobacteria were observed between the probiotic and placebo groups during any of the feeding periods. However, subgrouping subjects based on lower initial bifidobacterial numbers or higher initial clostridial numbers did show corresponding significant differences between the synbiotic yogurt and placebo groups. This was not observed for a subgroup with higher initial enterobacterial numbers. While this synbiotic yogurt can increase bifidobacterial numbers and decrease clostridial numbers (but not enterobacterial numbers) in some individuals, it cannot modulate these microbial groups in the majority of individuals. PMID:22101054

Differences in the profile of neonatal abstinence syndrome signs in methadone- versus buprenorphine-exposed neonates

PubMed Central

Gaalema, Diann E.; Scott, Teresa Linares; Heil, Sarah H.; Coyle, Mara G.; Kaltenbach, Karol; Badger, Gary J.; Arria, Amelia M.; Stine, Susan M.; Martin, Peter R.; Jones, Hendrée E.

2014-01-01

Aims To compare the profile of signs of neonatal abstinence syndrome (NAS) in methadone- versus buprenorphine-exposed infants. Design, setting and participants Secondary analysis of NAS data from a multi-site, double-blind, double-dummy, flexible-dosing, randomized clinical trial. Data from a total of 129 neonates born to opioid-dependent women who had been assigned to receive methadone or buprenorphine treatment during pregnancy were examined. Measurements For 10 days after delivery, neonates (methadone = 72, buprenorphine = 57) were assessed regularly using a 19-item modified Finnegan scale. Data from neonates who required pharmacological treatment (methadone = 41, buprenorphine = 27) were included up to the time treatment was initiated. The incidence and mean severity of the total NAS score and each individual sign of NAS were calculated and compared between medication conditions, as was the median time until morphine treatment initiation among treated infants in each condition. Findings Two NAS signs (undisturbed tremors and hyperactive Moro reflex) were observed significantly more frequently in methadone-exposed neonates and three (nasal stuffiness, sneezing, loose stools) were observed more frequently in buprenorphine-exposed neonates. Mean severity scores on the total NAS score and five individual signs (disturbed and undisturbed tremors, hyperactive Moro reflex, excessive irritability, failure to thrive) were significantly higher among methadone-exposed neonates, while sneezing was higher among buprenorphine-exposed neonates. Among treated neonates, methadone-exposed infants required treatment significantly earlier than buprenorphine-exposed infants (36 versus 59 hours postnatal, respectively). Conclusions The profile of neonatal abstinence syndrome differs in methadone- versus buprenorphine-exposed neonates, with significant differences in incidence, severity and treatment initiation time. Overall, methadone-exposed neonates have a more severe neonatal abstinence syndrome. PMID:23106927

Northwest Manufacturing Initiative

DTIC Science & Technology

2014-07-31

recommendations for getting cheaper, faster, and better. Objectives 1. Maintain opportunities for those considered unemployable , currently unemployed...thrive” (Cisco 2013). In addition, the U.S. Bank Foundation focuses on providing nonprofit organizations with grants in the areas of education, B2-3...Media survey found that consumers’ expectations of environmental sustainability for the energy and manufacturing sectors are significantly higher

Laying the Groundwork: The Journey of an Urban High School District Implementing a College Readiness Initiative

ERIC Educational Resources Information Center

Franco, Antonia O.

2012-01-01

National and state education reforms are centered on developing higher academic expectations and standards to ensure students transitions into postsecondary options, college and career ready. What does this national emphasis signify for urban school districts that are educating a significant proportion of first-generation students and that…

Building an Adverse Outcome Pathway Framework through HTS Data and Literature Mining Integration (FutureToxII)

EPA Science Inventory

Interpreting EPA’s ToxCast in vitro assay data in the context of Adverse Outcome Pathway (AOP) development is a significant challenge. While chemical activation in these assays may shed light on the molecular initiating event, the downstream effect of these activities at higher ...

Examining Social Presence Influence on Students' Satisfaction with Online Learning Environments

ERIC Educational Resources Information Center

Dajani, Fadi Khalil

2014-01-01

In recent years, many individuals started pursuing higher education to increase their marketability. The growth in the online market was significant and due to full-time workers, the fastest growing segment of the student population. Evidence indicates that many students become frustrated after their initial online experience and fail to pursue…

Model-Based Reasoning in the Physics Laboratory: Framework and Initial Results

ERIC Educational Resources Information Center

Zwickl, Benjamin M.; Hu, Dehui; Finkelstein, Noah; Lewandowski, H. J.

2015-01-01

We review and extend existing frameworks on modeling to develop a new framework that describes model-based reasoning in introductory and upper-division physics laboratories. Constructing and using models are core scientific practices that have gained significant attention within K-12 and higher education. Although modeling is a broadly applicable…

The influence of intravenous hydration on hospital length of stay in infants with hyperbilirubinemia.

PubMed

Patel, Shilpa J; Bergert, Lora; Klaus, Sybil; Klaus, George; Shea, William; Winkes, Adeline; Mavoori, Hareesh; Yamamoto, Loren

2008-01-01

A retrospective chart review compared data on neonates with physiologic jaundice admitted for phototherapy at a children's hospital. Those infants who received intravenous fluids (IVF) had significantly longer lengths of stay, higher initial bilirubin levels, and were more dehydrated than those babies who did not receive IVF.

Efficacy of Early Rehabilitation After Surgical Repair of Acute Aneurysmal Subarachnoid Hemorrhage: Outcomes After Verticalization on Days 2-5 Versus Day 12 Post-Bleeding.

PubMed

Milovanovic, Andjela; Grujicic, Danica; Bogosavljevic, Vojislav; Jokovic, Milos; Mujovic, Natasa; Markovic, Ivana Petronic

2017-01-01

To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

Determining the diagnostic value of endogenous carbon monoxide in chronic obstructive pulmonary disease exacerbations.

PubMed

Dogan, Nurettin Özgür; Corbacioglu, Seref Kerem; Bildik, Fikret; Kilicaslan, Isa; Günaydin, Gül Pamukcu; Cevik, Yunsur; Ülker, Volkan; Hakoglu, Onur; Gökcen, Emre

2014-09-01

To determine whether endogenous carbon monoxide levels in exacerbations of Chronic Obstructive Pulmonary Disease patients were higher compared to healthy individuals and to investigate alteration of carbon monoxide levels across the three different severity stages of Global Initiative for Chronic Obstructive Lung Disease criteria related to Chronic Obstructive Pulmonary Disease exacerbations. The prospective study was conducted from January to March 2011 at two medical institutions in Ankara, Turkey, and comprised patients of acute Chronic Obstructive Pulmonary Disease exacerbations. The severity of the exacerbations was based on the Global Initiative for Chronic Obstructive Lung Disease criteria. Patients with active tobacco smoking, suspicious carbon monoxide poisoning and uncertain diagnosis were excluded. healthy control subjects who did not have any comorbid diseases and smoking habitus were also enrolled to compare the differences between carboxyhaemoglobin levels A two-tailed Mann-Whitney U test with Bonferroni correction was done following a Kruskal-Wallis test for statistical purposes. There were 90 patients and 81 controls in the study. Carboxyhaemoglobin levels were higher in the patients than the controls (p < 0.001). As for the three severity stages, Group 1 had a median carboxyhaemoglobin of 1.6 (0.95- 2.00). The corresponding levels in Group 2 (1.8 [1.38-2.20]) and Group 3 (1.9 [1.5-3.0]) were higher than the controls (p < 0.001 and p < 0.005 respectively). No statistically significant difference between Group 1 and the controls (1.30 [1.10-1.55]) was observed (p < 0.434). Carboxyhaemoglobin levels were significantly higher in exacerbations compared with the normal population. Also, in more serious exacerbations, carboxyhaemoglobin levels were significantly increased compared with healthy individuals and mild exacerbations.

Understanding the gendered patterns of substance use initiation among adolescents living in rural, central Mexico

PubMed Central

Ayers, Stephanie; Marsiglia, Flavio; Hoffman, Steven; Urbaeva, Zhyldyz

2012-01-01

Background Little is known about the age of initiation and gender differences in substance use among adolescents in rural, central Mexico. Methods The cross-sectional data were collected from students enrolled in the Videobachillerato (VIBA) (video high school) program in Guanajuato, Mexico. Questionnaires asked students about the age at which they had used alcohol, cigarettes, or marijuana for the first time. Kaplan-Meier Survival Functions were used to estimate if males and females were significantly different in their cumulative probabilities of initiating substances over time. Results On average, alcohol is initiated at 14.7 years of age, cigarettes at 15.1 years of age, and marijuana at 16.5 years of age. Over time, males had a significantly higher probability of initiating alcohol (Kaplan-Meier Failure Curve: Χ2=26.35, p<0.001), cigarettes (Kaplan-Meier Failure Curve: Χ2=41.90, p<0.001), and marijuana (Kaplan-Meier Failure Curve: Χ2=38.01, p<0.001) compared to females. Conclusions These results highlight the gendered patterns of substance use initiation among adolescents in rural, central Mexico and underscore the need for gendered substance use prevention interventions with these adolescents. By putting forth efforts to understand substance use initiation patterns of adolescents living in rural, central Mexico, culturally specific and efficacious prevention efforts can be tailor-made to create lasting differences. PMID:22421555

Appropriate use of inhaled corticosteroid and long-acting beta(2)-adrenergic agonist combination therapy among asthma patients in a US commercially insured population.

PubMed

Ye, Xin; Gutierrez, Benjamin; Zarotsky, Victoria; Nelson, Michael; Blanchette, Christopher M

2009-09-01

To examine health care utilization measures indicating which asthma patients are appropriate for inhaled corticosteroid and long-acting beta(2)-adrenergic agonist (ICS/LABA) therapy and determine whether two ICS/LABA therapies were initiated in accordance with guidelines. A retrospective cohort study of commercially insured asthma patients aged > or =12 years that initiated fluticasone propionate/salmeterol (FSC) or budesonide/formoterol fumarate dihydrate (BFC) combination therapy in 2007 was conducted. Use was considered appropriate if patients met any of the following during a 1-year period before ICS/LABA initiation: ICS or leukotriene receptor antagonist (LTRA) use; an asthma-related emergency department (ED) visit or hospitalization; > or =2 oral corticosteroids (OCS) courses; or > or =6 short-acting beta(2)-adrenergic agonist (SABA) canisters. Multivariate logistic regression was used to assess factors associated with appropriate ICS/LABA use. Certain limitations inherent to the use of claims data for research apply to this study. Of 24,231 patients who initiated ICS/LABA therapy, 993 received BFC and 23,238 received FSC. Among all patients, 37.6% met > or =1 criteria for appropriate use. However, compared with FSC users, BFC users had a significantly higher likelihood of meeting > or =1 of these criteria (odds ratio, 2.01; 95% CI, 1.76-2.30; p < 0.001), and a higher proportion of BFC than FSC patients met 4 of the 5 appropriate use criteria. In total, 58.4% of BFC patients versus 36.7% of FSC patients met > or =1 criteria for appropriate use. Other factors associated with appropriate use included age, region, Charlson comorbidity score, number of medications, and prescriber specialty. Fewer than half of all patients fulfilled the specified criteria for being appropriate for ICS/LABA therapy. However, a significantly higher proportion of BFC than FSC users met the criteria for appropriate use of ICS/LABA therapy. These results may suggest a need for improved physician awareness of consensus guidelines for the initiation of ICS/LABA therapy.

Step-Initiation Deficits in Children with Faulty Posture Diagnosed with Neurodevelopmental Disorders during Infancy.

PubMed

Stania, Magdalena; Sarat-Spek, Alina; Blacha, Teresa; Kazek, Beata; Słomka, Kajetan J; Emich-Widera, Ewa; Juras, Grzegorz

2017-01-01

Early detection of movement deficits during step initiation will facilitate the selection of the optimal physiotherapy management strategy. The main aim of the study was to assess potential differences in step initiation between 5- and 6-year-old children with faulty posture who had been diagnosed with neurodevelopmental disorders during infancy and healthy children. The experimental group consisted of 19 children aged 5-6 years with faulty posture, who had been diagnosed with neurodevelopmental disorders during infancy and were given physiotherapy in the first year of their lives. The control group comprised 19 nursery school children aged 5-6 years with no postural defects, no history of postural control or movement deficits, and no physiotherapy interventions in the first year of their lives. Step initiation was performed on force platforms under various conditions, i.e., with and without an obstacle, stepping up onto a platform placed at a higher level, stepping down onto a platform placed on a lower level. The recording of center of foot pressure (COP) displacements was divided into three phases: phase 1 (P1)-quiet standing before step initiation, phase 2 (P2)-transit, phase 3 (P3)-quiet standing until measurement completion. The Tukey post hoc test showed that the means of sway range (raCOP) and mean velocity (vCOP) in sagittal ( AP ) plane for phase 1 and vCOP in frontal ( ML ) plane for phase 3 registered in the step-up trial were significantly higher ( p  < 0.05) in children with faulty posture compared to children with typical development. P1vCOP ML , P3vCOP AP , P3raCOP ML , and P3vCOP ML of the step-down trial were also significantly higher in children with faulty posture ( p  < 0.05). Inclusion of functional movement exercises (stair-walking tasks) in physiotherapy interventions for children with postural defects seems well justified.The trial was registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12617001068358).

Embargo on Lion Hunting Trophies from West Africa: An Effective Measure or a Threat to Lion Conservation?

PubMed Central

Bouché, Philippe; Crosmary, William; Kafando, Pierre; Doamba, Benoit; Kidjo, Ferdinand Claude; Vermeulen, Cédric; Chardonnet, Philippe

2016-01-01

The W-Arly-Pendjari (WAP) ecosystem, shared among Benin, Burkina Faso and Niger, represents the last lion stronghold of West Africa. To assess the impact of trophy hunting on lion populations in hunting areas of the WAP, we analyzed trends in harvest rates from 1999 to 2014. We also investigated whether the hunting areas with higher initial hunting intensity experienced steeper declines in lion harvest between 1999 and 2014, and whether lion densities in hunting areas were lower than in national parks. Lion harvest rate remained overall constant in the WAP. At initial hunting intensities below 1.5 lions/1000km2, most hunting areas experienced an increase in lion harvest rate, although that increase was of lower magnitude for hunting areas with higher initial hunting intensity. The proportion of hunting areas that experienced a decline in lion harvest rate increased at initial hunting intensities above 1.5 lions/1000km2. In 2014, the lion population of the WAP was estimated with a spoor count at 418 (230–648) adults and sub-adult individuals, comparable to the 311 (123–498) individuals estimated in the previous 2012 spoor survey. We found no significant lion spoor density differences between national parks and hunting areas. Hunting areas with higher mean harvest rates did not have lower lion densities. The ratio of large adult males, females and sub-adults was similar between the national parks and the hunting areas. These results suggested that the lion population was not significantly affected by hunting in the WAP. We concluded that a quota of 1 lion/1000km2 would be sustainable for the WAP. Based on our results, an import embargo on lion trophies from the WAP would not be justified. It could ruin the incentive of local actors to conserve lions in hunting areas, and lead to a drastic reduction of lion range in West Africa. PMID:27182985

Embargo on Lion Hunting Trophies from West Africa: An Effective Measure or a Threat to Lion Conservation?

PubMed

Bouché, Philippe; Crosmary, William; Kafando, Pierre; Doamba, Benoit; Kidjo, Ferdinand Claude; Vermeulen, Cédric; Chardonnet, Philippe

2016-01-01

The W-Arly-Pendjari (WAP) ecosystem, shared among Benin, Burkina Faso and Niger, represents the last lion stronghold of West Africa. To assess the impact of trophy hunting on lion populations in hunting areas of the WAP, we analyzed trends in harvest rates from 1999 to 2014. We also investigated whether the hunting areas with higher initial hunting intensity experienced steeper declines in lion harvest between 1999 and 2014, and whether lion densities in hunting areas were lower than in national parks. Lion harvest rate remained overall constant in the WAP. At initial hunting intensities below 1.5 lions/1000km2, most hunting areas experienced an increase in lion harvest rate, although that increase was of lower magnitude for hunting areas with higher initial hunting intensity. The proportion of hunting areas that experienced a decline in lion harvest rate increased at initial hunting intensities above 1.5 lions/1000km2. In 2014, the lion population of the WAP was estimated with a spoor count at 418 (230-648) adults and sub-adult individuals, comparable to the 311 (123-498) individuals estimated in the previous 2012 spoor survey. We found no significant lion spoor density differences between national parks and hunting areas. Hunting areas with higher mean harvest rates did not have lower lion densities. The ratio of large adult males, females and sub-adults was similar between the national parks and the hunting areas. These results suggested that the lion population was not significantly affected by hunting in the WAP. We concluded that a quota of 1 lion/1000km2 would be sustainable for the WAP. Based on our results, an import embargo on lion trophies from the WAP would not be justified. It could ruin the incentive of local actors to conserve lions in hunting areas, and lead to a drastic reduction of lion range in West Africa.

Ownership of alcohol-branded merchandise and initiation of teen drinking.

PubMed

McClure, Auden C; Dal Cin, Sonya; Gibson, Jennifer; Sargent, James D

2006-04-01

The alcohol industry spends over $5 billion a year on marketing, much of which is accessible to children. The distribution of branded articles of clothing and other personal items is one aspect of alcohol marketing that has not been adequately studied. In this study, the prevalence of ownership of alcohol-branded merchandise (ABM) was determined in a sample of rural northern New England adolescents, and the relationship between ownership of such items and initiation of alcohol use was examined. Northern New England middle school students who had not yet initiated alcohol use were captured at baseline in a 1999 school-based survey, and ownership of an ABM item and initiation of alcohol use were determined 1 to 2 years later by telephone. The analysis controlled for demographics (gender, grade in school); characteristics of the child (school performance, sensation seeking, rebelliousness); parenting style; and peer alcohol use. Of 2406 baseline never-drinkers, 15% had initiated alcohol use and 14% owned an ABM item by follow-up. ABM items consisted primarily of articles of clothing such as t-shirts and hats. ABM ownership was associated with higher grade in school, male gender, exposure to peer drinking, having tried smoking, poorer academic performance, higher levels of sensation seeking and rebelliousness, and less-responsive and restrictive parenting styles. Owners of ABM items at follow-up had higher rates of alcohol initiation compared with non-owners (25.5% vs 13.1%, respectively, p<0.001). After adjusting for the above confounders, students who owned an ABM item were significantly more likely to have initiated alcohol use compared with students who did not own one (adjusted odds ratio 1.5, 95% confidence interval, 1.1-2.0). In this northern New England adolescent sample, ownership of alcohol-branded merchandise was prevalent and exhibited an independent cross-sectional association with onset of adolescent drinking. Further studies are necessary to determine whether the relationship is causal, and whether teen use of ABM items influences peer drinking norms and behavior.

Role of Family and Peers in Initiation and Continuation of Substance Use

PubMed Central

Tsering, Dechenla; Pal, Ranabir

2009-01-01

Aims: To assess the impact of family and peers on both initiation and continuation of substance use among eighth, ninth and tenth grade adolescent high school students. Design: Population based cross-sectional study. Setting: Two high schools of West Bengal, India. Participants: 416 students in class VIII, IX, and X in two schools. Interventions: None. Measurements: Substance use: initiation, sources, reasons for continuation. Then proportions and chi-square test was used for statistical analysis. Materials and Methods: This was a population based cross sectional study conducted among 416 students from class VII, IX and X in two high schools( urban and rural) of West Bengal, India selected by Multistage random sampling. A self administered anonymous pretested close ended questionnaire was used with the main outcome measures of initiation, sources, reasons for continuation of substance use based on WHO study team questionnaire. Results: Prevalence of substance use was found to be higher among the urban students (15.1%) than their rural counterparts (10.7%). The proportion of users was higher in the higher grades as compared to the lower grades. Among urban as well as rural students, 16 years and above were significantly more likely than their counterparts aged 15 years and below to report lifetime use. The mean age of initiation ranged from 12.6 to 13.9 years. Family members and friends were found to have a considerable influence not only on initiation but also important sources for money as well as the substance. Easy availability in the neighborhood was also an important correlate to continuation of substances. Conclusions: Family environment as well as peer groups has an important bearing on initiation and continuation of substance use. Experimentation of substance use motivated by peer groups is common among adolescents and starts early in life. Hence, it is necessary to provide health promotion programs directed toward students and their families which encourage attitude shaping among school children towards self-confidence and adequacy. PMID:21938088

Tribological Behavior of Oil-Lubricated Laser Textured Steel Surfaces in Conformal Flat and Non-Conformal Contacts

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

Kovalchenko, A. M.; Erdemir, A.; Ajayi, O. O.

Changing the surface texture of sliding surfaces is an effective way to manipulate friction and wear of lubricated surfaces. Having realized its potential, we have done very extensive studies on the effects of laser surface texturing (LST, which involves the creation of an array of microdimples on a surface) on friction and wear behavior of oil-lubricated steel surfaces in the early 2000s. In this paper, we reviewed some of our research accomplishments and assessed future directions of the laser texturing field in many diverse industrial applications. Our studies specifically addressed the impact of laser texturing on friction and wear ofmore » both the flat conformal and initial non-conformal point contact configurations using a pin-on-disk test rig under fully-flooded synthetic oil lubricants with different viscosities. Electrical resistance measurement between pin and LST disks was also used to determine the operating lubrication regimes in relation to friction. In conformal contact, we confirmed that LST could significantly expand the operating conditions for hydrodynamic lubrication to significantly much higher loads and slower speeds. In particular, with LST and higher viscosity oils, the low-friction full hydrodynamic regime was shifted to the far left in the Stribeck diagram. Overall, the beneficial effects of laser surface texturing were more pronounced at higher speeds and loads and with higher viscosity oil. LST was also observed to reduce the magnitude of friction coefficients in the boundary regime. For the non-conformal contact configuration, we determined that LST would produce more abrasive wear on the rubbing counterface compared to the untreated surfaces due to a reduction in lubricant fluid film thickness, as well as the highly uneven and rough nature of the textured surfaces. However, this higher initial wear rate has led to faster generation of a conformal contact, and thus transition from the high-friction boundary to lower friction mixed lubrication regime, resulting in a rapid reduction in the friction coefficient with increased ball wear. Higher density of LST, lower oil viscosity, and hardness of counterface steel surface facilitate an increase of the initial wear, which promotes friction reduction. This phenomenon can be beneficial if the initial accelerated wear on the counterface is acceptable in intended applications. This paper summarizes our experimental investigation of the effect of LST on friction properties and lubrication regime transitions in a unidirectional sliding contact.« less

Antiepileptic drug behavioral side effects and baseline hyperactivity in children and adolescents with new onset epilepsy.

PubMed

Guilfoyle, Shanna M; Follansbee-Junger, Katherine; Smith, Aimee W; Combs, Angela; Ollier, Shannon; Hater, Brooke; Modi, Avani C

2018-01-01

To examine baseline psychological functioning and antiepileptic drug (AED) behavioral side effects in new onset epilepsy and determine, by age, whether baseline psychological functioning predicts AED behavioral side effects 1 month following AED initiation. A retrospective chart review was conducted between July 2011 and December 2014 that included youths with new onset epilepsy. As part of routine interdisciplinary care, caregivers completed the Behavior Assessment System for Children, 2nd Edition: Parent Rating Scale to report on baseline psychological functioning at the diagnostic visit and the Pediatric Epilepsy Side Effects Questionnaire to identify AED behavioral side effects at the 1-month follow-up clinic visit following AED initiation. Children (age = 2-11 years) and adolescents (age = 12-18 years) were examined separately. A total of 380 youths with new onset epilepsy (M age  = 8.9 ± 4.3 years; 83.4% Caucasian; 34.8% focal epilepsy, 41.1% generalized epilepsy, 23.7% unclassified epilepsy) were included. Seventy percent of youths had at-risk or clinically elevated baseline psychological symptoms. Children had significantly greater AED behavioral side effects (M = 25.08 ± 26.36) compared to adolescents (M = 12.36 ± 17.73), regardless of AED. Valproic acid demonstrated significantly greater behavioral side effects compared to all other AEDs, with the exception of levetiracetam. Higher hyperactivity/impulsivity at baseline significantly predicted higher AED behavioral side effects 1 month after AED initiation in both age groups. Younger children seem to be more prone to experience behavioral side effects, and these are likely to be higher if youths with epilepsy have baseline hyperactivity/impulsivity. Baseline psychological screening, specifically hyperactivity, can be used as a precision medicine tool for AED selection. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Effect of growth pressure on the morphology evolution and doping characteristics in nonpolar a-plane GaN

NASA Astrophysics Data System (ADS)

Song, Keun Man; Kim, Jong Min; Kang, Bong Kyun; Shin, Chan Soo; Ko, Chul Gi; Kong, Bo Hyun; Cho, Hyung Koun; Yoon, Dae Ho; Kim, Hogyoung; Hwang, Sung Min

2012-02-01

Nonpolar a-plane GaN layers grown on r-plane sapphire substrates were examined by using a two-step growth process. The higher initial growth pressure for the nucleation layer resulted in the improved crystalline quality with lower density of both threading dislocations and basal stacking faults. This was attributed to the higher degree of initial roughening and recovery time via a growth mode transition from three-dimensional (3D) to quasi two-dimensional (2D) lateral growth. Using Hall-effect measurements, the overgrown Si doped GaN layers grown with higher initial growth pressure were found to have higher mobility. The scattering mechanism due to the dislocations was dominant especially at low temperature (<200 K) for the lower initial growth pressure, which was insignificant for the higher initial growth pressure. The temperature-dependent Hall-effect measurements for the Mg doped GaN with a higher initial growth pressure yielded the activation energy and the acceptor concentration to be 128 meV and 1.2 × 1019 cm-3, respectively, corresponding to about 3.6% of activation at room temperature. Two-step growth scheme with a higher initial growth pressure is suggested as a potential method to improve the performance of nonpolar a-plane GaN based devices.

Migration of two antibiotics during resuspension under simulated wind-wave disturbances in a water-sediment system.

PubMed

Li, Shu; Huang, Zheng; Wang, Yi; Liu, Yu-Qing; Luo, Ran; Shang, Jing-Ge; Liao, Qian-Jia-Hua

2018-02-01

In this study, the migration of antibiotics (norfloxacin, NOR; and sulfamethoxazole, SMX) under simulated resuspension conditions across the sediment-water interface were quantified for two locations in China: point A, located in Meiliang Bay of Lake Taihu, and point B, located in Dapukou of Lake Taihu. The concentrations of suspended solids (SS) in the overlying water amounted to 100, 500, and 1000 mg/L during background, moderate, and strong simulated wind-wave disturbances, respectively. At each SS level, the initial concentrations of the two antibiotics were set to 1, 5, and 10 mg/L. The results showed that both resuspended SS and the initial concentration of antibiotics could influence the migration of NOR in the water-sediment system. Specifically, both higher SS and initial antibiotic concentrations were associated with higher rates of migration and accumulation of NOR from water to sediment. In contrast, the migration of SMX in the water-sediment system was not impacted by SS or initial antibiotic concentration. The adsorption capacities of sediments for NOR and SMX were significantly different at both locations, possibly reflecting differences in cation exchange capacity (CEC) and organic material (OM) contents. In general, higher CEC and OM values were found in sediments with a higher adsorption capacity for the antibiotics. When CEC and OM values of sediments were higher, the adsorption capacity reached up to 51.73 mg/kg. Large differences in the migration from water to sediment were observed for the two antibiotics, with NOR migration rates higher than those of SMX. The accumulation of NOR in surface sediment during resuspension was about 14 times higher than that of SMX. The main reason for this is that the chemical adsorption of NOR is seldom reversible. Overall, this study demonstrates that resuspension of NOR and SMX attached to sediments under simulated wind-wave disturbances can promote the migration of the antibiotics from water to sediment; these results could be useful for assessing the migration and fate of commonly used antibiotics in water-sediment systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multigenerational Effects of Heavy Metals on Feeding, Growth, Initial Reproduction and Antioxidants in Caenorhabditis elegans

PubMed Central

Yu, ZhenYang; Zhang, Jing; Yin, DaQiang

2016-01-01

Earlier studies showed that toxicities of excessive metals lasted over generations. Yet, these studies mainly employed one-generation exposure, and the effects of multigenerational challenges need further studies. Presently, Caenorhabditis elegans were exposed to cadmium, copper, lead and zinc for four consecutive generations (G1 to G4) at environmental concentrations. The feeding, growth, initial reproduction, superoxide dismutase (SOD) and catalase (CAT) were determined. All data were represented in the percentage of that in control (POC), and POC in the control was normalized to 100%. In G1 and G2, the POC values in feeding, growth and initial reproduction were generally within 10% of the control (100%), indicating non-significant effects. The POC values in SOD and CAT were significantly higher than 100%, showing stimulatory effects. In G3 and G4, the POC values in feeding, growth and initial reproduction were significantly lower than 100%, showing inhibitory effects which were more severe in G4 than in G3. Meanwhile, SOD and CAT continuously showed stimulatory effects, and the stimulatory effects on SOD increased from G1 to G4. The effects with multigenerational challenges were different from those in one-generation exposure. The effects in later generations demonstrated the importance of multigenerational challenges in judging long-term influences of metals. PMID:27116222

Circulating endothelial cells and their progenitors in acute myeloid leukemia

PubMed Central

Zahran, Asmaa Mohammed; Aly, Sanaa Shaker; Altayeb, Hanan Ahmed; Ali, Arwa Mohammed

2016-01-01

Acute myeloid leukemia (AML) is an aggressive hematological malignancy characterized by the accumulation of immature myeloid progenitor cells in the bone marrow. Studies are required to investigate the prognostic and predictive value of surrogate biomarkers. Given the importance of angiogenesis in oncology in terms of pathogenesis as well as being a target for treatment, circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) are promising candidates to serve as such markers. The aim of the present study was to quantify CECs and EPCs in patients with AML at initial diagnosis and following induction chemotherapy, and to correlate these findings with the response to treatment in AML patients. The present study included 40 patients with de novo AML and 20 age- and gender-matched healthy controls. CECs and EPCs were evaluated by flow cytometry at initial diagnosis and after induction chemotherapy (3+7 protocol for AML other than M3 and all-trans-retinoic acid plus anthracycline for M3 disease). CECs and EPCs were significantly higher in AML patients at diagnosis and after induction chemotherapy than in controls. After induction chemotherapy, CECs and EPCs were significantly decreased compared with the levels at initial diagnosis. Patients who achieved complete response (n=28) had lower initial CEC and EPC levels compared with patients who did not respond to treatment. These results suggest that CEC levels are higher in AML patients and may correlate with disease status and treatment response. Further investigations are required to better determine the predictive value and implication of these cells in AML management. PMID:27602121

Examining Temptation to Drink from an Existential Perspective: Associations among Temptation, Purpose in Life, and Drinking Outcomes

PubMed Central

Roos, Corey R.; Kirouac, Megan; Pearson, Matthew R.; Fink, Brandi C.; Witkiewitz, Katie

2015-01-01

Temptation to drink, defined as the degree to which one feels compelled to drink in the presence of internal or external alcohol-related cues, has been shown to predict alcohol treatment outcomes among individuals with alcohol use disorders (AUDs). Research examining temptation to drink from an existential perspective is lacking and little is known about how existential issues such as purpose in life (PIL) relate to temptation to drink, which is surprising given the role of existential issues in many treatments and mutual help approaches for AUDs. The current study examined the longitudinal associations among temptation to drink, PIL, and drinking outcomes using data from Project MATCH (N = 1726). Parallel process latent growth curve analyses indicated that PIL and temptation to drink were significantly associated across time, such that higher initial levels of PIL and increases in PIL over time were associated with lower initial levels of temptation to drink and decreases in temptation to drink over time. Higher initial levels of temptation to drink, lower initial levels of PIL, increases in temptation to drink, and decreases in PIL were significantly associated with greater intensity and frequency of drinking and greater drinking-related consequences at the 15-month follow-up. Accordingly, temptation to drink and PIL may be important constructs for clinicians to consider throughout the course of treatment. Future studies should examine if and how various kinds of treatments for AUDs are associated with increases in PIL, and whether these increases are related to decreased temptation to drink and reduced drinking. PMID:25730630

Replication RCT of Early Universal Prevention Effects on Young Adult Substance Misuse

PubMed Central

Spoth, Richard; Trudeau, Linda; Redmond, Cleve; Shin, Chungyeol

2014-01-01

Objective For many substances, more frequent and problematic use occurs in young adulthood; these types of use are predicted by the timing of initiation during adolescence. We replicated and extended an earlier study examining whether delayed substance initiation during adolescence, resulting from universal preventive interventions implemented in middle school, reduces problematic use in young adulthood. Method Participants were middle school students from 36 Iowa schools randomly assigned to the Strengthening Families Program plus Life Skills Training (SFP 10–14 + LST), LST-only, or a control condition. Self-report questionnaires were collected at 11 time points, including four during young adulthood. The intercept (average level) and rate of change (slope) in young adult frequency measures (drunkenness, alcohol-related problems, cigarettes, and illicit drugs) across ages 19–22 were modeled as outcomes influenced by growth factors describing substance initiation during adolescence. Analyses entailed testing a two-step hierarchical latent growth curve model; models included the effects of baseline risk, intervention condition assignment, and their interaction. Results Analyses showed significant indirect intervention effects on the average levels of all young adult outcomes, through effects on adolescent substance initiation growth factors, along with intervention by risk interaction effects favoring the higher-risk subsample. Additional direct effects on young adult use were observed in some cases. Relative reduction rates were larger for the higher-risk subsample at age 22, ranging from 5.8% to 36.4% on outcomes showing significant intervention effects. Conclusions Universal preventive interventions implemented during early adolescence have the potential to decrease the rates of substance use and associated problems, into young adulthood. PMID:24821095

Abiotic and biotic dynamics during the initial stages of high solids switchgrass degradation.

PubMed

Fontenelle, L T; Corgie, S C; Walker, L P

2011-07-01

An understanding of the underlying dynamics of how biotic variables drive changes in abiotic parameters in the early stages of biomass biodegradation is essential for better control of the process. Probe hybridization was used to quantitatively study the growth of bacteria, yeast and fungi for three levels of initial moisture content (60, 65 and 75% MC) over a period of 64 h. Changes in abiotic parameters were also documented. By 64 h, samples were significantly differentiated both in temporal and spatial dimension, proving that considerable changes had occurred in these initial stages. Maximum carbon (C) conversion occurred in the 75% MC reactor at a peak value of 49%, with 40% and 37% in the 65 and 60% MC reactors, respectively. Higher temperature, higher pH, higher rates of O2 consumption and CO2 evolution were also observed in the highest moisture reactor; suggesting that of the three MCs studied, 75% MC was the optimal one for the process. MC during the process also proved to be important because it greatly influenced variation in the spatial dimension, further underscoring the importance of characterizing changes with bed height. Most importantly, we were able to positively correlate the rate of substrate degradation with bacterial biomass levels and highlight the critical role of bacteria in biological decomposition.

Predictors of Energy Compensation during Exercise Interventions: A Systematic Review

PubMed Central

Riou, Marie-Ève; Jomphe-Tremblay, Simon; Lamothe, Gilles; Stacey, Dawn; Szczotka, Agnieszka; Doucet, Éric

2015-01-01

Weight loss from exercise-induced energy deficits is usually less than expected. The objective of this systematic review was to investigate predictors of energy compensation, which is defined as body energy changes (fat mass and fat-free mass) over the total amount of exercise energy expenditure. A search was conducted in multiple databases without date limits. Of 4745 studies found, 61 were included in this systematic review with a total of 928 subjects. The overall mean energy compensation was 18% ± 93%. The analyses indicated that 48% of the variance of energy compensation is explained by the interaction between initial fat mass, age and duration of exercise interventions. Sex, frequency, intensity and dose of exercise energy expenditure were not significant predictors of energy compensation. The fitted model suggested that for a shorter study duration, lower energy compensation was observed in younger individuals with higher initial fat mass (FM). In contrast, higher energy compensation was noted for younger individuals with lower initial FM. From 25 weeks onward, energy compensation was no longer different for these predictors. For studies of longer duration (about 80 weeks), the energy compensation approached 84%. Lower energy compensation occurs with short-term exercise, and a much higher level of energy compensation accompanies long-term exercise interventions. PMID:25988763

UV-Induced Triggering of a Biomechanical Initiation Switch within Collagen Promotes Development of a Melanoma-Permissive Microenvironment in the Skin

DTIC Science & Technology

2013-09-01

part, on the generation of reactive oxygen species. Surprisingly, while cell adhesion to UVB -irradiated MatrigelTM and collagen was higher than that to...non-irradiated substrates, migration was significantly inhibited. Moreover, UVB -induced cell adhesion to irradiated substrates was not significantly...altered by irradiation of these substrates in the presence of SOD suggesting that UVB -irradiation may cause exposure of a distinct subset of the

Mechanical and Histological Effects of Resorbable Blasting Media Surface Treatment on the Initial Stability of Orthodontic Mini-Implants

PubMed Central

2016-01-01

Introduction. This study aimed to evaluate the effects of resorbable blasting media (RBM) treatment on early stability of orthodontic mini-implants by mechanical, histomorphometric, and histological analyses. Methods. Ninety-six (64 for mechanical study and 32 for histological study and histomorphometric analysis) titanium orthodontic mini-implants (OMIs) with machined (machined group) or RBM-treated (CaP) surface (RBM group) were implanted in the tibiae of 24 rabbits. Maximum initial torque (MIT) was measured during insertion, and maximum removal torque (MRT) and removal angular momentum (RAM) were measured at 2 and 4 weeks after implantation. Bone-to-implant contact (BIC) and bone area (BA) were analyzed at 4 weeks after implantation. Results. RBM group exhibited significantly lower MIT and significantly higher MRT and RAM at 2 weeks than machined group. No significant difference in MRT, RAM, and BIC between the two groups was noted at 4 weeks, although BA was significantly higher in RBM group than in machined group. RBM group showed little bone resorption, whereas machined group showed new bone formation after bone resorption. Conclusions. RBM surface treatment can provide early stability of OMIs around 2 weeks after insertion, whereas stability of machined surface OMIs may decrease in early stages because of bone resorption, although it can subsequently recover by new bone apposition. PMID:26942200

Trunk's natural inclination influences stance limb kinetics, but not body kinematics, during gait initiation in able men.

PubMed

Leteneur, Sébastien; Simoneau, Emilie; Gillet, Christophe; Dessery, Yoann; Barbier, Franck

2013-01-01

The imposing mass of the trunk in relation to the whole body has an important impact on human motion. The objective of this study is to determine the influence of trunk's natural inclination--forward (FW) or backward (BW) with respect to the vertical--on body kinematics and stance limb kinetics during gait initiation.Twenty-five healthy males were divided based on their natural trunk inclination (FW or BW) during gait initiation. Instantaneous speed was calculated at the center of mass at the first heel strike. The antero-posterior impulse was calculated by integrating the antero-posterior ground reaction force in time. Ankle, knee, hip and thoraco-lumbar (L5) moments were calculated using inverse dynamics and only peaks of the joint moments were analyzed. Among all the investigated parameters, only joint moments present significant differences between the two groups. The knee extensor moment is 1.4 times higher (P<0.001) for the BW group, before the heel contact. At the hip, although the BW group displays a flexor moment 2.4 times higher (P<0.001) before the swing limb's heel-off, the FW group displays an extensor moment 3.1 times higher (P<0.01) during the swing phase. The three L5 extensor peaks after the toe-off are respectively 1.7 (P<0.001), 1.4 (P<0.001) and 1.7 (P<0.01) times higher for the FW group. The main results support the idea that the patterns described during steady-state gait are already observable during gait initiation. This study also provides reference data to further investigate stance limb kinetics in specific or pathologic populations during gait initiation. It will be of particular interest for elderly people, knowing that this population displays atypical trunk postures and present a high risk of falling during this forward stepping.

Nurse-led HIV services and quality of care at health facilities in Kenya, 2014-2016.

PubMed

Rabkin, Miriam; Lamb, Matthew; Osakwe, Zainab T; Mwangi, Peter R; El-Sadr, Wafaa M; Michaels-Strasser, Susan

2017-05-01

To develop a novel measure to characterize human immunodeficiency virus (HIV) programme quality at health facilities in Kenya and explore its associations with patient- and facility-level characteristics. We developed a composite indicator to measure quality of HIV care, comprising: assessment of eligibility for antiretroviral therapy (ART); initiation of ART; and retention on ART or in care, if ineligible for ART, for 12 months. We applied the comprehensive retention indicator to routinely collected clinical data from 13 331 patients enrolled in HIV care and treatment at 63 health facilities in the Eastern and Nyanza regions of Kenya from 1 January 2014 to 31 March 2016. We explored the association between facility- and patient-level characteristics and the primary outcome: appropriate staging and management of HIV, and retention in care over 12 months. Of the enrolled patients, 8404 (63%) achieved comprehensive retention 12 months after enrolment in care. In univariate analyses, patients at facilities where nurses delivered HIV treatment services (including eligibility assessment, initiation and follow up of ART) had significantly higher comprehensive retention rates at 12 months. In multivariate analyses, after adjusting for both facility- and patient-level characteristics, patients at facilities where nurses initiated ART had significantly higher comprehensive retention in care at 12 months (relative risk, RR: 1.22; 95% confidence interval, CI: 1.00-1.48). Nurse-led HIV services were significantly associated with quality of care, confirming the central role of nurses in the achievement of global health goals, and the need for further investment in nursing education, training and mentoring.

Initiation of growth hormone therapy in idiopathic short stature: do gender differences exist?

PubMed

Ben-Ari, Tal; Lebenthal, Yael; Phillip, Moshe; Lazar, Liora

2015-01-01

Growth hormone (GH) registries indicate that boys receive preferential GH treatment for idiopathic short stature (ISS). The aim was to determine whether age, auxological parameters, pubertal status, and target height differ between genders at GH initiation. Review of the computerized files of the endocrine department of a tertiary pediatric medical center identified 184 patients who started GH therapy for ISS between 2003-2011. Data on auxologic parameters, predicted height, parental height, and pubertal status were collected and compared between boys and girls. Boys accounted for a significantly higher percentage of the study group (65.8%, p<0.001). At onset of GH therapy, there were no significant differences between boys and girls in age (10.2±3.1 vs. 9.9±2.4 years), height-standard deviation score (SDS) (-2.64±0.5 vs. -2.79±0.5), body mass index-SDS[(-0.65±1.01) vs. (-0.80±1.13)], or pubertal status (66% vs. 63.5% prepubertal). Predicted height-SDS was significantly higher in boys (-1.95±1.05 vs. -2.56±0.73, p<0.001). Midparental height-SDS was similar in the two groups, as were paternal and maternal height. The similar age, height deficit, and pubertal status at onset of GH treatment in boys and girls suggests that gender differences do not exist. Male predominance may stem from family preferences to treat boys. Future studies are warranted to assess the psychosocial aspects in the decision to initiate therapy.

Primary Realignment for Pelvic Fracture Urethral Injury Is Associated With Prolonged Time to Urethroplasty and Increased Stenosis Complexity.

PubMed

Horiguchi, Akio; Shinchi, Masayuki; Masunaga, Ayako; Okubo, Kazuki; Kawamura, Kazuki; Ojima, Kenichiro; Ito, Keiichi; Asano, Tomohiko; Azuma, Ryuichi

2017-10-01

To compare the clinical courses of patients with pelvic fracture urethral injury (PFUI) according to initial management strategy. We reviewed the clinical courses of 63 patients with PFUI who were initially treated elsewhere and underwent delayed anastomotic urethroplasty by a single surgeon between 2008 and 2015. Patients were grouped according to their initial treatment: by suprapubic tube placement alone (49 patients, SPT group) or primary realignment (14 patients, PR group). Time to urethroplasty was defined as the period between injury and delayed urethroplasty. Clinical data regarding the status of urethral stenosis, urethroplasty procedure, and treatment outcome were analyzed. The mean time to urethroplasty in the PR group was about 3 times than that in the SPT group (133 months vs 47 months, P = .035). Fifty percent of the PR group (7 of 14) had a history of repeated urethrotomy or dilation before referral, a percentage significantly higher than that of the SPT group (20.4%, 10 of 49, P = .027). The percentage of patients having a false passage and iatrogenic scar was significantly higher in the PR group (42.9% vs 16.3%, P = .035), but there was no significant between-group difference in urethral stenosis length, operative time, operative blood loss, or the percentage of patients requiring inferior pubectomy or urethral rerouting. PR does not facilitate delayed urethroplasty, and patients who undergo PR are at high risk of having a more complicated stenosis and longer time to urethroplasty, presumably because of repeated transurethral procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Effects of dietary carbohydrates sources on lipids compositions in abalone, Haliotis discus hannai Ino

NASA Astrophysics Data System (ADS)

Wang, Weifang; Mai, Kangsen; Zhang, Wenbing; Xu, Wei; Ai, Qinghui; Yao, Chunfeng; Li, Huitao

2009-09-01

A study was conducted to evaluate the effects of dietary carbohydrates on triglyceride, cholesterol and fatty acid concentrations in abalone, Haliotis discus hannai Ino. Six semi-purified diets with different carbohydrates (dextrin, heat-treated wheat starch, wheat starch, corn starch, tapioca starch and potato starch, respectively), all containing a carbohydrate level of 33.5%, were fed to abalone (initial shell length: 29.98 mm ± 0.09 mm; initial weight: 3.42 g ± 0.02 g) for 24 weeks in a recirculation system. The results indicate that serum triglyceride concentrations were significantly ( P < 0.05) higher in the abalone fed with dextrin, heat-treated wheat starch and wheat starch than those fed with corn starch, and serum cholesterol concentrations were significantly ( P < 0.05) higher in the abalone fed with dextrin, heat-treated wheat starch than those fed with corn starch. Fatty acid C20:4n-6 in the foot muscles were significantly ( P < 0.05) lower in the abalone fed with dextrin than those fed with wheat starch, corn starch, tapioca starch and potato starch. Fatty acid C20:4n-6 in hepatopancreas was significantly ( P < 0.05) lower in abalone fed with heat-treated wheat starch than those fed with corn starch, tapioca starch and potato starch. Fatty acid C22:6n-3 in the foot muscles were significantly ( P < 0.05) lower in the abalone fed with dextrin and heat-treated wheat starch than those fed with wheat starch and potato starch.

An initial evaluation of the Social Communication Questionnaire for the assessment of autism spectrum disorders in children with Down syndrome.

PubMed

Magyar, Caroline I; Pandolfi, Vincent; Dill, Charles A

2012-02-01

This study investigated the psychometric properties of the Social Communication Questionnaire (SCQ) in a sample of children with Down syndrome (DS), many of whom had a co-occurring autism spectrum disorder (ASD). The SCQ is a widely used ASD screening measure; however, its measurement properties have not been comprehensively evaluated specifically in children with DS, a group that seems to be at higher risk for an ASD. Exploratory and confirmatory factor analyses, scale reliability, convergent and discriminant correlations, significance tests between groups of children with DS and DS + ASD, and diagnostic accuracy analyses were conducted. Factor analyses identified 2 reliable factors that we labeled Social-Communication and Stereotyped Behavior and Unusual Interests. Pearson correlations with Autism Diagnostic Interview-Revised subscales indicated support for the SCQ's convergent validity and some support for the discriminant validity of the factor-based scales. Significance tests and receiver operating characteristic analyses indicated that children with DS + ASD obtained significantly higher SCQ factor-based and total scores than children with DS alone, and that the SCQ Total Score evidenced good sensitivity and adequate specificity. Results indicated initial psychometric support for the SCQ as an ASD screening measure in children with DS. The SCQ should be considered as part of a multimethod evaluation when screening children with DS.

A retrospective study evaluating the tolerability and effectiveness of adjunctive antihypertensive drugs in patients with inadequate response to initial treatment.

PubMed

Ayyagari, Rajeev; Xie, Jipan; Cheng, David; Wu, Eric Q; Huang, Xing-Yue; Chen, Stephanie

2018-06-01

Real-world tolerability and effectiveness of nebivolol as first add-on therapy were compared with hydrochlorothiazide, metoprolol, and amlodipine. Medical records of hypertensive adults initiating nebivolol, hydrochlorothiazide, metoprolol, or amlodipine as first add-on therapy between December 16, 2010 and July 21, 2011 were retrospectively abstracted (N = 1600; 400/treatment). Outcomes included medication-related side-effect rates and blood pressure (BP) reduction and control. Compared with nebivolol, metoprolol and amlodipine had significantly higher side-effect rates (incidence rate ratio [95% CI]: 1.82 [1.14-2.92] and 2.67 [1.69-4.21]), respectively); the hydrochlorothiazide-nebivolol rate ratio was not significant (1.61 [0.95-2.71]). All treatments reduced BP at 2 months. Metoprolol, amlodipine, and hydrochlorothiazide were associated with significantly lower odds of achieving 2-month BP control than nebivolol (odds ratios [95% CI]: 0.34 [0.23-0.51], 0.51 [0.35-0.75] and 0.66 [0.44-0.99], respectively). In a real-world setting, nebivolol as first add-on therapy was associated with fewer side effects than metoprolol or amlodipine and with a higher BP control rate than hydrochlorothiazide, metoprolol, or amlodipine. © 2018 The Authors. The Journal of Clinical Hypertension Published by Wiley Periodicals, Inc.

Cost-Cutting in Higher Education: Lessons Learned from Collaboration, Technology, and Outsourcing Initiatives. Draft.

ERIC Educational Resources Information Center

Kaganoff, Tessa

This document presents a review of cost-containment initiatives relevant to higher education institutions. Originally commissioned to examine cost containment initiatives carried out by institutions affiliated with the Foundation for Independent Higher Education (FIHE), the paper was expanded to include a sector-wide review of three types of…

Initiation and Retention in Couples Outpatient Treatment for Parents with Drug and Alcohol Use Disorders

PubMed Central

Braitman, Abby L.; Kelley, Michelle L.

2016-01-01

The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy (BCT). Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, if they were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported less intimate partner victimization, if they sought treatment for both alcohol and drug use disorder, if they were older when they first suspected a substance use problem, and if they were more obsessive-compulsive, more phobic anxious, less hostile, and experienced less somatization and less paranoid ideation. For women, treatment initiation was associated with less cohesion in their relationships, more somatization, and being older when they first suspected an alcohol or drug use problem. Trends were observed between women’s treatment retention and being older, experiencing more somatization, and suspecting drug-related problems when they were younger; however, no predictors reached statistical significance for women. Results suggest that different factors may be associated with men and women’s willingness to initiate and attend conjoint treatment for substance abuse. PMID:27064819

Fears, Uncertainties, and Hopes: Patient-Initiated Actions and Doctors’ Responses During Oncology Interviews*

PubMed Central

Beach, Wayne A.; Dozier, David M.

2015-01-01

New cancer patients frequently raise concerns about fears, uncertainties, and hopes during oncology interviews. This study sought to understand when and how patients raise their concerns, how doctors responded to these patient-initiated actions, and implications for communication satisfaction. A sub-sampling of video recorded and transcribed encounters was investigated involving 44 new patients and 14 oncologists. Patients completed pre-post self-report measures about fears, uncertainties, and hopes as well as post-evaluations of interview satisfaction. Conversation Analysis (CA) was employed to initially identify pairs of patient-initiated and doctor-responsive actions. A coding scheme was subsequently developed, and two independent coding teams, comprised of two coders each, reliably identified patient-initiated and doctor-responsive social actions. Interactional findings reveal that new cancer patients initiate actions much more frequently than previous research had identified, concerns are usually raised indirectly, and with minimal emotion. Doctors tend to respond to these concerns immediately, but with even less affect, and rarely partner with patients. From pre-post results it was determined that the higher patients’ reported fears, the higher their post-visit fears and lower their satisfaction. Patients with high uncertainty were highly proactive (e.g., asked more questions), yet reported even greater uncertainties following encounters. Hopeful patients also exited interviews with high hopes. Overall, new patients were very satisfied: Oncology interviews significantly decreased patients’ fears and uncertainties, while increasing hopes. Discussion raises key issues for improving communication and managing quality cancer care. PMID:26134261

Measuring behavioral regulation in four societies

PubMed Central

Wanless, Shannon B.; McClelland, Megan M.; Acock, Alan C.; Ponitz, Claire C.; Son, Seung-Hee; Lan, Xuezhao; Morrison, Frederick J.; Chen, Jo-Lin; Chen, Taiwan Fu-Mei; Lee, Taiwan Kangyi; Sung, Miyoung; Li, Su

2010-01-01

The present study examined the psychometric properties of scores from a direct measure of behavioral regulation, the Head-Toes-Knees-Shoulders task (HTKS) with 3- to 6-year-old children in the U.S., Taiwan, South Korea, and China. Specifically, we investigated (1) the nature and variability of HTKS scores including relations to teacher-rated classroom behavioral regulation, and (2) relations between the HTKS and early mathematics, vocabulary, and literacy skills. Higher HTKS scores were significantly related to higher teacher ratings of classroom behavioral regulation in the U.S. and South Korea but not in Taiwan and China. Also, higher HTKS scores were significantly related to higher early mathematics, vocabulary, and literacy skills beyond the influence of demographic variables and teacher-rated classroom behavioral regulation. These initial findings suggest that HTKS scores may be interpreted as reflecting early behavioral regulation in these four societies, and that behavioral regulation is important for early academic success in the U.S. and in Asian countries. PMID:21381840

Tenofovir exposure alters associations of serum bicarbonate with chronic kidney disease risk in HIV-infected veterans.

PubMed

Kim, Julie E; Scherzer, Rebecca; Estrella, Michelle M; Ix, Joachim H; Shlipak, Michael G

2016-04-24

Among HIV-infected persons, tenofovir disoproxil fumarate (TDF) use is associated with higher risk of developing chronic kidney disease (CKD). Because lower serum bicarbonate concentrations may precede CKD onset, this study investigated the associations between TDF use and bicarbonate concentrations, and between bicarbonate with CKD risk among TDF users and nonusers. Retrospective cohort study of 16,070 HIV-infected US veterans who initiated antiretroviral therapy between 1997-2011. The association between TDF use with longitudinal bicarbonate concentrations and associations between bicarbonate with incident CKD stratified by TDF use (never, initial, and later user) were evaluated. Compared with TDF users, never users had faster declines in bicarbonate concentrations: change in bicarbonate -0.11 mmol/l per year (95% confidence interval -0.16, -0.05), compared with -0.04 mmol/l per year (-0.06, 0.05) in initial users and -0.02 mmol/l per year (-0.05, 0.01) in later users. Low baseline bicarbonate (<22 mmol/l) was significantly associated with CKD risk among TDF never users (1.80; 1.21, 2.68), but not among TDF users (0.98; 0.69, 1.38). Similarly, declining bicarbonate concentrations were associated with higher CKD risk among never users (hazard ratio 1.67 per mmol/l; 1.34, 2.08), but not among TDF users (1.09; 0.98, 1.22). Interactions were highly significant for both analyses (P value = 0.001). Despite associations with nephrotoxicity, TDF use was associated with higher serum bicarbonate concentrations longitudinally. Additionally, TDF use obscured the strong associations of bicarbonate with CKD risk in HIV-infected persons. Therefore, the role of bicarbonate concentrations as a tool to monitor kidney health in HIV-infected persons may be limited in the setting of TDF use.

Increased suicide risk and clinical correlates of suicide among patients with Parkinson's disease.

PubMed

Lee, Taeyeop; Lee, Hochang Benjamin; Ahn, Myung Hee; Kim, Juyeon; Kim, Mi Sun; Chung, Sun Ju; Hong, Jin Pyo

2016-11-01

Parkinson's disease (PD) is a debilitating, neurodegenerative condition frequently complicated by psychiatric symptoms. Patients with PD may be at higher risk for suicide than the general population, but previous estimates are limited and conflicting. The aim of this study is to estimate the suicide rate based on the clinical case registry and to identify risk factors for suicide among patients diagnosed with PD. The target sample consisted of 4362 patients diagnosed with PD who were evaluated at a general hospital in Seoul, South Korea, from 1996 to 2012. The standardized mortality ratio for suicide among PD patients was estimated. In order to identify the clinical correlates of suicide, case-control study was conducted based on retrospective chart review. The 29 suicide cases (age: 62.3 ± 13.7 years; females: 34.5%) were matched with 116 non-suicide controls (age: 63.5 ± 9.2 years; females 56.9%) by the year of initial PD evaluation. The SMR for suicide in PD patients was 1.99 (95% CI 1.33-2.85). Mean duration from time of initial diagnosis to suicide among cases was 6.1 ± 3.5 years. Case-control analysis revealed that male, initial extremity of motor symptom onset, history of depressive disorder, delusion, any psychiatric disorder, and higher L-dopa dosage were significantly associated with suicide among PD patients. Other PD-related variables such as UPDRS motor score were not significantly associated with death by suicide. Suicide risk in PD patients is approximately 2 times higher than that in the general population. Psychiatric disorders, and also L-dopa medication need further attention with respect to suicide. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of transfer from hemodialysis on peritoneal dialysis technique survival.

PubMed

Nessim, Sharon J; Bargman, Joanne M; Jassal, S Vanita; Oliver, Matthew J; Na, Yingbo; Perl, Jeffrey

2015-01-01

A significant proportion of peritoneal dialysis (PD) patients receive an initial period of hemodialysis (HD) before transitioning to PD ("PD-switch"). We sought to better understand the risks of PD technique failure (TF) and mortality for those patients compared with patients starting with PD as their first dialysis modality ("PD-first"). Using Canadian Organ Replacement Register data, we compared the risk of PD TF between PD-first and PD-switch patients within the first year after HD initiation. In a secondary analysis, the PD-switch patients were stratified into three groups based on timing of the switch from initial HD to PD as follows: 0 - 90 days, 91 - 180 days, and 181 - 365 days. Each group was compared with PD-first patients for risk of PD TF and death. Between 2001 and 2010, 9404 patients initiated PD as their first renal replacement therapy, and 3757 switched from HD to PD. After multivariable adjustment, the risk of PD TF was higher among PD-switch patients than among PD-first patients [adjusted hazard ratio (AHR): 1.37; 95% confidence interval (CI): 1.26 to 1.49], particularly within the first year after the switch from HD to PD (AHR: 1.51; 95% CI: 1.36 to 1.68). There was no association between time on HD within the first year and subsequent risk of PD TF. For all the stratified PD-switch groups, death rates were higher than those for PD-first patients. Compared with patients who start renal replacement therapy with PD, those who transfer from HD to PD within the first year on dialysis experience higher rates of PD TF and death, with the highest risk being observed in the initial year after the switch to PD. Copyright © 2015 International Society for Peritoneal Dialysis.

Continued importance of family factors in youth smoking behavior.

PubMed

Mahabee-Gittens, E Melinda; Xiao, Yang; Gordon, Judith S; Khoury, Jane C

2012-12-01

Although it is known that levels of family factors (FF) such as parental monitoring and parent-adolescent connectedness vary during adolescence, it is unknown which factors remain protective, preventing smoking initiation, in youth of differing racial/ethnic groups. Using a longitudinal, nationally representative sample, we examined which FF protect against smoking initiation in White, Black, and Hispanic youth. A total of 3,473 parent-nonsmoking youth dyads from Round 1 (T1) of the National Survey of Parents and Youth were followed to Round 3 (T2). Youth smoking status at T2 was assessed as the primary outcome. We examined changes in FF (T2 - T1) and the protection afforded by these factors at T1 and T2 for smoking initiation, both by race/ethnicity and overall. There were statistically significant decreases in levels of protective FF from T1 to T2 across all racial/ethnic groups; however, FF levels were higher in never-smokers compared with smoking initiators at both T1 and T2 (p < .05). Separate models by race/ethnicity showed the protective effect of increased perceived punishment in all racial/ethnic groups and protection against initiation by increased parental monitoring in Black and Hispanic youth. Overall, higher parental monitoring at T1 was associated with decreased odds of smoking initiation (33%); decreased parental monitoring and perceived punishment from T1 to T2 were associated with increased odds of smoking initiation (55% and 17%, respectively). Smoking prevention interventions should encourage parents to both enforce consistent consequences of smoking behavior, and continue monitoring, especially in minority groups.

Correlates of HPV vaccine initiation and provider recommendation among male adolescents, 2014 NIS-Teen.

PubMed

Landis, Kathryn; Bednarczyk, Robert A; Gaydos, Laura M

2018-05-08

Vaccination is a safe and effective way to prevent Human Papillomavirus (HPV) infection and related cancers; however, HPV vaccine uptake remains low in the US. After the 2011 Advisory Committee on Immunization Practices (ACIP) recommendation for routine HPV vaccination of adolescent males, several studies have examined predictors for initiating the vaccine series in this population of interest, particularly with regard to provider recommendations. This study examined racial and ethnic differences for HPV vaccine initiation and provider recommendation in male adolescents. Based on prior HPV vaccine uptake estimates and healthcare utilization data, we hypothesized that minority adolescents would be more likely to initiate HPV vaccines, but less likely to receive a provider recommendation compared to white counterparts. We analyzed the 2014 National Immunization Survey-Teen (NIS-Teen), which included 10,753 male adolescents with provider-verified vaccination data in 50 US states, using multivariate logistic regression models to evaluate racial/ethnic differences in HPV vaccine initiation and provider recommendation. The odds of HPV vaccine initiation were 76 percent higher for Hispanic adolescents and 43 percent higher for non-Hispanic Other or Multiple race adolescents compared to white adolescents. Approximately half of parents reported receiving a provider recommendation for vaccination, with no significant difference in the odds of receiving a provider recommendation across racial/ethnic groups. Despite similar frequency of recommendations across racial and ethnic groups, male adolescents who are racial/ethnic minorities are more likely to initiate vaccination. Future research should focus on developing tailored interventions to increase HPV vaccine receipt among males of all racial/ethnic groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

Longitudinal effects of hostility, depression, and bullying on adolescent smoking initiation.

PubMed

Weiss, Jie W; Mouttapa, Michele; Cen, Steven; Johnson, C Anderson; Unger, Jennifer

2011-06-01

The present study examined the associations between smoking initiation and, hostility, depressive symptoms, and bullying (bullies and bully-victims) among a culturally diverse sample of 1,771 adolescents who reported never having smoked at baseline. Data were obtained from a longitudinal school-based experimental trial of smoking prevention programs in Southern California. Annual survey was performed for students of the sixth, seventh, and eighth grades. All students in the 24 participating schools were invited to participate in the study during the sixth grade. The risk of smoking initiation was significantly higher among students who scored higher on hostility and depressive symptoms, and were bully-victims. The findings suggest that tobacco prevention programs should include strategies for managing hostile feelings and negative effect as part of the curriculum. In addition, it might be helpful to identify youth who score high on these psychosocial factors and teach them skills to handle interpersonal conflict and negative feelings to prevent their involvement in substance use. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Do infants perceive the social robot Keepon as a communicative partner?

PubMed

Peca, Andreea; Simut, Ramona; Cao, Hoang-Long; Vanderborght, Bram

2016-02-01

This study investigates if infants perceive an unfamiliar agent, such as the robot Keepon, as a social agent after observing an interaction between the robot and a human adult. 23 infants, aged 9-17 month, were exposed, in a first phase, to either a contingent interaction between the active robot and an active human adult, or to an interaction between an active human adult and the non-active robot, followed by a second phase, in which infants were offered the opportunity to initiate a turn-taking interaction with Keepon. The measured variables were: (1) the number of social initiations the infant directed toward the robot, and (2) the number of anticipatory orientations of attention to the agent that follows in the conversation. The results indicate a significant higher level of initiations in the interactive robot condition compared to the non-active robot condition, while the difference between the frequencies of anticipations of turn-taking behaviors was not significant. Copyright © 2015 Elsevier Inc. All rights reserved.

Associations Between Peer Counseling and Breastfeeding Initiation and Duration: An Analysis of Minnesota Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

PubMed

McCoy, Marcia Burton; Geppert, Joni; Dech, Linda; Richardson, Michaela

2018-01-01

Background Peer counseling (PC) has been associated with increased breastfeeding initiation and duration, but few analyses have examined the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) model for peer counseling or the continuation of breastfeeding from birth through 12 months postpartum. Objectives Identify associations between Minnesota WIC Peer Breastfeeding Support Program services and breastfeeding initiation and continuation. Methods Retrospective analysis of observational data from the Minnesota WIC program's administrative database of women who gave birth in 2012 and accepted a PC program referral prenatally (n = 2219). Multivariate logistic regression and Cox regression models examined associations between peer services and breastfeeding initiation and continuation of any breastfeeding. Results Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19-2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33-0.61; months two through twelve: 0.33; 95% CI 0.18-0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother's country of origin. Conclusion for practice Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.

Programmed initiation of hemodialysis for systemic amyloidosis patients associated with rheumatoid arthritis.

PubMed

Kuroda, Takeshi; Tanabe, Naohito; Kobayashi, Daisuke; Sato, Hiroe; Wada, Yoko; Murakami, Shuichi; Sakatsume, Minoru; Nakano, Masaaki; Narita, Ichiei

2011-09-01

Reactive amyloidosis is a serious systemic disease in rheumatoid arthritis (RA). Amyloid protein can be deposited in kidneys, heart or gastrointestinal tract leading to organ failure. Renal involvement is a well-known complication in amyloidosis as this may culminate in end-stage renal disease (ESRD). Hemodialysis (HD) is always considered the treatment of choice for such patients; however, the prognosis is usually poor due to a large number of sudden deaths immediately following HD therapy. To circumvent the problem of HD initiation while instituting HD safety, we devised a plan to start HD and compare patient's survival with our previous data. Sixty-three patients were treated with HD. They were categorized according to the initiation of first dialysis. All patients were divided into planned, unplanned and programmed initiation groups. First dialysis that had been initiated as not urgent was considered 'planned' (20 patients). First dialysis that had been performed urgently for life-threatening renal insufficiency was considered 'unplanned' (31 patients). First dialysis that had been initiated as not urgent and according to our dialysis program was considered 'programmed' (12 patients). Survival of these 63 patients from the initiation of HD at 38 days was 75%, at 321 days was 50% and at 1,784 days was 25%. Patients with unplanned initiation of HD showed a significant poor survival compared with those of both planned and programmed initiation. Additionally, patients with planned and programmed initiation of HD showed no significant difference for the patients' survival. Our study demonstrates that patients with amyloidosis have a higher mortality rate. Nevertheless, programmed initiation of HD will improve the prognosis of patients with ESRD. Such possibility needs to be considered in more detail in the future.

Let Us Use LET: A Quality Improvement Initiative.

PubMed

Sherman, Joshua M; Sheppard, Patrick; Hoppa, Eric; Krief, William; Avarello, Jahn

2016-07-01

Well-managed pain is associated with faster recovery, fewer complications, and decreased use of resources. In children, pain relief is also associated with higher patient and parent satisfaction. Studies have shown that there are deficiencies in pediatric pain management. LET gel (lidocaine 4%, epinephrine 0.1%, and tetracaine 0.5%) is a topical anesthetic that is routinely used before laceration repair. The aim of this study was to determine if educational initiatives as part of a quality improvement initiative lead to increased rates of early topical anesthetic usage in a large urban pediatric emergency department. The initiative consisted of an educational session and a triage booth poster. We then reviewed the charts of patients with facial and scalp lacerations for the month before the initiative, the month after the initiative, and 1 year after the initiative. We assessed if LET gel usage and time to administration improved and were sustainable. We reviewed 138 charts. Before the initiative, only 57.4% received LET gel before facial laceration repair with a mean time to application of 58.3 minutes. One month after the initiative, there was an increase in LET gel application by 20.1% with a reduction in time to application by 35.9 minutes (P < 0.05). In addition, these improvements were significantly sustainable. One year after the interventions, 82.4% received LET before facial laceration repair, and the time to LET application was 27.8 minutes. Simple educational initiatives can improve the use of topical anesthetics. By using educational tools as part of a quality improvement initiative, we were able to significantly improve the rates of LET gel application for facial lacerations in children and decrease the time to administration.

Theory-Based Evaluation of a Comprehensive Latino Education Initiative: An Interactive Evaluation Approach

ERIC Educational Resources Information Center

Nesman, Teresa M.; Batsche, Catherine; Hernandez, Mario

2007-01-01

Latino student access to higher education has received significant national attention in recent years. This article describes a theory-based evaluation approach used with ENLACE of Hillsborough, a 5-year project funded by the W.K. Kellogg Foundation for the purpose of increasing Latino student graduation from high school and college. Theory-based…

School Direct: A Hastily Constructed Model or a Systematically Designed Campaign?

ERIC Educational Resources Information Center

Kelly, Clare; Pitfield, Maggie

2013-01-01

This article examines School Direct, a model of initial teacher education (ITE) in England, recently introduced by the coalition government and based on a paradigm of teaching as a craft to be learned as an apprenticeship, significantly reducing and in some cases removing the influence of higher education. The history of the move away from…

Thoughts on History, Tuning and the Scholarship of Teaching and Learning in the United States

ERIC Educational Resources Information Center

Pace, David

2017-01-01

The Tuning Movement and the scholarship of teaching and learning have each had a significant impact on teaching history in higher education in the United States. But the isolation of these initiatives from each other has lessened their potential impact. Interactions between the two might bring together the intellectual exploration of scholarship…

The Disciplinary Literacy Discussion Matrix: A Heuristic Tool for Initiating Collaboration in Higher Education

ERIC Educational Resources Information Center

Airey, John

2011-01-01

In this paper I address the issue of collaboration between content lecturers and language lecturers or educational researchers. Whilst such collaboration is a desirable goal for disciplinary learning in monolingual settings, I suggest it takes on extra significance when two or more languages are involved in teaching and learning a discipline.…

Impact of Online Summer Mathematics Bridge Program on Placement Scores and Pass Rates

ERIC Educational Resources Information Center

Frost, Jodi L.; Dreher, J. P.

2017-01-01

An online four-week summer mathematics bridge program was implemented at a Midwest university with historically low pass rates in College Algebra and Remedial Mathematics. Students who completed the four week program significantly increased their mathematics placement exam scores. These students also had a higher pass rate in their initial college…

The Longitudinal Course of Depression in Adoptive and Birth Mothers of Children with Intellectual Disabilities

ERIC Educational Resources Information Center

Glidden, Laraine M.; Jobe, Brian M.

2006-01-01

This report extends by an additional 6 years the longitudinal research of Glidden and Schoolcraft, who found that adoptive mothers of children with intellectual disabilities displayed low depression at the initial time of adoption and thereafter, whereas birth mothers reported significantly higher levels when their children were first diagnosed,…

"It's Making Contacts": Notions of Social Capital and Implications for Widening Access to Medical Education

ERIC Educational Resources Information Center

Nicholson, S.; Cleland, J. A.

2017-01-01

In the UK widening access (WA) activities and policies aim to increase the representation from lower socio-economic groups into Higher Education. Whilst linked to a political rhetoric of inclusive education such initiatives have however failed to significantly increase the number of such students entering medicine. This is compounded by a…

The European Institute of Technology and the Europe of Knowledge: A Research Agenda

ERIC Educational Resources Information Center

Jones, Peter D.

2008-01-01

This paper explores the development and significance of the European Institute of Technology (EIT) in the period since 2005 when the European Union launched a suite of initiatives for higher education, research and innovation, including the EIT, as part of attempts to re-launch its Lisbon Strategy around a "growth and jobs" agenda. The…

Human Capital--Economic Growth Nexus in the Former Soviet Bloc

ERIC Educational Resources Information Center

Osipian, Ararat L.

2007-01-01

This study analyses the role and impact of higher education on per capita economic growth in the Former Soviet Bloc. It attempts to estimate the significance of educational levels for initiating substantial economic growth that now takes place in these two countries. This study estimates a system of linear and log-linear equations that account for…

Healthcare utilization and costs for patients initiating Dabigatran or Warfarin.

PubMed

Reynolds, Shannon L; Ghate, Sameer R; Sheer, Richard; Gandhi, Pranav K; Moretz, Chad; Wang, Cheng; Sander, Stephen; Costantino, Mary E; Annavarapu, Srinivas; Andrews, George

2017-06-21

Novel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population. A retrospective matched-cohort study was conducted using data from administrative health care claims during the study period 01/01/2010-12/31/2012. Cox regression analyses were used to compare all-cause risk of first hospitalizations and emergency room (ER) visits. Medical, pharmacy, and total costs per-patient-per-month (PPPM) were compared between dabigatran and warfarin users. A total of 1110 patients initiated on dabigatran were propensity score-matched with corresponding patients initiated on warfarin. The mean number of hospitalizations (0.92 vs. 1.13, P = 0.012), ER visits (1.32 vs. 1.56, P < 0.01), office visits (21.43 vs. 29.41; P < 0.01), and outpatient visits (10.86 vs. 22.02; P < 0.01) were lower among dabigatran compared to warfarin users. Patients initiated on dabigatran had significantly lower risk of first all-cause ER visits [hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.73-0.98] compared to those initiated on warfarin. Adjusted mean pharmacy costs PPPM were significantly greater for dabigatran users ($510 vs. $250, P < 0.001); however, mean medical costs PPPM ($1912 vs. $1956, P = 0.55) and mean total costs PPPM ($2381 vs. $2183, P = 0.10) were not significantly different compared to warfarin users. Dabigatran users had significantly lower HCRU compared to warfarin users. In addition, dabigatran users had lower risk of all-cause ER visits. Despite higher pharmacy costs, the two cohorts did not differ significantly in medical or total all-cause costs.

Incentivizing advanced mathematics study at upper secondary level: the case of bonus points in Ireland

NASA Astrophysics Data System (ADS)

Treacy, Páraic Thomas

2018-04-01

Secondary level mathematics education in Ireland has recently experienced a period of significant change with the introduction of new curricula and the addition of an incentive to study upper secondary mathematics at the most advanced level (Higher Level). This incentive, typically referred to as 'bonus points', appears to have aided a significant increase in the number of students studying upper secondary mathematics at Higher Level. However, thematic analysis of interviews with experienced upper secondary mathematics examiners and exploration of mathematics diagnostic test data outlined in this paper suggest that the difficulty of the Higher Level upper secondary mathematics final examination in Ireland has reduced since the introduction of the bonus points initiative. The sharp increase in students attempting this examination coupled with a policy of maintaining a consistent proportion of students achieving passing grades was identified as a key reason for this possible reduction in standards.

Abuse, Nocturnal Stress Hormones, and Coronary Heart Disease Risk Among Women with HIV

PubMed Central

Dale, Sannisha K.; Weber, Kathleen M.; Cohen, Mardge H.; Brody, Leslie R.

2017-01-01

This study investigated the relationships among abuse, nocturnal levels of cortisol and norepinephrine (NE), and coronary heart disease (CHD) risk as measured by the Framingham Risk Score (FRS) among women with HIV. Participants (n=53) from the Chicago Women's Interagency HIV Study, a longitudinal prospective cohort study initiated in 1994, were enrolled in this study during 2012. At WIHS baseline and annual follow-up visits women were asked about recent experiences of abuse. Summary variables captured the proportion of visits for which women reported recent (past 12 months) physical, sexual, and domestic abuse. Cortisol and NE were assayed in overnight urine samples and adjusted for creatinine levels. Recent abuse was not significantly associated with levels of cortisol, NE, or NE/cortisol ratio. However, higher NE/cortisol ratio was significantly related to higher CHD risk score, higher cortisol was significantly related to lower CHD risk score, and NE was not associated with CHD risk score. In addition, higher proportions of visits with recent sexual abuse, physical abuse, and domestic abuse were significantly related to higher CHD risk score. The association between abuse exposure and CHD risk in the context of HIV infection is likely complex and may involve dysregulation of multiple neurobiological systems. Future research is needed to better understand these relationships and prevention and intervention efforts are needed to address abuse among women with HIV. PMID:27733045

Kinetic analysis of Legionella inactivation using ozone in wastewater.

PubMed

Li, Jun; Li, Kunquan; Zhou, Yan; Li, Xuebin; Tao, Tao

2017-02-01

Legionella inactivation using ozone was studied in wastewater using kinetic analysis and modeling. The experimental results indicate that the relationship between the ozone concentration, germ concentration, and chemical oxygen demand (COD) can be used to predict variations in germ and COD concentrations. The ozone reaction with COD and inactivation of Legionella occurred simultaneously, but the reaction with COD likely occurred at a higher rate than the inactivation, as COD is more easily oxidized by ozone than Legionella. Higher initial COD concentrations resulted in a lower inactivation rate and higher lnN/N 0 . Higher temperature led to a higher inactivation efficiency. The relationship of the initial O 3 concentration and Legionella inactivation rate was not linear, and thus, the Ct value required for a 99.99% reduction was not constant. The initial O 3 concentration was more important than the contact time, and a reduction of the initial O 3 concentration could not be compensated by increasing the contact time. The Ct values were compared over a narrow range of initial concentrations; the Ct values could only be contrasted when the initial O 3 concentrations were very similar. A higher initial O 3 concentration led to a higher inflection point value for the lnN/N 0 vs C 0 t curve. Energy consumption using a plasma corona was lower than when using boron-doped diamond electrodes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Metformin selectively affects human glioblastoma tumor-initiating cell viability: A role for metformin-induced inhibition of Akt.

PubMed

Würth, Roberto; Pattarozzi, Alessandra; Gatti, Monica; Bajetto, Adirano; Corsaro, Alessandro; Parodi, Alessia; Sirito, Rodolfo; Massollo, Michela; Marini, Cecilia; Zona, Gianluigi; Fenoglio, Daniela; Sambuceti, Gianmario; Filaci, Gilberto; Daga, Antonio; Barbieri, Federica; Florio, Tullio

2013-01-01

Cancer stem cell theory postulates that a small population of tumor-initiating cells is responsible for the development, progression and recurrence of several malignancies, including glioblastoma. In this perspective, tumor-initiating cells represent the most relevant target to obtain effective cancer treatment. Metformin, a first-line drug for type II diabetes, was reported to possess anticancer properties affecting the survival of cancer stem cells in breast cancer models. We report that metformin treatment reduced the proliferation rate of tumor-initiating cell-enriched cultures isolated from four human glioblastomas. Metformin also impairs tumor-initiating cell spherogenesis, indicating a direct effect on self-renewal mechanisms. Interestingly, analyzing by FACS the antiproliferative effects of metformin on CD133-expressing subpopulation, a component of glioblastoma cancer stem cells, a higher reduction of proliferation was observed as compared with CD133-negative cells, suggesting a certain degree of cancer stem cell selectivity in its effects. In fact, glioblastoma cell differentiation strongly reduced sensitivity to metformin treatment. Metformin effects in tumor-initiating cell-enriched cultures were associated with a powerful inhibition of Akt-dependent cell survival pathway, while this pathway was not affected in differentiated cells. The specificity of metformin antiproliferative effects toward glioblastoma tumor-initiating cells was confirmed by the lack of significant inhibition of normal human stem cells (umbilical cord-derived mesenchymal stem cells) in vitro proliferation after metformin exposure. Altogether, these data clearly suggest that metformin exerts antiproliferative activity on glioblastoma cells, showing a higher specificity toward tumor-initiating cells, and that the inhibition of Akt pathway may represent a possible intracellular target of this effect.

Rates of escalation to triple COPD therapy among incident users of LAMA and LAMA/LABA.

PubMed

Hahn, Beth; Hull, Michael; Blauer-Peterson, Cori; Buikema, Ami R; Ray, Riju; Stanford, Richard H

2018-06-01

Improved outcomes have been reported for patients with chronic obstructive pulmonary disease (COPD) receiving combination long-acting muscarinic antagonist/long-acting β 2 -agonist (LAMA/LABA) therapy compared with LAMA monotherapy. However, little is known about the relative characteristics of these patients and their rates of escalation to triple therapy (TT, combining a LAMA, LABA, and inhaled corticosteroid). This study aimed to characterize patients initiating treatment with the LAMA tiotropium (TIO) and the fixed-dose LAMA/LABA combination therapy umeclidinium/vilanterol (UMEC/VI), and to compare rates of escalation to TT between patients receiving these therapies. Retrospective study of patients with COPD enrolled in a US health insurance plan during 2013-2015 and newly initiated on TIO or UMEC/VI. Patients were ≥40 years of age at index (date of therapy initiation) with continuous enrollment for 12 months pre-index and ≥30 days post-index. LAMA users were propensity score matched 1:1 to LAMA/LABA users, with TT initiation rates reported by cohort using pharmacy claims. 35,357 patients initiating on TIO and 2407 patients initiating on UMEC/VI were identified. After propensity score matching, the rate of TT initiation was significantly higher in new TIO users (n = 1320) than in new UMEC/VI users (n = 1320) (0.92 vs 0.49 per 100 months of exposure, respectively; p < 0.001). Relative to the UMEC/VI cohort, the TIO cohort had an 87% higher risk of TT initiation (hazard ratio: 1.87; 95% confidence interval: 1.4-2.5; p = 0.001). Patients receiving UMEC/VI progressed to TT more slowly, and were at lower risk of progressing to TT, than patients receiving TIO. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improved survival in HIV treatment programs in Asia

PubMed Central

De La Mata, Nicole L; Kumarasamy, Nagalingeswaran; Khol, Vohith; Ng, Oon Tek; Van Nguyen, Kinh; Merati, Tuti Parwati; Pham, Thuy Thanh; Lee, Man Po; Durier, Nicolas; Law, Matthew

2016-01-01

Background Antiretroviral treatment (ART) for HIV-positive patients has expanded rapidly in Asia over the last ten years. Our study aimed to describe the time trends and risk factors for overall survival in patients receiving first-line ART in Asia. Methods We included HIV-positive adult patients who initiated ART between 2003–2013 (n=16 546), from seven sites across six Asia-Pacific countries. Patient follow-up was to May 2014. We compared survival for each country and overall by time period of ART initiation using Kaplan-Meier curves. Factors associated with mortality were assessed using Cox regression, stratified by site. We also summarized first-line ART regimens, CD4 count at ART initiation, and CD4 and HIV viral load testing frequencies. Results There were 880 deaths observed over 54 532 person-years of follow-up, a crude rate of 1.61 (1.51, 1.72) per 100 person-years. Survival significantly improved in more recent years of ART initiation. The survival probabilities at 4 years follow-up for those initiating ART in 2003–05 was 92.1%, 2006–09 was 94.3% and 2010–2013 was 94.5% (p<0.001). Factors associated with higher mortality risk included initiating ART in earlier time periods, older age, male sex, injecting drug use as HIV exposure and lower pre-ART CD4 count. Concurrent with improved survival was increased tenofovir use, ART initiation at higher CD4 counts, and greater monitoring of CD4 and HIV viral load. Conclusions Our results suggest that HIV-positive patients from Asia have improved survival in more recent years of ART initiation. This is likely a consequence of improvements in treatment and, patient management and monitoring over time. PMID:26961354

The role of social networks and media receptivity in predicting age of smoking initiation: a proportional hazards model of risk and protective factors.

PubMed

Unger, J B; Chen, X

1999-01-01

The increasing prevalence of adolescent smoking demonstrates the need to identify factors associated with early smoking initiation. Previous studies have shown that smoking by social network members and receptivity to pro-tobacco marketing are associated with smoking among adolescents. It is not clear, however, whether these variables also are associated with the age of smoking initiation. Using data from 10,030 California adolescents, this study identified significant correlates of age of smoking initiation using bivariate methods and a multivariate proportional hazards model. Age of smoking initiation was earlier among those adolescents whose friends, siblings, or parents were smokers, and among those adolescents who had a favorite tobacco advertisement, had received tobacco promotional items, or would be willing to use tobacco promotional items. Results suggest that the smoking behavior of social network members and pro-tobacco media influences are important determinants of age of smoking initiation. Because early smoking initiation is associated with higher levels of addiction in adulthood, tobacco control programs should attempt to counter these influences.

Can species-specific differences in foliar chemistry influence leaf litter decomposition in grassland species?

NASA Astrophysics Data System (ADS)

Sanaullah, M.; Chabbi, A.; Rumpel, C.

2009-04-01

The influence of litter quality on its rate of decomposition is a crucial aspect of C cycle. In this study we concentrated on grassland ecosystems where leaf litter is one of the major sources of C input. To quantify the contribution of initial leaf chemistry within different plant species, the decomposition of chemically different leaf litter of three grassland species (Lolium perenne, Festuca arundinacea and Dactylis glomerata) was monitored, using the litter bag technique. Litter of different maturity stages i.e. green (fresh leaves) and brown litter (brown leaves were still attached to the plant), were incubated on bare soil surface. Samples were taken at different time intervals (0, 2, 4, 8, 20 and 44 weeks) and were analyzed for mass loss, organic C and N contents and stable isotopic signatures (C and N). Changes in litter chemistry were addressed by determining lignin-derived phenols after CuO oxidation and non-cellulosic polysaccharides after acid hydrolysis followed by gas chromatography. Green litter was chemically different from brown litter due to higher initial N and lower lignin contents. While in grassland species, both L. perenne and D. glomerata were similar in their initial chemical composition compared with F. arundinacea. Green litter showed higher rate of degradation. In green litter, Percent lignin remaining of initial (% OI) followed the similar decomposition pattern as of C remaining indicating lignin as controlling factor in decomposition. Constant Acid-to-Aldehyde ratios of lignin-derived phenols (vanillyl and syringyl) did not suggest any transformation in lignin structures. In green litter, increase in non-cellulosic polysaccharides ratios (C6/C5 and deoxy/C5) proposed microbial-derived sugars, while there was no significant increase in these ratios in brown litter. In conclusion, due to the differences in initial chemical composition (initial N and lignin contents), green litter decomposition was higher than brown litter in all grassland species. Regardless of similarities in initial composition of grassland species, green and brown litter of Lolium perenne decomposed more rapidly compared with other two species. So, Species related differences in initial litter chemistry did not control its degradation.

The effect of mother's educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal Demographic and Health Surveys.

PubMed

Acharya, Pawan; Khanal, Vishnu

2015-10-19

The World Health Organization recommends initiating breastfeeding within the first hour of birth. This study is aimed at assessing the effect of the mother's education on early initiation of breastfeeding. Data from the Nepal Demographic and Health Surveys (NDHS) 2001, 2006 and 2011 were used which included 12,845 last born children born within 5 years before the surveys. Early initiation of breastfeeding was defined as the initiation of breastfeeding within the first hour after birth. Hierarchical modelling was used to ascertain the association of maternal education and early initiation of breastfeeding, after controlling for other covariates in a multiple logistic regression. Maternal education was associated with a higher likelihood of early initiation of breastfeeding in each survey. Pooled data analysis revealed higher odds of early initiation of breastfeeding among the mothers with primary education (adjusted odds ratio (OR) 1.24, 95 % confidence interval (CI): 1.09, 1.42) and secondary or higher education (OR: 1.63 95 % CI: 1.42, 1.88). In the most recent NDHS 2011 survey, odds of early initiation of breastfeeding was higher among mothers with primary education (OR: 1.52; 95 % CI: 1.21, 1.91) and mothers with secondary or higher education (OR: 2.20; 95 % CI: 1.76, 2.76) compared to mothers with no education. Similarly, the odds of early initiation of breastfeeding was higher among mothers with secondary and higher education in the 2006 data (OR: 1.66; 95 % CI: 1.30, 2.12) and in 2001 (OR = 1.30; 95 % CI: 1.00, 1.67). As the association between a mother's educational status and her likelihood of early initiation of breastfeeding increases, long-term approaches to prioritising education for women and girls should be explored. In the short term, uneducated mothers should be targeted with breastfeeding promotion strategies such as counselling and peer education.

Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

PubMed Central

Bui, Quyen Thi-Tu; Lee, Hwa-Young; Le, Anh Thi-Kim; Van Dung, Do; Vu, Lan Thi-Hoang

2016-01-01

Background There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. Objective This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. Design Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes – early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. Results Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02–1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88–1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02–1.13), and those who delivered by Caesarean section were less likely to initiate early BF. Conclusions Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices. PMID:26950562

[Copper recovery from artificial bioleaching lixivium of waste printed circuit boards].

PubMed

Cheng, Dan; Zhu, Neng-Wu; Wu, Ping-Xiao; Zou, Ding-Hui; Xing, Yi-Jia

2014-04-01

The key step to realize metal recovery from bioleaching solutions is the recovery of copper from bioleaching lixivium of waste printed circuit boards in high-grade form. The influences of cathode material, current density, initial pH and initial copper ion concentration on the efficiency and energy consumption of copper recovery from artificial bioleaching lixivium under condition of constant current were investigated using an electro-deposition approach. The results showed that the larger specific surface area of the cathode material (carbon felt) led to the higher copper recovery efficiency (the recovery efficiencies of the anode and the cathode chambers were 96.56% and 99.25%, respectively) and the smaller the total and unit mass product energy consumption (the total and unit mass product energy consumptions were 0.022 kW x h and 15.71 kW x h x kg(-1), respectively). The copper recovery efficiency and energy consumption increased with the increase of current density. When the current density was 155.56 mA x cm(-2), the highest copper recovery efficiencies in the anode and cathode chambers reached 98.51% and 99.37%, respectively. Accordingly, the highest total and unit mass product energy consumptions were 0.037 kW x h and 24.34 kW x h x kg(-1), respectively. The copper recovery efficiency was also significantly affected by the initial copper ion concentration. The increase of the initial copper ion concentration would lead to faster decrease of copper ion concentration, higher total energy consumption, and lower unit mass product consumption. However, the initial pH had no significant effect on the copper recovery efficiency. Under the optimal conditions (carbon felt for cathode materials, current density of 111.11 mA x cm(-2), initial pH of 2.0, and initial copper ion concentration of 10 g x L(-1)), the copper recovery efficiencies of the anode and cathode chambers were 96.75% and 99.35%, and the total and unit mass product energy consumptions were 0.021 kW x h and 14.61 kW x h x kg(-1), respectively. The deposited copper on the cathode material was fascicularly distributed and no oxygen was detected.

Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia

PubMed Central

Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

2016-01-01

Background Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can’t control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Methods Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. Result The incidence rate of treatment failure was found 9.38 (95% CI 7.79–11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61–7.73)].Similarly, lower CD4 count (<100 m3/dl) at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46–5.84).Bedridden [AHR = 5.02; 95% CI: (1.98–12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08–4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72–5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99–9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing treatment failure [AHR = 7.0, 95% CI: (3.19–15.37)]. Similarly having fair [AHR = 4.99 95% CI: (1.90–13.13)] and poor drug adherence [AHR = 2.56; 95% CI: (1.12–5.86)]were significantly associated with higher odds of treatment failure as compared to clients with good adherence. Conclusion The rate of treatment failure in Bale zone hospitals needs attention. Prevention and control of TB and other opportunistic infections, promotion of ART initiation at higher CD4 level, and better functional status, improving drug adherence are important interventions to reduce treatment failure among ART clients in Southeastern Ethiopia. PMID:27716827

[The impact of glucose absorbed from dialysis solution on body weight gain in peritoneal dialysis treated patients].

PubMed

Jakić, Marko; Stipanić, Sanja; Mihaljević, Dubravka; Zibar, Lada; Lovcić, Vesna; Klarić, Dragan; Jakić, Marijana

2005-01-01

A proportion of peritoneal dialysis (PD) patients experience substantial body weight (BW) gain with time. It is caused by fat tissue accumulation or fluid retention. It is believed that fat tissue accumulates due to caloric contribution of glucose absorbed from dialysis solution or to the mitochondrial fat regulatory uncoupling protein (UCP) gene polymorphism. This study examined BW fluctuations in 40 patients (24 females, 16 males), treated by PD at least 36 months (initial mean age 54.50+/-9.00 years, mean BW 68.00+/-8.50 kg and mean height 164.00+/-8.50 cm), relation of the BW fluctuation and caloric contribution of glucose absorbed from dialysis solution and characteristics of the patients with BW gain. Initial BW increased after 6, 12, 24 and 36 months by 5.90+/-3.50 kg, 7.90+/-4.90 kg, 9.50+/-5.00 and 11.00+/-5.00 kg, or for 8.68, 11.62, 13.97 and 16.18% of the initial value, respectively. After the first 6 and 12 months 38 patients gained weight, 39 after 24 and all 40 patients after 36 months. There was not significant correlation between BW gain and caloric contribution of glucose absorbed from dialysis solution. Female patients had initially lower BW, but for the first 12 months period significantly increased BW more than males, and not for the other observed periods. High transporters (patients with higher transport, higher transmission of glucose from peritoneal solution into the blood, and urea and creatinine in the opposite direction, with rapid decrement of osmolality gradient between dialysate and blood that is necessary for excessive fluid elimination), had lower initial BW and, although without statistical significance, only within the first period increased BW more than low transporters. In conclusion, with time BW gain was found in all the PD dialysis patients, it was not related to caloric contribution of glucose absorbed from dialysis solution, and women and high transporters increased BW weight more than men and low transporters in the first year of treatment. The BW gain is at least in part caused by fluid retention.

Adherence to the Mediterranean diet is associated with better quality of life: data from the Osteoarthritis Initiative.

PubMed

Veronese, Nicola; Stubbs, Brendon; Noale, Marianna; Solmi, Marco; Luchini, Claudio; Maggi, Stefania

2016-11-01

The Mediterranean diet has positively influenced various medical conditions, but only a paucity of studies has considered the relation between the Mediterranean diet and quality of life (QOL) among people living in North America. We investigated whether a higher adherence to the Mediterranean diet (aMED) was associated with better QOL and decreased pain, stiffness, disability, and depression in a large cohort of North Americans from the Osteoarthritis Initiative. aMED was evaluated through a validated Mediterranean diet score categorized into quintiles. Outcomes of interest were QOL [assessed with the 12-Item Short-Form Health Outcome Survey (SF-12)]; disability, pain, and stiffness [assessed in both knees with the Western Ontario and McMaster Universities Arthritis Index (WOMAC)]; and depressive symptoms [assessed with the Center for Epidemiologic Studies Depression Scale (CES-D)]. Of the 4470 participants (2605 women; mean age: 61.3 y), those with a higher aMED had significantly more favorable scores on all outcomes investigated (P < 0.0001 for all comparisons). After adjustment for potential confounders in linear regression analyses, a higher aMED was significantly associated with a higher SF-12 physical composite scale value (β: 0.10; 95% CI: 0.05, 0.15; P < 0.0001), lower WOMAC scores (except for stiffness), and lower CES-D scores (β: -0.05; 95% CI: -0.09, -0.01; P = 0.01). An adjusted logistic regression analysis, taking as reference those in the 2 highest quintiles of the aMED score, confirmed these findings. Higher aMED is associated with better QOL and decreased pain, disability, and depressive symptoms. This trial was registered at clinicaltrials.gov as NCT00080171. © 2016 American Society for Nutrition.

The Relationship Between the Dietary Inflammatory Index and Incident Frailty: A Longitudinal Cohort Study.

PubMed

Shivappa, Nitin; Stubbs, Brendon; Hébert, James R; Cesari, Matteo; Schofield, Patricia; Soysal, Pinar; Maggi, Stefania; Veronese, Nicola

2018-01-01

Inflammation is key risk factor for several conditions in the elderly. However, the relationship between inflammation and frailty is still unclear. We investigated whether higher dietary inflammatory index (DII) scores were associated with higher incidence of frailty in a cohort of North Americans. Longitudinal, with a follow-up of 8 years. Osteoarthritis Initiative. A total of 4421 participants with, or at high risk of, knee osteoarthritis. DII scores were calculated using the validated Block Brief 2000 Food-Frequency Questionnaire and categorized into sex-specific quartiles. Frailty was defined as 2 out of 3 of the criteria of the Study of Osteoporotic Fracture study (ie, weight loss, inability to rise from a chair 5 times, and poor energy). The strength of the association between baseline DII score and incident frailty was assessed through a Cox's regression analysis, adjusted for potential baseline confounders, and reported as hazard ratios. A total of 4421 community-dwelling participants (2564 female participants; mean age: 61.3 years) without frailty at baseline were identified from the Osteoarthritis Initiative. During 8 years of follow-up, 356 individuals developed frailty (8.2%). Using Cox's regression analysis, adjusting for 11 potential confounders, participants with the highest DII score (quartile 4) had a significantly higher risk of experiencing frailty (hazard ratio 1.37; 95% confidence interval 1.01-1.89; P = .04) compared with participants with the lowest DII score (quartile 1). The association between DII score and frailty was significant only in men. Higher DII scores, indicating a more proinflammatory diet, are associated with higher incidence of frailty, particularly in men. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Do genetic risk scores for body mass index predict risk of phobic anxiety? Evidence for a shared genetic risk factor

PubMed Central

Walter, Stefan; Glymour, M. Maria; Koenen, Karestan; Liang, Liming; Tchetgen Tchetgen, Eric J; Cornelis, Marilyn; Chang, Shun-Chiao; Rewak, Marissa; Rimm, Eric; Kawachi, Ichiro; Kubzansky, Laura D.

2015-01-01

Background Obesity and anxiety are often linked but the direction of effects is not clear. Methods Using genetic instrumental variable (IV) analyses in a sample of 5911 female participants from the Nurses´ Health Study (NHS, initiated in 1976) and 3697 male participants from the Health Professional Follow-up Study (HPFS, initiated in 1986), we aim to determine whether obesity increases symptoms of phobic anxiety. FTO, MC4R, and a genetic risk score (GRS) based on 32 single nucleotide polymorphisms that significantly predict body mass index (BMI), were used as instrumental variables. “Functional” GRS corresponding with specific biological pathways that shape BMI (adipogenesis, appetite, and cardio-pulmonary), were considered. Phobic anxiety as measured by the Crown Crisp Experimental Index (CCI) in 2004 in NHS and 2000 in HPFS was the main outcome. Results In observational analysis, a one unit higher BMI was associated with higher phobic anxiety symptoms (women NHS: beta=0.05; 95% Confidence Interval (CI): 0.030 – 0.068 and men, HPFS, beta = 0.04; 95% CI: 0.016 – 0.071). IV analyses showed that BMI instrumented by FTO was associated with higher phobic anxiety symptoms (p = 0.005) but BMI instrumented by GRS was not (p=0.256). Functional GRS scores showed heterogeneous, non-significant effects of BMI on phobic anxiety symptoms. Conclusions Our findings do not provide conclusive evidence in favor of the hypothesis that higher BMI leads to higher levels of phobic anxiety, but rather suggest that genes that influence obesity, in particular FTO, may have direct effects on phobic anxiety, i.e., that obesity and phobic anxiety may share common genetic determinants. PMID:25065638

Do genetic risk scores for body mass index predict risk of phobic anxiety? Evidence for a shared genetic risk factor.

PubMed

Walter, S; Glymour, M M; Koenen, K; Liang, L; Tchetgen Tchetgen, E J; Cornelis, M; Chang, S-C; Rewak, M; Rimm, E; Kawachi, I; Kubzansky, L D

2015-01-01

Obesity and anxiety are often linked but the direction of effects is not clear. Using genetic instrumental variable (IV) analyses in 5911 female participants from the Nurses' Health Study (NHS, initiated 1976) and 3697 male participants from the Health Professional Follow-up Study (HPFS, initiated 1986), we aimed to determine whether obesity increases symptoms of phobic anxiety. As instrumental variables we used the fat mass and obesity-associated (FTO) gene, the melanocortin 4 receptor (MC4R) gene and a genetic risk score (GRS) based on 32 single nucleotide polymorphisms (SNPs) that significantly predict body mass index (BMI). 'Functional' GRSs corresponding with specific biological pathways that shape BMI (adipogenesis, appetite and cardiopulmonary) were considered. The main outcome was phobic anxiety measured by the Crown Crisp Index (CCI) in 2004 in the NHS and in 2000 in the HPFS. In observational analysis, a 1-unit higher BMI was associated with higher phobic anxiety symptoms [women: β = 0.05, 95% confidence interval (CI) 0.030-0.068; men: β = 0.04, 95% CI 0.016-0.071). IV analyses showed that BMI was associated with higher phobic anxiety symptoms in the FTO-instrumented analysis (p = 0.005) but not in the GRS-instrumented analysis (p = 0.256). Functional GRSs showed heterogeneous, non-significant effects of BMI on phobic anxiety symptoms. Our findings do not provide conclusive evidence in favor of the hypothesis that higher BMI leads to higher levels of phobic anxiety, but rather suggest that genes that influence obesity, in particular FTO, may have direct effects on phobic anxiety, and hence that obesity and phobic anxiety may share common genetic determinants.

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study.

PubMed

Maingi, Mildred; Kimiywe, Judith; Iron-Segev, Sharon

2018-05-08

Appropriate infant and young child nutrition is critical for proper growth and development. In order to promote optimal nutrition at an early age, the World Health Organization (WHO) and UNICEF have developed the Baby Friendly Hospital Initiative (BFHI) to address poor breastfeeding practices in maternity wards. However, impact is limited in less developed countries like Kenya, where more than half of all births are home deliveries. Therefore, Kenya has explored the adoption of Baby Friendly Community Initiative (BFCI) in its rural settings. In contrast to the BFHI, the BFCI supports breastfeeding and optimal infant feeding in community. BFCI has been implemented in Koibatek, in rural Kenya. This study aimed at assessing the effectiveness of BFCI on complementary feeding practices of children aged 6-23 months, by comparing intervention and control groups. This was a randomized control study design that included 270 mother-infant pairs enrolled in the Baby Friendly Community Initiative (BFCI) project in Koibatek. Evaluation was carried out using structured questionnaires. A statistically significantly higher proportion of children in the intervention group compared to the control group attained minimum dietary diversity (77% vs. 58%; p = 0.001), minimum meal frequency (96% vs. 89%; p = 0.046) and minimum acceptable diet (77% vs. 61%; p = 0.005). The odds of attaining minimum dietary diversity, minimum meal frequency and minimum acceptable diet were statistically significantly higher for the intervention group compared to control group (OR: 4.95; 95%CI 2.44-10.03, p = < 0.001; OR: 14.84; 95%CI 2.75-79.9, p = 0.002; OR: 4.61; 95%CI 2.17-9.78, p = < 0.001 respectively). The BFCI intervention was successful in improving complementary feeding practices. Strengthening and prioritizing BFCI interventions could have a significant impact on child health outcomes in rural Kenya. ISRCTN03467700 . Registration 24 September 2014. Retrospectively registered.

Evaluating the late career nurse initiative: a cross-sectional survey of senior nurses in Ontario.

PubMed

Doran, Diane; Jeffs, Lianne; Rizk, Paul; Laporte, Daniel R; Chilcote, Autumn Marie; Bai, Yu Qing

2015-10-01

This study evaluated the impact of the late career nurse initiative on nurse perceptions of their work environment, workplace burnout, job satisfaction, organisational commitment and intention to remain. The Ontario Ministry of Health and Long-Term Care introduced the late career nurse initiative with the goal of improving the retention of front-line nurses aged 55 and over by implementing a 0.20 full-time equivalent reduction of physically or psychologically demanding duties, enabling nurses to engage in special projects for the improvement of their organisations and patient care. A sample of 902 nurses aged 55 and over from acute and long-term care facilities were surveyed using valid and reliable questionnaires. Nurses who had participated in the initiative did not differ significantly from those who had not in terms of workplace burnout, job satisfaction, length of service or intention to remain within their current organisation. The late career nurse initiative participants reported significantly higher perceptions of managers' ability, leadership and support and their level of participation in hospital affairs. The late career nurse initiative was associated with perceived differences in nurses' work environment but not outcomes. Leaders need to pay attention to how late career nurses are selected and matched to organisational projects. © 2014 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Biomechanical aspects of initial intraosseous stability and implant design: a quantitative micro-morphometric analysis.

PubMed

Akça, Kivanç; Chang, Ting-Ling; Tekdemir, Ibrahim; Fanuscu, Mete I

2006-08-01

The objective of this biomechanical study was to explore the effect of bone micro-morphology on initial intraosseous stability of implants with different designs. Straumann and Astra Tech dental implants were placed into anterior and posterior regions of completely edentulous maxilla and mandible of a human cadaver. Experiments were undertaken to quantify initial implant stability and bone micro-morphology. Installation torque values (ITVs) and implant stability quotients (ISQs) were measured to determine initial intraosseous implant stability. For quantification of relative bone volume and micro-architecture, sectioned implant-bone and bone core specimens of each implant placement site were consecutively scanned and trabecular bone was analyzed in a micro-computed tomography (micro-CT) unit. Experimental outcomes were evaluated for correlations among implant designs, initial intraosseous implant stability and bone micro-structural parameters. ITVs correlated higher with bone volume fraction (BV/TV) than ISQs, at 88.1% and 68.9% levels, respectively. Correlations between ITVs and micro-morphometric parameters were significant at the 95% confidence level (P<0.05) while ISQs were not. Differences in ITVs, ISQs and BV/TV data in regards to implant designs used were not significant at the 95% confidence level (P>0.05). Bone micro-morphology has a prevailing effect over implant design on intraosseus initial implant stability, and ITV is more sensitive in terms of revealing biomechanical properties at the bone-implant interface in comparison with ISQ.

Effect of viscosity on food transport and swallow initiation during eating of two-phase food in normal young adults: a pilot study.

PubMed

Matsuo, Koichiro; Kawase, Soichiro; Wakimoto, Nina; Iwatani, Kazuhiro; Masuda, Yuji; Ogasawara, Tadashi

2013-03-01

When eating food containing both liquid and solid phases (two-phase food), the liquid component frequently enters the hypopharynx before swallowing, which may increase the risk of aspiration. We therefore tested whether preswallow bolus transport and swallow initiation would change as the viscosity of two-phase food was increased. Fiberoptic endoscopy was recorded while 18 adult subjects ate 5 g of steamed rice with 3 ml of blue-dye water. Liquid viscosity was set at four levels by adding a thickening agent (0, 1, 2, and 4 wt%, respectively). We measured the timing of the leading edge of the food reaching the base of the epiglottis, as well as the location of the leading edge at swallow initiation. As viscosity increased, the leading edge of the food reached the epiglottis significantly later during chewing and was higher in the pharynx at swallow onset. The time after the leading edge reached the epiglottis did not vary among the viscosities of the two-phase food. This study found that the initial viscosity of two-phase food significantly altered oropharyngeal bolus flow and the timing of swallow initiation. Accordingly, increased two-phase food viscosity may delay food entry into the pharynx and be of use in dysphagic diets.

[Effect of Ti bonder on the bond strength between porcelain and titanium].

PubMed

Yao, Hai; Luo, Xiao-ping

2009-12-01

To investigate the influence of GC Initial Ti Bonder on bond strength between Vita Titankeramik porcelain and titanium. Forty titanium samples were prepared and randomly assigned to 4 groups with 10 samples in each group. Samples in each group were subjected to one of the following surface treatments, burnishing (Group B), sandblasting (Group S), firing GC Initial Ti Bonder after burnishing (Group BG) and firing GC Initial Ti Bonder after sandblasting (Group SG). Vita Titankeramik porcelain were fired on the surface of each sample in the middle. Three-point bending tests were conducted on each sample according to the ISO 9693. The fracture patterns of all specimens were recorded using zoom stereo microscope (ZSM) and the fracture surfaces were observed under scanning electron microscope (SEM). With fired GC Initial Ti Bonder, the bond strength of Vita Titankeramik porcelain to titanium in Group BG and Group SG were (32.72 +/- 4.46) and (34.25 +/- 6.52) MPa respectively, which reach the ISO 9693 standard for clinical use and were significantly higher than those in Group B [(20.70 +/- 3.15) MPa] and Group S [(23.92 +/- 5.02) MPa]. GC Initial Ti Bonder can significantly improve bond strength between Vita Titankeramik porcelain and titanium.

Birdshot Retinochoroidopathy: Differences in Clinical Characteristics between Patients with Early and Late Age of Onset.

PubMed

Silpa-Archa, Sukhum; Cao, Jennifer H; Boonsopon, Sutasinee; Lee, Joan; Preble, Janine M; Foster, C Stephen

2017-10-01

To describe differences in the clinical characteristics of birdshot retinochoroidopathy (BSRC) patients diagnosed early and later in life. This is a retrospective cohort study. Age was primarily analyzed and 50 years of age at diagnosis was selected as a cut-off point. A total of 144 patients (288 eyes) were included; 68 with early-onset and 76 with late-onset BSRC. The younger group had a statistically significant higher rate of more severe iritis (p = 0.04); an average number of non-steroidal immunosuppressants and biologic agents (NSIB) (p = 0.04); and a prolonged time to initiation of NSIB (p = 0.01). There were only four patients (3%) who had >0.5+ cells in the anterior chamber. Patients with early-onset BSRC carried a higher risk for anterior segment inflammation, had a more prolonged delay to initiation of treatment with NSIB, and required a greater number of NSIBs to achieve remission.

Clinical outcomes, health resource use, and cost in patients with early versus late dual or triple anti-platelet treatment for acute coronary syndrome.

PubMed

Friedman, Howard; Mollon, Patrick; Lian, Jean; Navaratnam, Prakash

2013-08-01

Acute coronary syndrome (ACS) guidelines recommend early dual anti-platelet therapy (thienopyridines + acetylsalicylic acid [aspirin]). However, triple therapy (thienopyridines + aspirin + glycoprotein IIb/IIIa receptor inhibitors [GRIs]) has shown benefit in clinical trials. This study assessed real-world ACS treatment patterns and outcomes in the acute care setting. A retrospective analysis of patients admitted to hospital with ACS (index event) from January 2007 to December 2009 was conducted (Thomson's MarketScan Hospital Drug Database). Eligible patients were ≥18 years of age, of either sex, and had primary admission and discharge diagnoses of ACS. Cohorts were defined by anti-platelet treatment and then by the timing of treatment initiation (early initiation: within ≤2 days of admission; late initiation: ≥2 days post-admission). Patient characteristics, clinical outcomes, resource utilization, and costs were assessed using descriptive statistics. A total of 249,907 eligible patients were placed into four treatment cohorts (aspirin assumed for all patients): aspirin only; clopidogrel only (dual therapy); GRI only (dual therapy); and clopidogrel + GRI (triple therapy). Patients in the 'clopidogrel-only' cohort were more likely to be older, female, and have more co-morbidities than those in other cohorts; stroke (6.2 %) and re-hospitalization (15.4 %) rates were higher than in the 'GRI-only' and 'triple therapy' cohorts. The GRI-only cohort had higher major bleeding rates (3.3 %), mortality (7.6 %), and costs ($US21,975 [year 2010 values]) than the clopidogrel-only and triple-therapy cohorts. Late initiation cohorts were more likely to be older, female, and have more co-morbidities than early initiation cohorts. Major bleeding was more likely with GRI-only patients (regardless of initiation timing) than with other cohorts. Late-treated clopidogrel-only patients had higher rates of stroke (6.9 %), ACS-related re-admissions (6.1 %), and all-cause re-admissions (15.9 %) than other cohorts. Late treatment was associated with longer length of stay and significantly higher costs. Real-world anti-platelet treatment patterns are consistent with ACS guidelines recommending early initiation and selective GRI use. In contrast to recommendations, some outcomes were improved with triple therapy compared with dual therapy.

Impact of pitching rate on yeast fermentation performance and beer flavour.

PubMed

Verbelen, P J; Dekoninck, T M L; Saerens, S M G; Van Mulders, S E; Thevelein, J M; Delvaux, F R

2009-02-01

The volumetric productivity of the beer fermentation process can be increased by using a higher pitching rate (i.e. higher inoculum size). However, the impact of the pitching rate on crucial fermentation and beer quality parameters has never been assessed systematically. In this study, five pitching rates were applied to lab-scale fermentations to investigate its impact on the yeast physiology and beer quality. The fermentation rate increased significantly and the net yeast growth was lowered with increasing pitching rate, without affecting significantly the viability and the vitality of the yeast population. The build-up of unsaturated fatty acids in the initial phase of the fermentation was repressed when higher yeast concentrations were pitched. The expression levels of the genes HSP104 and HSP12 and the concentration of trehalose were higher with increased pitching rates, suggesting a moderate exposure to stress in case of higher cell concentrations. The influence of pitching rate on aroma compound production was rather limited, with the exception of total diacetyl levels, which strongly increased with the pitching rate. These results demonstrate that most aspects of the yeast physiology and flavour balance are not significantly or negatively affected when the pitching rate is changed. However, further research is needed to fully optimise the conditions for brewing beer with high cell density populations.

Initial varus displacement of proximal humerus fractures results in similar function but higher complication rates.

PubMed

Capriccioso, Christina E; Zuckerman, Joseph D; Egol, Kenneth A

2016-04-01

To investigate the effect of initial varus or valgus surgical neck alignment on outcomes of patients who sustained proximal humerus fractures treated with open reduction and internal fixation (ORIF). An institutional review board approved database of proximal humerus fractures treated with locked plates was reviewed. Of 185 fractures in the database, 101 fractures were identified and met inclusion criteria. Initial varus displacement was seen in 47 fractures (OTA types 11.A2.2, A3.1, A3.3, B1.2, B2.2, C1.2, C2.2, or C2.3) and initial valgus displacement was observed in 54 fractures (OTA types 11.A2.3, B1.1, C1.1, or C2.1). All patients were treated in a similar manner and examined by the treating physician at standard intervals. Functional outcomes were quantified via the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and physical examination data at 12 months. Radiographs were reviewed for complications of healing. Additionally, complication rate and reoperation rate were investigated. Patients who presented with initial varus displacement had an average age of 59.3 years, while patients in the valgus group had an average age of 62.4 years. Overall, there was no statistically significant difference in age, sex distribution, BMI, fracture parts, screws used, or implant plate type between the two groups. At a minimum 12 months follow up, there was no significant difference in DASH scores between those presenting with varus versus valgus fracture patterns. In addition, no significant differences were seen in final shoulder range of motion in any plane. Overall, 30 patients included in this study developed a complication. A significantly greater number of patients in the initial varus cohort developed complications (40.4%), as compared to 20.3% of patients in the initial valgus cohort (P=0.03). Fourteen patients in this study underwent reoperation. Nine of these patients were in the varus cohort, while 5 were in the valgus cohort (P=0.15). In this study, initial surgical neck displacement in varus or valgus was found to not significantly affect functional outcome. Based upon our findings, patients with varus displaced proximal humerus fractures are at a greater risk of developing postoperative complications than those who present with initial valgus displaced fracture patterns. Copyright © 2016 Elsevier Ltd. All rights reserved.

Gender difference in early initiation of methamphetamine use among current methamphetamine users in Muse, Northern Shan State, Myanmar.

PubMed

Saw, Yu Mon; Saw, Thu Nandar; Yasuoka, Junko; Chan, Nyein; Kham, Nang Pann Ei; Khine, Wint; Cho, Su Myat; Jimba, Masamine

2017-05-08

Globally, methamphetamine (MA) use is a significant public health concern due to unprecedented health effects of its use. However, gender similarities and differences in early age of MA initiation and its risk factors among current MA users have been understudied in a developing country setting. A community-based, cross-sectional study was conducted using a computer assisted self-interviewing program from January to March 2013 in Muse, Northern Shan State, Myanmar. A total of 1362 (775 male and 587 female) self-reported current MA users aged between 18 and 35 years were recruited using respondent-driven sampling. Two gender-stratified multiple logistic regression models (models I and II) were done for analysis. For similarities, 73.0% of males and 60.5% of females initiated MA before their 18th birthday. The early age of MA initiation was positively associated with the reasons and places of the first time MA use among both genders. For differences, males [hazard ratio 1.35; 95% confidence interval, 1.18-1.54] had a significantly higher risk than females to initiate MA at earlier age. Among male users, participants who had bisexual/homosexual preferences were more likely to initiate MA use earlier. In contrast, female users who exchanged sex for money and/or drugs were more likely to initiate MA in earlier age. More than 60.0% of male and female participants initiated MA use early; however, males initiated use earlier than females. Although similarities were found among both genders, differences found in key risk factors for early age MA initiation suggest that gender-specific, MA prevention programs are urgently needed in Myanmar.

Cytochrome P450 1b1 in polycyclic aromatic hydrocarbon (PAH)-induced skin carcinogenesis: Tumorigenicity of individual PAHs and coal-tar extract, DNA adduction and expression of select genes in the Cyp1b1 knockout mouse

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

Siddens, Lisbeth K.; Superfund Research Center, Oregon State University, Corvallis, OR 97331; Bunde, Kristi L.

FVB/N mice wild-type, heterozygous or null for Cyp 1b1 were used in a two-stage skin tumor study comparing PAH, benzo[a]pyrene (BaP), dibenzo[def,p]chrysene (DBC), and coal tar extract (CTE, SRM 1597a). Following 20 weeks of promotion with TPA the Cyp 1b1 null mice, initiated with DBC, exhibited reductions in incidence, multiplicity, and progression. None of these effects were observed with BaP or CTE. The mechanism of Cyp 1b1-dependent alteration of DBC skin carcinogenesis was further investigated by determining expression of select genes in skin from DBC-treated mice 2, 4 and 8 h post-initiation. A significant reduction in levels of Cyp 1a1,more » Nqo1 at 8 h and Akr 1c14 mRNA was observed in Cyp 1b1 null (but not wt or het) mice, whereas no impact was observed in Gst a1, Nqo 1 at 2 and 4 h or Akr 1c19 at any time point. Cyp 1b1 mRNA was not elevated by DBC. The major covalent DNA adducts, dibenzo[def,p]chrysene-(±)-11,12-dihydrodiol-cis and trans-13,14-epoxide-deoxyadenosine (DBCDE-dA) were quantified by UHPLC-MS/MS 8 h post-initiation. Loss of Cyp1 b1 expression reduced DBCDE-dA adducts in the skin but not to a statistically significant degree. The ratio of cis- to trans-DBCDE-dA adducts was higher in the skin than other target tissues such as the spleen, lung and liver (oral dosing). These results document that Cyp 1b1 plays a significant role in bioactivation and carcinogenesis of DBC in a two-stage mouse skin tumor model and that loss of Cyp 1b1 has little impact on tumor response with BaP or CTE as initiators. - Highlights: • Cyp1b1 null mice exhibit lower skin cancer sensitivity to DBC but not BaP or CTE. • Cyp1b1 expression impacts expression of other PAH metabolizing enzymes. • cis/trans-DBCDE-dA ratio significantly higher in the skin than the spleen, lung or liver • Potency of DBC and CTE in mouse skin is higher than predicted by RPFs.« less

America's College Promise: Situating President Obama's Initiative in the History of Federal Higher Education Aid and Access Policy

ERIC Educational Resources Information Center

Palmadessa, Allison L.

2017-01-01

Purpose: America's College Promise (ACP) is a legislative initiative introduced by President Obama to increase access to higher education, to build the economy, and to support his earlier American Graduation Initiative. This legislation has the potential to settle among the ranks of the most influential federal higher education aid and access…

Effects of pH, initial Pb2+ concentration, and polyculture on lead remediation by three duckweed species.

PubMed

Tang, Jie; Chen, Chunxia; Chen, Lei; Daroch, Maurycy; Cui, Yan

2017-10-01

Various geographical duckweed isolates have been developed for phytoremediation of lead. The Pb 2+ removal efficiency of Lemna aequinoctialis, Landoltia punctata, and Spirodela polyrhiza was investigated in monoculture and polyculture at different levels of pH and initial Pb 2+ concentrations. L. aequinoctialis was not sensitive to the tested pH but significantly affected by initial Pb 2+ concentration, whereas synergistic effect of pH and initial Pb 2+ concentration on removal efficiency of L. punctata and S. polyrhiza was found. Although the majority of polycultures showed median removal efficiency as compared to respective monocultures, some of the polycultures achieved higher Pb 2+ removal efficiencies and can promote population to remove Pb 2+ . Besides, the three duckweed strains could be potential candidates for Pb 2+ remediation as compared to previous reports. Conclusively, this study provides useful references for future large-scale duckweed phytoremediation.

Effect of initial phase on error in electron energy obtained using paraxial approximation for a focused laser pulse in vacuum

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

Singh, Kunwar Pal, E-mail: k-psingh@yahoo.com; Department of Physics, Shri Venkateshwara University, Gajraula, Amroha, Uttar Pradesh 244236; Arya, Rashmi

2015-09-14

We have investigated the effect of initial phase on error in electron energy obtained using paraxial approximation to study electron acceleration by a focused laser pulse in vacuum using a three dimensional test-particle simulation code. The error is obtained by comparing the energy of the electron for paraxial approximation and seventh-order correction description of the fields of Gaussian laser. The paraxial approximation predicts wrong laser divergence and wrong electron escape time from the pulse which leads to prediction of higher energy. The error shows strong phase dependence for the electrons lying along the axis of the laser for linearly polarizedmore » laser pulse. The relative error may be significant for some specific values of initial phase even at moderate values of laser spot sizes. The error does not show initial phase dependence for a circularly laser pulse.« less

Phacoemulsification with intravitreal bevacizumab injection in diabetic patients with macular edema and cataract.

PubMed

Akinci, Arsen; Batman, Cosar; Ozkilic, Ersel; Altinsoy, Ali

2009-01-01

The purpose of this study was to evaluate the results of phacoemulsification with intravitreal bevacizumab injection in patients with diabetic clinically significant macular edema and cataract. The records of 31 patients with diabetic clinically significant macular edema and cataract, which would interfere with macular laser photocoagulation, who have undergone phacoemulsification with intravitreal injection of 1.25 mg bevacizumab were retrospectively evaluated. All patients had undergone focal or modified grid laser photocoagulation 1 month after the surgery. All patients were evaluated by spectral optical coherence tomography/optical coherence tomography SLO before and 1 and 3 months after the surgery beyond complete ophthalmologic examination. The best-corrected visual acuity (BCVA) levels and central macular thickness (CMT) recorded at the first and third months after the surgery were compared with the initial values. Paired samples t test was used for statistical analysis. The mean initial BCVA was 0.10 +/- 0.04 (range, 0.05-0.2). The mean BCVA at the first and third months after the surgery were 0.47 +/- 0.16 (standard deviation) (range, 0.2-0.5) and 0.51 +/- 0.12 (standard deviation) (range, 0.3-0.6), respectively. The BCVA level recorded at the first and third months after the surgery were significantly higher than the initial BCVA (P = 0.004). The mean initial CMT was 387.5 +/- 109.5 microm. The mean CMT at the first and third months after the surgery were 292.7 +/- 57.2 and 275.5 +/- 40.3. The CMT recorded at the first and third months after the surgery were significantly lower than the initial CMT (P < 0.001, P < 0.001). Phacoemulsification with intravitreal injection of bevacizumab provides improvement in clinically significant macular edema with a gain in BCVA in patients with diabetes with clinically significant macular edema and cataract.

High-mobility group B1 proteins in canine lymphoma: prognostic value of initial and sequential serum levels in treatment outcome following combination chemotherapy.

PubMed

Meyer, A; Eberle, N; Bullerdiek, J; Nolte, I; Simon, D

2010-06-01

Elevated high-mobility group box 1 (HMGB1) levels have been demonstrated in different human neoplasias. Information on serum HMGB1 before and during chemotherapy is lacking, as is data pertaining to its prognostic significance. The aim of this study was to characterize serum HMGB1 level in dogs with lymphoma and to assess its influence on the outcome following chemotherapy. Serum HMGB1 concentrations were measured in 16 dogs with lymphoma before treatment (W1) and on weeks 2 (W2), 6 (W6) and 12 (W12) of treatment with chemotherapy. Initial serum HMGB1 levels were significantly higher than HMGB1concentrations in control dogs and the levels in W2, W6 and W12. HMGB1-W1 concentrations were lower in dogs achieving complete remission than that in the single dog with partial remission. The ratio W12/W6 exhibited significant influence on remission duration. In these dogs with lymphoma, serum HMGB1 was elevated in comparison with that in controls. Initial serum HMGB1 level and its modulation during treatment may possess prognostic value.

Flight behavior and performance of Rhodnius pallescens (Hemiptera: Reduviidae) on a tethered flight mill.

PubMed

Castro, Lauren A; Peterson, Jennifer K; Saldana, Azael; Perea, Milixa Y; Calzada, Jose E; Pineda, Vanessa; Dobson, Andrew P; Gottdenker, Nicole L

2014-09-01

ABSTRACT Flight dispersal of the triatomine bug species Rhodnius pallescens Barber, the principal vector of Chagas disease in Panama, is an important mechanism for spreading Trypanosoma cruzi, causative agent of Chagas disease. This study measures R. pallescens flight performance using a tethered flight mill both when uninfected, and when infected with T. cruzi or Trypanosoma rangeli. Forty-four out of the 48 (91.7%) insects initiated flight across all treatments, and trypanosome infection did not significantly impact flight initiation. Insects from all treatments flew a cumulative distance ranging from 0.5 to 5 km before fatiguing. The median cumulative distance flown before insect fatigue was higher in T. cruzi- and T. rangeli-infected insects than in control insects; however, this difference was not statistically significant. There was a positive relationship between parasite load ingested and time until flight initiation in T. rangeli-infected bugs, and T. rangeli- and T. cruzi-infected females flew significantly faster than males at different time points. These novel findings allow for a better understanding of R. pallescens dispersal ability and peridomestic management strategies for the prevention of Chagas disease in Panama.

Stability of Multi-Planet Systems in the Alpha Centauri System

NASA Technical Reports Server (NTRS)

Lissauer, Jack J.

2017-01-01

We evaluate the extent of the regions within the alpha Centauri AB star system where small planets are able to orbit for billion-year timescales (Quarles & Lissauer 2016, Astron. J. 151, 111), as well as how closely-spaced planetary orbits can be within those regions in which individual planets can survive. Although individual planets on low inclination, low eccentricity, orbits can survive throughout the habitable zones of both stars, perturbations from the companion star imply that the spacing of planets in multi-planet systems within the habitable zones of each star must be significantly larger than the spacing of similar multi-planet systems orbiting single stars in order to be long-lived. Because the binary companion induces a forced eccentricity upon the orbits of planets in orbit around either star, appropriately-aligned circumstellar orbits with small initial eccentricities are stable to slightly larger initial semimajor axes than are initially circular orbits. Initial eccentricities close to forced eccentricities can have a much larger affect on how closely planetary orbits can be spaced, and therefore on how many planets may remain in the habitable zones, although the required spacing remains significantly higher than for planets orbiting single stars.

The impact of social cognitive variables on the initial level of depression and recovery.

PubMed

Lam, D H; Green, B; Power, M J; Checkley, S

1994-10-01

Thirty-seven patients who fulfilled DSM-III-R criteria for Major Depressive Disorder were recruited for a double-blind controlled trial of Desipramine and placebo for 6 weeks. Data about social cognitive variables, including social adversities, investment in roles and goals, general social support and crisis support were collected. Crisis support had a moderating effect on the initial level of depression: the more crisis support the subjects had, the less depressed they were on recruitment. Initial level of depression, the experience of adversity and drugs all contributed significantly to recovery defined as Hamilton Rating for Depression less than 10 at week 6. When recovery was defined as Hamilton score halved or more than halved between week 2 and week 6, subjects' level of ideal emotional support, and whether they had experienced adversity in their most invested domains, contributed significantly to recovery, independent of any drug effects or the initial level of depression. The higher their level of ideal emotional support, the less was the chance of these subjects recovering. The findings of this study pointed to the importance of controlling for psycho-social variables in studies of response to treatment.

WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010.

PubMed

Wijnhoven, Trudy M A; van Raaij, Joop M A; Spinelli, Angela; Starc, Gregor; Hassapidou, Maria; Spiroski, Igor; Rutter, Harry; Martos, Éva; Rito, Ana I; Hovengen, Ragnhild; Pérez-Farinós, Napoleón; Petrauskiene, Ausra; Eldin, Nazih; Braeckevelt, Lien; Pudule, Iveta; Kunešová, Marie; Breda, João

2014-08-07

The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009/2010) and to explore changes in body mass index (BMI) and overweight among children within and across nine countries from school years 2007/2008 to 2009/2010. Using cross-sectional nationally representative samples of 6-9-year-olds, BMI, anthropometric Z-scores and overweight prevalence were derived from measured weight and height. Significant changes between rounds were assessed using variance and t-tests analyses. At Round 2, the prevalence of overweight (including obesity; WHO definitions) ranged from 18% to 57% among boys and from 18% to 50% among girls; 6 - 31% of boys and 5 - 21% of girls were obese. Southern European countries had the highest overweight prevalence. Between rounds, the absolute change in mean BMI (range: from -0.4 to +0.3) and BMI-for-age Z-scores (range: from -0.21 to +0.14) varied statistically significantly across countries. The highest significant decrease in BMI-for-age Z-scores was found in countries with higher absolute BMI values and the highest significant increase in countries with lower BMI values. The highest significant decrease in overweight prevalence was observed in Italy, Portugal and Slovenia and the highest significant increase in Latvia and Norway. Changes in BMI and prevalence of overweight over a two-year period varied significantly among European countries. It may be that countries with higher prevalence of overweight in COSI Round 1 have implemented interventions to try to remedy this situation.

Evaluation of economic and performance outcomes associated with the number of treatments after an initial diagnosis of bovine respiratory disease in commercial feeder cattle.

PubMed

Cernicchiaro, Natalia; White, Brad J; Renter, David G; Babcock, Abram H

2013-02-01

To evaluate associations between economic and performance outcomes with the number of treatments after an initial diagnosis of bovine respiratory disease (BRD) in commercial feedlot cattle. 212,867 cattle arriving in a Midwestern feedlot between 2001 and 2006. An economic model was created to estimate net returns. Generalized linear mixed models were used to determine associations between the frequency of BRD treatments and other demographic variables with economic and performance outcomes. Net returns decreased with increasing number of treatments for BRD. However, the magnitude depended on the season during which cattle arrived at the feedlot, with significantly higher returns for cattle arriving during fall and summer than for cattle arriving during winter and spring. For fall arrivals, there were higher mean net returns for cattle that were never treated ($39.41) than for cattle treated once ($29.49), twice ($16.56), or ≥ 3 times (-$33.00). For summer arrivals, there were higher least squares mean net returns for cattle that were never treated ($31.83) than for cattle treated once ($20.22), twice ($6.37), or ≥ 3 times ($-42.56). Carcass traits pertaining to weight and quality grade were deemed responsible for differences in net returns among cattle receiving different numbers of treatments after an initial diagnosis of BRD. Differences in economic net returns and performance outcomes for feedlot cattle were determined on the basis of number of treatments after an initial diagnosis of BRD; the analysis accounted for the season of arrival, sex, and weight class.

Effect of Initiators on Thermal Changes in Soft Tissues Using a Diode Laser.

PubMed

Romanos, Georgios E; Sacks, Danielle; Montanaro, Nicholas; Delgado-Ruiz, Rafael; Calvo-Guirado, Jose Luis; Javed, Fawad

2018-06-15

The aim was to determine the effect of various initiators on the thermal changes that occur during incisions performed in soft tissues using a diode laser. There are no studies that have assessed the effect of various initiators on the thermal changes that occur during incisions performed in soft tissues using a diode laser. Thermal changes were observed during standardized incisions in chicken breast (without skin) via thermoelements over a 10-sec irradiation period. Incisions were created using a 975 nm diode laser with a 320 μ fiber tip diameter. Incisions (10 in each group) were performed with and without an initiator (control group). Red/blue articulating paper, cork, and SureStep ® were used as initiators. The tissue was irradiated in a continuous wave mode at 3 and 6 W in room temperature (21°C). At 3 and 6 W without any initiator, the mean temperature increased by 5.7°C versus 12.4°C, respectively. Cork initiator at 3 and 6 W resulted in temperature increase by 4.88°C versus 6.21°C, respectively. Incisions made using the blue/red articulating paper-initiated tip resulted in temperature increase by 2.9/5.8°C versus 8.2/7.6°C at 3 and 6 W power settings, respectively. Initiation with SureStep resulted in temperature increase by 2.3°C and at 6 W by 4.1°C. No significant differences were recorded between the different groups, but higher temperatures were associated with higher power settings. The power settings of the diode laser and type of initiator used, both effect the degree to which the temperature of the soft tissue increases during incisions and have to be considered for the safety in soft tissue applications.

Initiation of small-satellite formations via satellite ejector

NASA Astrophysics Data System (ADS)

McMullen, Matthew G

Small satellites can be constructed at a fraction of the cost of a full-size satellite. One full-size satellite can be replaced with a multitude of small satellites, offering expanded area coverage through formation flight. However, the shortcoming to the smaller size is usually a lack of thrusting capabilities. Furthermore, current designs for small satellite deployment mechanisms are only capable of love deployment velocities (on the order of meters per second). Motivated to address this shortcoming, a conceived satellite ejector would offer a significant orbit change by ejecting the satellite at higher deployment velocities (125-200 m/s). Focusing on the applications of the ejector, it is sought to bridge the gap in prior research by offering a method to initiate formation flight. As a precursor to the initiation, the desired orbit properties to initiate the formation are specified in terms of spacing and velocity change vector. From this, a systematic method is developed to find the relationship among velocity change vector, the desired orbit's orientation, and the spacing required to initiate the formation.

Predictors of insulin uptake among adults with type 2 diabetes in the Stepping Up Study.

PubMed

Holmes-Truscott, Elizabeth; Furler, John; Blackberry, Irene; O'Neal, David N; Speight, Jane

2017-11-01

We aimed to investigate predictors of insulin uptake, and change in insulin appraisals, among adults with type 2 diabetes mellitus (T2DM) who participated in the Stepping Up trial. The Stepping Up model of care, supporting timely insulin initiation in primary care, was evaluated in a two-armed cluster-randomised controlled trial. Participants were 266 adults (mean±SD age 62±10years; 39% women) with T2DM (median (IQR) duration 8.5 (5, 13)years) from 74 primary care practices (Stepping Up intervention: 57%, control 43%). At 12months, 47% (n=126) had commenced insulin. Controlling for randomisation, logistic regression was used to explore baseline predictors of insulin uptake, including: demographic and clinical characteristics, emotional wellbeing (depressive symptoms and diabetes-related distress), insulin treatment appraisals, and, 'willingness' to initiate insulin. Two-way analysis of variance examined effects of, and interaction between, randomisation and insulin uptake on 12-month change in insulin appraisals. Participants using insulin at 12months were more likely (all p<0.05) than those with non-insulin-treated T2DM to report: lower socioeconomic status, higher baseline HbA1c (median difference: 0.3%; 3mmol/mol), greater willingness to commence insulin (very willing: 27% vs 12%), and less negative and more positive insulin appraisals. All contributed significantly to the final model (χ 2 (8)=92.1, p<0.001) except insulin appraisals. Regardless of trial allocation, those initiating insulin reported significantly greater reductions in negative insulin appraisals. Controlling for randomisation, 12-month insulin use was predicted by higher baseline HbA1c and 'willingness' to use insulin if recommended. Negative insulin appraisals reduced following insulin initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

Diarrhoea and Suboptimal Feeding Practices in Nigeria: Evidence from the National Household Surveys.

PubMed

Ogbo, Felix A; Page, Andrew; Idoko, John; Claudio, Fernanda; Agho, Kingsley E

2016-07-01

Globally, Nigeria has the largest burden of infectious diseases (including diarrhoea). Optimal feeding practices have been well-documented to protect against diarrhoea in other contexts; but this benefit has not been broadly studied in Nigeria. The study aimed to examine the association between diarrhoea and childhood feeding practices to provide country-specific evidence. Data from the Nigeria Demographic and Health Survey for the period spanning 1999-2013 were used. Prevalence of diarrhoea by infant and young child feeding indicators was estimated, and the association between diarrhoea and childhood feeding indicators was examined using multilevel regression analyses. Prevalence of diarrhoea was higher among children whose mothers did not initiate breast feeding within the first hour of birth, infants who were not exclusively breastfed, and infants who were prematurely introduced to complementary foods. Early initiation of breast feeding was significantly associated with lower risk of diarrhoea (RR 0.68, 95% confidence interval (CI) 0.63, 0.74). Exclusively breastfed infants were less likely to develop diarrhoea compared to non-exclusively breastfed infants (RR 0.61, 95% CI 0.44, 0.86). Predominant breast feeding was significantly associated with a lower risk of diarrhoea (RR 0.66, 95% CI 0.54, 0.80). Bottle feeding and introduction of complementary foods were associated with a higher risk of diarrhoea. Early initiation of breast feeding as well as exclusive and predominant breast feeding protect against diarrhoea in Nigeria, while bottle feeding and introduction of complementary foods were risk factors for diarrhoea. Community- and facility-based initiatives are needed to improve feeding practices, and to reduce diarrhoea prevalence in Nigeria. © 2016 John Wiley & Sons Ltd.

Sex differences on the Multitalent Perception Inventory among Malaysian students.

PubMed

Palaniappan, Ananda Kumar

2007-12-01

Malaysian high school students, 142 boys and 154 girls (M age= 13.3 yr., SD = 0.3) were compared on a talent measure, the Khatena-Morse Multitalent Perception Inventory. Boys obtained significantly higher means on the overall score of Versatility and the talent areas of Artistry, Creative Imagination, Initiative, and Leadership. Further replications involving other age groups and nationalities are recommended.

Delinquency and Reputational Orientations of Adolescent At-Risk and Not-at-Risk Males and Females

ERIC Educational Resources Information Center

Carroll, Annemaree; Houghton, Steve; Khan, Umneea; Tan, Carol

2008-01-01

This research investigated differences in delinquent activities and the reputational orientations of at-risk and not-at-risk male and female adolescents. Initially, we sought to establish that adolescent males and females differed in these respects. This was found to be the case: males (n = 722) scored significantly higher than females (n = 738)…

Spatial cues more salient than color cues in cotton-top tamarins (Saguinus oedipus) reversal learning.

PubMed

Gaudio, Jennifer L; Snowdon, Charles T

2008-11-01

Animals living in stable home ranges have many potential cues to locate food. Spatial and color cues are important for wild Callitrichids (marmosets and tamarins). Field studies have assigned the highest priority to distal spatial cues for determining the location of food resources with color cues serving as a secondary cue to assess relative ripeness, once a food source is located. We tested two hypotheses with captive cotton-top tamarins: (a) Tamarins will demonstrate higher rates of initial learning when rewarded for attending to spatial cues versus color cues. (b) Tamarins will show higher rates of correct responses when transferred from color cues to spatial cues than from spatial cues to color cues. The results supported both hypotheses. Tamarins rewarded based on spatial location made significantly more correct choices and fewer errors than tamarins rewarded based on color cues during initial learning. Furthermore, tamarins trained on color cues showed significantly increased correct responses and decreased errors when cues were reversed to reward spatial cues. Subsequent reversal to color cues induced a regression in performance. For tamarins spatial cues appear more salient than color cues in a foraging task. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Glucose Synthesis in a Protein-Based Artificial Photosynthesis System.

PubMed

Lu, Hao; Yuan, Wenqiao; Zhou, Jack; Chong, Parkson Lee-Gau

2015-09-01

The objective of this study was to understand glucose synthesis of a protein-based artificial photosynthesis system affected by operating conditions, including the concentrations of reactants, reaction temperature, and illumination. Results from non-vesicle-based glyceraldehyde-3-phosphate (GAP) and glucose synthesis showed that the initial concentrations of ribulose-1,5-bisphosphate (RuBP) and adenosine triphosphate (ATP), lighting source, and temperature significantly affected glucose synthesis. Higher initial concentrations of RuBP and ATP significantly enhanced GAP synthesis, which was linearly correlated to glucose synthesis, confirming the proper functions of all catalyzing enzymes in the system. White fluorescent light inhibited artificial photosynthesis and reduced glucose synthesis by 79.2 % compared to in the dark. The reaction temperature of 40 °C was optimum, whereas lower or higher temperature reduced glucose synthesis. Glucose synthesis in the vesicle-based artificial photosynthesis system reconstituted with bacteriorhodopsin, F 0 F 1 ATP synthase, and polydimethylsiloxane-methyloxazoline-polydimethylsiloxane triblock copolymer was successfully demonstrated. This system efficiently utilized light-induced ATP to drive glucose synthesis, and 5.2 μg ml(-1) glucose was synthesized in 0.78-ml reaction buffer in 7 h. Light-dependent reactions were found to be the bottleneck of the studied artificial photosynthesis system.

Associations of leisure-time sitting in cars with neighborhood walkability.

PubMed

Koohsari, Mohammad Javad; Sugiyama, Takemi; Kaczynski, Andrew T; Owen, Neville

2014-08-01

Too much sitting, including time spent sitting in cars, is associated with poor health outcomes. Identifying the built-environment attributes that may reduce vehicular sitting time can inform future initiatives linking the public health, urban design, and transportation sectors. Data collected in 2003-2004 from adult residents (n = 2521) of Adelaide, Australia were used. Logistic regression analyses examined associations of prolonged time spent sitting in cars during leisure time (30 min/day or more) with neighborhood walkability and its components (dwelling density; intersection density; land use mix; net retail area ratio). Lower overall walkability was significantly associated with a higher odds (OR = 1.43, 95% CI: 1.21-1.70) of spending prolonged time in cars. For analyses with walkability components, lower net retail area ratio, lower residential density, and lower intersection density were significantly associated with prolonged sitting in cars. This study found that residents of high walkable neighborhoods tended to spend less time sitting in cars. In particular, higher net retail area ratio, an indicator of tightly spaced commercial areas, was strongly associated with less time in cars. Policy and planning initiatives to reduce car use require further evidence, particularly on the influence of neighborhood retail areas.

Patterns of Cigarette Smoking Initiation in Two Culturally Distinct American Indian Tribes

PubMed Central

Kanekar, Shalini; Wen, Yang; Buchwald, Dedra; Goldberg, Jack; Choi, Won; Okuyemi, Kolawole S.; Ahluwalia, Jasjit; Henderson, Jeffrey A.

2009-01-01

Objectives. To better understand patterns of initiation among American Indians we examined age-related patterns of smoking initiation during adolescence and young adulthood in 2 American Indian tribes. Methods. We used log-rank comparison and a Cox proportional hazard regression model to analyze data from a population-based study of Southwest and Northern Plains American Indians aged 18 to 95 years who initiated smoking by age 18 years or younger. Results. The cumulative incidence of smoking initiation was much higher among the Northern Plains Indians (47%) than among the Southwest Indians (28%; P < .01). In the Southwest, men were more likely than women to initiate smoking at a younger age (P < .01); there was no such difference in the Northern Plains sample. Northern Plains men and women in more recent birth cohorts initiated smoking at an earlier age than did those born in older birth cohorts. Southwest men and women differed in the pattern of smoking initiation across birth cohorts as evidenced by the significant test for interaction (P = .01). Conclusion. Our findings underscore the need to implement tobacco prevention and control measures within American Indian communities. PMID:19820215

Effect of stocking density on performances of juvenile turbot ( Scophthalmus maximus) in recirculating aquaculture systems

NASA Astrophysics Data System (ADS)

Li, Xian; Liu, Ying; Blancheton, Jean-Paul

2013-05-01

Limited information has been available about the influence of loading density on the performances of Scophthalmus maximus, especially in recirculating aquaculture systems (RAS). In this study, turbot (13.84±2.74 g; average weight±SD) were reared at four different initial densities (low 0.66, medium 1.26, sub-high 2.56, high 4.00 kg/m2) for 10 weeks in RAS at 23±1°C. Final densities were 4.67, 7.25, 14.16, and 17.47 kg/m2, respectively, which translate to 82, 108, 214, and 282 percent coverage of the tank bottom. Density had both negative and independent impacts on growth. The final mean weight, specific growth rate (SGR), and voluntary feed intake significantly decreased and the coefficient of variation (CV) of final body weight increased with increase in stocking density. The medium and sub-high density groups did not differ significantly in SGR, mean weight, CV, food conversion rate (FCR), feed intake, blood parameters, and digestive enzymes. The protease activities of the digestive tract at pH 7, 8.5, 9, and 10 were significantly higher for the highest density group, but tended to be lower (not significantly) at pH 4 and 8.5 for the lowest density group. The intensity of protease activity was inversely related to feed intake at the different densities. Catalase activity was higher (but not significantly) at the highest density, perhaps because high density started to induce an oxidative effect in turbot. In conclusion, turbot can be cultured in RAS at a density of less than 17.47 kg/m2. With good water quality and no feed limitation, initial density between 1.26 and 2.56 kg/m2 (final: 7.25 and 14.16 kg/m2) would not negatively affect the turbot cultured in RAS. For culture at higher density, multi-level feeding devices are suggested to ease feeding competition.

Outcomes by Sex Following Treatment Initiation With Atazanavir Plus Ritonavir or Efavirenz With Abacavir/Lamivudine or Tenofovir/Emtricitabine

PubMed Central

Smith, Kimberly Y.; Tierney, Camlin; Mollan, Katie; Venuto, Charles S.; Budhathoki, Chakra; Ma, Qing; Morse, Gene D.; Sax, Paul; Katzenstein, David; Godfrey, Catherine; Fischl, Margaret; Daar, Eric S.; Collier, Ann C.; Bolivar, Hector H.; Navarro, Sandra; Koletar, Susan L.; Gochnour, Diane; Seefried, Edward; Hoffman, Julie; Feinberg, Judith; Saemann, Michelle; Patterson, Kristine; Pittard, Donna; Currin, David; Upton, Kerry; Saag, Michael; Ray, Graham; Johnson, Steven; Santos, Bartolo; Funk, Connie A.; Morgan, Michael; Jackson, Brenda; Tebas, Pablo; Thomas, Aleshia; Kim, Ge-Youl; Klebert, Michael K.; Santana, Jorge L.; Marrero, Santiago; Norris, Jane; Valle, Sandra; Cox, Gary Matthew; Silberman, Martha; Shaik, Sadia; Lopez, Ruben; Vasquez, Margie; Daskalakis, Demetre; Megill, Christina; Shore, Jessica; Taiwo, Babafemi; Goldman, Mitchell; Boston, Molly; Lennox, Jeffrey; del Rio, Carlos; Lane, Timothy W.; Epperson, Kim; Luetkemeyer, Annie; Payne, Mary; Gripshover, Barbara; Antosh, Dawn; Reid, Jane; Adams, Mary; Storey, Sheryl S.; Dunaway, Shelia B.; Gallant, Joel; Wiggins, Ilene; Smith, Kimberly Y.; Swiatek, Joan A.; Timpone, Joseph; Kumar, Princy; Moe, Ardis; Palmer, Maria; Gothing, Jon; Delaney, Joanne; Whitely, Kim; Anderson, Ann Marie; Hammer, Scott M.; Yin, Michael T.; Jain, Mamta; Petersen, Tianna; Corales, Roberto; Hurley, Christine; Henry, Keith; Bordenave, Bette; Youmans, Amanda; Albrecht, Mary; Pollard, Richard B.; Olusanya, Abimbola; Skolnik, Paul R.; Adams, Betsy; Tashima, Karen T.; Patterson, Helen; Ukwu, Michelle; Rogers, Lauren; Balfour, Henry H.; Fox, Kathy A.; Swindells, Susan; Van Meter, Frances; Robbins, Gregory; Burgett-Yandow, Nicole; Davis, Charles E.; Boyce, Colleen; O'Brien, William A.; Casey, Gerianne; Morse, Gene D.; Hsaio, Chiu-Bin; Meier, Jeffrey L.; Stapleton, Jack T.; Mildvan, Donna; Revuelta, Manuel; Currin, David; El Sadr, Wafaa; Loquere, Avelino; El-Daher, Nyef; Johnson, Tina; Gross, Robert; Maffei, Kathyrn; Hughes, Valery; Sturge, Glenn; McMahon, Deborah; Rutecki, Barbara; Wulfsohn, Michael; Cheng, Andrew; Dix, Lynn; Liao, Qiming

2014-01-01

Background. We aimed to evaluate treatment responses to atazanavir plus ritonavir (ATV/r) or efavirenz (EFV) in initial antiretroviral regimens among women and men, and determine if treatment outcomes differ by sex. Methods. We performed a randomized trial of open-label ATV/r or EFV combined with abacavir/lamivudine (ABC/3TC) or tenofovir/emtricitabine (TDF/FTC) in 1857 human immunodeficiency virus type 1–infected, treatment-naive persons enrolled between September 2005 and November 2007 at 59 sites in the United States and Puerto Rico. Associations of sex with 3 primary study endpoints of time to virologic failure, safety, and tolerability events were analyzed using Cox proportional hazards models. Model-based population pharmacokinetic analysis was performed using nonlinear mixed effects modeling (NONMEM version VII). Results. Of 1857 participants, 322 were women. Women assigned to ATV/r had a higher risk of virologic failure with either nucleoside reverse transcriptase inhibitor backbone than women assigned to EFV, or men assigned to ATV/r. The effects of ATV/r and EFV upon safety and tolerability risk did not differ significantly by sex. With ABC/3TC, women had a significantly higher (32%) safety risk compared to men; with TDF/FTC, the safety risk was 20% larger for women compared to men, but not statistically significant. Women had slower ATV clearance and higher predose levels of ATV compared to men. Self-reported adherence did not differ significantly by sex. Conclusions. This is the first randomized clinical trial to identify a significantly earlier time to virologic failure in women randomized to ATV/r compared to women randomized to EFV. This finding has important clinical implications given that boosted protease inhibitors are often favored over EFV in women of childbearing potential. Clinical Trials Registration NCT00118898. PMID:24253247

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases.

PubMed

Fan, Ye-Dong; Van Hoeck, Beatrice; Holovska, Vanda; Jashari, Ramadan

2012-06-01

To evaluate the efficiency of decontamination practice in European Homograft Bank (EHB), the data of the cardiovascular tissues received during recent 2 years were retrospectively analysed in this study. After initial assessment, the tissues were incubated in a 3-antibiotics' cocktail at 4°C for 20-48 h. The states of contamination were evaluated before and after incubation with the focus on the differences in donor type, tissue type, germ type and incubation time. Amongst 1,055 eligible tissues, 77.2% were hearts and 22.8% were arteries. 82.2% of the tissues were retrieved from the multi-organ donors (MOD), 15.4% from the recipients of heart transplantation (RHT) and 2.4% from the non-heart beating donors (NHBD). The initial contamination rate was 27.4% with a significantly higher incidence in arteries. The RHT tissues had the lowest contamination rate comparing to that of MOD and NHBD. Staphylococcus species was the major source of contamination. After antibiotic incubation, 76.8% of the contaminated tissues were disinfected, which was significantly higher for the hearts than the arteries. The RHT tissues had the highest decontamination rate than that of MOD and NHBD tissues. Propionibacterium acnes was detected in 48.1% of the remaining contaminated cases. The average incubation time of the Propionibacterium-positive tissues was significantly shorter than that of decontaminated tissues. In conclusion, the current decontamination protocol of EHB is sufficient for most of the initially contaminated bacteria, whereas it is inadequate for Propionibacterium acnes. This may be related to the slow-growing nature of this bacterium and thereby the relative shorter antibiotic incubation time.

The role of serum and urine interleukin-8 on acute pyelonephritis and subsequent renal scarring in children.

PubMed

Sheu, Ji-Nan; Chen, Shan-Ming; Meng, Meng-Hsiao; Lue, Ko-Huang

2009-10-01

Interleukin (IL)-8 acts as a potent neutrophils chemoattractant responsible for the migration of neutrophils into the infected renal tissue to protect against invading pathogens. The aim of this study was to assess the role of IL-8 on acute-phase pyelonephritis and later renal scarring in children. A total of 124 children with a first-time febrile urinary tract infection (UTI) were studied. The diagnosis of acute pyelonephritis was confirmed by Tc-dimercaptosuccinic acid (DMSA) renal scan. Serum and urine samples were obtained from 124 children with UTI and 20 healthy children for IL-8 measurement. The 124 children were divided into acute pyelonephritis (n = 70) and lower UTI (n = 54) groups according to the results of DMSA scans. The initial serum and urine IL-8 values of children with acute pyelonephritis were significantly higher when compared with lower UTI and healthy controls (all P < 0.001). Renal scarring was seen in 26 (38.8%) of these 67 children with acute pyelonephritis at follow-up DMSA scans. Both the initial serum and urine IL-8 concentrations were significantly higher in children with renal scarring than in those without (both P < 0.001). The mean age of children with renal scarring was also significantly lower than those without scarring (P = 0.004). Multivariate analysis showed that the highest initial IL-8 values, age <20 months and reflux grades > or =III all were independent predictors of renal scarring. Those children younger than 2 years of age with the highest IL-8 concentrations during the acute phase of pyelonephritis as well as children with reflux grades of III or greater are at a high-risk for developing renal scarring in the future.

Sex disparities in diagnosis of bladder cancer after initial presentation with hematuria: a nationwide claims-based investigation.

PubMed

Cohn, Joshua A; Vekhter, Benjamin; Lyttle, Christopher; Steinberg, Gary D; Large, Michael C

2014-02-15

Women have disproportionately higher mortality rates relative to incidence for bladder cancer. Multiple etiologies have been proposed, including delayed diagnosis and treatment. Guidelines recommend ruling out malignancy in men and women presenting with hematuria. This study sought to determine the difference in timing from presentation with hematuria to diagnosis of bladder cancer in women versus men. This is a retrospective population-based study examining the timing from presentation with hematuria to diagnosis of bladder cancer, based on data from the MarketScan databases, which include enrollees of more than 100 health insurance plans of approximately 40 large US employers from 2004 through 2010. All study patients presented with hematuria and were subsequently diagnosed with bladder cancer. The primary outcome measure was number of days between initial presentation with hematuria and diagnosis of bladder cancer by sex. A total of 5416 men and 2233 women met inclusion criteria. Mean days from initial hematuria claim to bladder cancer claim was significantly longer in women (85.4 versus 73.6 days, P < .001), and the proportion of women with >6 month delay in bladder cancer diagnosis was significantly higher (17.3% versus 14.1%, P < .001). Women were more likely to be diagnosed with urinary tract infection (odds ratio = 2.32, 95% confidence interval = 2.07-2.59) and less likely to undergo abdominal or pelvic imaging (odds ratio = 0.80, 95% confidence interval = 0.71-0.89). Both men and women experience significant delays between presentation with hematuria and diagnosis of bladder cancer, with longer delays for women. This may be partly responsible for the sex-based discrepancy in outcomes associated with bladder cancer. © 2013 American Cancer Society.

The Immune Pathogenesis of Immune Reconstitution Inflammatory Syndrome Associated with Highly Active Antiretroviral Therapy in AIDS

PubMed Central

Zhou, Huaying; He, Yan; Chen, Zi; He, Bo; He, Mei

2014-01-01

Abstract The present study investigated the immunological pathogenesis of immune reconstitution inflammatory syndrome (IRIS) in acquired immunodeficiency syndrome (AIDS) patients undergoing highly active antiretroviral therapy (HAART). A total of 238 patients with AIDS who received initial HAART were included in this prospective cohort study. Blood samples were collected immediately, at baseline, at week 12, and at week 24 after initial HAART and at the onset of IRIS. Lymphocyte subsets, Th1 and Th2 cytokines, and interleukin (IL)-7 levels were measured by flow cytometry or ELISA. Among the 238 patients with AIDS who received HAART, 47 patients developed IRIS. The percentages of CD4+ and CD8+ naive, memory, and activated cells exhibited no significant differences between AIDS patients with and without IRIS 24 weeks after initial HAART. The percentage of CD4+CD25+Foxp3+ regulatory T cells was lower in IRIS patients than in non-IRIS patients before HAART, 12 weeks after HAART, 24 weeks after HAART, and at the onset of IRIS. IL-2 and interferon (IFN)-γ levels were significantly higher at week 4 and at the onset of IRIS in IRIS patients than in non-IRIS patients. In contrast, IL-4 and IL-10 levels were significantly lower at week 4 and at the onset of IRIS in IRIS patients than in non-IRIS patients. Plasma IL-7 decreased gradually with the progression of HAART. The level of IL-7 was higher in IRIS patients than in non-IRIS patients at all follow-up time points. An imbalance of Th1/Th2 cytokines, a consistently low CD+CD25+Fox3+ percentage, and a high IL-7 level may be crucial in the pathogenesis of IRIS in AIDS patients who had received HAART. PMID:25131160

Impact of Masked Replacement of Sugar-Sweetened with Sugar-Free Beverages on Body Weight Increases with Initial BMI: Secondary Analysis of Data from an 18 Month Double–Blind Trial in Children

PubMed Central

Katan, Martijn B.; de Ruyter, Janne C.; Kuijper, Lothar D. J.; Chow, Carson C.; Hall, Kevin D.; Olthof, Margreet R.

2016-01-01

Background Substituting sugar-free for sugar-sweetened beverages reduces weight gain. This effect may be more pronounced in children with a high body mass index (BMI) because their sensing of kilocalories might be compromised. We investigated the impact of sugar-free versus sugary drinks separately in children with a higher and a lower initial BMI z score, and predicted caloric intakes and degree of compensation in the two groups. Methods and Findings This is a secondary, explorative analysis of our double-blind randomized controlled trial (RCT) which showed that replacement of one 250-mL sugary drink per day by a sugar—free drink for 18 months significantly reduced weight gain. In the 477 children who completed the trial, mean initial weights were close to the Dutch average. Only 16% were overweight and 3% obese. Weight changes were expressed as BMI z-score, i.e. as standard deviations of the BMI distribution per age and sex group. We designated the 239 children with an initial BMI z-score below the median as ‘lower BMI’ and the 238 children above the median as ‘higher BMI’. The difference in caloric intake from experimental beverages between treatments was 86 kcal/day both in the lower and in the higher BMI group. We used a multiple linear regression and the coefficient of the interaction term (initial BMI group times treatment), indicated whether children with a lower BMI responded differently from children with a higher BMI. Statistical significance was defined as p ≤ 0.05. Relative to the sugar sweetened beverage, consumption of the sugar—free beverage for 18 months reduced the BMI z-score by 0.05 SD units within the lower BMI group and by 0.21 SD within the higher BMI group. Body weight gain was reduced by 0.62 kg in the lower BMI group and by 1.53 kg in the higher BMI group. Thus the treatment reduced the BMI z-score by 0.16 SD units more in the higher BMI group than in the lower BMI group (p = 0.04; 95% CI -0.31 to -0.01). The impact of the intervention on body weight gain differed by 0.90 kg between BMI groups (p = 0.09; 95% CI -1.95 to 0.14). In addition, we used a physiologically-based model of growth and energy balance to estimate the degree to which children had compensated for the covertly removed sugar kilocalories by increasing their intake of other foods. The model predicts that children with a lower BMI had compensated 65% (95% CI 28 to 102) of the covertly removed sugar kilocalories, whereas children with a higher BMI compensated only 13% (95% CI -37 to 63). Conclusions The children with a BMI above the median might have a reduced tendency to compensate for changes in caloric intake. Differences in these subconscious compensatory mechanisms may be an important cause of differences in the tendency to gain weight. If further research bears this out, cutting down on the intake of sugar-sweetened drinks may benefit a large proportion of children, especially those who show a tendency to become overweight. Trial Registration ClinicalTrials.gov NCT00893529 PMID:27447721

Impact of Masked Replacement of Sugar-Sweetened with Sugar-Free Beverages on Body Weight Increases with Initial BMI: Secondary Analysis of Data from an 18 Month Double-Blind Trial in Children.

PubMed

Katan, Martijn B; de Ruyter, Janne C; Kuijper, Lothar D J; Chow, Carson C; Hall, Kevin D; Olthof, Margreet R

2016-01-01

Substituting sugar-free for sugar-sweetened beverages reduces weight gain. This effect may be more pronounced in children with a high body mass index (BMI) because their sensing of kilocalories might be compromised. We investigated the impact of sugar-free versus sugary drinks separately in children with a higher and a lower initial BMI z score, and predicted caloric intakes and degree of compensation in the two groups. This is a secondary, explorative analysis of our double-blind randomized controlled trial (RCT) which showed that replacement of one 250-mL sugary drink per day by a sugar-free drink for 18 months significantly reduced weight gain. In the 477 children who completed the trial, mean initial weights were close to the Dutch average. Only 16% were overweight and 3% obese. Weight changes were expressed as BMI z-score, i.e. as standard deviations of the BMI distribution per age and sex group. We designated the 239 children with an initial BMI z-score below the median as 'lower BMI' and the 238 children above the median as 'higher BMI'. The difference in caloric intake from experimental beverages between treatments was 86 kcal/day both in the lower and in the higher BMI group. We used a multiple linear regression and the coefficient of the interaction term (initial BMI group times treatment), indicated whether children with a lower BMI responded differently from children with a higher BMI. Statistical significance was defined as p ≤ 0.05. Relative to the sugar sweetened beverage, consumption of the sugar-free beverage for 18 months reduced the BMI z-score by 0.05 SD units within the lower BMI group and by 0.21 SD within the higher BMI group. Body weight gain was reduced by 0.62 kg in the lower BMI group and by 1.53 kg in the higher BMI group. Thus the treatment reduced the BMI z-score by 0.16 SD units more in the higher BMI group than in the lower BMI group (p = 0.04; 95% CI -0.31 to -0.01). The impact of the intervention on body weight gain differed by 0.90 kg between BMI groups (p = 0.09; 95% CI -1.95 to 0.14). In addition, we used a physiologically-based model of growth and energy balance to estimate the degree to which children had compensated for the covertly removed sugar kilocalories by increasing their intake of other foods. The model predicts that children with a lower BMI had compensated 65% (95% CI 28 to 102) of the covertly removed sugar kilocalories, whereas children with a higher BMI compensated only 13% (95% CI -37 to 63). The children with a BMI above the median might have a reduced tendency to compensate for changes in caloric intake. Differences in these subconscious compensatory mechanisms may be an important cause of differences in the tendency to gain weight. If further research bears this out, cutting down on the intake of sugar-sweetened drinks may benefit a large proportion of children, especially those who show a tendency to become overweight. ClinicalTrials.gov NCT00893529.

Marital stability and repartnering: infertility-related stress trajectories of unsuccessful fertility treatment.

PubMed

Martins, Mariana V; Costa, Patrício; Peterson, Brennan D; Costa, Maria E; Schmidt, Lone

2014-12-01

To compare the trajectories of infertility-related stress between patients who remain in the same relationship and patients who repartner. Longitudinal cohort study using latent growth modeling. Fertility centers. Childless men and women evaluated before starting a new cycle of fertility treatment and observed for a 5-year period of unsuccessful treatments. None. Marital stability and infertility-related stress. The majority of patients (86%) remained with their initial partner, but 14% of participants separated and repartnered while pursuing fertility treatments. Marital stability significantly predicted the initial status of infertility stress and infertility stress growth levels. Specifically, patients who repartnered had higher infertility stress levels at all time points compared with those who remained in the same relationship, regardless of the partner they were with at assessment. Furthermore, results showed an increasing stress trajectory over time for those who repartnered, compared with those who remained in a stable relationship. Men and women in fertility treatment who form a second union have higher initial levels of stress in their original relationship and higher changes in stress levels over the course of treatments. These findings suggest that high infertility-related stress levels before entering fertility treatment can negatively affect the stability of marital relationships and lead to repartnering. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Effect of Water Activity and Packaging Material on the Quality of Dehydrated Taro (Colocasia esculenta (L.) Schott) Slices during Accelerated Storage

PubMed Central

Jefferies, L. K.

2016-01-01

The quality of dehydrated taro slices in accelerated storage (45°C and 75% RH) was determined as a function of initial water activity (a w) and package type. Color, rehydration capacity, thiamin content, and α-tocopherol content were monitored during 34 weeks of storage in polyethylene and foil laminate packaging at initial storage a w of 0.35 to 0.71. Initial a w at or below 0.54 resulted in less browning and higher rehydration capacity, but not in significantly higher α-tocopherol retention. Foil laminate pouches resulted in a higher rehydration capacity and increased thiamin retention compared to polyethylene bags. Type of packaging had no effect on the color of the samples. Product stability was highest when stored in foil laminate pouches at 0.4a w. Sensory panels were held to determine the acceptability of rehydrated taro slices using samples representative of the taro used in the analytical tests. A hedonic test on rehydrated taro's acceptability was conducted in Fiji, with panelists rating the product an average of 7.2 ± 1.5 on a discrete 9-point scale. Using a modified Weibull analysis (with 50% probability of product failure), it was determined that the shelf life of dehydrated taro stored at 45°C was 38.3 weeks. PMID:27891508

High methane natural gas/air explosion characteristics in confined vessel.

PubMed

Tang, Chenglong; Zhang, Shuang; Si, Zhanbo; Huang, Zuohua; Zhang, Kongming; Jin, Zebing

2014-08-15

The explosion characteristics of high methane fraction natural gas were investigated in a constant volume combustion vessel at different initial conditions. Results show that with the increase of initial pressure, the peak explosion pressure, the maximum rate of pressure rise increase due to a higher amount (mass) of flammable mixture, which delivers an increased amount of heat. The increased total flame duration and flame development time result as a consequence of the higher amount of flammable mixture. With the increase of the initial temperature, the peak explosion pressures decrease, but the pressure increase during combustion is accelerated, which indicates a faster flame speed and heat release rate. The maximum value of the explosion pressure, the maximum rate of pressure rise, the minimum total combustion duration and the minimum flame development time is observed when the equivalence ratio of the mixture is 1.1. Additionally, for higher methane fraction natural gas, the explosion pressure and the maximum rate of pressure rise are slightly decreased, while the combustion duration is postponed. The combustion phasing is empirically correlated with the experimental parameters with good fitting performance. Furthermore, the addition of dilute gas significantly reduces the explosion pressure, the maximum rate of pressure rise and postpones the flame development and this flame retarding effect of carbon dioxide is stronger than that of nitrogen. Copyright © 2014 Elsevier B.V. All rights reserved.

Difference in initial dental biofilm accumulation between night and day.

PubMed

Dige, Irene; Schlafer, Sebastian; Nyvad, Bente

2012-12-01

The study of initial microbial colonization on dental surfaces is a field of intensive research because of the aetiological role of biofilms in oral diseases. Most previous studies of de novo accumulation and composition of dental biofilms in vivo do not differentiate between biofilms formed during day and night. This study hypothesized that there is a diurnal variation in the rate of accumulation of bacteria on solid surfaces in the oral cavity. In situ biofilm from healthy individuals was collected for 12 h during day and night, respectively, subjected to fluorescent in situ hybridization and visualized using confocal laser scanning microscopy. Analysis of the biofilms using stereological methods and digital image analysis revealed a consistent statistically significant difference between both the total number of bacteria and the biovolume in the two 12-h groups (p = 0.012), with the highest accumulation of bacteria during daytime (a factor of 8.8 and 6.1 higher, respectively). Hybridization with probes specific for streptococci and Actinomyces naeslundii indicated a higher proportion of streptococci in biofilms grown during daytime as compared to night-time. No differences could be observed for A. naeslundii. The degree of microbial coverage and the bacterial composition varied considerably between different individuals. The data provide firm evidence that initial biofilm formation decreases during the night, which may reflect differences in the availability of salivary nutrients. This finding is of significant importance when studying population dynamics during experimental dental biofilm formation.

SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors.

PubMed

Gregoric, Pavle; Pavle, Gregoric; Sijacki, Ana; Ana, Sijacki; Stankovic, Sanja; Sanja, Stankovic; Radenkovic, Dejan; Dejan, Radenkovic; Ivancevic, Nenad; Nenad, Ivancevic; Karamarkovic, Aleksandar; Aleksandar, Karamarkovic; Popovic, Nada; Nada, Popovic; Karadzic, Borivoje; Borivoje, Karadzic; Stijak, Lazar; Stefanovic, Branislav; Branislav, Stefanovic; Milosevic, Zoran; Zoran, Milosević; Bajec, Djordje; Djordje, Bajec

2010-01-01

Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP). We evaluated 234 patients with first onset of SAP appears in last twenty four hours. A total of 77 (33%) patients died. SIRS score and serum IL-6 concentration were measured in first hour after admission. In 105 patients with SIRS score 3 and higher, initial measured IL-6 levels were significantly higher than in the group of remaining 129 patients (72 +/- 67 pg/mL, vs 18 +/- 15 pg/mL). All nonsurvivals were in the first group, with SIRS score 3 and 4 and initial IL-6 concentration 113 +/- 27 pg/mL. The values of C-reactive Protein (CRP) measured after 48h, Acute Physiology and Chronic Health Evaluation (APACHE II) score on admission and Ranson score showed the similar correlation, but serum amylase level did not correlate significantly with Ranson score, IL-6 concentration and APACHE II score. The combination of SIRS score on admission and IL-6 serum concentration can be early, predictor of illness severity and outcome in SAP.

Continued Importance of Family Factors in Youth Smoking Behavior

PubMed Central

Xiao, Yang; Gordon, Judith S.; Khoury, Jane C.

2012-01-01

Introduction: Although it is known that levels of family factors (FF) such as parental monitoring and parent–adolescent connectedness vary during adolescence, it is unknown which factors remain protective, preventing smoking initiation, in youth of differing racial/ethnic groups. Using a longitudinal, nationally representative sample, we examined which FF protect against smoking initiation in White, Black, and Hispanic youth. Methods: A total of 3,473 parent-nonsmoking youth dyads from Round 1 (T1) of the National Survey of Parents and Youth were followed to Round 3 (T2). Youth smoking status at T2 was assessed as the primary outcome. We examined changes in FF (T2 – T1) and the protection afforded by these factors at T1 and T2 for smoking initiation, both by race/ethnicity and overall. Results: There were statistically significant decreases in levels of protective FF from T1 to T2 across all racial/ethnic groups; however, FF levels were higher in never-smokers compared with smoking initiators at both T1 and T2 (p < .05). Separate models by race/ethnicity showed the protective effect of increased perceived punishment in all racial/ethnic groups and protection against initiation by increased parental monitoring in Black and Hispanic youth. Overall, higher parental monitoring at T1 was associated with decreased odds of smoking initiation (33%); decreased parental monitoring and perceived punishment from T1 to T2 were associated with increased odds of smoking initiation (55% and 17%, respectively). Conclusions: Smoking prevention interventions should encourage parents to both enforce consistent consequences of smoking behavior, and continue monitoring, especially in minority groups. PMID:22454285

Obstructive Sleep Apnoea and Atrial Fibrillation

PubMed Central

Zhang, Ling; Hou, Yuemei; Po, Sunny S

2015-01-01

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and is associated with significant morbidity and mortality. Obstructive sleep apnoea (OSA) is common among patients with AF. Growing evidence suggests that OSA is associated with the initiation and maintenance of AF. This association is independent of obesity, body mass index and hypertension. OSA not only promotes initiation of AF but also has a significant negative impact on the treatment of AF. Patients with untreated OSA have a higher AF recurrence rate with drug therapy, electrical cardioversion and catheter ablation. Treatment with continuous positive airway pressure (CPAP) has been shown to improve AF control in patients with OSA. In this article, we will review and discuss the pathophysiological mechanisms of OSA that may predispose OSA patients to AF as well as the standard and emerging therapies for patients with both OSA and AF. PMID:26835094

Growth in Temperament and Parenting as Predictors of Adjustment During Children’s Transition to Adolescence

PubMed Central

Lengua, Liliana J.

2014-01-01

The author examined relations among demographic risk (income, maternal education, single-parent status), growth in temperament (fear, irritability, effortful control), and parenting (rejection, inconsistent discipline) across 3 years and the prediction of children’s adjustment problems in a community sample (N = 190; ages 8–12 years at Time 1). Family income was related to higher initial levels of fear, irritability, rejection, and inconsistency and lower effortful control but was not related to changes in these variables. Higher initial rejection predicted increases in child fear and irritability. Higher initial fear predicted decreases in rejection and inconsistency. Higher initial irritability predicted increases in inconsistency, and higher initial effortful control predicted decreases in rejection. When growth of parenting and temperament were considered simultaneously, increases in effortful control and decreases in fear and irritability predicted lower Time 3 internalizing and externalizing problems. Increases in rejection and inconsistent discipline predicted higher Time 3 externalizing, although sometimes the effect appeared to be indirect through temperament. The findings suggest that temperament and parenting predict changes in each other and predict adjustment during the transition to adolescence. PMID:16953689

Influence of breast-feeding on weight loss, jaundice, and waste elimination in neonates.

PubMed

Chen, Chien-Fu; Hsu, Mei-Ching; Shen, Chin-Hua; Wang, Chun-Lung; Chang, Shou-Chin; Wu, Keng-Gu; Wu, Shiao-Chi; Chen, Shu-Jen

2011-04-01

The Baby-Friendly Hospital Initiative began promoting exclusive breast-feeding in 2001 in Taiwan; however, few studies have investigated its impact. This study evaluated the influence of breast-feeding on Taiwanese neonates with regard to the frequency of jaundice, body weight loss (BWL), and elimination of both urine and stool. The medical records of 313 healthy mother-neonate pairs admitted at our hospital were reviewed retrospectively and divided into three groups: exclusively breast-feeding (n=161), mixed (breast/formula) feeding (n=80), and exclusively formula feeding (n=72). Compared with the exclusively formula feeding group, in the exclusively breast-fed neonates, the average total serum bilirubin level at 3 days after birth (p < 0.001) and the rate of significant hyperbilirubinemia ≥ 15 mg/dL (p<0.05) were significantly higher; the average BWLs at 2 and 3 days after birth (p < 0.001, p < 0.001) and the rate of BWL ≥ 10% (p < 0.05) were significantly higher; the average frequency of stool passage at 2 and 3 days after birth (p < 0.001, p < 0.001) and urination at 1, 2, and 3 days after birth (p < 0.001, p < 0.001, p < 0.001) were significantly less. The factors associated with a mother's choice of infant feeding type include maternal age and delivery method. Breast-feeding during the initial days of life has a significant influence on the degree of jaundice, amount of BWL, and the frequency of stool passage and urination. Copyright © 2011. Published by Elsevier B.V.

Tobacco Retail Outlet Density and Young Adult Tobacco Initiation

PubMed Central

Pearson, Jennifer L.; Anesetti-Rothermel, Andrew; Xiao, Haijun; Kirchner, Thomas R.; Vallone, Donna

2016-01-01

Background: A growing body of evidence indicates that the density of tobacco retail outlets around the home residence may influence tobacco use among youth and adults. The purpose of this study was to examine the impact of neighborhood tobacco retail outlet density on young adult initiation of different tobacco product types. Methods: Cross-sectional data from a 2013 nationally representative sample of young adults aged 18–34 was examined in relation to a 2012 geocoded listing of all outlets likely to sell tobacco in the United States. Separate multivariable logistic regression analyses examined associations between neighborhood outlet density and past 6 months first use of cigarettes, non-cigarette combustible products, and noncombustible products among adults aged 18–24 and 25–34. Results: Outlet density was significantly associated with recent initiation of cigarettes and other combustibles, but this impact varied for younger and older groups. Increased density was significantly associated with a higher likelihood of initiating cigarette use among adults aged 25–34 (OR = 3.75, 95% CI = 1.18, 11.90), and of initiating non-cigarette combustible use among 18–24 year olds (OR = 3.16, 95% CI = 1.03, 9.74). There was no impact of outlet density on recent noncombustible product initiation among either group. Conclusion: This study is the first to examine the impact of tobacco outlet density on young adult initiation of cigarettes and other tobacco products. Findings demonstrate that residential neighborhood outlet density is associated with recent initiation of combustible products and this effect varies by product type and age. The tobacco outlet environment may be a critical factor in promoting young adult tobacco use initiation. PMID:25666816

Recommend, but also Discuss: Different Patterns of Physician-Perceived Barriers to Discussing HPV Vaccination and Their Association with Vaccine Administration in 11-12 Year-Old Girls.

PubMed

Kulczycki, Andrzej; Qu, Haiyan; Shewchuk, Richard

2016-12-01

Objectives We examined variation in primary care physicians' (PCPs') perceptions of barriers to physician-initiated discussion of HPV vaccination, and how this is associated with the rates at which they discuss, initiate and continue to administer vaccination with 11-12 year-old girls. Methods We surveyed 301 PCPs using systematic random sampling. PCP variation in perceived barriers to discussing HPV vaccination was modeled using latent class analysis (LCA). The distinct PCP groups identified were compared with each other using three iterative logistic regression models to predict the likelihood of initiating vaccine discussion and the reported percentages of 11-12 year-old patients who initiated HPV vaccination and received follow-up shots. Results LCA revealed three groups of PCPs who perceived major, moderately significant and relatively minor barriers (17.9, 41.9 and 40.2 % of respondents, respectively). Pediatricians, PCPs who were female, had minority racial/ethnic status and who perceived only minor barriers had significantly higher odds of initiating discussion. PCPs were more likely to initiate HPV vaccination if they had initiated discussion and perceived minor or moderate communication barriers. Increased likelihood to administer follow-up HPV vaccine was associated with having initiated discussion, perceiving only minor barriers and working outside Deep South states, but not with having initiated vaccination. Conclusions for Practice PCPs who discuss HPV vaccination with girls aged 11-12 and their mothers are more likely to start and sustain vaccine administration. However, different PCPs perceive barriers to discussion in different ways. Interventions tailored to different groups of PCPs should assist them in overcoming barriers to discussing their recommendations when necessary.

Variability of Slip Behavior in Simulations of Dynamic Rupture Interaction With Stronger Fault Patches Over Long-Term Deformation Histories

NASA Astrophysics Data System (ADS)

Lapusta, N.; Liu, Y.

2007-12-01

Heterogeneity in fault properties can have significant effect on dynamic rupture propagation and aseismic slip. It is often assumed that a fixed heterogeneity would have similar effect on fault slip throughout the slip history. We investigate dynamic rupture interaction with a fault patch of higher normal stress over several earthquake cycles in a three-dimensional model. We find that the influence of the heterogeneity on dynamic events has significant variation and depends on prior slip history. We consider a planar strike-slip fault governed by rate and state friction and driven by slow tectonic loading on deeper extension of the fault. The 30 km by 12 km velocity-weakening region, which is potentially seismogenic, is surrounded by steady-state velocity-strengthening region. The normal stress is constant over the fault, except in a circular patch of 2 km in diameter located in the seismogenic region, where normal stress is higher than on the rest of the fault. Our simulations employ the methodology developed by Lapusta and Liu (AGU, 2006), which is able to resolve both dynamic and quasi-static stages of spontaneous slip accumulation in a single computational procedure. The initial shear stress is constant on the fault, except in a small area where it is higher and where the first large dynamic event initiates. For patches with 20%, 40%, 60% higher normal stress, the first event has significant dynamic interaction with the patch, creating a rupture speed decrease followed by a supershear burst and larger slip around the patch. Hence, in the first event, the patch acts as a seismic asperity. For the case of 100% higher stress, the rupture is not able to break the patch in the first event. In subsequent dynamic events, the behavior depends on the strength of heterogeneity. For the patch with 20% higher normal stress, dynamic rupture in subsequent events propagates through the patch without any noticeable perturbation in rupture speed or slip. In particular, supershear propagation and additional slip accumulation around the patch are never repeated in the simulated history of the fault, and the patch stops manifesting itself as a seismic asperity. This is due to higher shear stress that is established at the patch after the first earthquake cycle. For patches with higher normal stress, shear stress redistribution also occurs, but it is less effective. The patches with 40% and 60% higher normal stress continue to affect rupture speed and fault slip in some of subsequent events, although the effect is much diminished with respect to the first event. For example, there are no supershear bursts. The patch with 100% higher normal stress is first broken in the second large event, and it retains significant influence on rupture speed and slip throughout the fault history, occasionally resulting in supershear bursts. Additional slip complexity emerges for patches with 40% and higher normal stress contrast. Since higher normal stress corresponds to a smaller nucleation size, nucleation of some events moves from the rheological transitions (where nucleation occurs in the cases with no stronger patch and with the patch of 20% higher normal stress) to the patches of higher normal stress. The patches nucleate both large, model-spanning, events, and small events that arrest soon after exiting the patch. Hence not every event that originates at the location of a potential seismic asperity is destined to be large, as its subsequent propagation is significantly influenced by the state of stress outside the patch.

Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: a cross-sectional study.

PubMed

Apostolopoulou, Konstantina; Künzel, Heike E; Gerum, Sabine; Merkle, Katrin; Schulz, Sebastian; Fischer, Evelyn; Pallauf, Anna; Brand, Volker; Bidlingmaier, Martin; Endres, Stephan; Beuschlein, Felix; Reincke, Martin

2014-01-01

The renin-angiotensin-aldosterone-system (RAAS) has gained increasing attention in the investigation of the pathogenesis of depression. Primary hyperaldosteronism (PA) is associated with a marked aldosterone excess. Prior studies on PA describe an increased prevalence of anxiety and sub-threshold depressive symptoms in these patients. In a cross-sectional exploratory study we investigated 132 patients with PA. Twenty-seven patients were studied before initiation of specific treatment (U = untreated), 56 were studied 5.4 years after initiation of mineralocorticoid antagonist treatment (MRA) and 49 patients were studied 4.3 years after unilateral adrenalectomy (ADX). GAD-7 and PHQD self-rating questionnaires were used to assess symptoms for anxiety and depression. No significant difference was found between the three investigated groups. A higher prevalence for depression and anxiety compared to the normal population was found. Women of all groups had higher mean values compared to men, for depression in untreated patients this difference was found to be significant. Correlations between the psychopathology and hormones were only found for renin. Plasma renin concentration correlated significantly with anxious symptoms of untreated females. This study supports the RAAS to be involved in the pathogenesis of depression as patients with PA seem to be more depressive and anxious compared to the normal population. Gender differences in the regulation of the RAAS seem to be apparent, as females were more affected by the dysregulation than males.

Development and initial validation of a caffeine craving questionnaire.

PubMed

West, Oliver; Roderique-Davies, Gareth

2008-01-01

Craving for caffeine has received little empirical attention, despite considerable research into the potential for caffeine dependence. The main aim of this study was to develop, and initially validate, a multi-item, multidimensional instrument to measure cravings for caffeine. Participants were 189 caffeine consumers who completed the Questionnaire of Caffeine Cravings, which was based on the Questionnaire of Smoking Urges (QSU), in one of five naturally occurring periods of abstinence; 1-15 min; 16-120 mins; 3-7 h; 12-48 h and +48 h. Exploratory factor analysis suggested a three-factor solution best described the data; Factor 1 reflected strong desires, intentions and positive reinforcement; Factor 2 reflected mild/general positive and negative reinforcement and Factor 3 reflected functional/mood-based negative reinforcement. Significantly higher Factor 1 and Factor 2 scores were recorded for high frequency users; significantly higher Factor 1 and Factor 3 scores were recorded as a function of increased levels of dependence. Duration of abstinence did not significantly effect cravings across all three factors. Regression analyses suggested level of dependence best predicted both current cravings and frequency of daily use. These findings suggest caffeine cravings may be conceptualized multidimensionally and further validates the use of multidimensional, multi-item instruments. Cravings for caffeine may manifest and be detected across varying levels of dependence and, frequency of use and independently of duration of abstinence.

Substance use outcomes 5½ years past baseline for partnership-based, family-school preventive interventions

PubMed Central

Spoth, Richard L.; Randall, G. Kevin; Trudeau, Linda; Shin, Chungyeol; Redmond, Cleve

2008-01-01

This article reports adolescent substance use outcomes of universal family and school preventive interventions 5½ years past baseline. Participants were 1677 7th grade students from schools (N = 36) randomly assigned to the school-based Life Skills Training plus the Strengthening Families Program: For Parents and Youth 10–14 (LST + SFP 10–14), LST-alone, or a control condition. Self-reports were collected at baseline, 6 months later following the interventions, then yearly through the 12th grade. Measures included initiation—alcohol, cigarette, marijuana, and drunkenness, along with a Substance Initiation Index (SII)—and measures of more serious use—frequency of alcohol, cigarette, and marijuana use, drunkenness frequency, monthly poly-substance use, and advanced poly-substance use. Analyses ruled out differential attrition. For all substance initiation outcomes, one or both intervention groups showed significant, positive point-in-time differences at 12th grade and/or significant growth trajectory outcomes when compared with the control group. Although no main effects for the more serious substance use outcomes were observed, a higher-risk subsample demonstrated significant, positive 12th grade point-in-time and/or growth trajectory outcomes for one or both intervention groups on all measures. The observed pattern of results likely reflects a combination of predispositions of the higher-risk subsample, the timing of the interventions, and baseline differences between experimental conditions favoring the control group. PMID:18434045

Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS): reliability, initial validity and normative scores in higher education students.

PubMed

Allen Gomes, Ana; Ruivo Marques, Daniel; Meia-Via, Ana Maria; Meia-Via, Mariana; Tavares, José; Fernandes da Silva, Carlos; Pinto de Azevedo, Maria Helena

2015-04-01

Based on successive samples totaling more than 5000 higher education students, we scrutinized the reliability, structure, initial validity and normative scores of a brief self-report seven-item scale to screen for the continuum of nighttime insomnia complaints/perceived sleep quality, used by our team for more than a decade, henceforth labeled the Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS). In study/sample 1 (n = 1654), the items were developed based on part of a larger survey on higher education sleep-wake patterns. The test-retest study was conducted in an independent small group (n = 33) with a 2-8 week gap. In study/sample 2 (n = 360), focused mainly on validity, the BaSIQS was completed together with the Pittsburgh Sleep Quality Index (PSQI). In study 3, a large recent sample of students from universities all over the country (n = 2995) answered the BaSIQS items, based on which normative scores were determined, and an additional question on perceived sleep problems in order to further analyze the scale's validity. Regarding reliability, Cronbach alpha coefficients were systematically higher than 0.7, and the test-retest correlation coefficient was greater than 0.8. Structure analyses revealed consistently satisfactory two-factor and single-factor solutions. Concerning validity analyses, BaSIQS scores were significantly correlated with PSQI component scores and overall score (r = 0.652 corresponding to a large association); mean scores were significantly higher in those students classifying themselves as having sleep problems (p < 0.0001, d = 0.99 corresponding to a large effect size). In conclusion, the BaSIQS is very easy to administer, and appears to be a reliable and valid scale in higher education students. It might be a convenient short tool in research and applied settings to rapidly assess sleep quality or screen for insomnia complaints, and it may be easily used in other populations with minor adaptations.

[Results of Booster Vaccination in Children with Primary Vaccine Failure after Initial Varicella Vaccination].

PubMed

Ozakiv, Takao; Nishimura, Naoko; Gotoh, Kensei; Funahashi, Keiji; Yoshii, Hironori; Okuno, Yoshinobu

2016-05-01

In October 2014, the varicella vaccination policy in Japan was changed from a single voluntary inoculation to two routine inoculations. This paper reports the results of booster vaccination in children who did not show seroconversion after initial vaccination (i.e., primary vaccine failure : PVF) over a 7-year period prior to the introduction of routine varicella vaccination. Between November 2007 and May 2014, 273 healthy children aged between 1.1 and 14.5 years (median : 1.7 years) underwent varicella vaccination. Before and 4 to 6 weeks after vaccination, the antibody titers were measured using an immune adherence hemagglutination (IAHA) assay and a glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). In addition, side reactions were examined during the four-week period after vaccination. Children who did not show IAHA seroconversion (PVF) were recommended to receive a booster vaccination, and the measurement of antibody titers and an assessment of side reactions were performed after the booster dose. In May 2015, a questionnaire was mailed to each of the 273 participants to investigate whether they had developed varicella and/or herpes zoster after vaccination. After initial vaccination, the IAHA seroconversion rate was 75% and the mean antibody titer (Log2) with seroconversion was 4.7, while the gpELISA seroconversion rate was 84% and the mean antibody titer (Log10) with seroconversion was 2.4. Among children with PVF, 54 received booster vaccination within 81 to 714 days (median : 139 days) after the initial vaccination. After booster vaccination, the IAHA seroconversion rate was 98% and the mean antibody titer (Log2) with seroconversion was 5.8. Both the seroconversion rate and the antibody titer were higher compared with the values after the initial vaccination (p < 0.01). After booster vaccination, the gpELISA seropositive rate was 100% and the mean positive antibody titer (Log 10) was 3.6 ; similar results were obtained for the IAHA assay, with a significantly higher, antibody response than that after the initial vaccination (p < 0.01). Side reactions were generally minor, including fever (≥ 37.5 degrees C), rash at the injection site, and rash at other sites. There were no significant differences in the incidences of side reactions between the initial and booster vaccinations. A total of 185 participants responded to the questionnaire (response rate : 68%), and the period between receiving the initial vaccination and their response to the questionnaire ranged from 1.0 to 7.5 years (median : 4.0 years). The prevalence of breakthrough varicella after the initial vaccination was 17% among seroconverters who did not receive booster vaccination and 14% among non-seroconverters who received booster vaccination, showing no significant difference between the two groups. In conclusion, there are no safety issues regarding the administration of a booster vaccination to children with PVF after an initial varicella vaccination, and,a good antibody response can be expected.

Higher Order Aberration and Astigmatism in Children with Hyperopic Amblyopia

PubMed Central

Choi, Seung Kwon

2016-01-01

Purpose To investigate the changes in corneal higher-order aberration (HOA) during amblyopia treatment and the correlation between HOA and astigmatism in hyperopic amblyopia children. Methods In this retrospective study, a total of 72 eyes from 72 patients ranging in age from 38 to 161 months were included. Patients were divided into two groups based on the degree of astigmatism. Corneal HOA was measured using a KR-1W aberrometer at the initial visit and at 3-, 6-, and 12-month follow-ups. Correlation analysis was performed to assess the association between HOA and astigmatism. Results A total of 72 patients were enrolled in this study, 37 of which were classified as belonging to the higher astigmatism group, while 35 were assigned to the lower astigmatism group. There was a statistically significant difference in success rate between the higher and lower astigmatism groups. In both groups, all corneal HOAs were significantly reduced during amblyopia treatment. When comparing the two groups, a significant difference in coma HOA at the 12-month follow-up was detected (p = 0.043). In the Pearson correlation test, coma HOA at the 12-month follow-up demonstrated a statistically significant correlation with astigmatism and a stronger correlation with astigmatism in the higher astigmatism group than in the lower astigmatism group (coefficient values, 0.383 and 0.284 as well as p = 0.021 and p = 0.038, respectively). Conclusions HOA, particularly coma HOA, correlated with astigmatism and could exert effects in cases involving hyperopic amblyopia. PMID:26865804

Correlations of sleep disorders with severity of obstructive airway disease in mustard gas-injured patients.

PubMed

Vahedi, Ensieh; Taheri, Saeed; Alaedini, Farshid; Poursaleh, Zohreh; Ameli, Javad; Ghanei, Mostafa

2012-06-01

Mustard gas has serious adverse effects on several organs and functions in humans. In this study, we analyzed potential correlations between obstructive airway disease and sleep disorders in Iranian mustard gas-injured patients. We enrolled 30 male mustard gas-injured veterans and civilians from the Chemical Warfare Exposure Clinic at Baqiyatallah Hospital, Tehran. All the subjects underwent comprehensive polysomnographic and spirometric evaluations for diagnosis of sleep disorders. Patients were categorized into three groups according to the severity of their obstructive airway disease based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria: group 1 (GOLD I and II), group 2 (GOLD III), and group 3 (GOLD IV). Patients with less severe obstructive airway disease had significantly higher rate of hypopnea (p = 0.05) and AHI (p = 0.05). The number of REM events was significantly higher in patients with less severe airway disease (p = 0.028). Stage 1 sleep among patients with higher FEV1 significantly constituted a higher proportion of sleep, and stage 4 sleep was significantly longer in patients with higher DLCO (p = 0.043, both). We found that sleep parameters in SM-exposed patients have some relations with spirometric parameters. Future studies with large patient populations are needed for confirmation of our results, and therapeutic interventions are needed to evaluate endeavors we can do to enhance health and quality of life in our mustard gas-injured population.

Higher Order Aberration and Astigmatism in Children with Hyperopic Amblyopia.

PubMed

Choi, Seung Kwon; Chang, Ji Woong

2016-02-01

To investigate the changes in corneal higher-order aberration (HOA) during amblyopia treatment and the correlation between HOA and astigmatism in hyperopic amblyopia children. In this retrospective study, a total of 72 eyes from 72 patients ranging in age from 38 to 161 months were included. Patients were divided into two groups based on the degree of astigmatism. Corneal HOA was measured using a KR-1W aberrometer at the initial visit and at 3-, 6-, and 12-month follow-ups. Correlation analysis was performed to assess the association between HOA and astigmatism. A total of 72 patients were enrolled in this study, 37 of which were classified as belonging to the higher astigmatism group, while 35 were assigned to the lower astigmatism group. There was a statistically significant difference in success rate between the higher and lower astigmatism groups. In both groups, all corneal HOAs were significantly reduced during amblyopia treatment. When comparing the two groups, a significant difference in coma HOA at the 12-month follow-up was detected (p = 0.043). In the Pearson correlation test, coma HOA at the 12-month follow-up demonstrated a statistically significant correlation with astigmatism and a stronger correlation with astigmatism in the higher astigmatism group than in the lower astigmatism group (coefficient values, 0.383 and 0.284 as well as p = 0.021 and p = 0.038, respectively). HOA, particularly coma HOA, correlated with astigmatism and could exert effects in cases involving hyperopic amblyopia.

A comparison of GLAS SAT and NMC high resolution NOSAT forecasts from 19 and 11 February 1976

NASA Technical Reports Server (NTRS)

Atlas, R.

1979-01-01

A subjective comparison of the Goddard Laboratory for Atmospheric Sciences (GLAS) and the National Meteorological Center (NMC) high resolution model forecasts is presented. Two cases where NMC's operational model in 1976 had serious difficulties in forecasting for the United States were examined. For each of the cases, the GLAS model forecasts from initial conditions which included satellite sounding data were compared directly to the NMC higher resolution model forecasts, from initial conditions which excluded the satellite data. The comparison showed that the GLAS satellite forecasts significantly improved upon the current NMC operational model's predictions in both cases.

MORAL HAZARD IN HEALTH INSURANCE: DO DYNAMIC INCENTIVES MATTER?

PubMed Central

Aron-Dine, Aviva; Einav, Liran; Finkelstein, Amy; Cullen, Mark

2016-01-01

Using data from employer-provided health insurance and Medicare Part D, we investigate whether healthcare utilization responds to the dynamic incentives created by the nonlinear nature of health insurance contracts. We exploit the fact that, because annual coverage usually resets every January, individuals who join a plan later in the year face the same initial (“spot”) price of healthcare but a higher expected end-of-year (“future”) price. We find a statistically significant response of initial utilization to the future price, rejecting the null that individuals respond only to the spot price. We discuss implications for analysis of moral hazard in health insurance. PMID:26769985

Educating the Mind and the Spirit. Native American Higher Education Initiative. Profiles in Programming.

ERIC Educational Resources Information Center

Kellogg Foundation, Battle Creek, MI.

The Native American Higher Education Initiative (NAHEI), funded by the W. K. Kellogg Foundation, has departed from the assimilationist approach typical of past efforts to improve higher education for Native Americans. NAHEI supports Native American educational leaders' efforts to articulate their vision of higher education, strengthen their…

Serious fall injury history and adverse health outcomes after initiating hemodialysis among older U.S. adults.

PubMed

Bowling, C Barrett; Hall, Rasheeda; Khakharia, Anjali; Franch, Harold A; Plantinga, Laura C

2018-01-16

Although older adults with pre-dialysis chronic kidney disease (CKD) are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. We examined the association between a serious fall injury in the year prior to starting hemodialysis and adverse health outcomes in the year following dialysis initiation using a retrospective cohort study of U.S. Medicare beneficiaries ≥ 67 years old who initiated dialysis in 2010-2012. Serious fall injuries were defined using diagnostic codes for falls plus an injury (fracture, joint dislocation, or head injury). Health outcomes, defined as time-to-event variables within the first year of dialysis, included four outcomes: a subsequent serious fall injury, hospital admission, post-acute skilled nursing facility (SNF) utilization, and mortality. Among this cohort of 81,653 initiating hemodialysis, 2,958 (3.6%) patients had a serious fall injury in the year prior to hemodialysis initiation. In the first year of dialysis, 7.6% had a subsequent serious fall injury, 67.6% a hospitalization, 30.7% a SNF claim and 26.1% died. Those with vs. without a serious fall injury in the year prior to hemodialysis initiation were at higher risk (hazard ratio, 95% confidence interval) for a subsequent serious fall injury (2.65, 2.41-2.91), hospitalization (1.11, 1.06-1.16), SNF claim (1.40, 1.30-1.50), and death (1.14, 1.06-1.22). For older adults initiating dialysis, a history of a serious fall injury may provide prognostic information to support decision-making and establish expectations for life after dialysis initiation. Published by Oxford University Press on behalf of The Gerontological Society of America 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Effect of Reduced Phosphoric Acid Pre-etching Times 
on Enamel Surface Characteristics and Shear Fatigue Strength Using Universal Adhesives.

PubMed

Tsujimoto, Akimasa; Fischer, Nicholas; Barkmeier, Wayne; Baruth, Andrew; Takamizawa, Toshiki; Latta, Mark; Miyazaki, Masashi

2017-01-01

To examine the effect of reduced phosphoric acid pre-etching times on enamel fatigue bond strength of universal adhesives and surface characteristics by using atomic force microscopy (AFM). Three universal adhesives were used in this study (Clearfil Universal Bond [C], G-Premio Bond [GP], Scotchbond Universal Adhesive [SU]). Four pre-etching groups were employed: enamel pre-etched with phosphoric acid and immediately rinsed with an air-water spray, and enamel pre-etched with phosphoric acid for 5, 10, or 15 s. Ground enamel was used as the control group. For the initial bond strength test, 15 specimens per etching group for each adhesive were used. For the shear fatigue test, 20 specimens per etching group for each adhesive were loaded using a sine wave at a frequency of 20 Hz for 50,000 cycles or until failure occurred. Initial shear bond strengths and fatigue shear strengths of composite adhesively bonded to ground and pre-etched enamel were determined. AFM observations of ground and pre-etched enamel were also conducted, and surface roughness as well as surface area were evaluated. The initial shear bond strengths and fatigue shear strengths of the universal adhesives in the pre-etched groups were significantly higher than those of the control group, and were not influenced by the pre-etching time. Significantly higher surface roughness and surface area of enamel surfaces in pre-etched groups were observed compared with those in the control group. While the surface area was not significantly influenced by etching time, surface roughness of the enamel surfaces in the pre-etched groups significantly increased with pre-etching time. The results of this in vitro study suggest that reduced phosphoric acid pre-etching times do not impair the fatigue bond strength of universal adhesives. Although fatigue bond strength and surface area were not influenced by phosphoric-acid etching times, surface roughness increased with increasing etching time.

Predictors of supportive coparenting after relationship dissolution among at-risk parents.

PubMed

Kamp Dush, Claire M; Kotila, Letitia E; Schoppe-Sullivan, Sarah J

2011-06-01

Supportive coparenting after relationship dissolution is associated with increased father involvement which can buffer against the negative effects of parental relationship dissolution. Low-income, at-risk families are much more likely to experience relationship dissolutions; hence, supportive coparenting after dissolution is particularly important in these families. We examined whether relationship (commitment and quality) and child (difficult temperament and gender) characteristics predicted initial levels of, and change in, supportive coparenting after relationship dissolution in the Fragile Families and Child Wellbeing Study (N = 1,603). We used structural equation modeling of latent growth curves to examine four time points collected at the focal child's birth and first, third, and fifth birthdays. Ninety-percent of the mothers had nonmarital births, and about three-quarters had a high school diploma or less education. Overall, supportive coparenting decreased over time. Mothers in more committed relationships prior to the dissolution initially had significantly lower supportive coparenting. But over time, mothers who had been in more committed relationships increased in supportive coparenting. Mothers who had been in higher quality relationships prior to dissolution initially reported more supportive coparenting. At each time point, if a mother was romantically involved with a new partner, she reported significantly lower supportive coparenting compared to mothers who were single. With regard to child characteristics, mothers who reported their child as more difficult had significantly lower initial supportive coparenting. Similar results for fathers are discussed. Overall, the relationship characteristics of parents were important predictors of supportive coparenting both initially and over time. 2011 APA, all rights reserved

CCN production by new particle formation in the free troposphere

NASA Astrophysics Data System (ADS)

Rose, Clémence; Sellegri, Karine; Moreno, Isabel; Velarde, Fernando; Ramonet, Michel; Weinhold, Kay; Krejci, Radovan; Andrade, Marcos; Wiedensohler, Alfred; Ginot, Patrick; Laj, Paolo

2017-01-01

Global models predict that new particle formation (NPF) is, in some environments, responsible for a substantial fraction of the total atmospheric particle number concentration and subsequently contributes significantly to cloud condensation nuclei (CCN) concentrations. NPF events were frequently observed at the highest atmospheric observatory in the world, on Chacaltaya (5240 m a.s.l.), Bolivia. The present study focuses on the impact of NPF on CCN population. Neutral cluster and Air Ion Spectrometer and mobility particle size spectrometer measurements were simultaneously used to follow the growth of particles from cluster sizes down to ˜ 2 nm up to CCN threshold sizes set to 50, 80 and 100 nm. Using measurements performed between 1 January and 31 December 2012, we found that 61 % of the 94 analysed events showed a clear particle growth and significant enhancement of the CCN-relevant particle number concentration. We evaluated the contribution of NPF, relative to the transport and growth of pre-existing particles, to CCN size. The averaged production of 50 nm particles during those events was 5072, and 1481 cm-3 for 100 nm particles, with a larger contribution of NPF compared to transport, especially during the wet season. The data set was further segregated into boundary layer (BL) and free troposphere (FT) conditions at the site. The NPF frequency of occurrence was higher in the BL (48 %) compared to the FT (39 %). Particle condensational growth was more frequently observed for events initiated in the FT, but on average faster for those initiated in the BL, when the amount of condensable species was most probably larger. As a result, the potential to form new CCN was higher for events initiated in the BL (67 % against 53 % in the FT). In contrast, higher CCN number concentration increases were found when the NPF process initially occurred in the FT, under less polluted conditions. This work highlights the competition between particle growth and the removal of freshly nucleated particles by coagulation processes. The results support model predictions which suggest that NPF is an effective source of CCN in some environments, and thus may influence regional climate through cloud-related radiative processes.

Comparison between laparotomy first versus angiographic embolization first in patients with pelvic fracture and hemoperitoneum: a nationwide observational study from the Japan Trauma Data Bank

PubMed Central

2013-01-01

Background A common dilemma in the management of pelvic fractures is recognizing the presence of associated abdominal injury. The purpose of this study was to determine the association between initial therapeutic intervention (laparotomy or transcatheter arterial embolization (TAE)) and mortality. Methods This was a cohort study using the Japan Trauma Data Bank between 2004 and 2010, including blunt trauma patients with pelvic fractures and positive Focused Assessment with Sonography in Trauma (FAST) results. Eligible patients were restricted to those who underwent laparotomy or TAE/angiography as the initial therapeutic intervention. Crude and adjusted odds ratio (AOR) for in-hospital mortality were compared between the laparotomy first and TAE first groups (reference group). Multiple logistic regression analysis and propensity score adjusted analysis were used to adjust for clinically relevant confounders, including the severity of injury. Results Of the 317 participants, 123 patients underwent laparotomy first and 194 patients underwent TAE first. The two groups were similar in terms of age, although the laparotomy first group had higher mean Injury Severity Scores (ISS) and higher mean scores based on the abdominal Abbreviated Injury Scale (AIS), as well as lower mean pelvic AIS and systolic blood pressure (SBP). Half of the patients who were hypotensive (SBP < 90 mmHg) on arrival underwent TAE first. The laparotomy first group had a significantly higher crude in-hospital mortality (41% vs. 27%; P < 0.01). After adjusting for confounders, the choice of initial therapeutic intervention did not affect the in-hospital mortality (AOR, 1.20; 95% Confidence Interval (CI), 0.61-2.39). Even in the limited subgroup of hypotensive patients (SBP 66–89 mmHg and SBP < 65 mmHg subgroup), the effect was similar (AOR, 1.50; 95% CI, 0.56-4.05 and AOR, 1.05; 95% CI, 0.44-3.03). Conclusions In Japan, laparotomy and TAE are equally chosen as the initial therapeutic intervention regardless of hemodynamic status. No significant difference was seen between the laparotomy first and TAE first groups regarding in-hospital mortality. PMID:24299060

The Effect of Allopurinol on Renal Function.

PubMed

Krishnamurthy, Aneesa; Lazaro, Deana; Stefanov, Dimitre G; Blumenthal, David; Gerber, Donald; Patel, Sheetal

2017-01-01

Hyperuricemia is associated with development of gout, hypertension, and renal disease. The impact of allopurinol, a urate-lowering therapy, on renal function is unclear, especially in patients with chronic kidney disease who are at higher risk of hypersensitivity reaction. The aim of this study was to determine the effect of allopurinol on kidney function in hyperuricemic male veterans. This is a retrospective cohort study using pharmacy, medical, and laboratory records of veterans enrolled at the Veterans Administration New York Harbor Healthcare System, Brooklyn campus. Fifty patients with hyperuricemia defined as a serum uric acid greater than 7 mg/dL (average of ~9 mg/dL), newly started on allopurinol for any reason, with evidence of treatment compliance, were matched by age, race, sex, and estimated glomerular filtration rate (EGFR) to 50 hyperuricemic control subjects. The retrospective cases were observed from October 2000 until November 2006, at which time there was a change in the laboratory analyzer, making further comparisons inappropriate. On average, patients treated with a mean 221 (SD, 96) mg/d dose of allopurinol achieved 11.9 mL/min higher GFR (95% confidence interval, 4.8-11.9 mg/d dose; P = 0.01) than did the control group. Treatment effect was found to depend on the initial EGFR, as indicated by the significant treatment by initial EGFR interaction (P = 0.004) and increased with a higher initial EGFR. The allopurinol-treated group had a 0.10 mg/dL lower final creatinine level (95% confidence interval, 0.003-0.20 mg/dL; P = 0.04) than did the control subjects, adjusted for initial creatinine and age. The average length of follow-up was 3.4 years. There were 5 mild adverse events in the treated cases. Treatment of hyperuricemic patients with allopurinol over an average of 3.4 years resulted in a significant improvement of kidney function in this male cohort from the Veterans Administration Healthcare System. Clinicians should consider this potential benefit of allopurinol in the treatment of patients with hyperuricemia, those with overall maintained renal function.

Gut Microbiome Function Predicts Response to Anti-integrin Biologic Therapy in Inflammatory Bowel Diseases.

PubMed

Ananthakrishnan, Ashwin N; Luo, Chengwei; Yajnik, Vijay; Khalili, Hamed; Garber, John J; Stevens, Betsy W; Cleland, Thomas; Xavier, Ramnik J

2017-05-10

The gut microbiome plays a central role in inflammatory bowel diseases (IBDs) pathogenesis and propagation. To determine whether the gut microbiome may predict responses to IBD therapy, we conducted a prospective study with Crohn's disease (CD) or ulcerative colitis (UC) patients initiating anti-integrin therapy (vedolizumab). Disease activity and stool metagenomes at baseline, and weeks 14, 30, and 54 after therapy initiation were assessed. Community α-diversity was significantly higher, and Roseburia inulinivorans and a Burkholderiales species were more abundant at baseline among CD patients achieving week 14 remission. Several significant associations were identified with microbial function; 13 pathways including branched chain amino acid synthesis were significantly enriched in baseline samples from CD patients achieving remission. A neural network algorithm, vedoNet, incorporating microbiome and clinical data, provided highest classifying power for clinical remission. We hypothesize that the trajectory of early microbiome changes may be a marker of response to IBD treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of abutment screw coating on implant preload.

PubMed

Park, Jae-Kyoung; Choi, Jin-Uk; Jeon, Young-Chan; Choi, Kyung-Soo; Jeong, Chang-Mo

2010-08-01

The aim of the present study was to investigate the effects of tungsten carbide carbon (WC/CTa) screw surface coating on abutment screw preload in three implant connection systems in comparison to noncoated titanium alloy (Ta) screws. Preload of WC/CTa abutment screws was compared to noncoated Ta screws in three implant connection systems. The differences in preloads were measured in tightening rotational angle, compression force, initial screw removal torque, and postload screw removal torque after 1 million cyclic loads. Preload loss percent was calculated to determine the efficacy of maintaining the preload of two abutment screw types in relation to implant connection systems. WC/CTa screws provided 10 degrees higher tightening rotational angle than Ta screws in all three connection systems. This difference was statistically significant (p < 0.05). External-hex butt joint implant connections had a higher compression force than the two internal conical implant connections. WC/CTa screws provided a statistically significantly higher compression force than Ta screws in all three implant connections (p < 0.05). Ta screws required statistically higher removal torque than WC/CTa screws in all three implant connections (p < 0.05); however, Ta screws needed statistically lower postload removal torque than WC/CTa screws in all three implant connections (p < 0.05). Ta screws had a statistically higher preload loss percent than WC/CTa screws in all three implant connections (p < 0.05), indicating that WC/CTa screws were superior in maintaining the preload than Ta screws. Within the limits of present study, the following conclusions were made: (1) WC/CTa screws provided higher preload than noncoated Ta screws in all three implant connection systems. (2) The initial removal torque for Ta screws required higher force than WC/CTa screws, whereas postload removal torque for Ta screws was lower than WC/CTa screws. Calculated Ta screw preload loss percent was higher than for WC/CTa screws, suggesting that WC/CTa screws were more effective in maintaining the preload than Ta screws. (3) Internal conical connections were more effective in maintaining the screw preload in cyclic loads than external-hex butt joint connections.

Initial state with shear in peripheral heavy ion collisions

NASA Astrophysics Data System (ADS)

Magas, V. K.; Gordillo, J.; Strottman, D.; Xie, Y. L.; Csernai, L. P.

2018-06-01

In the present work we propose a new way of constructing the initial state for further hydrodynamic simulation of relativistic heavy ion collisions based on Bjorken-like solution applied streak by streak in the transverse plane. Previous fluid dynamical calculations in Cartesian coordinates with an initial state based on a streak by streak Yang-Mills field led for peripheral higher energy collisions to large angular momentum, initial shear flow and significant local vorticity. Recent experiments verified the existence of this vorticity via the resulting polarization of emitted Λ and Λ ¯ particles. At the same time parton cascade models indicated the existence of more compact initial state configurations, which we are going to simulate in our approach. The proposed model satisfies all the conservation laws, including conservation of a strong initial angular momentum, which is present in noncentral collisions. As a consequence of this large initial angular momentum we observe the rotation of the whole system as well as the fluid shear in the initial state, which leads to large flow vorticity. Another advantage of the proposed model is that the initial state can be given in both [t,x,y,z] and [τ ,x ,y ,η ] coordinates and thus can be tested by all 3+1D hydrodynamical codes which exist in the field.

Factors associated with higher levels of depressive symptoms among international university students in the Philippines.

PubMed

Lee, Romeo B; Maria, Madelene Sta; Estanislao, Susana; Rodriguez, Cristina

2013-11-01

Over the years, the number of international university students has been increasing in the Philippines. Depression tends to be common among this demographic sector, because of the varying challenges and expectations associated with studying abroad. Depression can be prevented if its symptoms, particularly those at higher levels, are identified and addressed early and effectively. This survey examined the social and demographic factors that are significantly associated with higher levels of depressive symptoms. One hundred twenty-six international university students were interviewed using the University Students Depression Inventory. Of the 13 factors analyzed, 3 were found with statistically significant associations with more intense levels of depressive symptoms. These factors were: level of satisfaction with one's financial condition, level of closeness with parents, and level of closeness with peers. In identifying international students with greater risk for depression, characteristics related to their financial condition and primary group relationships can be considered. There is a need to carry out more studies to confirm this initial evidence. The findings can help guide further discourse, research and program to benefit international students with higher levels of depressive symptoms.

The Effects of the Local Environment on Active Galactic Nuclei

NASA Astrophysics Data System (ADS)

Manzer, L. H.; De Robertis, M. M.

2014-06-01

There continues to be significant controversy regarding the mechanism(s) responsible for the initiation and maintenance of activity in galactic nuclei. In this paper we will investigate possible environmental triggers of nuclear activity through a statistical analysis of a large sample of galaxy groups. The focus of this paper is to identify active galactic nuclei (AGNs) and other emission-line galaxies in these groups and to compare their frequency with a sample of over 260,000 isolated galaxies from the same catalog. The galaxy groups are taken from the catalog of Yang et al., in which over 20,000 virialized groups of galaxies (2 <= N <= 20) with redshifts between 0.01 and 0.20 are from the Sloan Digital Sky Survey. We first investigate the completeness of our data set and find, though biases are a concern particularly at higher redshift, that our data provide a fair representation of the local universe. After correcting emission-line equivalent widths for extinction and underlying Balmer stellar absorption, we classify galaxies in the sample using traditional emission-line ratios, while incorporating measurement uncertainties. We find a significantly higher fraction of AGNs in groups compared with the isolated sample. Likewise, a significantly higher fraction of absorption-line galaxies are found in groups, while a higher fraction of star-forming galaxies prefer isolated environments. Within grouped environments, AGNs and star-forming galaxies are found more frequently in small- to medium-richness groups, while absorption-line galaxies prefer groups with larger richnesses. Groups containing only emission-line galaxies have smaller virial radii, velocity dispersions, and masses compared with those containing only absorption-line galaxies. Furthermore, the AGN fraction increases with decreasing distance to the group centroid, independent of galaxy morphology. Using properties obtained from Galaxy Zoo, there is an increased fraction of AGNs within merging systems, unlike star-forming galaxies. These results provide some indication that the local environment does play a role in initiating activity in galactic nuclei, but it is by no means simple or straightforward.

Effect of Chronic Social Stress on Prenatal Transfer of Antitetanus Immunity in Captive Breeding Rhesus Macaques (Macaca mulatta).

PubMed

Stammen, Rachelle L; Cohen, Joyce K; Meeker, Tracy L; Crane, Maria M; Amara, Rama R; Hicks, Sakeenah L; Meyer, Jerrold S; Ethun, Kelly F

2018-05-15

Because tetanus can cause significant morbidity and mortality in NHP, colonywide vaccination with tetanus toxoid is recommendedfor outdoor breeding colonies of rhesus macaques, with primary immunizations commonly given to infants at 6 mo of age followed by booster vaccines every 10 y. Maternal antibodies are thought to offer protective immunity to infants younger than 6 mo. However, historical colony data from the Yerkes National Primate Research Center show a higher incidence of tetanus among infants (≤ 6 mo old) born to subordinate dams. Whether this higher incidence of infantile tetanus is due to a higher incidence of trauma among subordinate animals or is a stress-induced impairment of maternal antibody protection is unknown. Studies in other NHP species suggest that chronic exposure to social stressors interferes with the receptor-mediated transplacental transfer of IgG. Therefore, the primary aim of this study was to determine whether chronic stress associated with social subordination impairs prenatal transfer of antitetanus immunity in breeding female rhesus macaques. Subjects included 26 high- and 26 low-ranking adult female rhesus macaques that were nearly 5 or 10 y after their initial immunization and their nonimmunized infants. We hypothesized that infants born to subordinate dams that were nearly 10 y after immunization would have the lowest infant-to-dam antibody ratios and thus would be at greatest risk for infection. Results revealed no significant intergroup differences in infant antitetanus IgG levels. However, infant-to-dam IgG ratios against tetanus were significantly lower among subordinate animals compared with dominant macaques, after accounting for the number of years since the dam's initial vaccination. In addition, higher maternal hair cortisol levels predicted lower infant-to-dam tetanus toxoid IgG ratios. Together, these findings suggest that chronic social stress in female rhesus macaques may hamper the prenatal transfer of antitetanus immunity to offspring.

Treatment Patterns, Complications, and Health Care Utilization Among Endometriosis Patients Undergoing a Laparoscopy or a Hysterectomy: A Retrospective Claims Analysis.

PubMed

Surrey, Eric S; Soliman, Ahmed M; Yang, Hongbo; Du, Ella Xiaoyan; Su, Bowdoin

2017-11-01

Hysterectomy and laparoscopy are common surgical procedures used for the treatment of endometriosis. This study compares outcomes for women who received either procedure within the first year post initial surgery. The study used data from the Truven Health MarketScan claims databases from 2004 to 2013 to identify women aged 18-49 years who received an endometriosis-related laparoscopy or hysterectomy. Patients were excluded if they did not have continuous insurance coverage from 1 year before through 1 year after their endometriosis-related procedure, if they were diagnosed with uterine fibroids prior to or on the date of surgery (i.e., index date), or if they had a hysterectomy prior to the index date. The descriptive analyses examined differences between patients with an endometriosis-related laparoscopy or hysterectomy in regard to medications prescribed, complications, and hospitalizations during the immediate year post procedure. The final sample consisted of 24,915 women who underwent a hysterectomy and 37,308 who underwent a laparoscopy. Results revealed significant differences between the cohorts, with women who received a laparoscopy more likely to be prescribed a GnRH agonist, progestin, danazol, or an opioid analgesic in the immediate year post procedure compared to women who underwent a hysterectomy. In contrast, women who underwent a hysterectomy generally had higher complication rates. Index hospitalization rates and length of stay (LOS) were higher for women who had a hysterectomy, while post-index hospitalization rates and LOS were higher for women who had a laparoscopy. For both cohorts, post-procedure complications were associated with significantly higher hospitalization rates and longer LOS. This study indicated significantly different 1-year post-surgical outcomes for patients who underwent an endometriosis-related hysterectomy relative to a laparoscopy. Furthermore, the endometriosis patients in this analysis had a considerable risk of surgical complications, subsequent surgeries, and hospital admissions, both during and after their initial therapeutic laparoscopy or hysterectomy. AbbVie.

Baseline characteristics of HIV & hepatitis B virus (HIV/HBV) co-infected patients from Kolkata, India.

PubMed

Sarkar, Jayeeta; Saha, Debraj; Bandyopadhyay, Bhaswati; Saha, Bibhuti; Kedia, Deepika; Guha Mazumder, D N; Chakravarty, Runu; Guha, Subhasish Kamal

2016-05-01

Hepatitis B virus (HBV) and HIV co-infection has variable prevalence worldwide. In comparison to HBV mono-infection, the course of chronic HBV infection is accelerated in HIV/HBV co-infected patients. the present study was carried out to analyse the baseline characteristics (clinical, biochemical, serological and virological) of treatment naïve HIV/HBV co-infected and HIV mono-infected patients. Between July 2011 and January 2013, a total number of 1331 HIV-seropositive treatment naïve individuals, enrolled in the ART Centre of Calcutta School of Tropical Medicine, Kolkata, India, were screened for hepatitis B surface antigen (HBsAg). A total of 1253 HIV mono-infected and 78 HIV/HBV co-infected patients were characterized. The co-infected patients were evaluated for HBeAg and anti-HBe antibody by ELISA. HIV RNA was quantified for all co-infected patients. HBV DNA was detected and quantified by real time-PCR amplification followed by HBV genotype determination. HIV/HBV co-infected patients had proportionately more advanced HIV disease (WHO clinical stage 3 and 4) than HIV mono-infected individuals (37.1 vs. 19.9%). The co-infected patients had significantly higher serum bilirubin, alanine aminotransferase (ALT), alkaline phosphatase and ALT/platelet ratio index (APRI). CD4 count was non-significantly lower in co-infected patients. Majority (61.5%) were HBeAg positive with higher HIV RNA (P<0.05), HBV DNA (p<0.001) and APRI (p<0.05) compared to those who were HBeAg negative. HBV/D was the predominant genotype (73.2%) and D2 (43.7%) was the commonest subgenotype. HIV/HBV co-infected patients had significantly higher serum bilirubin, ALT, alkaline phosphatase and lower platelet count. HBeAg positive co-infected patients had higher HIV RNA and HBV DNA compared to HBeAg negative co-infected patients. Prior to initiation of antiretroviral treatment (ART) all patients should be screened for HBsAg to initiate appropriate ART regimen.

Relationship between history of coronary heart disease at dialysis initiation and onset of events associated with heart disease: a propensity-matched analysis of a prospective cohort study.

PubMed

Inaguma, Daijo; Koide, Shigehisa; Takahashi, Kazuo; Hayashi, Hiroki; Hasegawa, Midori; Yuzawa, Yukio

2017-02-28

Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD) events, and a number of reports have shown a relationship between CKD and CVD in pre-dialysis or maintenance dialysis patients. However, few studies have reported serial observations during dialysis initiation and maintenance. Therefore, we examined whether the incidence of heart disease events differed between CKD patients with and without a history of coronary heart disease (CHD) at dialysis initiation. The subjects were patients in the 17 centers participating in the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis (AICOPP) from October 2011 to September 2013. We excluded nine patients whose outcomes were unknown, as determined by a survey conducted at the end of March 2015. Thus, we enrolled 1,515 subjects into the study. We classified patients into 2 groups according to the history of CHD (i.e., a CHD group and a non-CHD group). Propensity scores (PS) represented the probability of being assigned to a group with or without a history of CHD. Onset of heart disease events and associated mortality and all-cause mortality were compared in PS-matched patients by using the log-rank test for Kaplan-Meier curves. Factors contributing to heart disease events were examined using stepwise multivariate Cox proportional hazards analysis. There were 254 patients in each group after PS-matching. During observation, heart disease events occurred in 85 patients (33.5%) in the CHD group and 48 (18.9%) patients in the non-CHD group. The incidence was significantly higher in the CHD group (p < 0.0001). The CHD group was associated with higher incidence of heart disease events (vs. the non-CHD group, hazard ratio = 1.750, 95% confidence interval = 1.160-2.639). In addition, comorbidities such as diabetes mellitus, low body mass index, and low serum high-density lipoprotein cholesterol were associated with higher incidence of events. History of CHD at dialysis initiation was associated with a higher incidence of heart disease events and mortality and all-cause mortality. UMIN 000007096 . Registered 18 January 2012.

Maternal high-fat diet during pregnancy and lactation reduces the appetitive behavioral component in female offspring tested in a brief-access taste procedure.

PubMed

Treesukosol, Yada; Sun, Bo; Moghadam, Alexander A; Liang, Nu-Chu; Tamashiro, Kellie L; Moran, Timothy H

2014-04-01

Maternal high-fat diet appears to disrupt several energy balance mechanisms in offspring. Here, female offspring from dams fed a high-fat diet (HF) did not significantly differ in body weight compared with those fed chow (CHOW), when weaned onto chow diet. Yet when presented with both a chow and a high-fat diet, high-fat intake was significantly higher in HF compared with CHOW offspring. To assess taste-based responsiveness, offspring (12 wk old) were tested in 30-min sessions (10-s trials) to a sucrose concentration series in a brief-access taste test. Compared with CHOW, the HF offspring initiated significantly fewer trials but did not significantly differ in the amount of concentration-dependent licking. Thus, rather than affect lick response (consummatory), maternal diet affects spout approach (appetitive), which may be attributed to motivation-related mechanisms. Consistent with this possibility, naltrexone, an opioid receptor antagonist, further reduced trial initiation, but not licking in both groups. With naltrexone administration, the group difference in trial initiation was no longer evident, suggesting differences in endogenous opioid activity between the two groups. Relative expression of μ-opioid receptor in the ventral tegmental area was significantly lower in HF rats. When trial initiation was not required in one-bottle intake tests, no main effect of maternal diet on the intake of sucrose and corn oil emulsions was observed. Thus, the maternal high-fat diet-induced difference in diet preference is not likely due to changes in the sensory orosensory component of the taste stimulus but may depend on alterations in satiety signals or absorptive mechanisms.

Maternal high-fat diet during pregnancy and lactation reduces the appetitive behavioral component in female offspring tested in a brief-access taste procedure

PubMed Central

Sun, Bo; Moghadam, Alexander A.; Liang, Nu-Chu; Tamashiro, Kellie L.; Moran, Timothy H.

2014-01-01

Maternal high-fat diet appears to disrupt several energy balance mechanisms in offspring. Here, female offspring from dams fed a high-fat diet (HF) did not significantly differ in body weight compared with those fed chow (CHOW), when weaned onto chow diet. Yet when presented with both a chow and a high-fat diet, high-fat intake was significantly higher in HF compared with CHOW offspring. To assess taste-based responsiveness, offspring (12 wk old) were tested in 30-min sessions (10-s trials) to a sucrose concentration series in a brief-access taste test. Compared with CHOW, the HF offspring initiated significantly fewer trials but did not significantly differ in the amount of concentration-dependent licking. Thus, rather than affect lick response (consummatory), maternal diet affects spout approach (appetitive), which may be attributed to motivation-related mechanisms. Consistent with this possibility, naltrexone, an opioid receptor antagonist, further reduced trial initiation, but not licking in both groups. With naltrexone administration, the group difference in trial initiation was no longer evident, suggesting differences in endogenous opioid activity between the two groups. Relative expression of μ-opioid receptor in the ventral tegmental area was significantly lower in HF rats. When trial initiation was not required in one-bottle intake tests, no main effect of maternal diet on the intake of sucrose and corn oil emulsions was observed. Thus, the maternal high-fat diet-induced difference in diet preference is not likely due to changes in the sensory orosensory component of the taste stimulus but may depend on alterations in satiety signals or absorptive mechanisms. PMID:24500433

Emergent risk factors associated with eyeball loss and ambulatory vision loss after globe injuries.

PubMed

Hyun Lee, Seung; Ahn, Jae Kyoun

2010-07-01

The objective of this study was to evaluate risk factors associated with eyeball loss and ambulatory vision loss on emergent examination of patients with ocular trauma. We reviewed the medical records of 1,875 patients hospitalized in a single tertiary referral center between January 2003 and December 2007. Emergent examinations included a history of trauma, elapsed time between injury and hospital arrival, visible intraocular tissues, and initial visual acuity (VA) using a penlight. The main outcome measures were ocular survival and ambulatory vision survival (>20/200) at 1 year after trauma using univariate and multivariate regression analysis. The ocular trauma scores were significantly higher in open globe injuries than in closed globe injuries (p < 0.01). In open globe injuries, initial VA less than light perception (LP) and a history of golf ball injury were the significant risk factors associated with eyeball loss. Elapsed time more than 12 hours and visible intraocular tissues were the significant risk factors associated with ambulatory vision loss. The most powerful predictor of eyeball loss and ambulatory vision loss was eyeball rupture. In closed globe injuries, there were no significant risk factors of eyeball loss, whereas initial vision less than LP and the presence of relative afferent pupillary defect were the significant risk factors associated with ambulatory vision loss. An initial VA less than LP using a penlight, a history of golf ball injury, and elapsed time more than 12 hours between ocular trauma and hospital arrival were associated with eyeball loss and ambulatory vision loss. Physicians should bear these factors in mind so that they can more effectively counsel patients with such injuries.

Follow-up of patients with localized breast cancer and first indicators of advanced breast cancer recurrence: A retrospective study.

PubMed

Viot, Julien; Bachour, Martin; Meurisse, Aurélia; Pivot, Xavier; Fiteni, Frédéric

2017-08-01

We conducted a retrospective study to assess the follow-up of patients with localized breast cancer and the first indicators of advanced breast cancer recurrence. All patients with advanced breast cancer recurrence treated between January 2010 and June 2016 in our institution were registered. Among these patients, 303 patients initially treated for early breast cancer with curative intent were identified. After initial curative treatment, follow-up involved the oncologist, the general practitioner and the gynecologist in 68.0%, 48.9% and 19.1% of cases, respectively. The median DFI was 4 years for luminal A, 3.8 years for luminal B, 3.7 years for HER2-positive and 1.5 years for TNBC (p = 0.07). Breast cancer tumor marker was prescribed for 164 patients (54.1%). No difference in terms of follow-up was observed according to the molecular subtype. Symptoms were the primary indicator of relapse for 143 patients (47.2%). Breast cancer recurrence was discovered by CA 15.3 elevation in 57 patients (18.8%) and by CAE elevation in 3 patients (1%). The rate of relapse diagnosed by elevation of CA 15.3 or CAE was not statistically associated with the molecular subtype (p = 0.65). Luminal A cases showed a significantly higher rate of bone metastases (p = 0.0003). TNBC cases showed a significantly higher rate of local recurrence (p = 0.002) and a borderline statistical significant higher rate of lung/pleural metastases (p = 0.07). Follow-up recommendations could be adapted in clinical practice according to the molecular subtype. General practitioners should be more involved by the specialists in breast cancer follow-up. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of inhaled corticosteroid use on weight (BMI) in pediatric patients with moderate-severe asthma.

PubMed

Han, Jennifer; Nguyen, John; Kim, Yuna; Geng, Bob; Romanowski, Gale; Alejandro, Lawrence; Proudfoot, James; Xu, Ronghui; Leibel, Sydney

2018-04-19

Assess the relationship between inhaled corticosteroid use (ICS) and weight (BMI) in pediatric patients with moderate-severe asthma. Assess if the number of emergency department (ED) visits correlates with overall BMI trajectory. Assess the trend of prescribing biologic therapy in pediatric patients with moderate-severe asthma and determine its relationship with weight (BMI). A retrospective chart review was performed on 93 pediatric patients with moderate-severe asthma to determine the relationship between ICS use and weight (BMI), biologic therapy and BMI, and number of ED visits and BMI trajectory. A mixed effects model was employed with the correlation between repeated measures accounted for through the random effects. There is a statistically significant increase of 0.369 kg/m 2 in BMI trajectory per year in subjects on high-dose steroids compared to an increase of 0.195 kg/m 2 in the low dose group (p < 0.05). The BMI of subjects initiated on biologic therapy (omalizumab or mepolizumab) had a statistically significant decrease in BMI trajectory of 0.818 kg/m 2 per year (p < 0.05). Subjects with ≥5 ED visits due to asthma exacerbations had a significantly higher BMI trajectory (p < 0.05). The potency of ICS use in pediatric patients with moderate-severe asthma affects BMI trajectory; the higher the dose, the greater the projected BMI increase per year. Initiation of biologic therapy decreased BMI trajectory over time. Lastly, those with frequent ED visits had a higher BMI trend. Future prospective studies are warranted that further evaluate the potential metabolic impacts of ICS and assess the effects of biologic therapy on BMI.

Impact of nonadherence on complication risks and healthcare costs in patients newly-diagnosed with diabetes.

PubMed

Fukuda, Haruhisa; Mizobe, Miki

2017-01-01

To investigate the association between nonadherence to diabetes treatment and the occurrence of diabetes complications. Our study retrospectively identified adherence and nonadherence to diabetes treatment in patients during the first year of observation after new diagnoses of type 2 diabetes enrolled in commercial database from 52 health insurers in Japan. Participants were insurance enrollees with type 2 diabetes who received healthcare between 2005 and 2013, and who could be tracked for more than 12months from the initiation of diabetes treatment. We compared the occurrence of diabetes-related complications (retinopathy, nephropathy, neuropathy, ischemic heart disease, cerebrovascular disease, and chronic arterial occlusion) and all-cause healthcare expenditure during the second to eighth years. We identified 1784 nonadherent patients and 9547 adherent patients. Cox proportional hazard models showed that the occurrence of microvascular complications was significantly higher in the nonadherent group: the hazard ratios (95% confidence intervals) for retinopathy, nephropathy, and neuropathy were 2.04 (1.57-2.66), 1.91 (1.35-2.72), and 1.83 (1.02-3.27), respectively. However, no significant differences were observed between the adherent and nonadherent groups for the macrovascular complications (ischemic heart disease, cerebrovascular disease, and chronic arterial occlusion). In addition, the nonadherent group had a significantly higher cumulative healthcare expenditure than the adherent group during the second-to-fifth-year period (p=0.029) and the second-to-sixth-year period (p=0.009) after treatment initiation. Nonadherence in the first year of diabetes may increase the incidence of complications and result in higher expenditures for patients and payers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Relationship between Higher-order Aberrations and Amblyopia Treatment in Hyperopic Anisometropic Amblyopia

PubMed Central

Lee, Soo Han

2014-01-01

Purpose To investigate the relationship between higher-order aberrations (HOAs) and amblyopia treatment in children with hyperopic anisometropic amblyopia. Methods The medical records of hyperopic amblyopia patients with both spherical anisometropia of 1.00 diopter (D) or more and astigmatic anisometropia of less than 1.00 D were reviewed retrospectively. Based on the results of the amblyopia treatment, patients were divided into two groups: treatment successes and failures. Using the degree of spherical anisometropia, subjects were categorized into mild, moderate, or severe groups. Ocular, corneal, and internal HOAs were measured using a KR-1W aberrometer at the initial visit, and at 3-month, 6-month, and 12-month follow-ups. Results The results of the 45 (21 males and 24 females) hyperopic anisometropic amblyopia patients who completed the 12-month follow-up examinations were analyzed. The mean patient age at the initial visit was 70.3 months. In total, 28 patients (62.2%) had successful amblyopia treatments and 17 patients (37.8%) failed treatment after 12 months. Among the patient population, 24 (53.3%) had mild hyperopic anisometropia and 21 (46.7%) had moderate hyperopic anisometropia. When comparing the two groups (i.e., the success and failure groups), ocular spherical aberrations and internal spherical aberrations in the amblyopic eyes were significantly higher in the failure group at every follow-up point. There were no significant differences in any of the HOAs between mild and moderate cases of hyperopic anisometropia at any follow-up. When the amblyopic and fellow eyes were compared between the groups there were no significant differences in any of the HOAs. Conclusions HOAs, particularly ocular spherical aberrations and internal spherical aberrations, should be considered as reasons for failed amblyopia treatment. PMID:24505201

Freeing the Chi of Change: The Higher Education Academy and Enhancing Teaching and Learning in Higher Education

ERIC Educational Resources Information Center

Trowler, Paul; Fanghanel, Joelle; Wareham, Terry

2005-01-01

This article examines recent UK policy initiatives to enhance teaching and learning in higher education in the UK, and the quality of the student experience there. The Higher Education Academy has recently begun to work in this area and the Higher Education Bill (2004) has passed into law. A reflective review of previous initiatives is therefore…

The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions

PubMed Central

Quatela, Angelica; Callister, Robin; Patterson, Amanda; MacDonald-Wicks, Lesley

2016-01-01

This systematic review investigated the effects of differing energy intakes, macronutrient compositions, and eating patterns of meals consumed after an overnight fast on Diet Induced Thermogenesis (DIT). The initial search identified 2482 records; 26 papers remained once duplicates were removed and inclusion criteria were applied. Studies (n = 27) in the analyses were randomized crossover designs comparing the effects of two or more eating events on DIT. Higher energy intake increased DIT; in a mixed model meta-regression, for every 100 kJ increase in energy intake, DIT increased by 1.1 kJ/h (p < 0.001). Meals with a high protein or carbohydrate content had a higher DIT than high fat, although this effect was not always significant. Meals with medium chain triglycerides had a significantly higher DIT than long chain triglycerides (meta-analysis, p = 0.002). Consuming the same meal as a single bolus eating event compared to multiple small meals or snacks was associated with a significantly higher DIT (meta-analysis, p = 0.02). Unclear or inconsistent findings were found by comparing the consumption of meals quickly or slowly, and palatability was not significantly associated with DIT. These findings indicate that the magnitude of the increase in DIT is influenced by the energy intake, macronutrient composition, and eating pattern of the meal. PMID:27792142

Relationships Among Adaptive and Maladaptive Emotion Regulation Strategies and Psychopathology During the Treatment of Comorbid Anxiety and Alcohol Use Disorders

PubMed Central

Conklin, Laren R.; Cassiello-Robbins, Clair; Brake, C. Alex; Sauer-Zavala, Shannon; Farchione, Todd J.; Ciraulo, Domenic A.; Barlow, David H.

2015-01-01

Both maladaptive and adaptive emotion regulation strategies have been linked with psychopathology. However, previous studies have largely examined them separately, and little research has examined the interplay of these strategies cross-sectionally or longitudinally in patients undergoing psychological treatment. This study examined the use and interplay of adaptive and maladaptive emotion regulation strategies in 81 patients receiving cognitive-behavioral interventions for comorbid alcohol use and anxiety disorders. Patients completed measures of emotion regulation strategy use and symptoms of psychopathology pre- and post-treatment. Cross-sectionally, higher use of maladaptive strategies (e.g., denial) was significantly related to higher psychopathology pre- and post-treatment, whereas higher use of adaptive strategies (e.g., acceptance) only significantly related to lower psychopathology post-treatment. Prospectively, changes in maladaptive strategies, but not changes in adaptive strategies, were significantly associated with post-treatment psychopathology. However, for patients with higher pre-treatment maladaptive strategy use, gains in adaptive strategies were significantly associated with lower post-treatment psychopathology. These findings suggest that psychological treatments may maximize efficacy by considering patient skill use at treatment outset. By better understanding a patient's initial emotion regulation skills, clinicians may be better able to optimize treatment outcomes by emphasizing maladaptive strategy use reduction predominately, or in conjunction with increasing adaptive skill use. PMID:26310363

Current practice and barriers to the management of sexual issues in rheumatology: results of a survey of health professionals.

PubMed

Helland, Y; Garratt, A; Kjeken, I; Kvien, T K; Dagfinrud, H

2013-01-01

To explore multidisciplinary health professionals' (HPs) management of disease-related sexual issues in patients with rheumatic diseases, including their perceptions and assessments, and identify factors that prevent HPs from addressing sexuality as a topic with patients. A self-constructed questionnaire was sent to 647 nurses, physicians, physiotherapists, occupational therapists, social workers, and psychologists working within rheumatology care. A multivariate logistic regression model of significant determinants for initiating sexual topics with patients was built. The mean age of the responders (n = 274, 42% response rate, 87% female) was 46 years. While 96% considered sexuality a relevant topic in rheumatology care, 71% seldom/never raised the topic. The patient was the main initiator (53%), and 88% of HPs gave the patient responsibility to initiate. The HPs with relevant education in sexuality were significantly more comfortable talking about sexuality (p < 0.001) and raised sexual issues significantly more often (p < 0.001). In the multivariate analyses, higher age [odds ratio (OR) 3.69], having relevant education (OR 3.16), and being comfortable to some extent (OR 3.62) or to a large extent (OR 5.58) remained significant predictors to initiating sexual topics. Although HPs regarded sexuality as a relevant topic in rheumatic health care, they seldom raised the topic in consultations. Those with further education in sexuality addressed sexual issues more frequently and felt more comfortable. Correspondingly, the majority of respondents requested more education. Such training should be part of the basic HPs' education, as well as part of postgraduate courses.

The association of 22 Y chromosome short tandem repeat loci with initiative-aggressive behavior.

PubMed

Yang, Chun; Ba, Huajie; Zhang, Wei; Zhang, Shuyou; Zhao, Hanqing; Yu, Haiying; Gao, Zhiqin; Wang, Binbin

2018-05-15

Aggressive behavior represents an important public concern and a clinical challenge to behaviorists and psychiatrists. Aggression in humans is known to have an important genetic basis, so to investigate the association of Y chromosome short tandem repeat (Y-STR) loci with initiative-aggressive behavior, we compared allelic and haplotypic distributions of 22 Y-STRs in a group of Chinese males convicted of premeditated extremely violent crimes (n = 271) with a normal control group (n = 492). Allelic distributions of DYS533 and DYS437 loci differed significantly between the two groups (P < 0.05). The case group had higher frequencies of DYS533 allele 14, DYS437 allele 14, and haplotypes 11-14 of DYS533-DYS437 compared with the control group. Additionally, the DYS437 allele 15 frequency was significantly lower in cases than controls. No frequency differences were observed in the other 20 Y-STR loci between these two groups. Our results indicate a genetic role for Y-STR loci in the development of initiative aggression in non-psychiatric subjects. Copyright © 2018 Elsevier B.V. All rights reserved.

[Adsorption characteristics of acetone and butanone onto honeycomb ZSM-5 molecular sieve].

PubMed

Du, Juan; Luan, Zhi-Qiang; Xie, Qiang; Ye, Ping-Wei; Li, Kai; Wang, Xi-Qin

2013-12-01

Adsorption capacity of acetone and acetone-butanone mixture onto honeycomb ZSM-5 molecular sieve was measured in this paper, and the influences of relative humidity, initial adsorbate concentration and airflow velocity on the adsorption process were investigated. Besides, adsorption performance parameters were calculated by Wheeler's equation. The results showed that relative humidity had no obvious influence on the acetone adsorption performance, which suggests that this material has good hydrophobic ability; in the low concentration range, the dynamic saturated adsorption capacity of acetone increased with the increase of initial concentration, but in the occasion of high concentration of acetone gas (more than 9 mg x L(-1)), the dynamic saturated adsorption capacity maintained at a certain level and did not vary with the increase of initial concentration; the increase of air flow velocity resulted in significant increase of acetone adsorption rate constant, at the same time the critical layer thickness of the adsorbent bed also increased significantly. In the cases of acetone-butanone mixture, the adsorption capacity of butanone onto ZSM-5 was clearly higher than that of acetone.

Heterogeneity in phenotypes based on smoking status in the Great Lakes Smoker Sibling Registry.

PubMed

Pomerleau, Cynthia S; Pomerleau, Ovide F; Snedecor, Sandy M; Gaulrapp, Stefanie; Kardia, Sharon L R

2004-12-01

We investigated whether 52 same-sex sibling pairs discordant for ever-smoking differed on psychiatric cofactors, alcohol and caffeine use, and responses to initial exposure to smoking. Ever-smokers scored significantly higher on measures of novelty seeking, depression, and childhood ADHD, and on alcohol dependence, alcohol intake, and caffeine intake. They reported significantly more pleasurable experiences, dizziness, "buzz," and relaxation upon initial exposure to smoking and significantly fewer displeasurable sensations, nausea, and cough than did nicotine-exposed, never-smoking siblings. Ever-smokers had significantly fewer years of education than their never-smoking siblings, suggesting that the concentration of smokers in lower socioeconomic strata may be partly due to downward mobility among smokers, possibly because of the observed elevation in psychiatric cofactors, which may interfere with academic performance. These findings are consistent with differences previously identified in unrelated ever- and never-smokers. Because same-sex siblings typically share a large set of common environments during childhood, our findings could be due either to genetic differences among siblings and/or (excepting educational level and responses to early exposure) to differences in adult environments.

Landing strategies focusing on the control of tibial rotation in the initial contact period of one-leg forward hops.

PubMed

Chen, W-L; Chen, Y-T; Huang, S-Y; Yang, C-Y; Wu, C-D; Chang, C-W

2017-08-01

Anterior cruciate ligament (ACL) reconstruction (ACLR) surgeries successfully restore anterior tibial translation but not tibial rotation. This study aimed to explore landing strategies focusing on the control of tibial rotation at landing when the ACL is most vulnerable. Three groups of male subjects (50 ACLRs, 26 basketball players, and 31 controls) participated in one-leg forward hop tests for determining the tibial rotatory landing strategies adopted during the initial landing phase. The differences in knee kinematics and muscle activities between internal and external tibial rotatory (ITR, ETR) landing strategies were examined. A higher proportion of basketball players (34.6%) were found to adopt ITR strategies (controls: 6.5%), exhibiting significantly greater hopping distance and knee strength. After adjusting for hopping distance, subjects adopting ITR strategies were found to hop faster with straighter knees at foot contact and with greater ITR and less knee adduction angular displacement during the initial landing phase. However, significantly greater angular displacement in knee flexion, greater medial hamstring activities, and greater co-contraction index of hamstrings and medial knee muscles were also found during initial landing. Our results support the importance of the recruitments of medial hamstrings or the local co-contraction in assisting the rotatory control of the knee during initial landing for avoiding ACL injuries. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of high CD4 cell counts on death and attrition among HIV patients receiving antiretroviral treatment: an observational cohort study.

PubMed

Tang, Zhenzhu; Pan, Stephen W; Ruan, Yuhua; Liu, Xuanhua; Su, Jinming; Zhu, Qiuying; Shen, Zhiyong; Zhang, Heng; Chen, Yi; Lan, Guanghua; Xing, Hui; Liao, Lingjie; Feng, Yi; Shao, Yiming

2017-06-09

Current WHO guidelines recommend initiating ART regardless of CD4+ cell count. In response, we conducted an observational cohort study to assess the effects of pre-ART CD4+ cell count levels on death, attrition, and death or attrition in HIV treated patients. This large HIV treatment cohort study (n = 49,155) from 2010 to 2015 was conducted in Guangxi, China. We used a Cox regression model to analyze associations between pre-ART CD4+ cell counts and death, attrition, and death or attrition. The average mortality and ART attrition rates among all treated patients were 2.63 deaths and 5.32 attritions per 100 person-years, respectively. Compared to HIV patients with <350 CD4+ cells/mm 3 at ART initiation, HIV patients with >500 CD4+ cells/mm 3 at ART initiation had a significantly lower mortality rate (Adjusted hazard ratio: 0.56, 95% CI: 0.40-0.79), but significantly higher ART attrition rate (AHR: 1.17, 95% CI: 1.03-1.33). Results from this study suggest that HIV patients with high CD4+ cell counts at the time of ART initiation may be at greater risk of treatment attrition. To further reduce ART attrition, it is imperative that patient education and healthcare provider training on ART adherence be enhanced and account for CD4 levels at ART initiation.

Factors associated with the recruitment and retention of social workers in Wales: employer and employee perspectives.

PubMed

Evans, Sherrill; Huxley, Peter

2009-05-01

Despite acute staffing shortages in social work, workforce planning within the UK social care sector is compromised by poor workforce intelligence. This study aimed to inform the evidence base providing new data on recruitment and retention in Wales, examining what personal and organizational characteristics are associated with intentions to leave, and what initiatives or incentives might mediate that effect. A multi-method design facilitated comparisons between two data sources--a census of all 22 Welsh local authority employers about recruitment and retention practices and a survey of all social workers and senior practitioners employed in social services (n = 998; response rate 45.9%) about demography, workforce characteristics, working patterns, morale and plans and reasons for leaving one's job. Vacancy (mean 14.4%) and turnover (mean 15%) rates were statistically significantly higher in children's services than in adult services; vacancy rates were also higher in authorities that offered higher starting salaries. The provision of certain types of traineeship might also be associated with higher vacancy rates but these results should be treated with some caution. There was little evidence that recruitment and retention initiatives were associated with lower vacancy or turnover rates, despite employers' perceptions about their effectiveness. Social workers derived a lot of satisfaction from their work, but more than a quarter wanted to leave their job within 6 months, and almost as many were actively seeking alternative employment. Intention to leave was explained by job and employer satisfaction, and negative feelings about pay. Senior practitioners and staff members with longer lengths of service were less likely to want to leave, even if they were dissatisfied with their job or employer. Job and employer dissatisfaction was associated with retention initiatives related to facilities, good caseload management and home-working, suggesting that dissatisfied staff might remain in employment for longer if these initiatives were in place.

Multidisciplinary approach to obesity.

PubMed

Donini, L M; Donini, M L; Savina, C; Castellaneta, E; Coletti, C; Paolini, M; Scavone, L; Civale, C; Ceccarelli, P; Zaninotto, S; Tineri, M; Grossi, G; De Felice, M R; Cannella, C

2009-03-01

Obesity, associated with morbidity and mortality, is a complex disorder, characterised by an increase in fat mass (FM). Most authors agree in considering essential an integrated treatment made up of nutritional intervention, physical reconditioning programme and cognitive-behavioural psychotherapy. However, the feasibility is problematic and data in literature confirming the validity of this approach are poor. To verify the efficacy of a multidimensional approach (Nutritional Psycho-Physical Reconditioning - NPPR) in obesity treatment. All patients admitted from June 2002 to June 2004 (464 subjects) ranged from 18 to 65 years old, with a body mass index (BMI) >30 kg/m2 were included in the programme. After the nutritional status evaluation a standard dietetic treatment (group N) or an integrated and multidisciplinary obesity treatment (group NPPR) was proposed. In group NPPR treatment duration was significantly higher (142.6+/-26 vs 48.6+/-55 days - p=0.000), while the drop-out amount was definitely lower (5.5 vs 54.4%; p=0.000). Weight loss compared to the initial weight and the difference between initial and final FM resulted significantly higher in group NNPR. Subjects in NPPR obtained a higher increase in the distance covered in a 6-minute walk test (59.9+/-19 vs 40.5+/-17 m; p=0.04) and in muscular strength. State and trait anxiety, mood and quality of life scores improved in NPPR subjects while remained substantially stable in group N. An integrated approach to obesity is the way to be pursued in order to obtain important and at least short-term results.

Transferable Skills in Higher Education. Teaching and Learning in Higher Education Series.

ERIC Educational Resources Information Center

Assiter, Alison, Ed.

The 16 essays in this book discuss transferable skills in higher education drawing on the experience and information gained from two projects based in England, the Enterprise in Higher Education (EHE), initiated in 1989; and the Royal Society of Arts Education for Capability Initiative, instituted in 1991. Section 1 contains essays on transferable…

Improved statistical analysis of moclobemide dose effects on panic disorder treatment.

PubMed

Ross, Donald C; Klein, Donald F; Uhlenhuth, E H

2010-04-01

Clinical trials with several measurement occasions are frequently analyzed using only the last available observation as the dependent variable [last observation carried forward (LOCF)]. This ignores intermediate observations. We reanalyze, with complete data methods, a clinical trial previously reported using LOCF, comparing placebo and five dosage levels of moclobemide in the treatment of outpatients with panic disorder to illustrate the superiority of methods using repeated observations. We initially analyzed unprovoked and situational, major and minor attacks as the four dependent variables, by repeated measures maximum likelihood methods. The model included parameters for linear and curvilinear time trends and regression of measures during treatment on baseline measures. Significance tests using this method take into account the structure of the error covariance matrix. This makes the sphericity assumption irrelevant. Missingness is assumed to be unrelated to eventual outcome and the residuals are assumed to have a multivariate normal distribution. No differential treatment effects for limited attacks were found. Since similar results were obtained for both types of major attack, data for the two types of major attack were combined. Overall downward linear and negatively accelerated downward curvilinear time trends were found. There were highly significant treatment differences in the regression slopes of scores during treatment on baseline observations. For major attacks, all treatment groups improved over time. The flatter regression slopes, obtained with higher doses, indicated that higher doses result in uniformly lower attack rates regardless of initial severity. Lower doses do not lower the attack rate of severely ill patients to those achieved in the less severely ill. The clinical implication is that more severe patients require higher doses to attain best benefit. Further, the significance levels obtained by LOCF analyses were only in the 0.05-0.01 range, while significance levels of <0.00001 were obtained by these repeated measures analyses indicating increased power. The greater sensitivity to treatment effect of this complete data method is illustrated. To increase power, it is often recommended to increase sample size. However, this is often impractical since a major proportion of the cost per subject is due to the initial evaluation. Increasing the number of repeated observations increases power economically and also allows detailed longitudinal trajectory analyses.

Trends in the Inactive Kidney Transplant Waitlist and Implications for Candidate Survival

PubMed Central

Grams, Morgan E.; Massie, Allan B.; Schold, Jesse D.; Chen, B. Po-Han; Segev, Dorry L.

2014-01-01

In November 2003, OPTN policy was amended to allow kidney transplant (KT) candidates to accrue waiting time while registered as status 7, or inactive. We evaluated trends in inactive listings and the association of inactive status with transplantation and survival, studying 262,824 adult first-time KT candidates listed between 2000–2011. The proportion of waitlist candidates initially listed as inactive increased from 2.3% pre-policy change to 31.4% in 2011. Candidates initially listed as inactive were older, more often female, African-American, and with higher body mass index. Post-policy change, conversion from initially inactive to active status generally occurred early if at all: at one year after listing, 52.7% of initially inactive candidates had been activated; at 3 years, only 66.3% had been activated. Inactive status was associated with a substantially higher waitlist mortality (aHR 2.21, 95%CI:2.15–2.28, p<0.001) and lower rates of eventual transplantation (aRR 0.68, 95%CI:0.67–0.70, p<0.001). In summary, waitlist practice has changed significantly since November 2003, with a sharp increase in the number of inactive candidates. Using the full waitlist to estimate organ shortage or as a comparison group in transplant outcome studies is less appropriate in the current era. PMID:23399028

Self-reported assistive technology outcomes and personal characteristics in college students with less-apparent disabilities.

PubMed

Malcolm, Matt P; Roll, Marla C

2017-11-20

The impact of assistive technology (AT) services for college students with less-apparent disabilities is under-reported. Using the Canadian Occupational Performance Measure (COPM), we assessed student Performance and Satisfaction ratings of common academic tasks at the start and end of a semester during which 105 student-clients with less-apparent disabilities received AT services. We examined if COPM scores related to personal characteristics of gender, class-level (e.g., Sophomore), and STEM education; if personal characteristics predicted a student's follow-through with an AT service referral (n=231); and if personal characteristics and initial COPM scores predicted dropout from AT services (n=187). COPM ratings significantly increased in all academic tasks (p<.001). Gender predicted initial Satisfaction (male ratings > female ratings; p=.01), and Performance changes (females were more likely to have a service-meaningful change; p=.02). Higher class-level predicted better follow-through with a referral for AT services (p=.006). Increasing class-level (p=.05) and higher initial studying (p<.006) and reading (p<.029) ratings predicted a lower likelihood for dropout. These findings demonstrate that college students with less-apparent disabilities experience substantial improvements in their self-ratings of academic performance and satisfaction following AT services. Gender, class-level, and initial self-perceived reading and studying abilities may influence if and how the student participates with AT services.

Macro-level age norms for the timing of sexual initiation and adolescents' early sexual initiation in 17 European countries.

PubMed

Madkour, Aubrey Spriggs; de Looze, Margaretha; Ma, Ping; Halpern, Carolyn Tucker; Farhat, Tilda; Ter Bogt, Tom F M; Ehlinger, Virginie; Nic Gabhainn, Saoirse; Currie, Candace; Godeau, Emmanuelle

2014-07-01

To examine the relationship between country-level age norms for sexual initiation timing and early sexual initiation (ESI) among adolescent boys and girls. Nationally representative data from 17 countries that participated in the 2006/2007 European Social Survey (ESS-3, n = 33,092) and the 2005/2006 Health Behaviour in School-Aged Children Study (HBSC, n = 27,702) were analyzed. Age norms were measured as the average country-level response to an item asking the age at which ESS respondents believed someone is too young to have sexual intercourse. HBSC respondents (aged 14-16 years) self-reported age at sexual initiation, which we defined as early (<15 years) or not early (≥15 years or no initiation). Control variables included age, family affluence, perceived socioeconomic status, family living arrangement, substance use, school attachment, and country-level legal age of consent. Multivariable three-level logistic models with random intercepts were run separately by sex. In multivariable analyses, higher overall age norms were associated with reduced likelihood of ESI among girls (AOR .60, 95% CI .45-.79); associations with ESI were stronger for parent cohort (ages 31-65 years) norms (AOR .37, 95% CI .23-.58) than for peer cohort (ages 15-20 years) norms (AOR .60, 95% CI .49-.74). For boys, overall norms were also significantly negatively associated with ESI (AOR .68, 95% CI .46-.99), as were parent cohort norms (AOR .66, 95% CI .45-.96). Peer cohort norms were not significantly related to boys' ESI. Macrolevel cultural norms may impact adolescents' sexual initiation timing. Research exploring the sexual health outcomes of early initiators in countries with contrasting age norms is warranted. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Macro-level Age Norms for the Timing of Sexual Initiation and Adolescents’ Early Sexual Initiation in 17 European Countries

PubMed Central

Madkour, Aubrey Spriggs; de Looze, Margaretha; Ma, Ping; Halpern, Carolyn Tucker; Farhat, Tilda; ter Bogt, Tom F. M.; Ehlinger, Virginie; Nic Gabhainn, Saoirse; Currie, Candace; Godeau, Emmanuelle

2014-01-01

Purpose To examine the relationship between country-level age norms for sexual initiation timing and early sexual initiation (ESI) among adolescent boys and girls. Methods Nationally-representative data from 17 countries that participated in the 2006/07 European Social Survey (ESS-3, n=33,092) and the 2005/06 Health Behaviour in School-Aged Children Study (HBSC, n=27,702) were analyzed. Age norms were measured as the average country-level response to an item asking the age at which ESS respondents believed someone is too young to have sexual intercourse. HBSC respondents (aged 14-16) self-reported age at sexual initiation which we defined as early (<15 years) or not (≥15 years or no initiation). Control variables included age, family affluence, perceived socioeconomic status, family living arrangement, substance use, school attachment, and country-level legal age of consent. Multivariable three-level logistic models with random intercepts were run separately by sex. Results In multivariable analyses, higher overall age norms were associated with reduced likelihood of ESI among girls (AOR 0.60, 95% CI 0.45-0.79); associations with ESI were stronger for parent cohort (ages 31-65) norms (AOR 0.37, 95% CI 0.23-0.58) than for peer cohort (ages 15-20) norms (AOR 0.60, 95% CI 0.49-0.74). For boys, overall norms were also significantly negatively associated with ESI (AOR 0.68, 95% CI 0.46-0.99), as were parent cohort norms (AOR 0.66, 95% CI 0.45-0.96). Peer cohort norms were not significantly related to boys’ ESI. Conclusion Macro-level cultural norms may impact adolescents’ sexual initiation timing. Research exploring the sexual health outcomes of early initiators in countries with contrasting age norms is warranted. PMID:24508092

5 CFR 591.104 - Higher initial maximum uniform allowance rate.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Higher initial maximum uniform allowance rate. 591.104 Section 591.104 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... initial year a new style or type of minimum basic uniform is required for a category of employees, an...

Examining the links between therapeutic jurisprudence and mental health court completion.

PubMed

Redlich, Allison D; Han, Woojae

2014-04-01

Research demonstrates that mental health courts (MHCs) lead to improved outcomes compared to traditional criminal court processes. An underlying premise of MHCs is therapeutic jurisprudence (TJ). However, no research, to our knowledge, has examined whether MHC outcomes are predicted by TJ principles as theorized. In the present study, we examined whether principles measured at the onset of MHC enrollment (knowledge, perceived voluntariness, and procedural justice) predicted MHC completion (graduation). Using structural equation modeling with MHC participants from four courts, a significant, direct relationship between TJ and MHC completion was found, such that higher levels of TJ were associated with higher rates of success. Although this direct effect became nonsignificant when mediator variables were included, a significant indirect path remained, such that increased levels of initial perceived voluntariness and procedural justice, and MHC knowledge, led to decreased rates of new arrests, prison, MHC bench warrants, and increased court compliance, which, in turn, led to a higher likelihood of MHC graduation. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Cardiovascular responses of men and women to lower body negative pressure

NASA Technical Reports Server (NTRS)

Montgomery, L. D.; Kirk, P. J.; Payne, P. A.; Gerber, R. L.; Newton, S. D.; Williams, B. A.

1977-01-01

Changes in blood flow and blood redistribution were measured by impedance plethysmography in the pelvic and leg regions of six male and four female subjects during three 5-min exposures to -20, -40, and -60 mm Hg lower body negative pressure (LBNP). Female subjects demonstrated significantly higher mean heart rate and lower leg blood flow indices than the male subjects during the recumbent control periods. Men had slightly higher mean resting systolic and diastolic blood pressures and higher mean control pelvic blood indices. Women demonstrated significantly less blood pooling in the legs and slightly less in the pelvic region than the men. All of the 18 tests with male subjects at -60 mm Hg were completed without initial signs of syncope, while only two of the tests with women were completed successfully without the subject exhibiting presyncopal conditions. Results indicate that impedance plethysmography can be used to measure segmental cardiovascular responses during LBNP and that females may be less tolerant to -60 mm Hg LBNP than males.

Reasoning Training in the ACTIVE Study: How Much is Needed and Who Benefits?

PubMed Central

Willis, Sherry L.; Caskie, Grace I. L.

2013-01-01

Objective and Methods ACTIVE Reasoning training data (n = 699) were examined to characterize change through five-year follow-up, associated with training, booster, adherence, and other characteristics. Results Training resulted in improved reasoning performance through year five. A significant third annual booster effect was one-half the size of the training effect. Training adherence resulted in greater training effects. Higher education, MMSE, better health and younger age related to higher baseline performance. Higher MMSE was related to larger training effects, larger linear slopes and smaller Booster effects. Significant functional outcomes included a training effect for Complex Reaction Time (CRT), and first annual booster effects for the CRT and Observed Tasks of Daily Living. Discussion Initial training gain was comparable to magnitude of age-related cognitive decline over 5 years with no training. Neither age nor gender predicted training or booster effects, indicating the generality of training effects across age (65 – 90 years). PMID:24385639

A public health initiative to increase annual influenza immunization among hospital health care personnel: the San Diego Hospital Influenza Immunization Partnership.

PubMed

Sawyer, Mark H; Peddecord, K Michael; Wang, Wendy; Deguire, Michelle; Miskewitch-Dzulynsky, Michelle; Vuong, David D

2012-09-01

A public health department-supported intervention to increase influenza immunization among hospital-based health care practitioners (HCPs) in San Diego County took place between 2005 and 2008. The study included all major hospitals in the county, with a population of approximately 3.5 million. Information on hospital activities was collected from before, during and after initiative activities. Vaccination status and demographics were collected directly from HCP using hospital-based and random-dialed telephone surveys. Between 2006 and 2008, hospitals increased promotion activities and reported increases in vaccination rates. Based on the random-dialed surveys, HCP influenza vaccination coverage rates did not increase significantly. Vaccination rates were significantly higher in HCPs who reported that employers provided free vaccination and those who believed that their employers mandated influenza vaccination. This local public health initiative and concurrent state legislation were effective in increasing employer efforts to promote influenza vaccination; however, population-based surveys of HCPs did not show significant increases in influenza vaccination. Overall, this study suggests that public health leadership, intensive employer promotion activities, and state-required declinations alone were not sufficient to significantly increase HCP influenza vaccination. Policymakers and employers should consider mandates to achieve optimal influenza vaccination among HCPs. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Effects of Temperature on Bacterial Communities and Metabolites during Fermentation of Myeolchi-Aekjeot, a Traditional Korean Fermented Anchovy Sauce

PubMed Central

Chun, Byung Hee; Jeon, Che Ok

2016-01-01

Myeolchi-aekjeot (MA) in Korea is produced outdoors without temperature controls, which is a major obstacle to produce commercial MA products with uniform quality. To investigate the effects of temperature on MA fermentation, pH, bacterial abundance and community, and metabolites were monitored during fermentation at 15°C, 20°C, 25°C, and 30°C. Initial pH values were approximately 6.0, and pH values increased after approximately 42 days, with faster increases at higher temperatures. Bacterial abundances increased rapidly in all MA samples after quick initial decreases during early fermentation and then they again steadily decreased after reaching their maxima, which were significantly greater at higher temperatures. Bacterial community analysis revealed that Proteobacteria and Tenericutes were predominant in all initial MA samples, but they were rapidly displaced by Firmicutes as fermentation progressed. Photobacterium and Mycoplasma belonging to Proteobacteria and Tenericutes, respectively, which may include potentially pathogenic strains, were dominant in initial MA, but decreased with the growth of Chromohalobacter, which occurred faster at higher temperatures––they were dominant until 273 and 100 days at 15°C and 20°C, respectively, but not detected after 30 days at 25°C and 30°C. Chromohalobacter also decreased with the appearance of subsequent genera belonging to Firmicutes in all MA samples. Tetragenococcus, halophilic lactic acid bacteria, appeared predominantly at 20°C, 25°C, and 30°C; they were most abundant at 30°C, but not detected at 15°C. Alkalibacillus and Lentibacillus appeared as dominant genera with the decrease of Tetragenococcus at 25°C and 30°C, but only Lentibacillus was dominant at 15°C and 20°C. Metabolite analysis showed that amino acids related to tastes were major metabolites and their concentrations were relatively higher at high temperatures. This study suggests that high temperatures (approximately 30°C) may be appropriate in MA fermentation, in the light of faster disappearance of potentially pathogenic genera, higher amino acids, growth of Tetragenococcus, and faster fermentation. PMID:26977596

Effects of Temperature on Bacterial Communities and Metabolites during Fermentation of Myeolchi-Aekjeot, a Traditional Korean Fermented Anchovy Sauce.

PubMed

Jung, Ji Young; Lee, Hyo Jung; Chun, Byung Hee; Jeon, Che Ok

2016-01-01

Myeolchi-aekjeot (MA) in Korea is produced outdoors without temperature controls, which is a major obstacle to produce commercial MA products with uniform quality. To investigate the effects of temperature on MA fermentation, pH, bacterial abundance and community, and metabolites were monitored during fermentation at 15°C, 20°C, 25°C, and 30°C. Initial pH values were approximately 6.0, and pH values increased after approximately 42 days, with faster increases at higher temperatures. Bacterial abundances increased rapidly in all MA samples after quick initial decreases during early fermentation and then they again steadily decreased after reaching their maxima, which were significantly greater at higher temperatures. Bacterial community analysis revealed that Proteobacteria and Tenericutes were predominant in all initial MA samples, but they were rapidly displaced by Firmicutes as fermentation progressed. Photobacterium and Mycoplasma belonging to Proteobacteria and Tenericutes, respectively, which may include potentially pathogenic strains, were dominant in initial MA, but decreased with the growth of Chromohalobacter, which occurred faster at higher temperatures--they were dominant until 273 and 100 days at 15°C and 20°C, respectively, but not detected after 30 days at 25°C and 30°C. Chromohalobacter also decreased with the appearance of subsequent genera belonging to Firmicutes in all MA samples. Tetragenococcus, halophilic lactic acid bacteria, appeared predominantly at 20°C, 25°C, and 30°C; they were most abundant at 30°C, but not detected at 15°C. Alkalibacillus and Lentibacillus appeared as dominant genera with the decrease of Tetragenococcus at 25°C and 30°C, but only Lentibacillus was dominant at 15°C and 20°C. Metabolite analysis showed that amino acids related to tastes were major metabolites and their concentrations were relatively higher at high temperatures. This study suggests that high temperatures (approximately 30°C) may be appropriate in MA fermentation, in the light of faster disappearance of potentially pathogenic genera, higher amino acids, growth of Tetragenococcus, and faster fermentation.

The factors associated with longitudinal changes in liver stiffness in patients with chronic hepatitis B

PubMed Central

Yo, In Ku; Park, Jin Woong; Lee, Jong Joon; Lee, Jung Hyun; Won, In Sik; Na, Sun Young; Jang, Pil Kyu; Park, Pyung Hwa; Choi, Duck Joo; Kim, Yun Soo; Kim, Ju Hyun

2015-01-01

Background/Aims Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. Methods Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared. Results No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. Conclusions A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study. PMID:25834800

The factors associated with longitudinal changes in liver stiffness in patients with chronic hepatitis B.

PubMed

Yo, In Ku; Kwon, Oh Sang; Park, Jin Woong; Lee, Jong Joon; Lee, Jung Hyun; Won, In Sik; Na, Sun Young; Jang, Pil Kyu; Park, Pyung Hwa; Choi, Duck Joo; Kim, Yun Soo; Kim, Ju Hyun

2015-03-01

Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared. No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study.

Smoker Characteristics and Smoking-Cessation Milestones

PubMed Central

Japuntich, Sandra J.; Leventhal, Adam M.; Piper, Megan E.; Bolt, Daniel M.; Roberts, Linda J.; Fiore, Michael C.; Baker, Timothy B.

2011-01-01

Background Contextual variables often predict long-term abstinence, but little is known about how these variables exert their effects. These variables could influence abstinence by affecting the ability to quit at all, or by altering risk of lapsing, or progressing from a lapse to relapse. Purpose To examine the effect of common predictors of smoking-cessation failure on smoking-cessation processes. Methods The current study (N = 1504, 58% female, 84% Caucasian; recruited from January 2005 to June 2007; data analyzed in 2009) uses the approach advocated by Shiffman et al., (2006), which measures cessation outcomes on three different cessation milestones (achieving initial abstinence, lapse risk, and the lapse-relapse transition) to examine relationships of smoker characteristics (dependence, contextual and demographic factors) with smoking-cessation process. Results High nicotine dependence strongly predicted all milestones: not achieving initial abstinence, and a higher risk of both lapse and transitioning from lapse to complete relapse. Numerous contextual and demographic variables were associated with higher initial cessation rates and/or decreased lapse risk at 6 months post-quit (e.g., ethnicity, gender, marital status, education, smoking in the workplace, number of smokers in the social network, and number of supportive others). However, aside from nicotine dependence, only gender significantly predicted the risk of transition from lapse to relapse. Conclusions These findings demonstrate that: (1) higher nicotine dependence predicted worse outcomes across every cessation milestone; (2) demographic and contextual variables are generally associated with initial abstinence rates and lapse risk and not the lapse-relapse transition. These results identify groups who are at risk for failure at specific stages of the smoking-cessation process, and this may have implications for treatment. PMID:21335259

Surface modification of zinc oxide nanoparticles with amorphous silica alters their fate in the circulation.

PubMed

Konduru, Nagarjun V; Murdaugh, Kimberly M; Swami, Archana; Jimenez, Renato J; Donaghey, Thomas C; Demokritou, Philip; Brain, Joseph D; Molina, Ramon M

2016-08-01

Nanoparticle (NP) pharmacokinetics and biological effects are influenced by many factors, especially surface physicochemical properties. We assessed the effects of an amorphous silica coating on the fate of zinc after intravenous (IV) injection of neutron activated uncoated (65)ZnO or silica-coated (65)ZnO NPs in male Wistar Han rats. Groups of IV-injected rats were sequentially euthanized, and 18 tissues were collected and analyzed for (65)Zn radioactivity. The protein coronas on each ZnO NP after incubation in rat plasma were analyzed by SDS-PAGE gel electrophoresis and mass spectrometry of selected gel bands. Plasma clearance for both NPs was biphasic with rapid initial and slower terminal clearance rates. Half-lives of plasma clearance of silica-coated (65)ZnO were shorter (initial - <1 min; terminal - 2.5 min) than uncoated (65)ZnO (initial - 1.9 min; terminal - 38 min). Interestingly, the silica-coated (65)ZnO group had higher (65)Zn associated with red blood cells and higher initial uptake in the liver. The (65)Zn concentrations in all the other tissues were significantly lower in the silica-coated than uncoated groups. We also found that the protein corona formed on silica-coated ZnO NPs had higher amounts of plasma proteins, particularly albumin, transferrin, A1 inhibitor 3, α-2-hs-glycoprotein, apoprotein E and α-1 antitrypsin. Surface modification with amorphous silica alters the protein corona, agglomerate size, and zeta potential of ZnO NPs, which in turn influences ZnO biokinetic behavior in the circulation. This emphasizes the critical role of the protein corona in the biokinetics, toxicology and nanomedical applications of NPs.

Out-of-range international normalized ratio values and healthcare cost among new warfarin patients with non-valvular atrial fibrillation.

PubMed

Nelson, Winnie W; Wang, Li; Baser, Onur; Damaraju, C V; Schein, Jeffrey R

2015-05-01

Patients with out-of-range international normalized ratio (INR) values <2.0 and >3.0 have been associated with increased risk of thromboembolic and bleeding events. INR monitoring is costly, because of associated physician and nurse time, laboratory resource use, and dose adjustments. This study assessed the healthcare cost burden associated with out-of-range INR among warfarin initiator patients diagnosed with non-valvular atrial fibrillation (NVAF) in the US Veterans Health Administration (VHA) population. Adult NVAF patients (≥18 years) initiating warfarin were selected from the VHA dataset for the study period October 1, 2007-September 30, 2012. Only valid INR measurements (0.5 ≤ INR ≤ 20) were examined for the follow-up period, from the index date (warfarin initiation date) until the end of warfarin exposure or death. All-cause healthcare costs within 30 days were measured starting from the second month (31 days post-index date) to the end of the study period. Costs for inpatient stays, emergency room, outpatient facility, physician office visits, and other services were computed separately. Multiple regression was performed using the generalized linear model for overall cost analysis. In total, 29,463 patients were included in the study sample. Mean costs for out-of-range INR ranged from $3419 to $5126. Inpatient, outpatient, outpatient pharmacy, and total costs were significantly higher after patients experienced out-of-range results (INR < 2, INR > 3), compared with in-range INR (2 ≤ INR ≤ 3). When exposed to out-of-range INR, patients also incurred higher mean total costs within 2-6 months ($3840-$5820) than after the first 6 months ($2789-$3503) of warfarin therapy. In the VHA population, INR measures outside of the 2-3 range were associated with significantly higher healthcare costs. Increased costs were especially apparent when INR values were below 2, although INR measures above 3 were also associated with higher costs relative to in-range values.

Comparison of Changes in Anxiety and Depression Level Between Dabigatran and Warfarin Use in Patients With Atrial Fibrillation.

PubMed

Turker, Yasin; Ekinozu, Ismail; Aytekin, Seda; Turker, Yasemin; Basar, Cengiz; Baltaci, Davut; Kaya, Ertugrul

2017-03-01

We hypothesized that patients taking warfarin require frequent hospital follow-up and they are at higher risk for complications, so the incidence of depression and anxiety is higher in patients with atrial fibrillation (AF) in the period of taking warfarin compared to the period of taking dabigatran. Fifty patients having AF without valvular diseases under treatment of warfarin in whom a transition to dabigatran was planned were consecutively enrolled in this study and followed up prospectively between July 2013 and July 2014. All patients completed Beck Depression Inventory and Hamilton Anxiety Scale (HAS) at the initiation of study and 6 months after initiation of study. Of the patients enrolled in the study, age, gender, smoking status, and comorbidities were questioned. A total of 50 patients (28 women; mean age 74.6 ± 8.7 years) treated with warfarin in whom a transition to dabigatran was planned were included. Basal mean value of BDS (15.6 ± 7.8 vs 11.5 ± 4.8, P < .001) and HAS (16.8 ± 10.4 vs 12.6 ± 8.1, P < 0.001) was significantly higher in patients when they used warfarin than when they switched to dabigatran. In categorical analysis, frequency of patients with depression (mild, moderate, and severe) was significantly higher in period of warfarin use than after dabigatran transition (n = 24, 48% vs n = 14, 28%, P = .039). Our study demonstrates that patients with nonvalvular AF under treatment of dabigatran had lower BDS and HAS scores compared to warfarin. These findings suggest that dabigatran may increase quality of life and decrease morbidity and mortality due to reduction in anxiety and depression.

The impact of disease activity and tumour necrosis factor-α inhibitor therapy on cytokine levels in juvenile idiopathic arthritis.

PubMed

Walters, H M; Pan, N; Lehman, T J A; Adams, A; Kalliolias, G D; Zhu, Y S; Santiago, F; Nguyen, J; Sitaras, L; Cunningham-Rundles, S; Walsh, T J; Toussi, S S

2016-06-01

The aim of this study was to evaluate prospectively cytokine levels and disease activity in juvenile idiopathic arthritis (JIA) patients treated with and without tumour necrosis factor (TNF)-α inhibitors. TNF-α inhibitor-naive JIA subjects were followed prospectively for 6 months. Cytokine levels of TNF-α, interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-17 were measured at baseline for JIA subjects and healthy controls (HCs). Cytokine levels were then measured at four time-points after initiation of TNF-α inhibition for anti-TNF-α-treated (anti-TNF) JIA subjects, and at two subsequent time-points for other JIA (non-TNF) subjects. JIA disease activity by Childhood Health Assessment Questionnaire (CHAQ) disability index/pain score and physician joint count/global assessment was recorded. Sixteen anti-TNF, 31 non-TNF and 16 HCs were analysed. Among JIA subjects, those with higher baseline disease activity (subsequent anti-TNFs) had higher baseline TNF-α, IL-6 and IL-8 than those with lower disease activity (non-TNFs) (P < 0·05). TNF-α and IL-10 increased, and IL-6 and IL-8 no longer remained significantly higher after TNF-α inhibitor initiation in anti-TNF subjects. Subgroup analysis of etanercept versus adalimumab-treated subjects showed that TNF-α and IL-17 increased significantly in etanercept but not adalimumab-treated subjects, despite clinical improvement in both groups of subjects. JIA subjects with increased disease activity at baseline had higher serum proinflammatory cytokines. TNF-α inhibition resulted in suppression of IL-6 and IL-8 in parallel with clinical improvement in all anti-TNF-treated subjects, but was also associated with elevated TNF-α and IL-17 in etanercept-treated subjects. © 2016 British Society for Immunology.

Associations between deprived life circumstances, wellbeing and self-rated health in a socially marginalized population.

PubMed

Pedersen, Pia V; Grønbæk, Morten; Curtis, Tine

2012-10-01

Previous studies of self-rated health among socially marginalized people provide insufficient understandings of what influences their self-rated health. This study aimed to examine how disadvantaged life circumstances (homelessness, substance abuse, poverty) and general well-being were associated with poor self-rated health among the socially marginalized. In a nationwide survey in Denmark, 1348 users of shelters, drop-in centres, treatment centres and social psychiatric centres answered a self-administered questionnaire. We analysed data using logistic regression. Disadvantaged life circumstances and well-being were associated with self-rated health, also when controlling for illness, mental disorder and age. Male respondents exposed to two or more disadvantaged life circumstances had higher odds of poor self-rated health [odds ratio (OR): 2.96; 95% confidence interval (CI): 1.80-4.87] than males exposed to fewer disadvantages. A low sense of personal well-being implied higher odds of poor self-rated health among both men and women. Among men, not showering regularly (OR: 1.81; 95% CI: 1.17-2.79), and among women, not eating varied food (OR: 2.24; 95% CI: 1.20-4.20) and exposure to physical violence (borderline significant) implied higher odds of poor self-rated health. Male and female respondents reporting lack of sleep and loneliness (borderline significant among women) had higher odds of poor self-rated health. The poor self-rated health among socially marginalized is strongly associated with massive social problems, poor living conditions and poor well-being. This study elucidates the need for more broadly based and holistic initiatives by both the health sector and the social services, incorporating health promotion initiatives into social work.

The initiation of boiling during pressure transients. [water boiling on metal surfaces

NASA Technical Reports Server (NTRS)

Weisman, J.; Bussell, G.; Jashnani, I. L.; Hsieh, T.

1973-01-01

The initiation of boiling of water on metal surfaces during pressure transients has been investigated. The data were obtained by a new technique in which light beam fluctuations and a pressure signal were simultaneously recorded on a dual beam oscilloscope. The results obtained agreed with those obtained using high speed photography. It was found that, for water temperatures between 90-150 C, the wall superheat required to initiate boiling during a rapid pressure transient was significantly higher than required when the pressure was slowly reduced. This result is explained by assuming that a finite time is necessary for vapor to fill the cavity at which the bubble originates. Experimental measurements of this time are in reasonably good agreement with calculations based on the proposed theory. The theory includes a new procedure for estimating the coefficient of vaporization.

Initial condition for baryogenesis via neutrino oscillation

NASA Astrophysics Data System (ADS)

Asaka, Takehiko; Eijima, Shintaro; Ishida, Hiroyuki; Minogawa, Kosuke; Yoshii, Tomoya

2017-10-01

We consider a baryogenesis scenario via the oscillation of right-handed neutrinos with Majorana masses of the order of GeV, which are also responsible for neutrino masses by the seesaw mechanism. We study how the initial condition alters the prediction of the present baryon asymmetry by this mechanism. It is usually assumed that the abundance of right-handed neutrinos is zero after the reheating of the inflationary universe and they are produced in scattering processes by the renomalizable Yukawa interaction. However, the higher-dimensional operator with right-handed neutrinos may provide an additional production which is most effective at the reheating epoch. It is shown that such an initial abundance of right-handed neutrinos can significantly modify the prediction when the strong washout of the asymmetry is absent. This leads to the parameter space of the model for the successful baryogenesis being enlarged.

A Laboratory Assessment of Factors That Affect Bacterial Adhesion to Contact Lenses

PubMed Central

Dutta, Debarun; Willcox, Mark DP

2013-01-01

Adhesion of pathogenic microbes, particularly bacteria, to contact lenses is implicated in contact lens related microbial adverse events. Various in vitro conditions such as type of bacteria, the size of initial inoculum, contact lens material, nutritional content of media, and incubation period can influence bacterial adhesion to contact lenses and the current study investigated the effect of these conditions on bacterial adhesion to contact lenses. There was no significant difference in numbers of bacteria that adhered to hydrogel etafilcon A or silicone hydrogel senofilcon A contact lenses. Pseudomonas aeruginosa adhered in higher numbers compared to Staphylococcus aureus. Within a genera/species, adhesion of different bacterial strains did not differ appreciably. The size of initial inoculum, nutritional content of media, and incubation period played significant roles in bacterial adhesion to lenses. A set of in vitro assay conditions to help standardize adhesion between studies have been recommended. PMID:24833224

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

Cole, K.C.; Noel, D.; Hechler, J.J.

Data are presented on physicochemical tests carried out on room-temperature aged samples of a commercially available carbon-epoxy composite prepreg system. The analytical methods used included Fourier transform IR (FTIR) spectroscopy, reverse-phase liquid chromatography (RPLC), high-speed RPLC, high-performance size-exclusion chromatography, differential scanning calorimetry and thermogravimetry, and pyrolysis/gas chromatography. All data indicated significant changes in these samples due to aging, with the most sensitive indices being those of FTIR and RPLC procedures. Results indicate that the number of unreacted epoxy groups decreased steadily at a rate of 0.34 percent per day, based on the initial amount, and the number of free amine-hardenermore » molecules decreased at a rate of 1.05 percent per day. The amount of initial epoxy-amine reaction product increased significantly over the first 30 days, but then declined, due to further reactions of these to give higher-molecular-weight products. 23 refs.« less

From oligomers to molecular giants of soybean oil in supercritical carbon dioxide medium: 1. Preparation of polymers with lower molecular weight from soybean oil.

PubMed

Liu, Zengshe; Sharma, Brajendra K; Erhan, Sevim Z

2007-01-01

Polymers with a low molecular weight derived from soybean oil have been prepared in a supercritical carbon dioxide medium by cationic polymerization. Boron trifluoride diethyl etherate was used as an initiator. Influences of polymerization temperature, amount of initiator, and carbon dioxide pressure on the molecular weight were investigated. It is shown that the higher polymerization temperature favors polymers with relatively higher molecular weights. Larger amounts of initiator also provide polymers with higher molecular weights. Higher pressure favors polymers with relatively higher molecular weights. The applications of these soy-based materials will be in the lubrication and hydraulic fluid areas.

Pentadecapeptide BPC 157 attenuates chronic amphetamine-induced behavior disturbances.

PubMed

Sikiric, Predrag; Jelovac, Nikola; Jelovac-Gjeldum, Andjelka; Dodig, Goran; Staresinic, Mario; Anic, Tomislav; Zoricic, Ivan; Rak, Davor; Perovic, Darko; Aralica, Gorana; Buljat, Gojko; Prkacin, Ingrid; Lovric-Bencic, Martina; Separovic, Jadranka; Seiwerth, Sven; Rucman, Rudolf; Petek, Marijan; Turkovic, Branko; Ziger, Tihomil; Boban-Blagaic, Alenka; Bedekovic, Vlado; Tonkic, Ante; Babic, Slaven

2002-05-01

To investigate the effect of pentadecapeptide BPC 157 on chronic exposure to amphetamine in rats, particularly the changes commonly referred in chronic amphetamine studies as tolerance (lesser grade of stereotyped behavior, without increased excitability) and reverse tolerance (ie, prominent stereotyped behavior and heightened startle response upon late amphetamine challenges). After initial application (initial single dose-regimen), amphetamine (10 mg/kg,ip) was given once daily till d 5 (continuous administration-regimen), and thereafter on d 8, 16, and 46 (intermittent administration regimen). Fo r stereotyped behavior and heightened startle response the observation period was 120 min after amphetamine application, and each animal was observed for 10 s in 5 min intervals. Pentadecapeptide BPC 157 (10 microg/kg or 10 ng/k g, ip) or saline (5.0 mL/kg, ip) were given only at the beginning of the experiment, simultaneously with the initial dose of amphetamine. In relation to applied initial-single/continuous/intermittent amphetamine applications regimen, the control amphetamine rats throughout the experiment showed the changes in stereotyped behavior and heightened startle response, increment or decrement, commonly explained in chronic amphetamine studies as tolerance and reverse tolerance. After t he initial application of the amphetamine, the higher BPC 157 dosage apparently attenuated the stereotyped behavior, while the lower dosage of BPC 157 did not reach a statistical significance. Considering the forthcoming amphetamine challenges, in the rats initially treated with pentadecapeptide BPC 157, either 10 microg- or 10 ng-dose, at the time of the first application of amphetamine, the stereotyped behavior remains to be attenuated after all additional amphetamine challenges (on d 2-5, 8, 16, and 46). This attenuation was not limited to stereotyped behavior only. After the initial application of the amphetamine the heighten ed startle response was also apparently mitigated in rats receiving the BPC 157 dosage, either higher or lower. Later, confronted with the forthcoming amphetamine challenges, they showed apparently less abnormal excitability at all tested points. In summary, gastric pentadecapeptide BPC 157 (ie, both microg- and ng-BPC 157 regimens) attenuated chronic amphetamine disturbances. This effect was present throughout the observation period at a statistically significant level. Therefore, it seems that this gastric pentadecapeptide BPC 157 has a modulatory effect on dopamine system, and it could be used in chronic amphetamine disturbances.

Retrospective cohort study of anti-tumor necrosis factor agent use in a veteran population

PubMed Central

Madkour, Nermeen; Kazerooni, Rashid

2014-01-01

Introduction. Anti-tumor necrosis factor (TNF) agents are effective for several immunologic conditions (rheumatoid arthritis (RA), Crohn’s disease (CD), and psoriasis). The purpose of this study was to evaluate the efficacy and safety of anti-TNF agents via chart review. Methods. Single-site, retrospective cohort study that evaluated the efficacy and safety of anti-TNF agents in veterans initiated between 2010 and 2011. Primary aim evaluated response at 12 months post-index date. Secondary aims evaluated initial response prior to 12 months post-index date and infection events. Results. A majority of patients were prescribed anti-TNF agents for CD (27%) and RA (24%). Patients were initiated on etanercept (41%), adalimumab (40%), and infliximab (18%) between 2010 and 2011. No differences in patient demographics were reported. Response rates were high overall. Sixty-five percent of etanercept patients, 82% of adalimumab patients, and 59% of infliximab patients were either partial or full responders, respectively. Approximately 16%, 11%, and 12% of etanercept, adalimumab, and infliximab were non-responders, respectively. Infections between the groups were non-significant. Etanercept and adalimumab patients had higher but non-significant odds of being a responder relative to infliximab. Conclusions. Most patients initiated with anti-TNF agent were responders at 12 months follow-up for all indications in a veteran population. PMID:24883246

Effects of sentence-structure complexity on speech initiation time and disfluency.

PubMed

Tsiamtsiouris, Jim; Cairns, Helen Smith

2013-03-01

There is general agreement that stuttering is caused by a variety of factors, and language formulation and speech motor control are two important factors that have been implicated in previous research, yet the exact nature of their effects is still not well understood. Our goal was to test the hypothesis that sentences of high structural complexity would incur greater processing costs than sentences of low structural complexity and these costs would be higher for adults who stutter than for adults who do not stutter. Fluent adults and adults who stutter participated in an experiment that required memorization of a sentence classified as low or high structural complexity followed by production of that sentence upon a visual cue. Both groups of speakers initiated most sentences significantly faster in the low structural complexity condition than in the high structural complexity condition. Adults who stutter were over-all slower in speech initiation than were fluent speakers, but there were no significant interactions between complexity and group. However, adults who stutter produced significantly more disfluencies in sentences of high structural complexity than in those of low complexity. After reading this article, the learner will be able to: (a) identify integral parts of all well-known models of adult sentence production; (b) summarize the way that sentence structure might negatively influence the speech production processes; (c) discuss whether sentence structure influences speech initiation time and disfluencies. Copyright © 2012 Elsevier Inc. All rights reserved.

Analysis of Class II patients, successfully treated with the straight-wire and Forsus appliances, based on cervical vertebral maturation status.

PubMed

Servello, David F; Fallis, Drew W; Alvetro, Lisa

2015-01-01

To assess skeletal and dental changes in patients successfully treated with the Forsus appliance based on cervical vertebral maturation status. Forty-seven Class II patients, successfully treated with the Forsus appliance, were divided into peak and postpeak growth groups determined immediately prior to Forsus placement. The mean (SD) ages of the peak and postpeak groups were 13.4 (1.0) and 14.1 (1.3) years, respectively. Superimpositions of initial, Forsus placement, Forsus removal, and final cephalometric radiographs were completed, allowing the measurement of changes during three treatment phases. There were no significant differences between groups during treatment phase 1 (alignment/leveling), with both groups demonstrating a worsening of the Class II molar relationship. However, during treatment phase 2 (Class II correction), patients within the peak group demonstrated significantly higher mean apical base, mandibular and molar changes, and an increased rate of change compared with those in the postpeak group. No significant differences were observed during treatment phase 3 (detail/finishing). Following an initial worsening of the Class II molar relationship as a result of straight-wire appliance effects, Forsus appliance treatment initiated during cervical vertebral maturation status (CS) 3-4 elicits more effective and efficient correction of Class II molar relationships than when initiated during CS 5-6. Data support that these effects are due mainly to maxillary skeletal and dentoalveolar restraint during a period of more rapid mandibular growth.

Spontaneous circulation of myeloid-lymphoid-initiating cells and SCID-repopulating cells in sickle cell crisis.

PubMed

Lamming, Christopher E D; Augustin, Lance; Blackstad, Mark; Lund, Troy C; Hebbel, Robert P; Verfaillie, Catherine M

2003-03-01

The only curative therapy for sickle cell disease (SCD) is allogeneic hematopoietic stem cell (HSC) transplantation. Gene therapy approaches for autologous HSC transplantation are being developed. Although earlier engraftment is seen when cells from GCSF-mobilized blood are transplanted than when bone marrow is transplanted, administration of GCSF to patients with SCD can cause significant morbidity. We tested whether primitive hematopoietic progenitors are spontaneously mobilized in the blood of patients with SCD during acute crisis (AC-SCD patients). The frequency of myeloid-lymphoid-initiating cells (ML-ICs) and SCID-repopulating cells (SRCs) was significantly higher in blood from AC-SCD patients than in blood from patients with steady-state SCD or from normal donors. The presence of SRCs in peripheral blood was not associated with detection of long-term culture-initiating cells, consistent with the notion that SRCs are more primitive than long-term culture-initiating cells. As ML-ICs and SRCs were both detected in blood of AC-SCD patients only, these assays may both measure primitive progenitors. The frequency of ML-ICs also correlated with increases in stem cell factor, GCSF, and IL-8 levels in AC-SCD compared with steady-state SCD and normal-donor sera. Because significant numbers of ML-ICs and SRCs are mobilized in the blood without exogenous cytokine treatment during acute crisis of SCD, collection of peripheral blood progenitors during crisis may yield a source of autologous HSCs suitable for ex-vivo correction by gene therapy approaches and subsequent transplantation.

Gluten-free diet may improve obstructive sleep apnea-related symptoms in children with celiac disease.

PubMed

Yerushalmy-Feler, Anat; Tauman, Riva; Derowe, Ari; Averbuch, Eran; Ben-Tov, Amir; Weintraub, Yael; Weiner, Dror; Amir, Achiya; Moran-Lev, Hadar; Cohen, Shlomi

2018-02-07

Enlarged tonsils and adenoids are the major etiology of obstructive sleep apnea (OSA) in children. Lymphatic hyperplasia is common to both OSA and celiac disease. We aimed to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease. Children with celiac disease aged 2-18 years were prospectively recruited before the initiation of a gluten-free diet. Children with negative celiac serology who underwent gastrointestinal endoscopies for other indications served as controls. All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at baseline and 6 months later. Thirty-four children with celiac disease (mean age 6.6 ± 3.5 years) and 24 controls (mean age 7.3 ± 4.6 years, P = 0.5) were recruited. There were no significant differences in gender, body mass index or season at recruitment between the two groups. The rate of positive PSQ scores was higher (more OSA-related symptoms) in the control group compared to the celiac group, both at recruitment and at the 6-month follow-up (33.3% vs. 11.8%, P = 0.046, and 16.7% vs. 0, P = 0.014, respectively). PSQ scores improved significantly in both groups at the 6-month follow-up (P < 0.001 for both). Improvement was significantly higher in the celiac group compared to controls (0.1 ± 0.09 vs.0.06 ± 0.06, respectively, P = 0.04). Children with celiac disease had fewer OSA-related symptoms than controls, but the degree of improvement following the initiation of a gluten-free diet was significantly higher. These findings suggest that a gluten-free diet may improve OSA-related symptoms in children with celiac disease.

[Analysis of drug resistance to antituberculosis drugs of the first time retreated pulmonary tuberculosis patients in Shanghai].

PubMed

Fan, Yu-mei; Xiao, He-ping; Mei, Jian

2006-10-01

To investigate antituberculosis drug resistance among the first time retreated pulmonary tuberculosis patients in Shanghai, and therefore to provide evidence for establishing retreatment regimen. Analysis was conducted retrospectively on drug susceptibility tests to isoniazid, rifampin, streptomycin, ethambutol and para-aminosalicylates of the first time retreated pulmonary tuberculosis patients with a positive sputum culture in Shanghai Center for Disease Control from January 2002 to December 2004. The total drug resistance rate was 39.6%. The drug resistance rate in male and female patients was 38.5% and 44.4% respectively, the difference being not significant. The drug resistance rate in the young age group, the middle age group and the old age group were 50.0%, 41.6% and 34.6% respectively, the difference being not significant. The total drug resistance rates in the treatment failure group with standard initial chemotherapy and in the relapse group with standard regimen were both higher than in the relapse group with non-standard regimen (70.0%, 47.5%, 28.2%). So do the drug resistance rates of more than two drugs (70.0%, 18.3%, 6.4%). The multi-drug resistance rate of the failures with standard regimen was 70.0%, much higher than the relapses with standard regimen and the relapses with non-standard regimen. In relapses with non-standard initial therapy, the drug resistance rate of patients who received medications > or = 12 months was 55.0%, significantly higher than those treated for 1 - 5 months (13.0%). The drug resistance rate of patients who were treated with one to two drugs was lower than those treated with > or = 3 drugs, but no significant difference was observed (24.4% and 30.8%). Drug resistance rate varies in different types of the first time retreated pulmonary tuberculosis patients due to the history of drug use, which indicates that the current standard retreatment regimen is probably ineffective for some patients.

Direct and indirect effects of development temperature on adult water balance traits of Eldana saccharina (Lepidoptera: Pyralidae).

PubMed

Kleynhans, Elsje; Conlong, Des E; Terblanche, John S

2014-09-01

For water balance physiology, prior thermal history may pre-condition individuals to be more sparing in their water consumption at a given temperature upon subsequent exposure, or alternatively, may relax constraints on water economy leading to more frivolous use of water at a later stage. Here we test these two major alternative hypotheses on the adult life stage of Eldana saccharina Walker (Lepidoptera: Pyralidae) by exposing them to different rearing temperatures (acclimation treatments) during immature stage development and comparing adult physiological performance (water loss rates, time to death) and water-balance related traits (body size, water content). Developmental acclimation at 20°C, 25°C or 30°C throughout the larval and pupal stage resulted in significant effects on water balance traits of two-day old adult male and female E. saccharina. In summary, lower developmental acclimation resulted in a 61% increase in water loss rate (range: 0.78mg/h) and a 26% reduction in survival time (6.8h). Initial body water content and initial body mass generally remained similar across male acclimation groups while higher developmental acclimation reduced female body mass significantly. High developmental acclimation resulted in significantly higher (∼23%) body water content at death possibly indicating a better overall ability to withstand desiccating conditions, although there was no difference in time to death compared to the intermediate group. The relationship between time to death and body mass was altered from negative at 25°C and 30°C acclimation, to positive at 20°C acclimation. These results show pervasive effects of rearing temperature on adult physiological performance, with low temperature relaxing what appear to be substantial constraints on water economy at higher temperatures for E. saccharina. Furthermore, they are significant for understanding the recent range expansion of E. saccharina into cooler environments in southern Africa and for management of the species. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experimental investigation of the Peregrine Breather of gravity waves on finite water depth

NASA Astrophysics Data System (ADS)

Dong, G.; Liao, B.; Ma, Y.; Perlin, M.

2018-06-01

A series of laboratory experiments were performed to study the Peregrine Breather (PB) evolution in a wave flume of finite depth and deep water. Experimental cases were selected with water depths k0h (k0 is the wave number and h is the water depth) varying from 3.11 to 8.17 and initial steepness k0a0 (a0 is the background wave amplitude) in the range 0.06 to 0.12, and the corresponding initial Ursell number in the range 0.03 to 0.061. Experimental results indicate that the water depth plays an important role in the formation of the extreme waves in finite depth; the maximum wave amplification of the PB packets is also strongly dependent on the initial Ursell number. For experimental cases with the initial Ursell number larger than 0.05, the maximum crest amplification can exceed three. If the initial Ursell number is nearly 0.05, a shorter propagation distance is needed for maximum amplification of the height in deeper water. A time-frequency analysis using the wavelet transform reveals that the energy of the higher harmonics is almost in-phase with the carrier wave. The contribution of the higher harmonics to the extreme wave is significant for the cases with initial Ursell number larger than 0.05 in water depth k0h < 5.0. Additionally, the experimental results are compared with computations based on both the nonlinear Schrödinger (NLS) equation and the Dysthe equation, both with a dissipation term. It is found that both models with a dissipation term can predict the maximum amplitude amplification of the primary waves. However, the Dysthe equation also can predict the group horizontal asymmetry.

Use and cost comparison of clobazam to other antiepileptic drugs for treatment of Lennox-Gastaut syndrome

PubMed Central

François, Clément; Stern, John M.; Ogbonnaya, Augustina; Lokhandwala, Tasneem; Landsman-Blumberg, Pamela; Duhig, Amy; Shen, Vivienne; Tan, Robin

2017-01-01

ABSTRACT Background: Lennox-Gastaut syndrome (LGS) is a severe form of childhood-onset epilepsy associated with serious injuries due to frequent and severe seizures. Of the antiepileptic drugs (AEDs) approved for LGS, clobazam is a more recent market entrant, having been approved in October 2011. Recent AED budget impact and cost-effectiveness analyses for LGS suggest that adding clobazam to a health plan formulary may result in decreased medical costs; however, research on clinical and economic outcomes and treatment patterns with these AED treatments in LGS is limited. Objectives: To compare the baseline characteristics and treatment patterns of new initiators of clobazam and other AEDs among LGS patients and compare healthcare utilization and costs before and after clobazam initiation among LGS patients. Methods: A retrospective study of probable LGS patients was conducted using the MarketScan® Commercial, Medicare Supplemental, and Medicaid databases (10/1/2010-3/31/2014). Results: In the Commercial/Medicare Supplemental population, clobazam users were younger, had fewer comorbidities, and more prior AED use than non-clobazam users. In the 12 months pre-treatment initiation, clobazam users had significantly more seizure-related inpatient stays and outpatient visits and higher total seizure-related (P < 0.001) and all-cause (P < 0.001) costs than non-clobazam users. Among clobazam users, when compared to the 12 months pre-clobazam initiation, seizure-related medical utilization and costs were lower in the 12 months post-clobazam initiation (P = 0.004). Total all-cause (P < 0.001) and seizure-related (P = 0.029) costs increased post-clobazam initiation mainly due to the increase in outpatient pharmacy costs. Similar results were observed in the Medicaid population. Conclusions: Baseline results suggest a prescribing preference for clobazam in severe LGS patients. Clobazam users had a reduction in seizure-related medical utilization and costs after clobazam initiation. The improvement in medical costs mostly offset the higher prescription costs following clobazam initiation. PMID:28740620

Quality of life in newly diagnosed glaucoma patients : The Collaborative Initial Glaucoma Treatment Study.

PubMed

Janz, N K; Wren, P A; Lichter, P R; Musch, D C; Gillespie, B W; Guire, K E

2001-05-01

The Collaborative Initial Glaucoma Treatment Study (CIGTS) was designed to determine whether patients with newly diagnosed open-angle glaucoma are better treated initially by medicine or immediate filtering surgery. This paper describes the quality-of-life (QOL) measurement approach, instruments included, and the CIGTS participants' QOL findings at the time of diagnosis. Baseline results from a randomized, controlled clinical trial. Six hundred seven patients from 14 clinical centers were enrolled. Patients randomized to initial medication received a stepped medical regimen (n = 307). Those randomized to initial surgery underwent a trabeculectomy (n = 300). The baseline interview was conducted before treatment initiation. All baseline and posttreatment QOL assessments were conducted by telephone from a centralized interviewing center. The primary outcome measure described in this paper was QOL. The QOL instrument is multidimensional and incorporates both disease-specific and generic measures, including the Visual Activities Questionnaire, Sickness Impact Profile, and a Symptom and Health Problem CHECKLIST: The correlations between QOL measures and clinical outcomes were in the expected direction, but relatively weak. At initial diagnosis, difficulty with bright lights and with light and dark adaptation were the most frequently reported symptoms related to visual function, whereas visual distortion was the most bothersome. Approximately half of the patients reported at least some worry or concern about the possibility of blindness. Within the Visual Activities Questionnaire, higher scores on the Peripheral Vision subscale were associated with more field loss (P < 0.01). In regression analyses controlling for sociodemographics and nonocular comorbidities, increased visual field loss was significantly associated with higher dysfunction among five disease-specific QOL measures (P < 0.05). Newly diagnosed glaucoma patients reported experiencing some visual function symptoms at the time of diagnosis that would not be intuitively expected based on clinical testing. Some discussion about the association between clinical presentation and worry about blindness may reduce unnecessary concern. These results provide the basis for long-term comparisons of the QOL effects of initial medical and surgical treatment for open-angle glaucoma.

Analysis of compaction initiation in human embryos by using time-lapse cinematography.

PubMed

Iwata, Kyoko; Yumoto, Keitaro; Sugishima, Minako; Mizoguchi, Chizuru; Kai, Yoshiteru; Iba, Yumiko; Mio, Yasuyuki

2014-04-01

To analyze the initiation of compaction in human embryos in vitro by using time-lapse cinematography (TLC), with the goal of determining the precise timing of compaction and clarifying the morphological changes underlying the compaction process. One hundred and fifteen embryos donated by couples with no further need for embryo-transfer were used in this study. Donated embryos were thawed and processed, and then their morphological behavior during the initiation of compaction was dynamically observed via time-lapse cinematography (TLC) for 5 days. Although the initiation of compaction occurred throughout the period from the 4-cell to 16-cell stage, 99 (86.1 %) embryos initiated compaction at the 8-cell stage or later, with initiation at the 8-cell stage being most frequent (22.6 %). Of these 99 embryos, 49.5 % developed into good-quality blastocysts. In contrast, of the 16 (13.9 %) embryos that initiated compaction prior to the 8-cell stage, only 18.8 % developed into good-quality blastocysts. Embryos that initiated compaction before the 8-cell stage showed significantly higher numbers of multinucleated blastomeres, due to asynchronism in nuclear division at the third mitotic division resulting from cytokinetic failure. The initiation of compaction primarily occurs at the third mitotic division or later in human embryos. Embryos that initiate compaction before the 8-cell stage are usually associated with aberrant embryonic development (i.e., cytokinetic failure accompanied by karyokinesis).

Plasma Density Effects on Toroidal Flow Stabilization of Edge Localized Modes

NASA Astrophysics Data System (ADS)

Cheng, Shikui; Zhu, Ping; Banerjee, Debabrata

2016-10-01

Recent EAST experiments have demonstrated mitigation and suppression of edge localized modes (ELMs) with toroidal rotation flow in higher collisionality regime, suggesting potential roles of plasma density. In this work, the effects of plasma density on the toroidal flow stabilization of the high- n edge localized modes have been extensively studied in linear calculations for a circular-shaped limiter H-mode tokamak, using the initial-value extended MHD code NIMROD. In the single MHD model, toroidal flow has a weak stabilizing effects on the high- n modes. Such a stabilization, however, can be significantly enhanced with the increase in plasma density. Furthermore, our calculations show that the enhanced stabilization of high- n modes from toroidal flow with higher edge plasma density persists in the 2-fluid MHD model. These findings may explain the ELM mitigation and suppression by toroidal rotation in higher collisionality regime due to the enhancement of plasma density obtained in EAST experiment. Supported by the National Magnetic Confinement Fusion Program of China under Grant Nos. 2014GB124002 and 2015GB101004, the 100 Talent Program and the President International Fellowship Initiative of Chinese Academy of Sciences.

Executive function predicts the development of play skills for verbal preschoolers with autism spectrum disorders.

PubMed

Faja, Susan; Dawson, Geraldine; Sullivan, Katherine; Meltzoff, Andrew N; Estes, Annette; Bernier, Raphael

2016-12-01

Executive function and play skills develop in early childhood and are linked to cognitive and language ability. The present study examined these abilities longitudinally in two groups with autism spectrum disorder-a group with higher initial language (n = 30) and a group with lower initial language ability (n = 36). Among the lower language group, concurrent nonverbal cognitive ability contributed most to individual differences in executive function and play skills. For the higher language group, executive function during preschool significantly predicted play ability at age 6 over and above intelligence, but early play did not predict later executive function. These results suggested that factors related to the development of play and executive function differ for subgroups of children with different language abilities and that early executive function skills may be critical in order for verbal children with autism to develop play. Autism Res 2016, 9: 1274-1284. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Mean-level change and intraindividual variability in self-esteem and depression among high-risk children

PubMed Central

Kim, Jungmeen; Cicchetti, Dante

2012-01-01

This study investigated mean-level changes and intraindividual variability of self-esteem among maltreated (n=142) and nonmaltreated (n=109) school-aged children from low-income families. Longitudinal factor analysis revealed higher temporal stability of self-esteem among maltreated children compared to nonmaltreated children. Cross-domain latent growth curve models indicated that nonmaltreated children showed higher initial levels and greater increases in self-esteem than maltreated children, and that the initial levels of self-esteem were significantly associated with depressive symptoms among maltreated and nonmaltreated children. The average level (mean of repeated measurements) of self-esteem was predictive of depression at the final occasion for both maltreated and nonmaltreated children. For nonmaltreated children intraindividual variability of self-esteem had a direct contribution to prediction of depression. The findings enhance our understanding of developmental changes in self-esteem and the role of the average level and within-person variability of self-esteem in predicting depressive symptoms among high-risk children. PMID:22822280

Rebound weight gain as associated with high plasma norepinephrine levels that are mediated through polymorphisms in the beta2-adrenoceptor.

PubMed

Masuo, Kazuko; Katsuya, Tomohiro; Kawaguchi, Hideki; Fu, Yuxiao; Rakugi, Hiromi; Ogihara, Toshio; Tuck, Michael L

2005-11-01

A successful weight loss program is essential treatment for obesity-related diseases, but it is well known that the majority of individuals do not succeed in weight loss maintenance. The present study evaluates hormonal mechanisms and the relationship of beta2-adrenoceptor polymorphisms involved in individuals who regain weight after initially successful weight loss. Overweight Japanese men (n = 154) were enrolled in a 24-month weight loss program. Body mass index (BMI), total body fat mass, plasma norepinephrine (NE) and leptin levels, and beta2-adrenoceptor polymorphisms (Arg16Gly, Gln27Glu) were measured every 6 months for the 24-month period. Maintenance of weight loss was defined as significant weight loss (>or=10% reduction) from entry weight at 6 months and maintenance of the weight loss for an additional 18 months. Rebound weight gain was defined as significant weight loss at 6 months but subsequent regain of body weight during the next 18 months. The results showed that 37 subjects maintained weight loss during 24 months, whereas 36 subjects had rebound weight gain. The BMI at entry and calorie intake and physical activity at each period were similar between the two groups. Subjects who maintained weight loss had at entry a significantly lower fat mass and plasma NE levels compared to those with rebound weight gain. Body fat mass, NE, and leptin levels at entry predicted the degree of change in body weight during the 24-month study period. Subjects with rebound weight gain had a significantly higher frequency of the Gly16 allele for the beta2-adrenoceptor polymorphism compared to subjects who had a 24-month maintenance of weight loss. Subjects carrying the Gly16 allele also had significantly higher plasma NE, leptin, and body fat mass levels and a greater waist-to-hip ratio both at entry and throughout the study. A high initial degree of body fat mass and high plasma NE levels as determined by the Gly16 allele for the beta2-adrenoceptor polymorphisms predict those individuals who will have rebound weight gain after their initial successful weight loss.

Speed-difficulty trade-off in speech: Chinese versus English

PubMed Central

Sun, Yao; Latash, Elizaveta M.; Mikaelian, Irina L.

2011-01-01

This study continues the investigation of the previously described speed-difficulty trade-off in picture description tasks. In particular, we tested a hypothesis that the Mandarin Chinese and American English are similar in showing logarithmic dependences between speech time and index of difficulty (ID), while they differ significantly in the amount of time needed to describe simple pictures, this difference increases for more complex pictures, and it is associated with a proportional difference in the number of syllables used. Subjects (eight Chinese speakers and eight English speakers) were tested in pairs. One subject (the Speaker) described simple pictures, while the other subject (the Performer) tried to reproduce the pictures based on the verbal description as quickly as possible with a set of objects. The Chinese speakers initiated speech production significantly faster than the English speakers. Speech time scaled linearly with ln(ID) in all subjects, but the regression coefficient was significantly higher in the English speakers as compared with the Chinese speakers. The number of errors was somewhat lower in the Chinese participants (not significantly). The Chinese pairs also showed a shorter delay between the initiation of speech and initiation of action by the Performer, shorter movement time by the Performer, and shorter overall performance time. The number of syllables scaled with ID, and the Chinese speakers used significantly smaller numbers of syllables. Speech rate was comparable between the two groups, about 3 syllables/s; it dropped for more complex pictures (higher ID). When asked to reproduce the same pictures without speaking, movement time scaled linearly with ln(ID); the Chinese performers were slower than the English performers. We conclude that natural languages show a speed-difficulty trade-off similar to Fitts’ law; the trade-offs in movement and speech production are likely to originate at a cognitive level. The time advantage of the Chinese participants originates not from similarity of the simple pictures and Chinese written characters and not from more sloppy performance. It is linked to using fewer syllables to transmit the same information. We suggest that natural languages may differ by informational density defined as the amount of information transmitted by a given number of syllables. PMID:21479658

The influence of primary caregivers on the sexual behavior of early adolescents.

PubMed

Rose, Allison; Koo, Helen P; Bhaskar, Brinda; Anderson, Karen; White, Gregory; Jenkins, Renee R

2005-08-01

To describe rates of sexual intercourse initiation, anticipated level of sexual activity in the next 12 months, and other risk behaviors among fifth graders and to examine parental factors associated with such behaviors. This study is based on a cross-sectional, self-administered survey conducted with a nonrandom sample of 408 fifth graders and their caregivers. Children answered questions regarding sexual intercourse initiation, anticipated sexual activity in the next 12 months, and involvement in other risk behaviors. Caregivers answered questions about parenting factors such as monitoring behaviors, parent-child relationship quality, and parent-child communication. Bivariate and multivariable analyses examined the association of these variables with the adolescents' behaviors. Almost 5% of girls and 17% of boys reported they had engaged in sexual intercourse. Only 34% of girls and 13% of boys said they did not expect to engage in any type of sexual contact in the next 12 months if they were going with someone they "liked a lot." Parental factors associated with fewer risk behaviors and expected sexual behaviors included higher levels of monitoring, fewer communication barriers, less permissive attitudes regarding adolescent sexual behavior, higher relationship quality with child, having fewer than five children in the household, higher levels of education, and being employed. Significant gender interactions were found for several variables. Adolescents are initiating sexual intercourse at extremely young ages. To delay early sexual activity and prevent adolescent pregnancy, prevention efforts must begin during the elementary school years and include those who raise and care for the adolescent.

Tenofovir exposure alters associations of serum bicarbonate with chronic kidney disease risk in HIV-infected Veterans

PubMed Central

KIM, Julie; SCHERZER, Rebecca; ESTRELLA, Michelle; IX, Joachim; SHLIPAK, Michael G.

2016-01-01

Objective Among HIV-infected persons, tenofovir disoproxil fumarate (TDF) use is associated with higher risk of developing chronic kidney disease (CKD). Because lower serum bicarbonate concentrations may precede CKD onset, this study investigated the associations between TDF use and bicarbonate concentrations, and between bicarbonate with CKD risk among TDF users and non-users. Methods Retrospective cohort study of 16,070 HIV-infected US veterans who initiated antiretroviral therapy between 1997–2011. The association between TDF use with longitudinal bicarbonate concentrations and associations between bicarbonate with incident CKD stratified by TDF use (never, initial, and later user) were evaluated. Results Compared to TDF users, never users had faster declines in bicarbonate concentrations: change in bicarbonate −0.11 mmol/L/year (95% CI −0.16, −0.05), compared with −0.04 mmol/L/year (−0.06, 0.05) in initial users and −0.02 mmol/L/year (−0.05, 0.01) in later users. Low baseline bicarbonate (<22 mmol/L) was significantly associated with CKD risk among TDF never users (1.80; 1.21, 2.68), but not among TDF users (0.98; 0.69, 1.38). Similarly, declining bicarbonate concentrations were associated with higher CKD risk among never users(HR 1.67 per mmol/L; 1.34, 2.08), but not among TDF users (1.09; 0.98, 1.22). Interactions were highly significant for both analyses (p-value = 0.001). Conclusions Despite associations with nephrotoxicity, TDF use was associated with higher serum bicarbonate concentrations longitudinally. Additionally, TDF use obscured the strong associations of bicarbonate with CKD risk in HIV-infected persons. Therefore, the role of bicarbonate concentrations as a tool to monitor kidney health in HIV-infected persons may be limited in the setting of TDF use. PMID:26760455

Prognostic Implications of Dual Platelet Reactivity Testing in Acute Coronary Syndrome.

PubMed

de Carvalho, Leonardo P; Fong, Alan; Troughton, Richard; Yan, Bryan P; Chin, Chee-Tang; Poh, Sock-Cheng; Mejin, Melissa; Huang, Nancy; Seneviratna, Aruni; Lee, Chi-Hang; Low, Adrian F; Tan, Huay-Cheem; Chan, Siew-Pang; Frampton, Christopher; Richards, A Mark; Chan, Mark Y

2018-02-01

Studies on platelet reactivity (PR) testing commonly test PR only after percutaneous coronary intervention (PCI) has been performed. There are few data on pre- and post-PCI testing. Data on simultaneous testing of aspirin and adenosine diphosphate antagonist response are conflicting. We investigated the prognostic value of combined serial assessments of high on-aspirin PR (HASPR) and high on-adenosine diphosphate receptor antagonist PR (HADPR) in patients with acute coronary syndrome (ACS). HASPR and HADPR were assessed in 928 ACS patients before (initial test) and 24 hours after (final test) coronary angiography, with or without revascularization. Patients with HASPR on the initial test, compared with those without, had significantly higher intraprocedural thrombotic events (IPTE) (8.6 vs. 1.2%, p  ≤ 0.001) and higher 30-day major adverse cardiovascular and cerebrovascular events (MACCE; 5.2 vs. 2.3%, p  = 0.05), but not 12-month MACCE (13.0 vs. 15.1%, p  = 0.50). Patients with initial HADPR, compared with those without, had significantly higher IPTE (4.4 vs. 0.9%, p  = 0.004), but not 30-day (3.5 vs. 2.3%, p  = 0.32) or 12-month MACCE (14.0 vs. 12.5%, p  = 0.54). The c-statistic of the Global Registry of Acute Coronary Events (GRACE) score alone, GRACE score + ASPR test and GRACE score + ADPR test for discriminating 30-day MACCE was 0.649, 0.803 and 0.757, respectively. Final ADPR was associated with 30-day MACCE among patients with intermediate-to-high GRACE score (adjusted odds ratio [OR]: 4.50, 95% confidence interval [CI]: 1.14-17.66), but not low GRACE score (adjusted OR: 1.19, 95% CI: 0.13-10.79). In conclusion, both HASPR and HADPR predict ischaemic events in ACS. This predictive utility is time-dependent and risk-dependent. Schattauer GmbH Stuttgart.

Lack of efficacy of homeopathic therapy against post-calving clinical mastitis in dairy herds in the Waikato region of New Zealand.

PubMed

Williamson, J H; Lacy-Hulbert, S J

2014-01-01

To compare clinical and bacteriological cure rates of clinical mastitis following treatment with either antimicrobials or homeopathic preparations. Seven spring-calving herds from the Waikato region of New Zealand were used to source cases of clinical mastitis (n = 263 glands) during the first 90 days following calving. Duplicate milk samples were collected for bacteriology from each clinically infected gland at diagnosis and 25 (SD 5.3) days after initial treatment. Affected glands were treated with either an antimicrobial formulation or a homeopathic remedy. Generalised linear models with binomial error distribution and logit link were used to analyse the proportion of cows that were clinical treatment cures and the proportion of glands that were classified as bacteriological cures, based on initial and post-treatment milk samples. Mean cumulative incidence of clinical mastitis was 7% (range 2-13% across herds) of cows. Streptococcus uberis was the most common pathogen isolated from culture-positive samples from affected glands (140/209; 67%). The clinical cure rate was higher for cows treated with antimicrobials (107/113; 95%) than for cows treated with homeopathic remedies (72/114; 63%) (p < 0.001) based on the observance of clinical signs following initial treatment. Across all pathogen types bacteriological cure rate at gland level was higher for those cows treated with antimicrobials (75/102; 74%) than for those treated with a homeopathic preparation (39/107; 36%) (p < 0.001). Using herds located in the Waikato region of New Zealand, homeopathic remedies had significantly lower clinical and bacteriological cure rates compared with antimicrobials when used to treat post-calving clinical mastitis where S. uberis was the most common pathogen. The proportion of cows that needed retreatment was significantly higher for the homeopathic treated cows. This, combined with lower bacteriological cure rates, has implications for duration of infection, individual cow somatic cell count, costs associated with treatment and animal welfare.

Thesis Abstract Fermented milk elaborated with Camellia sinensis.

PubMed

Ribeiro, O A S; Silva, M I A; Boari, C A

2016-05-13

This study aimed to develop and to characterize fermented dairy beverage formulated with Camellia sinensis. The infusion was elaborated with the addiction of dehydrated leaves of C. sinensis in whey (1g/100g) which added in sweetened milk (10% sucrose w/w) coagulated by Streptococcus salivarius subspecies thermophilus and Lactobacillus delbrueckii subspecies bulgaricus in proportions of 10, 20, 30 and 40% (v/w). The control treatment consisted of yogurt added with sucrose (10% w/w). Analysis were performed to quantify dry mass, moisture, ash, protein, fat, sodium, acidity, total quantification of lactic acid bacteria, total antioxidant activity and viscosity at the initial time of production and at 15 and 30 days of storage. Chromatographic determination of volatile compounds and sensory tests of acceptance and consumption intention were conducted at the initial time of production. Dry matter content, moisture, ash and total count of lactic acid bacteria from fermented milk drink formulations were not significantly affected by the amount of infusion of C. sinensis. However, the content of protein, fat and sodium were significantly lower with the increase of the proportion of infusion incorporated into the product. Significant reduction in apparent viscosity occurs with the increase in the amount of infusion added. The total antioxidant activity of the formulations was significantly higher as higher were the amount of added infusion. The addition of infusion contributed to the diversification of volatile aroma and taste makers in the product. The formulation of fermented dairy drink with addition of 30% infusion C. sinensis was better evaluated in sensory tests, with greater acceptance and greater consumer intent of consumption.

Randomised trial of LHRH analogue treatment on final height in girls with onset of puberty aged 7.5-8.5 years

PubMed Central

Cassio, A.; Cacciari, E.; Balsamo, A.; Bal, M.; Tassinari, D.

1999-01-01

OBJECTIVE—To study the effectiveness of luteinising hormone releasing hormone (LHRH) analogues in improving final height in girls affected by early puberty.
PATIENTS—Forty six consecutive girls with onset of puberty aged 7.5-8.5 years randomly divided into two groups: one treated with 3.75 mg triptorelin intramuscularly every four weeks (group 1); and the other with no treatment (group 2).
RESULTS—Mean (SD) chronological age at onset of menarche was significantly higher in group 1 than in group 2 (11.9 (1.0) v 10.8 (0.7) years). However, mean (SD) height at menarche (152.7 (7.2) v 152.5(5.7) cm) and mean (SD) growth after menarche (4.9 (3.0) v 5.4(2.2) cm) were similar in both groups. The mean (SD) final height was similar in the two groups (group 1, 158.1 (6.2) cm; group 2, 158.6 (6.0) cm) and not significantly different from target height. Fourteen of 20 patients in group 1 and 12 of 18 patients in group 2 showed final height equal to or higher than target height. Final heights of girls with poor initial height prognosis were significantly lower than those of girls with good prognosis, but in patients with the same initial height prognosis, both groups showed final heights similar and not significantly different from their target heights.
CONCLUSIONS—LHRH analogue has no apparent effect on final height in subjects with onset of puberty between 7.5 and 8.5years.

 PMID:10490438

Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care.

PubMed

Mitchell, Stephanie J; Bilderback, Andrew L; Okelo, Sande O

2016-01-01

To elucidate whether there may be a higher morbidity threshold for African American versus white children to be referred to or seek asthma specialist care. Secondary analysis of registry data captured from children presenting for an initial routine outpatient asthma consultation. Parents completed standard survey instruments, and spirometry was conducted when deemed appropriate by the provider. Wilcoxon rank sum tests revealed that African American patients had been hospitalized twice as often and admitted to the intensive care unit or intubated significantly more than 1½ times more frequently than their white patient counterparts. t tests indicated African American patients' forced expiratory volume in 1 second (FEV1) percentage predicted was significantly worse than that of whites, but there was no significant difference for FEV1/forced vital capacity ratio. t tests suggested that African American patients had statistically worse asthma control than did white patients at the time of initial presentation to the pulmonologist, but there was no difference in the distribution of asthma severity categories. Multivariate regression models indicated that racial differences in parent education did not explain the disparities in asthma morbidity. African American patients had significantly worse asthma morbidity than their white counterparts, including higher rates of hospitalization and intensive care unit admission and poorer lung functioning. Given that receipt of asthma specialist care can improve those outcomes that are disparately experienced by African American children, methods of increasing their access to and use of asthma specialist care need to be developed. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A Framework for Mobile Learning for Enhancing Learning in Higher Education

ERIC Educational Resources Information Center

Barreh, Kadar Abdillahi; Abas, Zoraini Wati

2015-01-01

As mobile learning becomes increasingly pervasive, many higher education institutions have initiated a number of mobile learning initiatives to support their traditional learning modes. This study proposes a framework for mobile learning for enhancing learning in higher education. This framework for mobile learning is based on research conducted…

Mass carbon monoxide poisoning at an ice-hockey game: initial approach and long-term follow-up.

PubMed

Mortelmans, Luc J M; Populaire, Jacques; Desruelles, Didier; Sabbe, Marc B

2013-12-01

A mass carbon monoxide (CO) intoxication during an ice-hockey game is described. Two hundred and thirty-five patients were seen in different hospitals, 88 of them the same night at the nearby emergency department. To evaluate long-term implications and to identify relevant indicators, a follow-up study was organized 1 year after the incident. Apart from the file data from the emergency departments, a 1-year follow-up mailing was sent to all patients. One hundred and ninety-one patients returned their questionnaire (86%). The mean age of the patients was 28 years, with 61% men. The mean carboxyhaemoglobin (COHb) was 9.9%. COHb levels were significantly higher for individuals on the ice (referee, players and maintenance personnel). There was a significant relationship with the initial presence of dizziness, fatigue and the COHb level. Headache, abdominal pain, nausea and vomiting were not significantly related to the COHb levels. The relationship between symptoms and CO level, however, should be interpreted with caution as there was a wide range between exposure and blood tests. 5.2% of patients had residual complaints, all including headache, with a significant higher incidence with high COHb levels. Only two patients had an abnormal neurological control (one slightly disturbed electroencephalography and one persistent encephalopathic complaint). Work incapacity was also significantly related to COHb levels. CO mass poisonings remain a risk in indoor sporting events. Although it causes an acute mass casualty incident, it is limited in time and delayed problems are scarce. Symptomatology is a poor tool for triage. The best prevention is the use of nonmineral energy sources such as for example electricity.

A comparative survey of missed initial and follow-up appointments to psychiatric specialties in the United kingdom.

PubMed

Mitchell, Alex J; Selmes, Thomas

2007-06-01

Missed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom. The pooled missed appointment rate was 15.9%, higher than in previous studies on primary and secondary care attendance in the United Kingdom. Nonattendance was lowest on Fridays, in winter months, and in geriatric psychiatry and highest for substance abuse services and in community psychiatry. In most services, attendance improved after the initial appointment, but in psychosomatic medicine and geriatric psychiatry this pattern was reversed. There was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.

Metabolic characteristics and renal dysfunction in 65 patients with tophi prior to gout.

PubMed

Lu, Chuan-Chin; Wu, Shyi-Kuen; Chung, Wei-Sheng; Lin, Liang-Hung; Hung, Ta-Wei; Yeh, Chih-Jung

2017-08-01

Tophi typically occur many years after uncontrolled gout. Therefore, their development before gout remains unusual. Such patients might exhibit some characteristic differences compared with typical tophaceous gout patients. In this study, 65 tophaceous gout patients with tophi as the first sign of gout (tophi-first group) were enrolled. Their clinical characteristics were compared with those of 1421 patients whose tophi occurred after gout (tophi-after group). Compared with the tophi-after group, the tophi-first group had a significantly higher percentage of female patients and patients with elderly onset of disease and a lower percentage of patients with a positive family history; these patients had lower body mass indices, serum urate levels, and estimated glomerular filtration rates (eGFRs). Female sex and negative family history were identified as the principal determinants of tophi development before gout. The decreasing eGFR among the tophi-first group was not due to the group per se but was a result of older age, longer tophi duration, and hyperuricemia. The most common site of initial tophi occurrence in both groups was the toe. In the tophi-first group, the occurrence rates for initial tophi sites were significantly higher at the finger but were lower at the ankle. The tophi-first group exhibited distinct characteristics of age, gender, family history, BMI, serum urate levels, and initial tophi site. This group had fewer comorbidities but similar renal dysfunction compared with the tophi-after group. Thus, patients presenting with tophi should be treated promptly, even if they have no history of gout symptoms.

Implementation of a pharmacist-managed heart failure medication titration clinic.

PubMed

Martinez, Amanda S; Saef, Jerold; Paszczuk, Anna; Bhatt-Chugani, Hetal

2013-06-15

The development, implementation, and initial results of a pharmacist-managed heart failure (HF) medication titration clinic are described. In a quality-improvement initiative at a Veterans Affairs health care system, clinical pharmacists were incorporated into the hospital system's interprofessional outpatient HF clinic. In addition, a separate pharmacist-managed HF medication titration clinic was established, in which pharmacists were granted an advanced scope of practice and prescribing privileges, enabling them to initiate and adjust medication dosages under specific protocols jointly established by cardiology and pharmacy staff. Pharmacists involved in the titration clinic tracked patients' daily body weight, vital signs, and volume status using telephone-monitoring technology and via patient interviews. A retrospective chart review comparing achievement of target doses of angiotensin-converting enzyme inhibitor (ACEI), angiotensin-receptor blocker (ARB), and β-blocker therapies in a group of patients (n = 28) whose dosage titrations were carried out by nurses or physicians prior to implementation of the pharmacist-managed HF medication titration clinic and a group of patients (n = 27) enrolled in the medication titration clinic during its first six months of operation indicated that target ACEI and ARB doses were achieved in a significantly higher percentage of pharmacist-managed titration clinic enrollees (52.9% versus 31%, p = 0.007). Patients enrolled in the pharmacist-managed HF medication titration clinic also had a significantly higher rate of attainment of optimal β-blocker doses (49% versus 24.7%, p = 0.012). Implementation of a pharmacist-managed HF medication titration clinic increased the percentage of patients achieving optimal ACEI, ARB, and β-blocker dosages.

Isolating the Role of Psychological Dysfunction in Smoking Cessation Failure: Relations of Personality and Psychopathology to Attaining Smoking Cessation Milestones

PubMed Central

Leventhal, Adam M.; Japuntich, Sandra J.; Piper, Megan E.; Jorenby, Douglas E.; Schlam, Tanya R.; Baker, Timothy B.

2012-01-01

Research exploring psychological dysfunction as a predictor of smoking cessation success may be limited by nonoptimal predictor variables (i.e., categorical psychodiagnostic measures vs. continuous personality-based manifestations of dysfunction) and imprecise outcomes (i.e., summative point prevalence abstinence vs. constituent cessation milestone measures). Accordingly, this study evaluated the unique and overlapping relations of broad-spectrum personality traits (positive emotionality, negative emotionality, and constraint) and past-year psychopathology (anxiety, mood, and substance use disorder) to point prevalence abstinence and three smoking cessation milestones: (1) initiating abstinence; (2) first lapse; and (3) transition from lapse to relapse. Participants were daily smokers (N=1365) enrolled in a smoking cessation treatment study. In single predictor regression models, each manifestation of internalizing dysfunction (lower positive emotionality, higher negative emotionality, and anxiety and mood disorder) predicted failure at one or more cessation milestone. In simultaneous predictor models, lower positive and higher negative emotionality significantly predicted failure to achieve milestones after controlling for psychopathology. Psychopathology did not predict any outcome when controlling for personality. Negative emotionality showed the most robust and consistent effects, significantly predicting failure to initiate abstinence, earlier lapse, and lower point prevalence abstinence rates. Substance use disorder and constraint did not predict cessation outcomes, and no single variable predicted lapse-to-relapse transition. These findings suggest that personality-related manifestations of internalizing dysfunction are more accurate markers of affective sources of relapse risk than mood and anxiety disorders. Further, individuals with high trait negative emotionality may require intensive intervention to promote the initiation and early maintenance of abstinence. PMID:22642858

Expression of C-type lectin receptor mRNA in chronic otitis media with cholesteatoma.

PubMed

Kim, Sang Hoon; Han, Seung-Ho; Byun, Jae Yong; Park, Moon Suh; Kim, Young Il; Yeo, Seung Geun

2017-06-01

The levels of expression of various C-type lectin receptors (CLRs) messenger ribo nucleic acids (mRNAs) were significantly higher in cholesteatomas than in normal skin, suggesting that these CLRs may be involved in the pathogenesis of cholesteatoma. Altered expression of pattern recognition receptors may be associated with immune responses in patients with cholesteatoma. This study assessed the levels of expression of CLR mRNAs in normal skin and in cholesteatoma. Cholesteatoma specimens were obtained from 38 patients with acquired cholesteatoma. The levels of expression of various CLR mRNAs were assessed quantitatively using real-time RT-PCR (Reverse transcription polymerase chain reaction) and correlated with age, sex, the presence of bacteria, hearing level, frequency of surgery, and degree of ossicle destruction. The levels of CD206 (cluster of differentiation 206), DEC-205 (Dendritic and epithelial cell-205), MGL (monoacylglycerol lipase), CLEC5A (C-type lectin domain family 5 member A), Dectin-2 (dendrite cell-associated C-type lectin-2), BDCA2 (Blood dendritic cell antigen 2), Mincle, DCIR (dendritic cell immunoreceptor), Dectin-1, MICL (Myeloid inhibitory C type-like lectin), and CLEC12B (C-type lectin domain family 12, member B) mRNAs were significantly higher in cholesteatoma than in control skin samples (p < 0.05). The levels of CLEC5A (C-type lectin domain family 5 member) and Dectin-1 mRNAs were significantly higher in cholesteatomas with ≥2 than ≤1 destroyed ossicles (p < 0.05), and the levels of MGL, Mincle, Dectin-1, and CLEC12B mRNAs were significantly higher in recurrent than initial cholesteatoma specimens (p < 0.05). The level of CLEC5A mRNAs was significantly higher in patients with severe than mild-to-moderate hearing loss (p < 0.05).

Numerical investigation of spontaneous flame propagation under RCCI conditions

DOE PAGES

Bhagatwala, Ankit V; Sankaran, Ramanan; Kokjohn, Sage; ...

2015-06-30

This paper presents results from one and two-dimensional direct numerical simulations under Reactivity Controlled Compression Ignition (RCCI) conditions of a primary reference fuel (PRF) mixture consisting of n-heptane and iso-octane. RCCI uses in-cylinder blending of two fuels with different autoignition characteristics to control combustion phasing and the rate of heat release. These simulations employ an improved model of compression heating through mass source/sink terms developed in a previous work by Bhagatwala et al. (2014), which incorporates feedback from the flow to follow a predetermined experimental pressure trace. Two-dimensional simulations explored parametric variations with respect to temperature stratification, pressure profiles andmore » n-heptane concentration. Furthermore, statistics derived from analysis of diffusion/reaction balances locally normal to the flame surface were used to elucidate combustion characteristics for the different cases. Both deflagration and spontaneous ignition fronts were observed to co-exist, however it was found that higher n-heptane concentration provided a greater degree of flame propagation, whereas lower n-heptane concentration (higher fraction of iso-octane) resulted in more spontaneous ignition fronts. A significant finding was that simulations initialized with a uniform initial temperature and a stratified n-heptane concentration field, resulted in a large fraction of combustion occurring through flame propagation. The proportion of spontaneous ignition fronts increased at higher pressures due to shorter ignition delay when other factors were held constant. For the same pressure and fuel concentration, the contribution of flame propagation to the overall combustion was found to depend on the level of thermal stratification, with higher initial temperature gradients resulting in more deflagration and lower gradients generating more ignition fronts. Statistics of ignition delay are computed to assess the Zel’dovich (1980) theory for the mode of combustion propagation based on ignition delay gradients.« less

(18)F-Fluorodeoxyglucose PET/MR Imaging in Head and Neck Cancer.

PubMed

Platzek, Ivan

2016-10-01

(18)F-fluorodeoxyglucose (FDG) PET/MR imaging does not offer significant additional information in initial staging of squamous cell carcinoma of the head and neck when compared with standalone MR imaging. In patients with suspected tumor recurrence, FDG PET/MR imaging has higher sensitivity than MR imaging, although its accuracy is equivalent to the accuracy of FDG PET/CT. Copyright © 2016 Elsevier Inc. All rights reserved.

Getting used to academic public speaking: global self-esteem predicts habituation in blood pressure response to repeated thesis presentations.

PubMed

Elfering, Achim; Grebner, Simone

2012-06-01

Global self-esteem was tested to predict quicker cardiovascular adaptation during stressful oral thesis presentation and faster habituation from the first to the second and third thesis presentations. Nineteen graduate students initially rated their global self-esteem and afterwards orally presented their theses proposals in 20-min presentations to their thesis supervisor and peers. A second and third presentation of the revised thesis concepts took place at 4-weeks intervals. Ambulatory blood pressure and heart rate were assessed repeatedly during the presentations. Post-talk self ratings of stressfulness indicated presentations to be a strong public speaking stressor. One hundred and thirty-eight measurements of systolic (SBP), diastolic blood pressure (DBP), and heart rate (HR) showed a significant adaptation (decrease) during presentations. There was an overall mean level decrease from the first to the second, and the second to the third presentations in HR, but not in SBP and DBP. However, habituation in SBP and DBP across three presentations was significantly faster (p < .05) in those participants who initially reported higher levels of global self-esteem. Higher global self-esteem did not foster adaptation within the presentations. Self-esteem is discussed as an important individual resource that allows successful coping with recurring evaluative threats.

Effects of neuromuscular fatigue on perceptual-cognitive skills between genders in the contribution to the knee joint loading during side-stepping tasks.

PubMed

Khalid, Abdul Jabbar; Harris, Sujae Ian; Michael, Loke; Joseph, Hamill; Qu, Xingda

2015-01-01

This study investigated whether neuromuscular fatigue affects the neuromuscular control of an athlete within a sports context setting and whether these effects were more pronounced in the females. Lower limb joint kinetics of 6 male and 6 female inter-varsity soccer players performing side-stepping tasks in non-fatigue versus fatigue and anticipated versus unanticipated conditions were quantified using 10 Motion Analysis Corporation cameras and a Kistler(™) force platform. The Yo-Yo intermittent recovery Level 1 fatigue protocol was employed. Stance foot initial contact and peak forces, and peak joint knee moments of the lower limb were submitted to a 3-way mixed-model repeated measure ANOVA. The results suggested that males tend to elicit significantly higher knee joint loadings when fatigued. In addition, males elicited significantly higher peak proximal tibia anterior/posterior shear force, vertical ground reaction force at initial contact and peak internal rotational moments than females. These findings suggested that males were at greater overall injury risk than females, especially in the sagittal plane. Neuromuscular control-based training programmes/interventions that are designed to reduce the risk of the non-contact ACL injury need to be customised for the different genders.

Predictors of early stable symptomatic remission after an exacerbation of schizophrenia: the significance of symptoms, neuropsychological performance and cognitive biases.

PubMed

Andreou, Christina; Roesch-Ely, Daniela; Veckenstedt, Ruth; Bohn, Francesca; Aghotor, Julia; Köther, Ulf; Pfueller, Ute; Moritz, Steffen

2013-12-30

Neuropsychological deficits and severity of initial psychopathology have been repeatedly associated with poor symptomatic outcomes in schizophrenia. The role of higher-order cognitive biases on symptomatic outcomes of the disorder has not yet been investigated. The present study aimed to assess the contribution of cognitive biases, psychopathology and neuropsychological deficits on the probability of achieving early symptomatic remission after a psychotic episode in patients with schizophrenia. Participants were 79 patients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder undergoing an acute psychotic episode, and 25 healthy controls. According to psychopathology assessments, patients were split into those who had achieved remission after an average follow-up interval of 7 months, and those who had not (NR). Patients who achieved remission exhibited higher premorbid IQ and better performance on the TMT-B, as well as lower baseline positive, disorganized and distress symptoms than NR patients. TMT-B performance and positive symptoms at baseline were the best predictors of remission. Cognitive biases and negative symptoms were not associated with later remission. The findings highlight the significance of initial symptom severity for at least short-term symptomatic outcomes and, thus, the importance of adequate symptomatic treatment and prevention of psychotic outbreaks in patients. © 2013 Elsevier Ireland Ltd. All rights reserved.

Knee Kinematics is Altered Post-Fatigue While Performing a Crossover Task

PubMed Central

Cortes, Nelson; Greska, Eric; Ambegaonkar, Jatin P.; Kollock, Roger O.; Caswell, Shane V.; Onate, James A.

2013-01-01

Purpose To examine the effect of a sequential fatigue protocol on lower extremity biomechanics during a crossover cutting task in female soccer players. Methods Eighteen female collegiate soccer players alternated between a fatigue protocol and two consecutive unanticipated crossover trials until fatigue was reached. Lower extremity biomechanics were evaluated during the crossover using a 3D motion capture system and two force plates. Repeated measures ANOVAs analyzed differences between three sequential stages of fatigue (pre, 50%, 100%) for each dependent variable (α=0.05). Results Knee flexion angles at initial contact (IC) for pre- (−32±9°) and 50% (−29±11°) were significantly higher than at 100% fatigue (−22±9°) (p<0.001 and p=0.015, respectively). Knee adduction angles at IC for pre- (9±5°) and 50% (8±4°) were significantly higher (p=0.006 and p=0.049, respectively) than at 100% fatigue (6±4°). Conclusions Fatigue altered sagittal and frontal knee kinematics after 50% fatigue whereupon participants had diminished knee control at initial contact. Interventions should attempt to reduce the negative effects of fatigue on lower extremity biomechanics by promotion appropriate frontal plane alignment, and increased knee flexion during fatigue status. PMID:24045915

Overgeneral Autobiographical Memory as a Predictor of the Course of Depression: A Meta-Analysis

PubMed Central

Sumner, Jennifer A.; Griffith, James W.; Mineka, Susan

2010-01-01

Overgeneral autobiographical memory (OGM) is a robust phenomenon in depression, but the extent to which OGM predicts the course of depression is not well-established. This meta-analysis synthesized data from 15 studies to examine the degree to which OGM 1) correlates with depressive symptoms at follow-up, and 2) predicts depressive symptoms at follow-up over and above initial depressive symptoms. Although the effects are small, specific and categoric/overgeneral memories generated during the Autobiographical Memory Test significantly predicted the course of depression. Fewer specific memories and more categoric/overgeneral memories were associated with higher follow-up depressive symptoms, and predicted higher follow-up symptoms over and above initial symptoms. Potential moderators were also examined. The age and clinical depression status of participants, as well as the length of follow-up between the two depressive symptom assessments, significantly moderated the predictive relationship between OGM and the course of depression. The predictive relationship between specific memories and follow-up depressive symptoms became greater with increasing age and a shorter length of follow-up, and the predictive relationship was stronger for participants with clinical depression diagnoses than for nonclinical participants. These findings highlight OGM as a predictor of the course of depression, and future studies should investigate the mechanisms underlying this relationship. PMID:20399418

Controlling Heterogeneous Catalysis of Water Dissociation Using Cu-Ni Bimetallic Alloy Surfaces: A Quantum Dynamics Study.

PubMed

Ray, Dhiman; Ghosh, Smita; Tiwari, Ashwani Kumar

2018-06-07

Copper-Nickel bimetallic alloys are emerging heterogeneous catalysts for water dissociation which is the rate determining step of industrially important Water Gas Shift (WGS) reaction. Yet, the detailed quantum dynamics studies of water-surface scattering in literature are limited to pure metal surfaces. We present here, a three dimensional wave-packet dynamics study of water dissociation on Cu-Ni alloy surfaces, using a pseudo diatomic model of water on a London-Eyring-Polanyi-Sato (LEPS) potential energy surface in order to study the effect of initial vibration, rotation and orientation of water molecule on reactivity. For all the chosen surfaces reactivity increases significantly with vibrational excitation. In general, for lower vibrational states the reactivity increases with increasing rotational excitation but it decreases in higher vibrational states. Molecular orientation strongly affects reactivity by helping the molecule to align along the reaction path at higher vibrational states. For different alloys, the reaction probability follows the trend of barrier heights and the surfaces having all Ni atoms in the uppermost layer are much more reactive than the ones with Cu atoms. Hence the nature of the alloy surface and initial quantum state of the incoming molecule significantly influence the reactivity in surface catalyzed water dissociation.

A high proportion of blue light increases the photosynthesis capacity and leaf formation rate of Rosa × hybrida but does not affect time to flower opening.

PubMed

Terfa, Meseret Tesema; Solhaug, Knut Asbjørn; Gislerød, Hans Ragnar; Olsen, Jorunn Elisabeth; Torre, Sissel

2013-05-01

Alterations in light quality affect plant morphogenesis and photosynthetic responses but the effects vary significantly between species. Roses exhibit an irradiance-dependent flowering control but knowledge on light quality responses is scarce. In this study we analyzed, the responses in morphology, photosynthesis and flowering of Rosa × hybrida to different blue (B) light proportions provided by light-emitting diodes (LED, high B 20%) and high pressure sodium (HPS, low B 5%) lamps. There was a strong morphological and growth effect of the light sources but no significant difference in total dry matter production and flowering. HPS-grown plants had significantly higher leaf area and plant height, yet a higher dry weight proportion was allocated to leaves than stems under LED. LED plants showed 20% higher photosynthetic capacity (Amax ) and higher levels of soluble carbohydrates. The increase in Amax correlated with an increase in leaf mass per unit leaf area, higher stomata conductance and CO2 exchange, total chlorophyll (Chl) content per area and Chl a/b ratio. LED-grown leaves also displayed a more sun-type leaf anatomy with more and longer palisade cells and a higher stomata frequency. Although floral initiation occurred at a higher leaf number in LED, the time to open flowers was the same under both light conditions. Thereby the study shows that a higher portion of B light is efficient in increasing photosynthesis performance per unit leaf area, enhancing growth and morphological changes in roses but does not affect the total Dry Matter (DM) production or time to open flower. Copyright © Physiologia Plantarum 2012.

Demographic and socioenvironmental predictors of premorbid marijuana use among patients with first-episode psychosis.

PubMed

Pauselli, Luca; Birnbaum, Michael L; Vázquez Jaime, Beatriz Paulina; Paolini, Enrico; Kelley, Mary E; Broussard, Beth; Compton, Michael T

2018-01-31

We identified, in subjects with first-episode psychosis, demographic and socioenvironmental predictors of three variables pertaining to premorbid marijuana use: age at initiation of marijuana use, trajectories of marijuana use in the five years prior to onset of psychosis, and the cumulative "dose" of marijuana intake in that same premorbid period. We enrolled 247 first-episode psychosis patients and collected data on lifetime marijuana/alcohol/tobacco use, age at onset of psychosis, diverse socioenvironmental variables, premorbid adjustment, past traumatic experiences, perceived neighborhood-level social disorder, and cannabis use experiences. Bivariate tests were used to examine associations between the three premorbid marijuana use variables and hypothesized predictors. Regression models determined which variables remained independently significantly associated. Age at initiation of cigarette smoking was linked to earlier initiation, faster escalation, and higher cumulative dose of premorbid marijuana use. During childhood, poorer academic performance was predictive of an earlier age at initiation of marijuana use, while poorer sociability was related to more rapid escalation to daily use and a higher cumulative dose. As expected, experiencing euphoric effects was positively correlated with trajectories and cumulative dose, but having negative experiences was unrelated. Traumatic childhood/adolescent experiences were correlated with rapid escalation and amount of marijuana used, but not with age at initiation of marijuana use. These data expand the very limited literature on predictors of premorbid marijuana use in first-episode psychosis. Given its association with earlier age at onset of psychosis, and poorer outcomes among first-episode patients, prevention and treatment efforts should be further developed. Copyright © 2018 Elsevier B.V. All rights reserved.

Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese

PubMed Central

Meng, Zhaowei; Liu, Ming; Zhang, Qing; Liu, Li; Song, Kun; Tan, Jian; Jia, Qiang; Zhang, Guizhi; Wang, Renfei; He, Yajing; Ren, Xiaojun; Zhu, Mei; He, Qing; Wang, Shen; Li, Xue; Hu, Tianpeng; Liu, Na; Upadhyaya, Arun; Zhou, Pingping; Zhang, Jianping

2015-01-01

Abstract The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort. This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models. Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408–58.455) higher than males (2.588–4.943). Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs. PMID:26683929

A survey of injuries at five greyhound racing tracks.

PubMed

Sicard, G K; Short, K; Manley, P A

1999-09-01

The number of orthopaedic injuries sustained by racing greyhounds from five greyhound tracks in the state of Wisconsin, USA, was obtained over a two-year period. Calculated injury rates were analysed to predict the probability that a given competitor would have an injury based on track design, temperature, bodyweight, grade of race, race distance, race number, injury location on track and type of trauma. One track had a significantly higher injury rate than the others, and this track was constructed with a decreased initial straightaway, a decreased turning radius in the second turn and an increased turn bank. Increased injury rates were also seen with successively higher grades of race, suggesting a possible correlation with speed. Race distance had a significant effect on racing greyhound injury rates as well. Races measuring 3/16 mile and 7/16 mile resulted in a higher incidence of injury as compared with races with lengths of 5/16 mile and 3/8 mile. Injuries were most likely to occur at the first turn of a race. Temperature, bodyweight, race number and type of trauma had no significant effect on injury rate. Speed, race distance and track design were significant factors that were found to influence the injury rate of the racing greyhound and should be areas to focus on for the prevention of injury.

Promoting Handwashing Behavior: The Effects of Large-scale Community and School-level Interventions.

PubMed

Galiani, Sebastian; Gertler, Paul; Ajzenman, Nicolas; Orsola-Vidal, Alexandra

2016-12-01

This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical points in time in Peru. It evaluates a large-scale comprehensive initiative that involved both community and school activities in addition to communication campaigns. The analysis indicates that the initiative was successful in reaching the target audience and in increasing the treated population's knowledge about appropriate handwashing behavior. These improvements translated into higher self-reported and observed handwashing with soap at critical junctures. However, no significant improvements in the health of children under the age of 5 years were observed. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Effect of endomycorrhizae on interactions between mycorrhizal and nonmycorrhizal plants. [Glomus monosporum/mosseae; Atriplex canescens; Sitanion hystrix

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

Franson, R.; Miller, R.M.

1984-01-01

An investigation on how infection with vesicular-arbuscular mycorrhizal fungi (VAM) changes interactions between plants was initiated. Specifically addressed were how does the presence or absence of VAM affect: (1) a species that typically shows little or no infection; and (2) a species that typically possesses moderate levels of infection. Results show: roots for inoculated species were higher than uninoculated treatments; the above ground dry weight gain were significantly higher with inoculation. The growth response of both species suggests a fungus-to-plant interaction even though infection, as measured by arbuscules a vesicles, was not always present. 2 figures. (MF)

Evaluation of an emotional support service for the visually impaired.

PubMed

Latham, Keziah

2013-08-01

To evaluate the impact of a facilitated peer group emotional support service on visual quality of life (VQoL). Consecutive participants in an emotional support service delivered to groups of up to six and facilitated by trained counselors were recruited (n = 29). The VCM1 (Vision Quality-of-life Core Measure) instrument was administered to participants at the start of the service, at the end of the service, and 6 months after completion of the service. For the group as a whole, VQoL significantly improved between the beginning of the service and the end (F(1,23) = 16.43, p = 0.000) but was no better than at the start 6 months later (F(1,23) = 3.60, p = 0.07). However, those with poorer initial VQoL showed significantly greater improvements after 6 months (1.74 ± 2.21 logits) than those with higher initial VQoL (-0.12 ± 0.71 logits) (t23 = 2.89, p = 0.008). The effect size of the intervention for those with poor initial VQoL was 1.10 at the end of service and 0.92 after 6 months. The items that became and remained easier were "feeling lonely or isolated due to eyesight," "feeling sad or low due to eyesight," and "feeling worried about general safety outside the home." This facilitated peer group emotional support service significantly improves VQoL as assessed with the VCM1 over at least 6 months for those with poorer initial VQoL. Different interventions may be needed for those with initially good VQoL and to improve other aspects of QoL not influenced by the service.

Effects of prehospital epinephrine during out-of-hospital cardiac arrest with initial non-shockable rhythm: an observational cohort study

PubMed Central

2013-01-01

Introduction Few clinical trials have provided evidence that epinephrine administration after out-of-hospital cardiac arrest (OHCA) improves long-term survival. Here we determined whether prehospital epinephrine administration would improve 1-month survival in OHCA patients. Methods We analyzed the data of 209,577 OHCA patients; the data were prospectively collected in a nationwide Utstein-style Japanese database between 2009 and 2010. Patients were divided into the initial shockable rhythm (n = 15,492) and initial non-shockable rhythm (n = 194,085) cohorts. The endpoints were prehospital return of spontaneous circulation (ROSC), 1-month survival, and 1-month favorable neurological outcomes (cerebral performance category scale, category 1 or 2) after OHCA. We defined epinephrine administration time as the time from the start of cardiopulmonary resuscitation (CPR) by emergency medical services personnel to the first epinephrine administration. Results In the initial shockable rhythm cohort, the ratios of prehospital ROSC, 1-month survival, and 1-month favorable neurological outcomes in the non-epinephrine group were significantly higher than those in the epinephrine group (27.7% vs. 22.8%, 27.0% vs. 15.4%, and 18.6% vs. 7.0%, respectively; all P < 0.001). However, in the initial non-shockable rhythm cohort, the ratios of prehospital ROSC and 1-month survival in the epinephrine group were significantly higher than those in the non-epinephrine group (18.7% vs. 3.0% and 3.9% vs. 2.2%, respectively; all P < 0.001) and there was no significant difference between the epinephrine and non-epinephrine groups for 1-month favorable neurological outcomes (P = 0.62). Prehospital epinephrine administration for OHCA patients with initial non-shockable rhythms was independently associated with prehospital ROSC (adjusted odds ratio [aOR], 8.83, 6.18, 4.32; 95% confidence interval [CI], 8.01-9.73, 5.82-6.56, 3.98-4.69; for epinephrine administration times ≤9 min, 10-19 min, and ≥20 min, respectively), with improved 1-month survival when epinephrine administration time was <20 min (aOR, 1.78, 1.29; 95% CI, 1.50-2.10, 1.17-1.43; for epinephrine administration times ≤9 min and 10-19 min, respectively), and with deteriorated 1-month favorable neurological outcomes (aOR, 0.63, 0.49; 95% CI, 0.48-0.80, 0.32-0.71; for epinephrine administration times 10-19 min and ≥20 min, respectively). Conclusions Prehospital epinephrine administration for OHCA patients with initial nonshockable rhythms was independently associated with achievement of prehospital ROSC and had association with improved 1-month survival when epinephrine administration time was <20 min. PMID:24004456

Dexpanthenol pastille and benzydamine hydrochloride spray for the prevention of post-operative sore throat.

PubMed

Gulhas, N; Canpolat, H; Cicek, M; Yologlu, S; Togal, T; Durmus, M; Ozcan Ersoy, M

2007-02-01

In this study, we aimed to compare the effectiveness of dexpanthenol pastille and benzydamine hydrochloride spray on the prevention of a sore throat. One hundred and eighty patients undergoing general anaesthesia, who were ASA I-II and with their ages ranging between 15 and 70 years, were randomly allocated to three groups, each consisting of 60 patients. For group B, four puffs of benzydamine hydrochloride were sprayed into the mouth initially 30 min before the operation and repeatedly 5 min before anaesthesia induction. For group D, two pastilles of dexpanthenol were administered orally to be sucked 30 min before the operation. For group P, four puffs of distilled water were sprayed into the mouth initially 30 min before the operation. Post-operatively, patients were evaluated for a sore throat for the duration of 24 h. The incidence of a sore throat was significantly lower for group D when compared with group B and group P. The incidence of a sore throat was similar for group B and group P. According to the sore throat grading system, the number of patients experiencing no complaints was significantly higher for group D when compared with group B and group P. The number of patients achieving moderate scores was significantly higher for group B when compared with group D. The administration of 200 mg of dexpanthenol prophylactically before endotracheal intubation is effective in the prevention of post-operative sore throat.

Autopsy of forestry ballot initiative: characterizing voter support for Oregon's measure 64.

Treesearch

Jeffrey D. Kline; Catriona Armstrong

2001-01-01

On November 3,1998, Oregon voters soundly rejected a ballot initiative intended to promote sustainable forestry practices and protect forest ecosystems by restricting clearcut logging and herbicide and pesticide use. We found that initiative support was greater in more urban counties composed of more educated residents earning higher incomes and with higher proportions...

Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia: impact on survival and bacterial resistance.

PubMed

Adrie, Christophe; Schwebel, Carole; Garrouste-Orgeas, Maïté; Vignoud, Lucile; Planquette, Benjamin; Azoulay, Elie; Kallel, Hatem; Darmon, Michael; Souweine, Bertrand; Dinh-Xuan, Anh-Tuan; Jamali, Samir; Zahar, Jean-Ralph; Timsit, Jean-François

2013-11-07

Several guidelines recommend initial empirical treatment with two antibiotics instead of one to decrease mortality in community-acquired pneumonia (CAP) requiring intensive-care-unit (ICU) admission. We compared the impact on 60-day mortality of using one or two antibiotics. We also compared the rates of nosocomial pneumonia and multidrug-resistant bacteria. This is an observational cohort study of 956 immunocompetent patients with CAP admitted to ICUs in France and entered into a prospective database between 1997 and 2010. Initial adequate antibiotic therapy was significantly associated with better survival (subdistribution hazard ratio (sHR), 0.63; 95% confidence interval (95% CI), 0.42 to 0.94; P = 0.02); this effect was strongest in patients with Streptococcus pneumonia CAP (sHR, 0.05; 95% CI, 0.005 to 0.46; p = 0.001) or septic shock (sHR: 0.62; 95% CI 0.38 to 1.00; p = 0.05). Dual therapy was associated with a higher frequency of initial adequate antibiotic therapy. However, no difference in 60-day mortality was found between monotherapy (β-lactam) and either of the two dual-therapy groups (β-lactam plus macrolide or fluoroquinolone). The rates of nosocomial pneumonia and multidrug-resistant bacteria were not significantly different across these three groups. Initial adequate antibiotic therapy markedly decreased 60-day mortality. Dual therapy improved the likelihood of initial adequate therapy but did not predict decreased 60-day mortality. Dual therapy did not increase the risk of nosocomial pneumonia or multidrug-resistant bacteria.

Increased risk of hospital admission for dehydration or heat-related illness after initiation of medicines: a sequence symmetry analysis.

PubMed

Kalisch Ellett, L M; Pratt, N L; Le Blanc, V T; Westaway, K; Roughead, E E

2016-10-01

Although several studies have identified factors which increase the risk of heat-related illness, few have assessed the contribution of medicines. To address this knowledge gap, our study aimed to assess the risk of hospital admission for dehydration or other heat-related illness following initiation of medicines. We conducted a retrospective analysis using prescription event symmetry analysis (PESA) of 6700 veterans with incident hospital admission for dehydration or heat-related illness (ICD-10-AM codes E86, X30, T67), between 1 January 2001 and 30 June 2013. The main outcome measure was first ever hospital admission for dehydration or heat-related illness following initiation of commonly used medicines. A significantly higher risk of incident hospital admission for dehydration or heat-related illness was observed following initiation of anticoagulants, cardiovascular medicines, NSAIDs, antipsychotics, antidepressants and anticholinergic agents. The risk of hospital admission for dehydration or heat-related illness ranged from 1·17 (SSRIs) to 2·79 (ACEI plus diuretic combination product). No significant association was observed between initiation of anticonvulsants, anti-Parkinson's agents, hypnotics, anxiolytics or antihistamines and hospital admission for dehydration or heat-related illness. Many commonly used medicines were found to be associated with increased risk of hospitalization for dehydration or heat-related illness. Initiation of ACE inhibitors in combination with diuretics had the highest risk. Prescribers and patients should be aware of the potential for medicines to be associated with increased risk of dehydration and heat-related illness. © 2016 John Wiley & Sons Ltd.

Rehydration Capacities and Rates for Various Porcine Tissues after Dehydration

PubMed Central

Meyer, Jacob P.; McAvoy, Kieran E.; Jiang, Jack

2013-01-01

The biphasic effects of liquid on tissue biomechanics are well known in cartilage and vocal folds, yet not extensively in other tissue types. Past studies have shown that tissue dehydration significantly impacts biomechanical properties and that rehydration can restore these properties in certain tissue types. However, these studies failed to consider how temporal exposure to dehydrating or rehydrating agents may alter tissue rehydration capacity, as overexposure to dehydration may permanently prevent rehydration to the initial liquid volume. Select porcine tissues were dehydrated until they reached between 100% and 40% of their initial mass. Each sample was allowed to rehydrate for 5 hours in a 0.9% saline solution, and the percent change between the initial and rehydrated mass values was calculated. Spearman correlation tests indicated a greater loss in mass despite rehydration when tissues were previously exposed to greater levels of dehydration. Additionally, Pearson correlation tests indicated the total liquid mass of samples after complete rehydration decreased when previously exposed to higher levels of dehydration. Rehydration rates were found by dehydrating tissues to 40% of their initial mass followed by rehydration in a 0.9% saline solution for 60 minutes, with mass measurements occurring in 15 minute intervals. All tissues rehydrated nonlinearly, most increasing significantly in mass up to 30 minutes after initial soaking. This study suggests the ability for tissues to rehydrate is dependent on the level of initial dehydration exposure. In vitro rehydration experiments therefore require controlled dosage and temporal exposure to dehydrating and rehydrating agents to avoid incomplete rehydration, and caution should be taken when combining different tissue types in models of hydration. PMID:24023753

A population-based study of the comparative effectiveness of second-generation antipsychotics vs older antimanic agents in bipolar disorder.

PubMed

Bauer, Mark S; Miller, Christopher J; Li, Mingfei; Bajor, Laura A; Lee, Austin

2016-09-01

Numerous antimanic treatments have been introduced over the past two decades, particularly second-generation antipsychotics (SGAs). However, it is not clear whether such newer agents provide any advantage over older treatments. A historical cohort design investigated the nationwide population of outpatients with bipolar disorder treated in the Department of Veterans Affairs who were newly initiated on an antimanic agent between 2003 and 2010 (N=27 727). The primary outcome was likelihood of all-cause hospitalization during the year after initiation, controlling for numerous demographic, clinical, and treatment characteristics. Potential correlates of effect were explored by investigating time to initiation of a second antimanic agent or antidepressant. After control for covariates, those initiated on lithium or valproate monotherapy, compared to those beginning SGA monotherapy, were significantly less likely to be hospitalized, had a longer time to hospitalization, and had fewer hospitalizations in the subsequent year. Those on combination treatment had a significantly higher likelihood of hospitalization, although they also had a longer time to addition of an additional antimanic agent or antidepressant. The present analysis of a large and unselected nationwide population provides important complementary data to that from controlled trials. Although various mechanisms may be responsible for the results, the data support the utilization of lithium or valproate, rather than SGAs, as the initial antimanic treatment in bipolar disorder. A large-scale, prospective, randomized, pragmatic clinical trial comparing the initiation of SGA monotherapy to that of lithium or valproate monotherapy is a logical next step. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Japan's English-Medium Instruction Initiatives and the Globalization of Higher Education

ERIC Educational Resources Information Center

Rose, Heath; McKinley, Jim

2018-01-01

This article analyzes a recent initiative of Japan's Ministry of Education, which aims to internationalize higher education in Japan. The large-investment project "Top Global University Project" (TGUP) has emerged to create globally oriented universities, to increase the role of foreign languages in higher education, and to foster global…

The National Higher Education and Workforce Initiative: Strategy in Action: Building the Cybersecurity Workforce in Maryland

ERIC Educational Resources Information Center

Business-Higher Education Forum, 2014

2014-01-01

The Business-Higher Education Forum (BHEF) has achieved particular success in operationalizing the National Higher Education and Workforce Initiative (HEWI) in Maryland around cybersecurity. Leveraging its membership of corporate CEOs, university presidents, and government agency leaders, BHEF partnered with the University System of Maryland to…

The Relationship of Vocabulary Learning Strategies and Self-Efficacy with Medical English and Terminology.

PubMed

Wang, Ya-Huei; Kao, Pan-Fu; Liao, Hung-Chang

2016-02-01

This study examined the relationship between the use of vocabulary learning strategies and self-efficacy in medical English learning, and whether after an initial six-week course to master the basics of medical terminology, those with higher use of vocabulary learning strategies and those with a higher degree of self-efficacy would have significant score improvements in the medical English proficiency. Second-year medical students (N = 115; M age = 19.6, SD = 0.5; 82 men, 33 women) participated in the study. A one-group pretest-posttest design was used. Measures included medical English tests, the English Vocabulary Learning Strategies Survey (EVLSS), and the English Learning Self-Efficacy Scale (ELSES). Results showed that there was no significant correlation between vocabulary learning strategies and English learning self-efficacy. In addition, as a whole, vocabulary learning strategies and self-efficacy significantly predicted students' score improvements in medical English proficiency. © The Author(s) 2016.

Effects of two diets on the haematology, plasma chemistry and intestinal flora of budgerigars (Melopsittacus undulatus).

PubMed

Fischer, I; Christen, C; Lutz, H; Gerlach, H; Hässig, M; Hatt, J-M

2006-10-07

Two groups of 22 budgerigars (Melopsittacus undulatus) were housed for 12 months under identical conditions. One group was fed a commercial seed mixture plus carrots and a mineral supplement, and the other group was fed a commercially formulated diet plus carrots. Samples of blood and faeces were collected initially and after three, six, nine and 12 months. There were no significant differences between the haematological values of the two groups. The group fed the seed mixture had significantly higher concentrations of glucose, albumin, triglycerides and uric acid, and higher activity of aspartate aminotransferase, but the values were within the published reference ranges for normal birds. There were no significant differences between the faecal samples from the two groups, except that the fungus Macrorhabdus ornithogaster was identified in 48.3 per cent of the samples from the group fed the commercially formulated diet but from only 3.4 per cent of the samples from the group fed the seed mixture.

Changes in bone mineral metabolism parameters, including FGF23, after discontinuing cinacalcet at kidney transplantation.

PubMed

Barros, Xoana; Fuster, David; Paschoalin, Raphael; Oppenheimer, Federico; Rubello, Domenico; Perlaza, Pilar; Pons, Francesca; Torregrosa, Jose V

2015-05-01

Little is known about the effects of the administration of cinacalcet in dialytic patients who are scheduled for kidney transplantation, and in particular about the changes in FGF23 and other mineral metabolism parameters after surgery compared with recipients not on cinacalcet at kidney transplantation. We performed a prospective observational cohort study with recruitment of consecutive kidney transplant recipients at our institution. Patients were classified according to whether they were under treatment with cinacalcet before transplantation. Bone mineral metabolism parameters, including C-terminal FGF23, were measured at baseline, on day 15, and at 1, 3, and 6 months after transplantation. In previously cinacalcet-treated patients, cinacalcet therapy was discontinued on the day of surgery and was not restarted after transplantation. A total of 48 kidney transplant recipients, 20 on cinacalcet at surgery and 28 cinacalcet non-treated patients, completed the follow-up. Serum phosphate declined significantly in the first 15 days after transplantation with no differences between the two groups, whereas cinacalcet-treated patients showed higher FGF23 levels, although not significant. After transplantation, PTH and serum calcium were significantly higher in cinacalcet-treated patients. We conclude that patients receiving cinacalcet on dialysis presented similar serum phosphate levels but higher PTH and serum calcium levels during the initial six months after kidney transplantation than cinacalcet non-treated patients. The group previously treated with cinacalcet before transplantation showed higher FGF23 levels without significant differences, so further studies should investigate its relevance in the management of these patients.

Stress response of wild bottlenose dolphins (Tursiops truncatus) during capture-release health assessment studies.

PubMed

Fair, Patricia A; Schaefer, Adam M; Romano, Tracy A; Bossart, Gregory D; Lamb, Stephen V; Reif, John S

2014-09-15

There is a growing concern about the impacts of stress in marine mammals as they face a greater array of threats. The stress response of free-ranging dolphins (Tursiops truncatus) was examined by measuring their physiologic response to capture and handling. Samples were collected from 168 dolphins during capture-release health assessments 2003-2007 at two study sites: Charleston, SC (CHS) and the Indian River Lagoon, FL (IRL). Adrenocorticotropic hormone (ACTH), cortisol, aldosterone (ALD) and catecholamines (epinephrine (EPI), norepinephrine (NOR), dopamine (DA)), were measured in blood and cortisol in urine. Mean time to collect pre-examination samples after netting the animals was 22min; post-examination samples were taken prior to release (mean 1h 37min). EPI and DA concentrations decreased significantly with increased time to blood sampling. ACTH and cortisol levels increased from the initial capture event to the post-examination sample. EPI concentrations increased significantly with increasing time to the pre-examination sample and decreased significantly with time between the pre- and post-examination sample. Cortisol concentrations increased between the pre- and post-examination in CHS dolphins. Age- and sex-adjusted mean pre-examination values of catecholamines were significantly higher in CHS dolphins; ALD was higher in IRL dolphins. Significant differences related to age or sex included higher NOR concentrations in males; higher ALD and urine cortisol levels in juveniles than adults. Wild dolphins exhibited a typical mammalian response to acute stress of capture and restraint. Further studies that relate hormone levels to biological and health endpoints are warranted. Published by Elsevier Inc.

Simultaneous effect of initial moisture content and airflow rate on biodrying of sewage sludge.

PubMed

Huiliñir, Cesar; Villegas, Manuel

2015-10-01

The simultaneous effect of initial moisture content (initial Mc) and air-flow rate (AFR) on biodrying performance was evaluated. For the study, a 3(2) factorial design, whose factors were AFR (1, 2 and 3 L/min kg(TS)) and initial Mc (59, 68 and 78% w.b.), was used. Using energy and water mass balance the main routes of water removal, energy use and efficiencies were determined. The results show that initial Mc has a stronger effect on the biodrying than the AFR, affecting the air outlet temperature and improving the water removal, with higher maximum temperatures obtained around 68% and the lowest maximum matrix temperature obtained at initial Mc = 78%.Through the water mass balance it was found that the main mechanism for water removal was the aeration, with higher water removal at intermediate initial Mc (68%) and high AFR (3 L/min kg(TS)). The energy balance indicated that bioreaction is the main energy source for water evaporation, with higher energy produced at intermediate initial Mc (68%). Finally, it was found that low values of initial Mc (59%) improve biodrying efficiency. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hypertonic 15% sodium pyruvate offers no initial resuscitation advantage compared with 8% hypertonic NACl in sheep with multiple hemorrhages.

PubMed

do Nascimento, Paulo; Vaid, Sumreen U; Hoskins, Stephen L; Espana, Jonathan M; Kinsky, Michael P; Kramer, George C

2007-05-01

Initial fluid resuscitation of hemorrhagic shock might be enhanced by the infusion of monocarboxylate-energy substrates. We evaluated hemodynamics, metabolism, and fluid dynamics for initial resuscitation of hemorrhage using small volume 15% sodium pyruvate solution (HPY) compared with osmotically matched 8% hypertonic saline (HS). Instrumented conscious sheep were hemorrhaged 25 mL/kg at time zero through 15 min (T0-T15) and 5 mL/kg for 5 min at T50 to T55 and T70 to T75. Fluid resuscitation from T30 to T180 was performed by a computer-controlled closed-loop system, which titrated infusion rate to a mean arterial pressure of 90 mmHg. Initial infusion was 4 mL/kg of either HPY or HS, followed by the administration of lactated Ringer. Both HPY and HS restored cardiac index similarly. The lactate/pyruvate ratio was used to assess metabolic debt and was significantly higher (T180), whereas oxygen delivery was significantly lower (T120) with HPY versus HS. Total fluid administered was similar, with 43.7 +/- 6.2 mL/kg for HPY and 39.4 +/- 6.8 mL/kg for HS. Plasma volume was similarly increased and approached baseline values for both groups. Initial resuscitation with small volume HPY offered no hemodynamic or metabolic advantage compared with small volume HS when the fluids were infused to an end point pressure.

An In-vitro Comparison of Force Loss of Orthodontic Non-Latex Elastics

PubMed Central

Alavi, Shiva; Tabatabaie, Atusa Rahnama; Hajizadeh, Fatemeh; Ardekani, Alireza Haerian

2014-01-01

Objective: The amount and consistency of the applied forces to the tooth are important factors in tooth movements; therefore, the aim of this study was to compare the initial force and the force loss of three brands of elastics in 24 hours. Materials and Methods: In this in-vitro study sixty non-latex elastics (3/16 medium) from three companies (Forestadent, Dentaurum and Ortho Technology) were randomly selected. Two static tests were performed, the first in a dry environment to evaluate the initial force and the other performed in a wet environment (artificial saliva) to evaluate the force loss in 24 hours. The Universal testing machine measured the forces after stretching the elastics to three times the lumen diameter. Data were analyzed by repeated measures ANOVA, One-way ANOVA, Tukey-HSD, Paired samples test, and one sample test. Results: The difference between the brands was significant (p=0.002). Force loss was observed in all samples; 4–7.5% force loss occurred after one hour and 19–38% force loss occurred after 24 hours. The average initial force of Forestadent and Ortho Technology was significantly higher than marketed forces (p<0.001), but the initial force of Dentaurum elastics was similar to the marketed force. Conclusion: The force loss over 24 hours time period was Forestadent>Dentaurum>Ortho-Technology. According to the initial force and force loss percentage it is suggested to replace the non-latex elastics several times a day. PMID:24910671

Neighborhood Predictors of Cognitive Training Outcomes and Trajectories in ACTIVE

PubMed Central

Meyer, Oanh L.; Sisco, Shannon M.; Harvey, Danielle; Zahodne, Laura B.; Glymour, M. Maria; Manly, Jennifer J.; Marsiske, Michael

2015-01-01

We examined the influence of neighborhood socioeconomic position (SEP), racial/ethnic composition, and living in a major city on cognitive trajectories and intervention outcomes. Data came from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 2,438). Mixed effects analyses examined associations between neighborhood variables and memory, reasoning, speed of processing, and everyday cognition, estimating differences in initial gains (potentially related to practice) and long-term rate of change over 10 years. The effect of reasoning training on initial gain was weaker for individuals in a major city. For everyday cognition, there was a stronger initial gain for memory-trained and control participants in areas with more racial/ethnic minorities, and for speed-trained and control individuals in higher SEP areas. The racial/ethnic minority effect was no longer significant after adjustment for multiple comparisons. Neighborhood factors may be more important in practice-related improvement than in long-term change. PMID:26667987

Manufacturing in space: Fluid dynamics numerical analysis

NASA Technical Reports Server (NTRS)

Robertson, S. J.; Nicholson, L. A.; Spradley, L. W.

1982-01-01

Numerical computations were performed for natural convection in circular enclosures under various conditions of acceleration. It was found that subcritical acceleration vectors applied in the direction of the temperature gradient will lead to an eventual state of rest regardless of the initial state of motion. Supercritical acceleration vectors will lead to the same steady state condition of motion regardless of the initial state of motion. Convection velocities were computed for acceleration vectors at various angles of the initial temperature gradient. The results for Rayleigh numbers of 1000 or less were found to closely follow Weinbaum's first order theory. Higher Rayleigh number results were shown to depart significantly from the first order theory. Supercritical behavior was confirmed for Rayleigh numbers greater than the known supercritical value of 9216. Response times were determined to provide an indication of the time required to change states of motion for the various cases considered.

Theory-based evaluation of a comprehensive Latino education initiative: an interactive evaluation approach.

PubMed

Nesman, Teresa M; Batsche, Catherine; Hernandez, Mario

2007-08-01

Latino student access to higher education has received significant national attention in recent years. This article describes a theory-based evaluation approach used with ENLACE of Hillsborough, a 5-year project funded by the W.K. Kellogg Foundation for the purpose of increasing Latino student graduation from high school and college. Theory-based evaluation guided planning, implementation as well as evaluation through the process of developing consensus on the Latino population of focus, adoption of culturally appropriate principles and values to guide the project, and identification of strategies to reach, engage, and impact outcomes for Latino students and their families. The approach included interactive development of logic models that focused the scope of interventions and guided evaluation designs for addressing three stages of the initiative. Challenges and opportunities created by the approach are discussed, as well as ways in which the initiative impacted Latino students and collaborating educational institutions.

Leadership, self-efficacy, and student achievement

NASA Astrophysics Data System (ADS)

Grayson, Kristin

This study examined the relationships between teacher leadership, science teacher self-efficacy, and fifth-grade science student achievement in diverse schools in a San Antonio, Texas, metropolitan school district. Teachers completed a modified version of the Leadership Behavior Description Question (LBDQ) Form XII by Stogdill (1969), the Science Efficacy and Belief Expectations for Science Teaching (SEBEST) by Ritter, Boone, and Rubba (2001, January). Students' scores on the Texas Assessment of Knowledge and Skills (TAKS) measured fifth-grade science achievement. At the teacher level of analysis multiple regressions showed the following relationships between teachers' science self-efficacy and teacher classroom leadership behaviors and the various teacher and school demographic variables. Predictors of teacher self efficacy beliefs included teacher's level of education, gender, and leadership initiating structure. The only significant predictor of teacher self-efficacy outcome expectancy was gender. Higher teacher self-efficacy beliefs predicted higher leadership initiating structure. At the school level of analysis, higher school levels of percentage of students from low socio-economic backgrounds and higher percentage of limited English proficient students predicted lower school student mean science achievement. These findings suggest a need for continued research to clarify relationships between teacher classroom leadership, science teacher self-efficacy, and student achievement especially at the teacher level of analysis. Findings also indicate the importance of developing instructional methods to address student demographics and their needs so that all students, despite their backgrounds, will achieve in science.

Economic outcomes of exenatide vs liraglutide in type 2 diabetes patients in the United States: results from a retrospective claims database analysis.

PubMed

Pelletier, Elise M; Pawaskar, Manjiri; Smith, Paula J; Best, Jennie H; Chapman, Richard H

2012-01-01

The safety and efficacy of the GLP-1 receptor agonists exenatide BID (exenatide) and liraglutide for treating type 2 diabetes mellitus (T2DM) have been established in clinical trials. Effective treatments may lower overall treatment costs. This study examined cost offsets and medication adherence for exenatide vs liraglutide in a large, managed care population in the US. This was a retrospective cohort analysis comprising adult patients with T2DM who initiated exenatide or liraglutide between 1/1/2010 and 6/30/2010 and had 6 months pre-index and post-index continuous eligibility. Patients were propensity score-matched to controls for baseline differences. Medication adherence was measured by proportion of days covered (PDC). Paired t-test and McNemar's test were used to compare outcomes. Matched exenatide and liraglutide cohorts (n=1347 pairs) had similar average total 6-month follow-up costs ($6688 vs $7346). However, exenatide patients had significantly lower mean pharmacy costs ($2925 vs $3272, p<0.001). Among liraglutide patients, patients receiving the 1.8 mg dose had significantly higher average total costs compared to those receiving the 1.2 mg dose ($8031 vs $6536, p=0.026), with higher mean pharmacy costs in the 1.8 mg cohort ($3935 vs $3146, p<0.001). There were no significant differences in inpatient or outpatient costs or medication adherence between groups (mean PDC: exenatide 56% vs liraglutide 57%, p=0.088). The study assumed that all information needed for case classification and matching of cohorts was present and not differential across cohorts. The study did not control for covariates that were unavailable, such as HbA1c and duration of diabetes. Patients initiating exenatide vs liraglutide for T2DM had similar medication adherence and total healthcare costs; however, exenatide patients had significantly lower total pharmacy costs. Patients prescribed 1.8 mg liraglutide had significantly higher costs compared to those on 1.2 mg.

The influence of discovery learning model application to the higher order thinking skills student of Srijaya Negara Senior High School Palembang on the animal kingdom subject matter

NASA Astrophysics Data System (ADS)

Riandari, F.; Susanti, R.; Suratmi

2018-05-01

This study aimed to find out the information in concerning the influence of discovery learning model application to the higher order thinking skills at the tenth grade students of Srijaya Negara senior high school Palembang on the animal kingdom subject matter. The research method used was pre-experimental with one-group pretest-posttest design. The researchconducted at Srijaya Negara senior high school Palembang academic year 2016/2017. The population sample of this research was tenth grade students of natural science 2. Purposive sampling techniquewas applied in this research. Data was collected by(1) the written test, consist of pretest to determine the initial ability and posttest to determine higher order thinking skills of students after learning by using discovery learning models. (2) Questionnaire sheet, aimed to investigate the response of the students during the learning process by using discovery learning models. The t-test result indicated there was significant increasement of higher order thinking skills students. Thus, it can be concluded that the application of discovery learning modelhad a significant effect and increased to higher order thinking skills students of Srijaya Negara senior high school Palembang on the animal kingdom subject matter.

Determinants of body composition in preterm infants at the time of hospital discharge.

PubMed

Simon, Laure; Frondas-Chauty, Anne; Senterre, Thibault; Flamant, Cyril; Darmaun, Dominique; Rozé, Jean-Christophe

2014-07-01

Preterm infants have a higher fat mass (FM) percentage and a lower fat-free mass (FFM) than do term infants at the time of hospital discharge. We determined perinatal and nutritional factors that affect the body composition of preterm infants at discharge. A total of 141 preterm infants born at <35 wk of gestation and admitted to Nantes University Hospital Neonatology Unit over a period of 2 y were enrolled. Nutritional intake and growth were monitored during hospitalization. Body composition was assessed by using air-displacement plethysmography at discharge. FFM was compared with reference data in term infants according to sex and gestational age. Linear regression produced an excellent model to predict absolute FFM from perinatal characteristics and nutrition (R(2) = 0.82) but not the FM percentage (R(2) = 0.24). Gestational and postnatal ages played an equal role in absolute FFM accretion, as did the initial growth (between birth and day 5) and growth between day 5 and discharge. Antenatal corticosteroid treatment slightly reduced FFM accretion. As concerns nutritional intake, a higher protein:energy ratio at days 10 and 21 was significantly associated with decreased risk of an FFM deficit when preterm infants were compared with reference values for term infants. Boys had higher risk of an FFM deficit than did girls. The initial growth and quality of nutrition were significantly associated with absolute FFM accretion during a hospital stay in preterm infants. This trial was registered at clinicaltrials.gov as NCT01450436. © 2014 American Society for Nutrition.

Comparison of the epidemiologic features and patterns of initial care for prostate cancer between public and private institutions: a survey by the Brazilian Society of Urology.

PubMed

Nardi, Aguinaldo Cesar; Reis, Rodolfo Borges dos; Zequi, Stenio de Cassio; Nardozza, Archimedes

2012-01-01

To describe the epidemiological features and patterns of initial care for prostate cancer at public and private institutions in the State of Sao Paulo, Brazil. A total of 1,082 physicians affiliated to the Sao Paulo Section of the Brazilian Society of Urology were invited to participate in this cross-sectional, web-based survey. Between September 2004 and September 2005, participating urologists entered data on demographic, clinical and pathological characteristics of patients diagnosed with prostate cancer in their practice. Data on patients attended at public institutions were analyzed and compared with those patients attended at private practice. One hundred and ten society members contributed with data from 1915 patients, 1026 (53.6%) of whom from public institutions. When compared with patients attended at private institutions, those attended at public institutions were older and more likely to be black, had higher serum prostate specific antigen (PSA) levels, had a higher probability of being diagnosed with metastatic disease, but were less likely to undergo prostatectomy (all P < 0.001). In multivariate analysis, age, biopsy Gleason score, and being attended at a public institution were independently associated with metastatic disease upon diagnosis. The significant predictors of nonsurgical treatment were age, black race, and higher serum levels of PSA. A statewide registry provides valuable information regarding patient demographics, clinical features, and patterns of care. The results of this study suggest that significant disparities exist for patients with prostate cancer attended at different health-care systems. The relative contribution of biological versus socioeconomic features remains uncertain.

Effects of drop freezing on microphysics of an ascending cloud parcel under biomass burning conditions

NASA Astrophysics Data System (ADS)

Diehl, K.; Simmel, M.; Wurzler, S.

There is some evidence that the initiation of warm rain is suppressed in clouds over regions with vegetation fires. Thus, the ice phase becomes important as another possibility to initiate precipitation. Numerical simulations were performed to investigate heterogeneous drop freezing for a biomass-burning situation. An air parcel model with a sectional two-dimensional description of the cloud microphysics was employed with parameterizations for immersion and contact freezing which consider the different ice nucleating efficiencies of various ice nuclei. Three scenarios were simulated resulting to mixed-phase or completely glaciated clouds. According to the high insoluble fraction of the biomass-burning particles drop freezing via immersion and contact modes was very efficient. The preferential freezing of large drops followed by riming (i.e. the deposition of liquid drops on ice particles) and the evaporation of the liquid drops (Bergeron-Findeisen process) caused a further decrease of the liquid drops' effective radius in higher altitudes. In turn ice particle sizes increased so that they could serve as germs for graupel or hailstone formation. The effects of ice initiation on the vertical cloud dynamics were fairly significant leading to a development of the cloud to much higher altitudes than in a warm cloud without ice formation.

Solid Rocket Booster Hydraulic Pump Port Cap Joint Load Testing

NASA Technical Reports Server (NTRS)

Gamwell, W. R.; Murphy, N. C.

2004-01-01

The solid rocket booster uses hydraulic pumps fabricated from cast C355 aluminum alloy, with 17-4 PH stainless steel pump port caps. Corrosion-resistant steel, MS51830 CA204L self-locking screw thread inserts are installed into C355 pump housings, with A286 stainless steel fasteners installed into the insert to secure the pump port cap to the housing. In the past, pump port cap fasteners were installed to a torque of 33 Nm (300 in-lb). However, the structural analyses used a significantly higher nut factor than indicated during tests conducted by Boeing Space Systems. When the torque values were reassessed using Boeing's nut factor, the fastener preload had a factor of safety of less than 1, with potential for overloading the joint. This paper describes how behavior was determined for a preloaded joint with a steel bolt threaded into steel inserts in aluminum parts. Finite element models were compared with test results. For all initial bolt preloads, bolt loads increased as external applied loads increased. For higher initial bolt preloads, less load was transferred into the bolt, due to external applied loading. Lower torque limits were established for pump port cap fasteners and additional limits were placed on insert axial deformation under operating conditions after seating the insert with an initial preload.

Reduction rate by decompression as a treatment of odontogenic cysts.

PubMed

Oliveros-Lopez, L; Fernandez-Olavarria, A; Torres-Lagares, D; Serrera-Figallo, M-A; Castillo-Oyagüe, R; Segura-Egea, J-J; Gutierrez-Perez, J-L

2017-09-01

Odontogenic cysts are defined as those cysts that arise from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. Cystectomy, marsupialization or decompression of odontogenic cyst are treatment approach to this pathology. The aim of this study was to evaluate the effectiveness of the decompression as the primary treatment of the cystic lesions of the jaws and them reduction rates involving different factors. 23 patients with odontogenic cysts of the jaws, previously diagnosed by anatomical histopathology (follicular cysts (7) and radicular cysts (16)) underwent decompression as an initial treatment. Clinical examination and pre and post panoramic radiograph were measured and analyzed. In addition, data as gender, age, time reduction and location of the lesion were collected. Significant results were obtained in relation to the location of lesions and the reduction rate (p<0.01). In a higher initial lesion, a greater reduction rate was observed (p<0.05). Decompression as an initial treatment of cystic lesions of the jaws was effective; it reduces the size of the lesions avoiding a possible damage to adjacent structures. Cystic lesions in the mandible, regardless of the area where they occur will have a higher reduction rate if it is compared with the maxilla. Similar behavior was identified in large lesions compared to smaller.

Mitigation potential of soil carbon management overestimated by neglecting N2O emissions

NASA Astrophysics Data System (ADS)

Lugato, Emanuele; Leip, Adrian; Jones, Arwyn

2018-03-01

International initiatives such as the `4 per 1000' are promoting enhanced carbon (C) sequestration in agricultural soils as a way to mitigate greenhouse gas emissions1. However, changes in soil organic C turnover feed back into the nitrogen (N) cycle2, meaning that variation in soil nitrous oxide (N2O) emissions may offset or enhance C sequestration actions3. Here we use a biogeochemistry model on approximately 8,000 soil sampling locations in the European Union4 to quantify the net CO2 equivalent (CO2e) fluxes associated with representative C-mitigating agricultural practices. Practices based on integrated crop residue retention and lower soil disturbance are found to not increase N2O emissions as long as C accumulation continues (until around 2040), thereafter leading to a moderate C sequestration offset mostly below 47% by 2100. The introduction of N-fixing cover crops allowed higher C accumulation over the initial 20 years, but this gain was progressively offset by higher N2O emissions over time. By 2060, around half of the sites became a net source of greenhouse gases. We conclude that significant CO2 mitigation can be achieved in the initial 20-30 years of any C management scheme, but after that N inputs should be controlled through appropriate management.

Hemodilution after Initial Treatment in Patients with Acute Decompensated Heart Failure.

PubMed

Fujita, Teppei; Inomata, Takayuki; Yazaki, Mayu; Iida, Yuichiro; Kaida, Toyoji; Ikeda, Yuki; Nabeta, Takeru; Ishii, Shunsuke; Maekawa, Emi; Yanagisawa, Tomoyoshi; Koitabashi, Toshimi; Takeuchi, Ichiro; Ako, Junya

2018-05-09

Decongestion is an important goal of heart failure (HF) management. Blood cell concentration is a recognized indicator for guiding decongestive treatment for HF. We aimed to assess the clinical impact of hemodilution and hemoconcentration after initial treatment in acute decompensated HF (ADHF) patients. We retrospectively evaluated hemoglobin levels and body weight obtained before admission, on admission, 3 days after admission, and at discharge in 102 consecutive patients admitted with ADHF. Patients were then stratified into hemodilution (n = 55) and hemoconcentration (n = 47) groups based on whether their hemoglobin levels decreased or increased, respectively, during the first 3 days after admission. From before admission to admission, hemoglobin levels decreased less in the hemodilution group (-0.16 ± 0.98 g/dL) than in the hemoconcentration group (-0.88 ± 1.11 g/dL) (P < 0.001); however, there was no significant difference in body weight (P≥ 0.05). More patients in the hemodilution group (85%) had grade III/IV pulmonary edema (Turner's criteria) compared with the hemoconcentration group (63%) (P < 0.01). Rate of readmission for HF within 180 days of discharge was higher in the hemodilution group (34%) compared with the hemoconcentration group (9%) (P < 0.01). Hemodilution after initial treatment for ADHF was associated with severe pulmonary edema at admission and higher readmission rates.

Dietary fiber and flavan-3-ols in shortbread biscuits enriched with barley flours co-products.

PubMed

Verardo, Vito; Riciputi, Ylenia; Messia, Maria Cristina; Vallicelli, Melania; Falasca, Luisa; Marconi, Emanuele; Caboni, Maria Fiorenza

2011-05-01

The coarse fraction obtained by air classification of barley flour, rich in dietary fiber and flavan-3-ols, was utilized to develop functional biscuits. The flavan-3-ol content, antioxidant activity and oxidative stability of biscuits were measured during storage under retail conditions for 1 year. The replacement of 60% (w/w) refined wheat flour with barley coarse fraction increased the ash, fiber and flavan-3-ol contents significantly. Biscuit samples enriched with barley coarse fraction had a significantly higher amount of fiber compared with the control sample (six times higher). The β-glucan content in enriched samples was 15 times higher than control samples. The flavan-3-ol loss in biscuits after baking was about 67%. The initial content of flavan-3-ols increased from 0.6 to 4.3 mg/100 g in biscuits formulated with barley coarse fraction and showed improved antioxidant properties. Lipid oxidation increased during the shelf-life; the enriched biscuit showed the higher lipid oxidation status, but the level reached during the shelf-life was lower than the limit of acceptance reported for bakery products and, for this reason, does not compromise the safety.

Does education modify motor compensation in Parkinson's disease?

PubMed

Sunwoo, Mun K; Hong, Jin Yong; Lee, Jae J; Lee, Phil H; Sohn, Young H

2016-03-15

In Alzheimer's disease, higher educational attainment is associated with fewer cognitive deficits despite similar pathological lesions. In animal models of Parkinson's disease (PD), enhanced levels of cognitive and physical stimulation can reduce motor deficits due to dopaminergic neuronal loss. Therefore, in this study, we tested whether higher educational attainment has a beneficial influence on PD motor symptoms. We included data from 182 patients with de novo PD without dementia, who underwent dopamine transporter (DAT) scans for an initial diagnostic work-up. Patients were divided into 2 groups according to their educational attainment; high education (HE-PD; ≥12years of education) and low education (LE-PD; <12years of education). The HE-PD group exhibited significantly higher mini-mental state exam scores, fewer motor deficits, and lower DAT binding to the posterior putamen than the LE-PD group, despite a similar duration of PD symptoms. A general linear model revealed that this difference in motor deficits remained statistically significant after controlling for potential confounding factors (p=0.032). These results suggest that higher educational attainment can lead to reduced motor deficits in PD despite greater reductions in dopamine levels. Copyright © 2016 Elsevier B.V. All rights reserved.

The BHEF National Higher Education and Workforce Initiative: A Model for Pathways to Baccalaureate Attainment and High-Skill Careers in Emerging Fields, Part 3

ERIC Educational Resources Information Center

Fitzgerald, Brian K.; Barkanic, Steve; Cárdenas-Navia, Isabel; Chen, Janet; Elzey, Karen; Hughes, Debbie; Troyan, Danielle

2016-01-01

BHEF has achieved particular success in operationalizing its National Higher Education and Workforce Initiative (HEWI) through regional initiatives in data science and analytics (DSA). Leveraging its membership of corporate CEOs, university presidents and government agency leaders, BHEF seeded new undergraduate pathways in DSA at Case Western…

Impact of atmosphere and land surface initial conditions on seasonal forecast of global surface temperature

NASA Astrophysics Data System (ADS)

Materia, Stefano; Borrelli, Andrea; Bellucci, Alessio; Alessandri, Andrea; Di Pietro, Pierluigi; Athanasiadis, Panagiotis; Navarra, Antonio; Gualdi, Silvio

2014-05-01

The impact of land surface and atmosphere initialization on the forecast skill of a seasonal prediction system is investigated, and an effort to disentangle the role played by the individual components to the global predictability is done, via a hierarchy of seasonal forecast experiments performed under different initialization strategies. A realistic atmospheric initial state allows an improved equilibrium between the ocean and overlying atmosphere, mitigating the coupling shock and possibly increasing the model predictive skill in the ocean. In fact, in a few regions characterized by strong air-sea coupling, the atmosphere initial condition affects the forecast skill for several months. In particular, the ENSO region, the eastern tropical Atlantic and the North Pacific benefit significantly from the atmosphere initialization. On mainland, the impact of atmospheric initial conditions is detected in the early phase of the forecast, while the quality of land surface initialization affects the forecast skill in the following lead seasons. The winter forecast in the high latitude plains of Siberia and Canada benefit from the snow initialization, while the impact of soil moisture initial state is particularly effective in the Mediterranean region, in central Asia and Australia. However, initialization through land surface reanalysis does not systematically guarantee an enhancement of the predictive skill: the quality of the forecast is sometimes higher for the non-constrained model. Overall, the introduction of a realistic initialization of land surface and atmosphere substantially increases skill and accuracy. However, further developments in the operating procedure for land surface initialization are required for more accurate seasonal forecasts.

DIETARY BAKED EGG ACCELERATES RESOLUTION OF EGG ALLERGY IN CHILDREN

PubMed Central

Leonard, Stephanie A.; Sampson, Hugh A.; Sicherer, Scott H.; Noone, Sally; Moshier, Erin L.; Godbold, James; Nowak-Wȩgrzyn, Anna

2012-01-01

Background Baked egg is tolerated by a majority of egg-allergic children. Objective To characterize immunologic changes associated with ingestion of baked egg and evaluate the role that baked egg diets plays in the development of tolerance to regular egg. Methods Egg-allergic subjects who tolerated baked egg challenge incorporated baked egg into their diet. Immunologic parameters were measured at follow-up visits. A comparison group strictly avoiding egg was used to evaluate the natural history of the development of tolerance. Results Of the 79 subjects in the intent-to-treat group followed for a median of 37.8 months, 89% now tolerate baked egg and 53% now tolerate regular egg. Of 23 initial baked egg-reactive subjects, 14 (61%) subsequently tolerated baked egg and 6 (26%) now tolerate regular egg. Within the initially baked egg-reactive group, subjects with persistent reactivity to baked egg had higher median baseline egg white (EW)-specific IgE levels (13.5 kUA/L) than those who subsequently tolerated baked egg (4.4 kUA/L; P=0.04) and regular egg (3.1 kUA/L, P=0.05). In subjects ingesting baked egg, EW-induced SPT wheal diameter and EW-, ovalbumin-, and ovomucoid-specific IgE levels decreased significantly, while ovalbumin- and ovomucoid-specific IgG4 levels increased significantly. Subjects in the per-protocol group were 14.6 times more likely to develop regular egg tolerance than subjects in the comparison group (P < 0.0001), and they developed tolerance earlier (median 50.0 versus 78.7 months; P<0.0001). Conclusion Initiation of a baked egg diet accelerates the development of regular egg tolerance compared to strict avoidance. Higher serum EW-specific IgE level is associated with persistent baked and regular egg reactivity, while initial baked egg reactivity is not. PMID:22846751

Dietary baked egg accelerates resolution of egg allergy in children.

PubMed

Leonard, Stephanie A; Sampson, Hugh A; Sicherer, Scott H; Noone, Sally; Moshier, Erin L; Godbold, James; Nowak-Węgrzyn, Anna

2012-08-01

Baked egg is tolerated by a majority of egg-allergic children. To characterize immunologic changes associated with ingestion of baked egg and evaluate the role that baked egg diets play in the development of tolerance to regular egg. Egg-allergic subjects who tolerated baked egg challenge incorporated baked egg into their diet. Immunologic parameters were measured at follow-up visits. A comparison group strictly avoiding egg was used to evaluate the natural history of the development of tolerance. Of the 79 subjects in the intent-to-treat group followed for a median of 37.8 months, 89% now tolerate baked egg and 53% now tolerate regular egg. Of 23 initially baked egg-reactive subjects, 14 (61%) subsequently tolerated baked egg and 6 (26%) now tolerate regular egg. Within the initially baked egg-reactive group, subjects with persistent reactivity to baked egg had higher median baseline egg white (EW)-specific IgE levels (13.5 kU(A)/L) than those who subsequently tolerated baked egg (4.4 kU(A)/L; P= .04) and regular egg (3.1 kU(A)/L; P= .05). In subjects ingesting baked egg, EW-induced skin prick test wheal diameter and EW-, ovalbumin-, and ovomucoid-specific IgE levels decreased significantly, while ovalbumin- and ovomucoid-specific IgG(4) levels increased significantly. Subjects in the per-protocol group were 14.6 times more likely than subjects in the comparison group (P< .0001) to develop regular egg tolerance, and they developed tolerance earlier (median 50.0 vs 78.7 months; P< .0001). Initiation of a baked egg diet accelerates the development of regular egg tolerance compared with strict avoidance. Higher serum EW-specific IgE level is associated with persistent baked and regular egg reactivity, while initial baked egg reactivity is not. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Assessment of quality of care among in-patients with postpartum haemorrhage and severe pre-eclampsia at st. Francis hospital nsambya: a criteria-based audit.

PubMed

Lumala, Alfred; Sekweyama, Peter; Abaasa, Andrew; Lwanga, Humphrey; Byaruhanga, Romano

2017-01-13

The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find out if the implementation of recommendations from the audit cycle resulted in improvement in quality of care. This study was a CBA following a time series study design. It was done in St. Francis Hospital Nsambya and it involved assessment of adherence to standards of care for PPH, severe pre-eclampsia and eclampsia. An initial audit was done for 3 consecutive months, then findings were presented to health workers and recommendations made; we implemented the recommendations in a subsequent month and this comprised three interventions namely continuing medical education (CME), drills and displaying guidelines; a re-audit was done in the proceeding 3 consecutive months and analysis compared adherence rates of the initial audit with those of the re-audit. Pearson Chi-Square test revealed that the adherence rates of 7 out of 10 standards of care for severe pre-eclampsia/eclampsia were statistically significantly higher in the re-audit than in the initial audit; also, the adherence rates of 3 out of 4 standards of care for PPH were statistically significantly higher in the re-audit than in the initial audit. The giving of feedback on quality of care and the implementation of recommendations made during the CBA including CME, drills and displaying guidelines was associated with improvements in the quality of care for patients with PPH, severe pre-eclampsia and eclampsia.

Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia: unmatched case-control study design.

PubMed

Gebrekidan, Kahasse; Worku, Alemayehu

2017-01-01

Although Ethiopia has shown remarkable achievements in reducing maternal mortality in the last 10 years, the prevalence of late antenatal care (ANC) initiation is still high in the country. The primary purpose of this study was to identify the factors related to late ANC initiation among pregnant women in selected public health centers in Addis Ababa, Ethiopia. A total of 402 pregnant women (cases=134, controls=268) were recruited using multistage sampling. The design selected for the study was unmatched case-control. EpiData version 3.02 and SPSS version 20.0 were used for data entry and statistical analysis, respectively. Binary logistic regression model was used to model the odds of late ANC initiation. The odds of attending ANC late were significantly higher for mothers with a monthly household income of $8.50 to start the ANC service (AOR=3.04; 95% CI: 1.98, 4.67). Low educational level, low income of the household, unplanned pregnancy, stay for <5 years in Addis Ababa, not getting advice from health extension workers or local TV/radio and higher cost associated with initiation of the first ANC service were the main predictors of late ANC initiation. Therefore, any intervention which would need to improve early ANC initiation should focus on economic empowerment of women, and tailored health education for migrant women should be strengthened.

Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia: unmatched case–control study design

PubMed Central

Gebrekidan, Kahasse; Worku, Alemayehu

2017-01-01

Background Although Ethiopia has shown remarkable achievements in reducing maternal mortality in the last 10 years, the prevalence of late antenatal care (ANC) initiation is still high in the country. Objective The primary purpose of this study was to identify the factors related to late ANC initiation among pregnant women in selected public health centers in Addis Ababa, Ethiopia. Subjects and methods A total of 402 pregnant women (cases=134, controls=268) were recruited using multistage sampling. The design selected for the study was unmatched case–control. EpiData version 3.02 and SPSS version 20.0 were used for data entry and statistical analysis, respectively. Binary logistic regression model was used to model the odds of late ANC initiation. Results The odds of attending ANC late were significantly higher for mothers with a monthly household income of $8.50 to start the ANC service (AOR=3.04; 95% CI: 1.98, 4.67). Conclusion Low educational level, low income of the household, unplanned pregnancy, stay for <5 years in Addis Ababa, not getting advice from health extension workers or local TV/radio and higher cost associated with initiation of the first ANC service were the main predictors of late ANC initiation. Therefore, any intervention which would need to improve early ANC initiation should focus on economic empowerment of women, and tailored health education for migrant women should be strengthened. PMID:29138615

Comparative effectiveness of antihypertensive therapeutic classes and treatment strategies in the initiation of therapy in primary care patients: a Distributed Ambulatory Research in Therapeutics Network (DARTNet) study.

PubMed

Bronsert, Michael R; Henderson, William G; Valuck, Robert; Hosokawa, Patrick; Hammermeister, Karl

2013-01-01

Few comparative effectiveness studies of treatment strategies using antihypertensive therapeutic classes in hypertension control have been assessed in a primary care environment. The objectives are to compare the effectiveness of common antihypertensive therapeutic classes initiated as monotherapy and of fixed-dose combinations (FDCs), free-equivalent combinations (FECs), and monotherapy on hypertension control. This article reports observational comparative effectiveness analyses of data electronically extracted from electronic health records. The study population consisted of 8,676 patients with an incident prescription for an antihypertensive agent of a total of 79,176 patients receiving antihypertensive therapy in 33 geographically diverse primary care clinics. The main measures were reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) and rates of attaining goals per the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7). There were small, clinically insignificant differences in blood pressure reductions between the monotherapy classes. Higher rates of blood pressure control were obtained when patients were initiated on an angiotensin-converting enzyme inhibitor than a thiazide or thiazide-like diuretic (47.8% vs 39.9%) or a β-blocker versus a thiazide (45.9% vs 39.9%). Patients initiated on FDCs had significantly larger reductions in blood pressure than patients initiated on FECs (-17.3 vs -12.0 mm Hg SBP; -10.1 vs -6.0 mm Hg DBP) or monotherapy (-17.3 vs -13.6 mm Hg SBP; -10.1 vs -7.9 mm Hg DBP). Rates of attaining JNC7 goals also were better for FDCs than FECs (57.2% vs 42.5%) and for FDCs versus monotherapy (57.2% vs 44.9%). Patients initiated on angiotensin-converting enzyme inhibitors and β-blockers had slightly higher rates of blood pressure control. The use of FDCs as initial therapy is more effective in the control of hypertension than monotherapy or FECs.

Impact of computerized order entry and pre-mixed dialysis solutions for continuous veno-venous hemodiafiltration on selection of therapy for acute renal failure.

PubMed

Saadulla, Lawand; Reeves, W Brian; Irey, Brittany; Ghahramani, Nasrollah

2012-02-01

To investigate the impacts of availability of pre-mixed solutions and computerized order entry on nephrologists' choice of the initial mode of renal replacement therapy in acute renal failure. We studied 898 patients with acute renal failure in 3 consecutive eras: era 1 (custom-mixed solution; n = 309), era 2 (pre-mixed commercial solution; n = 324), and era 3 (post-computerized order entry; n = 265). The proportion of patients treated with renal replacement therapy and the time from consult to initiation of continuous renal replacement therapy was similar in the 3 eras. Following introduction of the pre-mixed solution, the proportion of patients treated with continuous renal replacement therapy increased (20% vs. 33%; p < 0.05), it was initiated at a lower serum creatinine (353 ± 123 μmol/L vs. 300 ± 80 μmol/L; p < 0.05) and in older patients (53 ± 12 vs. 61 ± 14 years; p < 0.05). There was a progressive increase in the use of continuous veno-venous hemodialysis (18% vs. 79% vs. 100%; p < 0.05) and in the total prescribed flow rate (1,382 ± 546 vs. 2,324 ± 737 vs. 2,900 ± 305 mL/hr 3; p < 0.05). There was no significant impact on mortality. The availability of a pre-mixed solution increases the likelihood of initiating continuous renal replacement therapy in acute renal failure, initiating it at a lower creatinine and for older patients, use of continuous veno-venous hemodialysis and higher prescribed continuous renal replacement therapy dose. Computerized order entry implementation is associated with an additional increase in the use of continuous veno-venous hemodialysis, higher total prescribed dialysis dose, and use of CRRT among an increasing number of patients not on mechanical ventilation. The effect of these changes on patient survival is not significant.

[Factors influencing the effectiveness of physical rehabilitation after myocardial infarction].

PubMed

Sumin, A N; Beresneva, V L; Enina, T N; Verkhoshapova, T N; Kabova, E A; Valeeva, V I; Shapaurina, N V

2007-01-01

The aim of the study was to compare initial clinical, hemodynamic, and vegetative parameters in patients with myocardial infarction (MI) who had undergone physical rehabilitation with different results. The subjects were 106 male patients aged 48.6 +/- 0.95 years undergoing sanatorium rehabilitation after MI. According to the dynamics of exercise tolerance (ET) during the course of treatment, the subjects were divided into three groups: group one consisted of 39 patients with a significant ET growth of more than 10W, group two consisted of 47 patients with no changes in ET or its insignificant growth of less than 10W, and group three consisted of 20 patients with a decrease in ET revealed during a repeated test. In group three patients, the initial EchoCG examination revealed a higher degree of myocardial lesion, which was manifested by lowered ejection fraction and sphericity index, increased end-diastolic volume, and increased degree of left ventricular (LV) asynergy. Furthermore, day-time ventricular extrasystoles were more frequent in these patients; the number of patients with large-focal MI, LV aneurysm, and post-infarction stenocardia was also higher in group three. Correlation and multiple step regression analysis revealed that both initial parameters of vegetative nervous system, data from initial load test, and the EchoCG measurements of the right atrium were associated with the degree of ET growth according to VEM results. The data from the study are able to help individualize rehabilitation of MI patients, especially those with severe myocardial lesion.

Assessing Europe's Initiatives to Boost the Competitive Position of Its Higher Education

ERIC Educational Resources Information Center

Charlier, Jean-Emile

2008-01-01

This issue and the winter 2007-2008 issue (vol. 39, no. 4) of "European Education" address the implications of competition for the future of European higher education. Studies bear on the initiatives taken over the past few years in Europe to enhance the harmonization of European higher education systems and particularly the Bologna…

The Business of Higher Education. The Guardians Initiative: Reclaiming the Public Trust

ERIC Educational Resources Information Center

Association of Governing Boards of Universities and Colleges, 2017

2017-01-01

This report is first in a series of informational briefings developed as part of "The Guardians Initiative: Reclaiming the Public Trust," an effort to educate and engage trustees as advocates on key issues in higher education. While the tone of public criticism of higher education has sharpened, public understanding about the sector's…

Correlates of human papillomavirus vaccine coverage: a state-level analysis.

PubMed

Moss, Jennifer L; Reiter, Paul L; Brewer, Noel T

2015-02-01

We tested the hypothesis that states with higher rates of cancers associated with human papillomavirus (HPV) would have lower HPV vaccine coverage. We gathered state-level data on HPV-related cancer rates and HPV vaccine initiation coverage for girls and boys, separately, and HPV vaccine follow-through (i.e., receipt of 3 doses among those initiating the series) for girls only. In addition, we gathered state-level data on demographic composition and contact with the health care system. We calculated Pearson correlations for these ecological relationships. Human papillomavirus vaccine initiation among girls was lower in states with higher levels of cervical cancer incidence and mortality (r = -0.29 and -0.46, respectively). In addition, vaccine follow-through among girls was lower in states with higher levels of cervical cancer mortality (r = -0.30). Other cancer rates were associated with HPV vaccine initiation and follow-through among girls, but not among boys. Human papillomavirus vaccine initiation among girls was lower in states with higher proportions of non-Hispanic black residents and lower proportions of higher-income residents. Human papillomavirus vaccine follow-through was higher in states with greater levels of adolescents' contact with the health care system. Human papillomavirus vaccine coverage for girls was lower in states with higher HPV-related cancer rates. Public health efforts should concentrate on geographic areas with higher cancer rates. Strengthening adolescent preventive health care use may be particularly important to increase vaccine follow-through. Cost-effectiveness analyses may overestimate the benefits of current vaccination coverage and underestimate the benefits of increasing coverage.

Comprehensive Family Services and customer satisfaction outcomes.

PubMed

Huebner, Ruth A; Jones, Blake L; Miller, Viola P; Custer, Melba; Critchfield, Becky

2006-01-01

Comprehensive Family Services (CFS) is a strengths-based and partnership-oriented approach to casework implemented through multiple initiatives. This study examines the relationship between the practice of CFS and satisfaction of clients, foster parents, and community partners. CFS indicators are paired with statewide customer satisfaction survey results. CFS practices are associated with significantly higher customer satisfaction that improved over time for all groups. Although causality cannot be determined, the relationship is consistent, robust, and meaningful.

Prognostic significance of the initial cerebro-spinal fluid (CSF) involvement of children with acute lymphoblastic leukaemia (ALL) treated without cranial irradiation: results of European Organization for Research and Treatment of Cancer (EORTC) Children Leukemia Group study 58881.

PubMed

Sirvent, Nicolas; Suciu, Stefan; Rialland, Xavier; Millot, Frédéric; Benoit, Yves; Plantaz, Dominique; Ferster, Alice; Robert, Alain; Lutz, Patrick; Nelken, Brigitte; Plouvier, Emmanuel; Norton, Lucilia; Bertrand, Yves; Otten, Jacques

2011-01-01

To evaluate the prognostic significance of the initial cerebro-spinal fluid (CSF) involvement of children with ALL enrolled from 1989 to 1996 in the EORTC 58881 trial. Patients (2025) were categorised according to initial central nervous system (CNS) status: CNS-1 (CNS negative, n=1866), CNS-2 (<5 leucocytes/mm(3), CSF with blasts, n=50), CNS-3 (CNS positive, n=49), TLP+ (TLP with blasts, n=60). CNS-directed therapy consisted in intravenous (i.v.) methotrexate (5 g/sqm) in 4-10 courses, and intrathecal methotrexate injections (10-20), according to CNS status. Cranial irradiation was omitted in all patients. In the CNS1, TLP+, CNS2 and CNS3 group the 8-year EFS rate (SE%) was 69.7% (1.1%), 68.8% (6.2%), 71.3% (6.5%) and 68.3% (6.2%), respectively. The 8-year incidence of isolated CNS relapse (SE%) was 3.4% (0.4%), 1.7% (1.7%), 6.1% (3.5%) and 9.4% (4.5%), respectively, whereas the 8-year isolated or combined CNS relapse incidence was 7.6% (0.6%), 3.5% (2.4%), 10.2% (4.4%) and 11.7% (5.0%), respectively. Patients with CSF blasts had a higher rate of initial bad risk features. Multivariate analysis indicated that presence of blasts in the CSF had no prognostic value: (i) for EFS and OS; (ii) for isolated and isolated or combined CNS relapse; WBC count<25 × 10(9)/L and Medac E-coli asparaginase treatment were each related to a lower CNS relapse risk. The presence of initial CNS involvement has no prognostic significance in EORTC 58881. Intensification of CNS-directed chemotherapy, without CNS radiation, is an effective treatment of initial meningeal leukaemic involvement. Copyright © 2010 Elsevier Ltd. All rights reserved.

Protective Effects of the Launch/Entry Suit (LES) and the Liquid Cooling Garment(LCG) During Re-entry and Landing After Spaceflight

NASA Technical Reports Server (NTRS)

Perez, Sondra A.; Charles, John B.; Fortner, G. William; Hurst, Victor, IV; Meck, Janice V.

2002-01-01

Heart rate and arterial pressure were measured during shuttle re-entry, landing and initial standing in crewmembers with and without inflated anti-g suits and with and without liquid cooling garments (LCG). Preflight, three measurements were obtained seated, then standing. Prior to and during re-entry, arterial pressure and heart rate were measured every five minutes until wheels stop (WS). Then crewmembers initiated three seated and three standing measurements. In subjects without inflated anti-g suits, SBP and DBP were significantly lower during preflight standing (P = 0.006; P = 0.001 respectively) and at touchdown (TD) (P = 0.001; P = 0.003 respectively); standing SBP was significantly lower after WS. on-LeG users developed significantly higher heart rates during re-entry (P = 0.029, maxG; P = 0.05, TD; P = 0.02, post-WS seated; P = 0.01, post-WS standing) than LCG users. Our data suggest that the anti-g suit is effective, but the combined anti-g suit with LCG is more effective.

Clinical evaluation of higher stimulation rates in the nucleus research platform 8 system.

PubMed

Plant, Kerrie; Holden, Laura; Skinner, Margo; Arcaroli, Jennifer; Whitford, Lesley; Law, Mary-Ann; Nel, Esti

2007-06-01

The effect on speech perception of using higher stimulation rates than the 14.4 kHz available in the Nucleus 24 cochlear implant system was investigated. The study used the Nucleus Research Platform 8 (RP8) system, comprising the CI24RE receiver-stimulator with the Contour electrode array, the L34SP body-worn research speech processor, and the Nucleus Programming Environment (NPE) fitting and Neural Response Telemetry (NRT) software. This system enabled clinical investigation of higher stimulation rates before an implementation in the Freedom cochlear implant system commercially released by Cochlear Limited. Use of higher stimulation rates in the ACE coding strategy was assessed in 15 adult subjects. An ABAB experimental design was used to control for order effects. Program A used a total stimulation rate of between 12 kHz and 14.4 kHz. This program was used for at least the first 3 mo after initial device activation. After evaluation with this program, each subject was provided with two different higher stimulation rate programs: one with a total stimulation rate of 24 kHz and the other with a total stimulation rate of 32 kHz. After a 6-week period of familiarization, each subject identified his/her preferred higher rate program (program B), and this was used for the evaluation. Subjects then repeated their use of program A for 3 wk, then program B for 3 wk, before the second evaluation with each. Speech perception was evaluated by using CNC open-set monosyllabic words presented in quiet and CUNY open-set sentences presented in noise. Preference for stimulation rate program was assessed via a subjective questionnaire. Threshold (T)- and Comfortable (C)-levels, as well as subjective reports of tinnitus, were monitored for each subject throughout the study to determine whether there were any changes that might be associated with the use of higher stimulation rates. No significant mean differences in speech perception results were found for the group between the two programs for tests in either quiet or noise. Analysis of individual subject data showed that five subjects had significant benefit from use of program B for tests administered in quiet and for tests administered in noise. However, only two of these subjects showed benefit in both test conditions. One subject showed significant benefit from use of program A when tested in quiet, whereas another showed benefit with this program in noise. Each subject's preferred program varied. Five subjects reported a preference for program A, eight subjects reported a preference for program B and two reported no overall preference. Preference between the different stimulation rates provided within program B also varied, with 10 subjects preferring 24 kHz and five preferring 32 kHz total stimulation rates. A significant increase in T-levels from baseline measures was observed after three weeks of initial experience with program B, however there was no difference between the baseline levels and those obtained after five weeks of use. No significant change in C-levels was found over the monitoring period. No long-term changes in tinnitus that could be associated with the use of the higher stimulation rates were reported by any of the subjects. The use of higher stimulation rates may provide benefit to some but not all cochlear implant recipients. It is important to optimize the stimulation rate for an individual to ensure maximal benefit. The absence of any changes in T- and C-levels or in tinnitus suggests that higher stimulation rates are safe for clinical use.

The development and evaluation of ultrasound for the treatment of bacterial suspensions. A study of frequency, power and sonication time on cultured Bacillus species.

PubMed

Joyce, E; Phull, S S; Lorimer, J P; Mason, T J

2003-10-01

Some species of bacteria produce colonies and spores which agglomerate in spherical clusters (Bacillus subtilis) and this serves as a protection for the organisms inside against biocidal attack. Flocs of fine particles e.g. clay can entrap bacteria which can also protect them against the biocides. It is because of problems such as these that alternative methods of disinfecting water are under active investigation. One such method is the use of power ultrasound, either alone or in combination with other methods. Ultrasound is able to inactivate bacteria and deagglomerate bacterial clusters or flocs through a number of physical, mechanical and chemical effects arising from acoustic cavitation. The aim of this study was to investigate the effect of power ultrasound at different powers and frequencies on Bacillus subtilis. Viable plate count techniques were used as a measure of microbial activity. Results showed a significant increase in percent kill for Bacillus species with increasing duration of exposure and intensity of ultrasound in the low-kilohertz range (20 and 38 kHz). Results obtained at two higher frequencies (512 and 850 kHz) indicated a significant increase in bacteria count suggesting declumping. In assessing the bacterial kill with time under different sonication regimes three types of behaviour were characterized: High power ultrasound (lower frequencies) in low volumes of bacterial suspension results in a continuous reduction in bacterial cell numbers i.e. the kill rate predominates. High power ultrasound (lower frequencies) in larger volumes results in an initial rise in cell numbers suggesting declumping of the bacteria but this initial rise then falls as the declumping finishes and the kill rate becomes more important. Low intensity ultrasound (higher frequencies) gives an initial rise in cell numbers as a result of declumping. The kill rate is low and so there is no significant subsequent decrease in bacterial cell numbers.

Automatic image fusion of real-time ultrasound with computed tomography images: a prospective comparison between two auto-registration methods.

PubMed

Cha, Dong Ik; Lee, Min Woo; Kim, Ah Yeong; Kang, Tae Wook; Oh, Young-Taek; Jeong, Ja-Yeon; Chang, Jung-Woo; Ryu, Jiwon; Lee, Kyong Joon; Kim, Jaeil; Bang, Won-Chul; Shin, Dong Kuk; Choi, Sung Jin; Koh, Dalkwon; Seo, Bong Koo; Kim, Kyunga

2017-11-01

Background A major drawback of conventional manual image fusion is that the process may be complex, especially for less-experienced operators. Recently, two automatic image fusion techniques called Positioning and Sweeping auto-registration have been developed. Purpose To compare the accuracy and required time for image fusion of real-time ultrasonography (US) and computed tomography (CT) images between Positioning and Sweeping auto-registration. Material and Methods Eighteen consecutive patients referred for planning US for radiofrequency ablation or biopsy for focal hepatic lesions were enrolled. Image fusion using both auto-registration methods was performed for each patient. Registration error, time required for image fusion, and number of point locks used were compared using the Wilcoxon signed rank test. Results Image fusion was successful in all patients. Positioning auto-registration was significantly faster than Sweeping auto-registration for both initial (median, 11 s [range, 3-16 s] vs. 32 s [range, 21-38 s]; P < 0.001] and complete (median, 34.0 s [range, 26-66 s] vs. 47.5 s [range, 32-90]; P = 0.001] image fusion. Registration error of Positioning auto-registration was significantly higher for initial image fusion (median, 38.8 mm [range, 16.0-84.6 mm] vs. 18.2 mm [6.7-73.4 mm]; P = 0.029), but not for complete image fusion (median, 4.75 mm [range, 1.7-9.9 mm] vs. 5.8 mm [range, 2.0-13.0 mm]; P = 0.338]. Number of point locks required to refine the initially fused images was significantly higher with Positioning auto-registration (median, 2 [range, 2-3] vs. 1 [range, 1-2]; P = 0.012]. Conclusion Positioning auto-registration offers faster image fusion between real-time US and pre-procedural CT images than Sweeping auto-registration. The final registration error is similar between the two methods.

Weight Loss Associated with Cholinesterase Inhibitors In Patients With Dementia in a National Healthcare System

PubMed Central

Sheffrin, Meera; Miao, Yinghui; Boscardin, W. John; Steinman, Michael A.

2016-01-01

Background/Objectives Inconsistent data from randomized trials suggest cholinesterase inhibitors may cause weight loss. We sought to determine if the initiation of cholinesterase inhibitors is associated with significant weight loss in a real-word clinical setting. Design Retrospective cohort study from 2007-2010, comparing weight loss in patients with dementia newly prescribed cholinesterase inhibitors and patients newly prescribed other chronic medications Setting National Veterans Affairs (VA) data Participants Patients 65 years or older with a diagnosis of dementia who received a new prescription for a cholinesterase inhibitor or other new other chronic medication. Measurements The primary outcome was time to 10 pound weight loss over 12 months. We used propensity score matching patients to control for the likelihood of receiving a cholinesterase inhibitor based on baseline characteristics. Data were analyzed in a priori defined subgroups by age, comorbid burden, and initial weight. Results Of 6,504 patients that met study criteria, 1188 patients started on cholinesterase inhibitors were matched to 2189 patients started on other medications. The propensity-matched cohorts were well balanced on baseline covariates. Patients initiated on cholinesterase inhibitors had a higher risk of weight loss compared to matched controls at 12 months, HR 1.23 (95% CI 1.07 - 1.41). At twelve months, 29.3% of patients on cholinesterase inhibitors had experienced weight loss compared to 22.8% of non-users, corresponding to a number needed to harm of 21.2 (95% CI 12.5 – 71.4) over one year. There were no significant differences across subgroups. Conclusion Patients with dementia started on cholinesterase inhibitors had a higher risk of clinically significant weight loss over a 12-month period compared to matched controls. These results are consistent with the available data from randomized controlled trials. Clinicians should consider the risk of weight loss when prescribing cholinesterase inhibitors. PMID:26234945

Behavioural activation versus mindfulness-based guided self-help treatment administered through a smartphone application: a randomised controlled trial.

PubMed

Ly, Kien Hoa; Trüschel, Anna; Jarl, Linnea; Magnusson, Susanna; Windahl, Tove; Johansson, Robert; Carlbring, Per; Andersson, Gerhard

2014-01-09

Evaluating and comparing the effectiveness of two smartphone-delivered treatments: one based on behavioural activation (BA) and other on mindfulness. Parallel randomised controlled, open, trial. Participants were allocated using an online randomisation tool, handled by an independent person who was separate from the staff conducting the study. General community, with recruitment nationally through mass media and advertisements. 40 participants diagnosed with major depressive disorder received a BA treatment, and 41 participants received a mindfulness treatment. 9 participants were lost at the post-treatment. An 8-week long behaviour programme administered via a smartphone application. Mindfulness: An 8-week long mindfulness programme, administered via a smartphone application. The Beck Depression Inventory-II (BDI-II) and the nine-item Patient Health Questionnaire Depression Scale (PHQ-9). 81 participants were randomised (mean age 36.0 years (SD=10.8)) and analysed. Results showed no significant interaction effects of group and time on any of the outcome measures either from pretreatment to post-treatment or from pretreatment to the 6-month follow-up. Subgroup analyses showed that the BA treatment was more effective than the mindfulness treatment among participants with higher initial severity of depression from pretreatment to the 6-month follow-up (PHQ-9: F (1, 362.1)=5.2, p<0.05). In contrast, the mindfulness treatment worked better than the BA treatment among participants with lower initial severity from pretreatment to the 6-month follow-up (PHQ-9: F (1, 69.3)=7.7, p<0.01); BDI-II: (F(1, 53.60)=6.25, p<0.05). The two interventions did not differ significantly from one another. For participants with higher severity of depression, the treatment based on BA was superior to the treatment based on mindfulness. For participants with lower initial severity, the treatment based on mindfulness worked significantly better than the treatment based on BA. Clinical Trials NCT01463020.

Processing F0 with cochlear implants: Modulation frequency discrimination and speech intonation recognition.

PubMed

Chatterjee, Monita; Peng, Shu-Chen

2008-01-01

Fundamental frequency (F0) processing by cochlear implant (CI) listeners was measured using a psychophysical task and a speech intonation recognition task. Listeners' Weber fractions for modulation frequency discrimination were measured using an adaptive, 3-interval, forced-choice paradigm: stimuli were presented through a custom research interface. In the speech intonation recognition task, listeners were asked to indicate whether resynthesized bisyllabic words, when presented in the free field through the listeners' everyday speech processor, were question-like or statement-like. The resynthesized tokens were systematically manipulated to have different initial-F0s to represent male vs. female voices, and different F0 contours (i.e. falling, flat, and rising) Although the CI listeners showed considerable variation in performance on both tasks, significant correlations were observed between the CI listeners' sensitivity to modulation frequency in the psychophysical task and their performance in intonation recognition. Consistent with their greater reliance on temporal cues, the CI listeners' performance in the intonation recognition task was significantly poorer with the higher initial-F0 stimuli than with the lower initial-F0 stimuli. Similar results were obtained with normal hearing listeners attending to noiseband-vocoded CI simulations with reduced spectral resolution.

Processing F0 with Cochlear Implants: Modulation Frequency Discrimination and Speech Intonation Recognition

PubMed Central

Chatterjee, Monita; Peng, Shu-Chen

2008-01-01

Fundamental frequency (F0) processing by cochlear implant (CI) listeners was measured using a psychophysical task and a speech intonation recognition task. Listeners’ Weber fractions for modulation frequency discrimination were measured using an adaptive, 3-interval, forced-choice paradigm: stimuli were presented through a custom research interface. In the speech intonation recognition task, listeners were asked to indicate whether resynthesized bisyllabic words, when presented in the free field through the listeners’ everyday speech processor, were question-like or statement-like. The resynthesized tokens were systematically manipulated to have different initial F0s to represent male vs. female voices, and different F0 contours (i.e., falling, flat, and rising) Although the CI listeners showed considerable variation in performance on both tasks, significant correlations were observed between the CI listeners’ sensitivity to modulation frequency in the psychophysical task and their performance in intonation recognition. Consistent with their greater reliance on temporal cues, the CI listeners’ performance in the intonation recognition task was significantly poorer with the higher initial-F0 stimuli than with the lower initial-F0 stimuli. Similar results were obtained with normal hearing listeners attending to noiseband-vocoded CI simulations with reduced spectral resolution. PMID:18093766

Sequential nitric oxide measurements during the emergency department treatment of acute vasoocclusive sickle cell crisis.

PubMed

Lopez, B L; Davis-Moon, L; Ballas, S K; Ma, X L

2000-05-01

This prospective study was designed to examine the relationship between serial serum nitric oxide (NO) levels and pain during the emergency department (ED) treatment of acute vasoocclusive sickle cell crisis (SCC). 102 patient visits, age > or =18 years of age, presenting to the ED with uncomplicated, typical SCC pain had serum NO levels obtained at 2-hr intervals during treatment of pain and were measured using an NO-specific chemiluminesence technique. Pain was measured prior to each NO measurement using a 10 cm visual analog scale (VAS), and subjects were divided into a persistent pain group and an improved pain group. Patients with persistent pain had significantly low initial NO levels (11.51 microM +/- 2.8, P < 0.05) while those with pain improvement had higher initial NO levels (18.1 microM +/- 3.08, P < 0.05). There was no significant correlation between changes in NO and changes in pain scores. These results suggest that the initial NO level may serve as a marker for the severity of tissue ischemia. Sequential NO levels do not appear useful in predicting the course of SCC.

Early regimes of water capillary flow in slit silica nanochannels.

PubMed

Oyarzua, Elton; Walther, Jens H; Mejía, Andrés; Zambrano, Harvey A

2015-06-14

Molecular dynamics simulations are conducted to investigate the initial stages of spontaneous imbibition of water in slit silica nanochannels surrounded by air. An analysis is performed for the effects of nanoscopic confinement, initial conditions of liquid uptake and air pressurization on the dynamics of capillary filling. The results indicate that the nanoscale imbibition process is divided into three main flow regimes: an initial regime where the capillary force is balanced only by the inertial drag and characterized by a constant velocity and a plug flow profile. In this regime, the meniscus formation process plays a central role in the imbibition rate. Thereafter, a transitional regime takes place, in which, the force balance has significant contributions from both inertia and viscous friction. Subsequently, a regime wherein viscous forces dominate the capillary force balance is attained. Flow velocity profiles identify the passage from an inviscid flow to a developing Poiseuille flow. Gas density profiles ahead of the capillary front indicate a transient accumulation of air on the advancing meniscus. Furthermore, slower capillary filling rates computed for higher air pressures reveal a significant retarding effect of the gas displaced by the advancing meniscus.

Lactate Dehydrogenase Activity in Gingival Crevicular Fluid as a Marker in Orthodontic Tooth Movement

PubMed Central

Alfaqeeh, Sarah A; Anil, Sukumaran

2011-01-01

Objectives: This study aims at analyzing the changes in gingival crevicular fluid (GCF) lactate dehydrogenase (LDH) activity during orthodontic movement. Methods: Twenty patients all requiring first premolar extractions were selected and treated with conventional straight wire mechanotherapy. Canine retraction was done using 125 g Nitinol closed coil springs. The maxillary canine on one side served as the experimental site while the contralateral canine served as the control. GCF was collected from the canines before initiation of retraction, then 1 hour after initiating canine retraction, followed by 1 day, 7 days, 14 days and 21 days. GCF LDH levels were estimated and compared with the control site. Results The results revealed significantly higher LDH levels on the 7th, 14th and 21st day at the sites where orthodontic force had been applied. The levels also showed a significant increase from 0 hour to the 21st day. Peak levels were seen on 14th and 21st day following initiation of retraction. Conclusions: The study showed that LDH could be successfully estimated in the GCF and its increased levels could indicate active tooth movement, which could aid the clinician in monitoring active orthodontic tooth movement. PMID:21760863

Study of oxidative stress biomarkers in chronic obstructive pulmonary disease and their correlation with disease severity in north Indian population cohort

PubMed Central

Bajpai, Jyoti; Prakash, Ved; Kant, Surya; Verma, Ajay Kumar; Srivastava, Anand; Bajaj, Darshan K; Ahmad, MK; Agarwal, Avinash

2017-01-01

Background: Oxidant-antioxidant imbalance forms a prime component in pathogenesis of chronic obstructive pulmonary disease (COPD). Studies of oxidative stress markers in South Asians were sparse. Methods: One hundred and eighty COPD patients and eighty healthy nonsmokers were enrolled in the study. Serum malondialdehyde (MDA) and iron levels were estimated for oxidative stress. Three antioxidant markers evaluated-catalase, superoxide dismutase (SOD), and serum copper. Patients on antioxidant therapy and with sepsis and chronic illness were excluded from the study. Results: The mean age of COPD patients was 59.29 ± 10.3 years. Serum levels of MDA and iron were significantly higher in COPD patients compared to controls (5.21 ± 1.9 vs. 0.71 ± 0.29 nmol MDA/ml, P = 0.0001 and 69.85 ± 85.49 vs. 79.32 ± 24.39 μg/dl, P = 0.0001, respectively). Mean level of all antioxidant enzymes catalase, SOD, and copper were significantly diminished in cases when compared to control population (P = 0.001). Levels of MDA and iron were found to be significantly elevated in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes (III, IV) when compared to lower GOLD Classes (I, II). The levels of serum antioxidants were significantly depleted in higher GOLD grades too. COPD patients who were male and smoked had significantly higher levels of oxidants and depleted antioxidant levels compared to female and nonsmoking compatriots. Serum MDA levels negatively correlated with forced expiratory volume 1 s and forced vital capacity (r = −0.19 and r = −0.21, P ≤ 0.01). The presence of a cough significantly correlated with higher levels of MDA and iron (P = 0.001). The levels of MDA negatively correlated with SOD and catalase levels. Conclusion: Oxidative markers (MDA and iron) are higher whereas antioxidants (catalase, copper, and SOD) are significantly reduced in patients of COPD. Serum MDA levels correlate with lung functions and disease severity. PMID:28671162

Certolizumab pegol in a heterogeneous population of patients with moderate-to-severe rheumatoid arthritis

PubMed Central

Soriano, Enrique R; Dellepiane, Analia; Salvatierra, Gabriela; Benítez, Cristian Alejandro; Salinas, Rodrigo Garcia; Baruzzo, Carlos

2018-01-01

Aim: To determine the efficacy and safety of certolizumab pegol for the treatment of rheumatoid arthritis in a real-world setting. Materials & methods: Patients with moderate-to-severe rheumatoid arthritis who initiated therapy with certolizumab were followed for 12 weeks. Response was assessed with Disease Activity Score of 28 joints, European Ligue Against Rheumatism criteria and Simplified Disease Activity Index. Predictors of response were analyzed with binary logistic regression models. Results: Statistically significant decreases in tender and swollen joint counts, laboratory parameters and use of corticosteroids and disease-modifying antirheumatic drugs were found. Disease activity also significantly diminished. Higher Disease Activity Score of 28 joints at baseline was the main predictor of response. No severe adverse events were reported. Conclusion: Certolizumab was effective and well tolerated, particularly in the subpopulation with higher inflammatory burden at baseline. PMID:29682324

Lead induced changes in growth and micronutrient uptake of Jatropha curcas L.

PubMed

Shu, Xiao; Zhang, QuanFa; Wang, WeiBo

2014-11-01

Effects of lead treatment on growth and micronutrient uptake in Jatropha curcas L. seedlings were assessed by means of microcosm experiments. Results suggested that superoxide dismutase (SOD) activity increased with increasing lead concentration. There was significant positive correlation between lead treatment concentration and SOD and peroxidase activity. Catalase activity was initiated under lower lead stress but, was inhibited under higher lead exposure. Lead had a stimulating effect on seedlings height and leaf area at lower lead concentrations. The J. curcas can accumulate higher amounts of available lead from soil but can translocate only low amounts to the shoots. Results indicating SOD and peroxidase activity in J. curcas seedlings played an important role in resisting the oxidative stress induced by lead. The addition of lead significantly increased the content of zinc in plant tissue and enhanced the transport of iron from roots to shoots but contributed to a decrease in measured copper, iron, and manganese content.