2011 Annual Survey of Journalism and Mass Communication Enrollments: Enrollments Decline, Reversing the Increase of a Year Earlier, and Suggesting Slow Growth for Future

ERIC Educational Resources Information Center

Becker, Lee B.; Vlad, Tudor; Kalpen, Konrad

2012-01-01

Enrollments in journalism and mass communication programs declined in the autumn of 2011, compared to a year earlier. Enrollments were down slightly at the senior and junior levels and substantially at the freshman level. Enrollment increased at the sophomore level. The majority of administrators say they have made curricular changes in the past…

Changing facial phenotype in Cohen syndrome: towards clues for an earlier diagnosis.

PubMed

El Chehadeh-Djebbar, Salima; Blair, Edward; Holder-Espinasse, Muriel; Moncla, Anne; Frances, Anne-Marie; Rio, Marlène; Debray, François-Guillaume; Rump, Patrick; Masurel-Paulet, Alice; Gigot, Nadège; Callier, Patrick; Duplomb, Laurence; Aral, Bernard; Huet, Frédéric; Thauvin-Robinet, Christel; Faivre, Laurence

2013-07-01

Cohen syndrome (CS) is a rare autosomal recessive condition caused by mutations and/or large rearrangements in the VPS13B gene. CS clinical features, including developmental delay, the typical facial gestalt, chorioretinal dystrophy (CRD) and neutropenia, are well described. CS diagnosis is generally raised after school age, when visual disturbances lead to CRD diagnosis and to VPS13B gene testing. This relatively late diagnosis precludes accurate genetic counselling. The aim of this study was to analyse the evolution of CS facial features in the early period of life, particularly before school age (6 years), to find clues for an earlier diagnosis. Photographs of 17 patients with molecularly confirmed CS were analysed, from birth to preschool age. By comparing their facial phenotype when growing, we show that there are no special facial characteristics before 1 year. However, between 2 and 6 years, CS children already share common facial features such as a short neck, a square face with micrognathia and full cheeks, a hypotonic facial appearance, epicanthic folds, long ears with an everted upper part of the auricle and/or a prominent lobe, a relatively short philtrum, a small and open mouth with downturned corners, a thick lower lip and abnormal eye shapes. These early transient facial features evolve to typical CS facial features with aging. These observations emphasize the importance of ophthalmological tests and neutrophil count in children in preschool age presenting with developmental delay, hypotonia and the facial features we described here, for an earlier CS diagnosis.

Changes toward earlier streamflow timing across western North America

USGS Publications Warehouse

Stewart, I.T.; Cayan, D.R.; Dettinger, M.D.

2005-01-01

The highly variable timing of streamflow in snowmelt-dominated basins across western North America is an important consequence, and indicator, of climate fluctuations. Changes in the timing of snowmelt-derived streamflow from 1948 to 2002 were investigated in a network of 302 western North America gauges by examining the center of mass for flow, spring pulse onset dates, and seasonal fractional flows through trend and principal component analyses. Statistical analysis of the streamflow timing measures with Pacific climate indicators identified local and key large-scale processes that govern the regionally coherent parts of the changes and their relative importance. Widespread and regionally coherent trends toward earlier onsets of springtime snowmelt and streamflow have taken place across most of western North America, affecting an area that is much larger than previously recognized. These timing changes have resulted in increasing fractions of annual flow occurring earlier in the water year by 1-4 weeks. The immediate (or proximal) forcings for the spatially coherent parts of the year-to-year fluctuations and longer-term trends of streamflow timing have been higher winter and spring temperatures. Although these temperature changes are partly controlled by the decadal-scale Pacific climate mode [Pacific decadal oscillation (PDO)], a separate and significant part of the variance is associated with a springtime warming trend that spans the PDO phases. ?? 2005 American Meteorological Society.

Cardiac Complications, Earlier Treatment, and Initial Disease Severity in Kawasaki Disease.

PubMed

Abrams, Joseph Y; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

2017-09-01

To assess if observed higher observed risks of cardiac complications for patients with Kawasaki disease (KD) treated earlier may reflect bias due to confounding from initial disease severity, as opposed to any negative effect of earlier treatment. We used data from Japanese nationwide KD surveys from 1997 to 2004. Receipt of additional intravenous immunoglobulin (IVIG) (data available all years) or any additional treatment (available for 2003-2004) were assessed as proxies for initial disease severity. We determined associations between earlier or later IVIG treatment (defined as receipt of IVIG on days 1-4 vs days 5-10 of illness) and cardiac complications by stratifying by receipt of additional treatment or by using logistic modeling to control for the effect of receiving additional treatment. A total of 48 310 patients with KD were included in the analysis. In unadjusted analysis, earlier IVIG treatment was associated with a higher risk for 4 categories of cardiac complications, including all major cardiac complications (risk ratio, 1.10; 95% CI, 1.06-1.15). Stratifying by receipt of additional treatment removed this association, and earlier IVIG treatment became protective against all major cardiac complications when controlling for any additional treatment in logistic regressions (OR, 0.90; 95% CI, 0.80-1.00). Observed higher risks of cardiac complications among patients with KD receiving IVIG treatment on days 1-4 of the illness are most likely due to underlying higher initial disease severity, and patients with KD should continue to be treated with IVIG as early as possible. Published by Elsevier Inc.

Prescription stimulant use is associated with earlier onset of psychosis.

PubMed

Moran, Lauren V; Masters, Grace A; Pingali, Samira; Cohen, Bruce M; Liebson, Elizabeth; Rajarethinam, R P; Ongur, Dost

2015-12-01

A childhood history of attention deficit hyperactivity disorder (ADHD) is common in psychotic disorders, yet prescription stimulants may interact adversely with the physiology of these disorders. Specifically, exposure to stimulants leads to long-term increases in dopamine release. We therefore hypothesized that individuals with psychotic disorders previously exposed to prescription stimulants will have an earlier onset of psychosis. Age of onset of psychosis (AOP) was compared in individuals with and without prior exposure to prescription stimulants while controlling for potential confounding factors. In a sample of 205 patients recruited from an inpatient psychiatric unit, 40% (n = 82) reported use of stimulants prior to the onset of psychosis. Most participants were prescribed stimulants during childhood or adolescence for a diagnosis of ADHD. AOP was significantly earlier in those exposed to stimulants (20.5 vs. 24.6 years stimulants vs. no stimulants, p < 0.001). After controlling for gender, IQ, educational attainment, lifetime history of a cannabis use disorder or other drugs of abuse, and family history of a first-degree relative with psychosis, the association between stimulant exposure and earlier AOP remained significant. There was a significant gender × stimulant interaction with a greater reduction in AOP for females, whereas the smaller effect of stimulant use on AOP in males did not reach statistical significance. In conclusion, individuals with psychotic disorders exposed to prescription stimulants had an earlier onset of psychosis, and this relationship did not appear to be mediated by IQ or cannabis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Variations in a university subject pool as a function of earlier or later participation and self-report: a replication and extension.

PubMed

Bernard, Larry C; Walsh, R Patricia

2002-10-01

The present study replicated and extended earlier research on temporal sampling effects in university subject pools. Data were obtained from 236 participants, 79 men and 157 women, in a university subject pool during a 15-wk. semester. Without knowing the purpose of the study, participants self-selected to participate earlier (Weeks 4 and 5; n = 105) or later (Weeks 14 and 15; n = 131). Three hypotheses were investigated: (1) that the personality patterns of earlier and later participants on the NEO Personality Inventory-Revised and the Personality Research Form differ significantly, with earlier participants scoring higher on the latter scales reflecting social responsibility and higher on former Conscientiousness and Neuroticism scales; (2) that there are similar significant differences between participants in the earlier and later groups compared to the male and female college normative samples for the two tests: and (3) that earlier participants will have higher actual Scholastic Assessment Test scores and Grade Point Averages. Also investigated was whether participants' foreknowledge that their actual Scholastic Assessment Test scores and Grade Point Averages would be obtained would affect their accuracy of self-report. In contrast to prior research, neither the first nor second hypothesis was supported by the current study; there do not appear to be consistent differences on personality variables. However, the third hypothesis was supported. Earlier participants had higher actual high school Grade Point Average, college Grade Point Average, and Scholastic Assessment Test Verbal scores. Foreknowledge that actual Scholastic Assessment Test scores and Grade Point Averages would be obtained did not affect the accuracy of self-report. In addition, later participants significantly over-reported their scores, and significantly more women than men and more first-year than senior-year subjects participated in the early group.

Traumatic Brain Injury History is Associated with Earlier Age of Onset of Alzheimer Disease

PubMed Central

LoBue, Christian; Wadsworth, Hannah; Wilmoth, Kristin; Clem, Matthew; Hart, John; Womack, Kyle B.; Didehbani, Nyaz; Lacritz, Laura H.; Rossetti, Heidi C.; Cullum, C. Munro

2016-01-01

Objective This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein ε4 status (Apoe4) and gender. Method Participants with a clinical diagnosis of AD (n=7625) were obtained from the National Alzheimer’s Coordinating Center Uniform Data Set, and categorized based on self-reported lifetime TBI with loss of consciousness (LOC) (TBI+ vs TBI-) and presence of Apoe4. ANCOVAs, controlling for gender, race, and education were used to examine the association between history of TBI, presence of Apoe4, and an interaction of both risk factors on estimated age of AD onset. Results Estimated AD onset differed by TBI history and Apoe4 independently (p’s <.001). The TBI+ group had a mean age of onset 2.5 years earlier than the TBI- group. Likewise, Apoe4 carriers had a mean age of onset 2.3 years earlier than non-carriers. While the interaction was non-significant (p = .34), participants having both a history of TBI and Apoe4 had the earliest mean age of onset compared to those with a TBI history or Apoe4 alone (MDifference = 2.8 & 2.7 years, respectively). These results remained unchanged when stratified by gender. Conclusions History of self-reported TBI can be associated with an earlier onset of AD-related cognitive decline, regardless of Apoe4 status and gender. TBI may be related to an underlying neurodegenerative process in AD, but the implications of age at time of injury, severity, and repetitive injuries remain unclear. PMID:27855547

Psychological health in siblings who lost a brother or sister to cancer 2 to 9 years earlier.

PubMed

Eilegård, Alexandra; Steineck, Gunnar; Nyberg, Tommy; Kreicbergs, Ulrika

2013-03-01

The objective of this study was to assess long-term psychological distress in siblings who lost a brother or sister to cancer 2 to 9 years earlier, as compared with a control group of non-bereaved siblings from the general population. During 2009, we conducted a nationwide follow-up study in Sweden by using an anonymous study-specific questionnaire. Siblings who had lost a brother or sister to cancer between the years 2000 and 2007 and also a control group of non-bereaved siblings from the general population were invited to participate. The Hospital Anxiety and Depression Scale (HADS) was used to measure psychological distress, and to test for differences in the ordinal outcome responses between the groups, we used Wilcoxon-Mann-Whitney rank-sum test. Among the bereaved siblings, 174/240 (73%) participated and 219/293 (75%) among the non-bereaved. Self-assessed low self-esteem (p = 0.002), difficulties falling asleep (p = 0.005), and low level of personal maturity (p = 0.007) at follow-up were more prevalent among bereaved siblings. However, anxiety (p = 0.298) and depression (p = 0.946), according to HADS, were similar. Bereaved siblings are at increased risk of low self-esteem, low level of personal maturity and difficulties falling asleep as compared with non-bereaved peers. Yet, the bereaved were not more likely to report anxiety or depression. Copyright © 2012 John Wiley & Sons, Ltd.

Factors associated with late diagnosis of HIV infection and missed opportunities for earlier testing.

PubMed

Gullón, Alejandra; Verdejo, José; de Miguel, Rosa; Gómez, Ana; Sanz, Jesús

2016-10-01

Late diagnosis (LD) of human immunodeficiency virus (HIV) infection continues to be a significant problem that increases disease burden both for patients and for the public health system. Guidelines have been updated in order to facilitate earlier HIV diagnosis, introducing "indicator condition-guided HIV testing". In this study, we analysed the frequency of LD and associated risk factors. We retrospectively identified those cases that could be considered missed opportunities for an earlier diagnosis. All patients newly diagnosed with HIV infection who attended Hospital La Princesa, Madrid (Spain) between 2007 and 2014 were analysed. We collected epidemiological, clinical and immunological data. We also reviewed electronic medical records from the year before the HIV diagnosis to search for medical consultations due to clinical indicators. HIV infection was diagnosed in 354 patients. The median CD4 count at presentation was 352 cells/mm(3). Overall, 158 patients (50%) met the definition of LD, and 97 (30.7%) the diagnosis of advanced disease. LD was associated with older age and was more frequent amongst immigrants. Heterosexual relations and injection drug use were more likely to be the reasons for LD than relations between men who have sex with men. During the year preceding the diagnosis, 46.6% of the patients had sought medical advice owing to the presence of clinical indicators that should have led to HIV testing. Of those, 24 cases (14.5%) were classified as missed opportunities for earlier HIV diagnosis because testing was not performed. According to these results, all health workers should pursue early HIV diagnosis through the proper implementation of HIV testing guidelines. Such an approach would prove directly beneficial to the patient and indirectly beneficial to the general population through the reduction in the risk of transmission.

Insight Into Illness and Cognition in Schizophrenia in Earlier and Later Life.

PubMed

Gerretsen, Philip; Voineskos, Aristotle N; Graff-Guerrero, Ariel; Menon, Mahesh; Pollock, Bruce G; Mamo, David C; Mulsant, Benoit H; Rajji, Tarek K

2017-04-01

Impaired insight into illness in schizophrenia is associated with illness severity and deficits in premorbid intellectual function, executive function, and memory. A previous study of patients aged 60 years and older found that illness severity and premorbid intellectual function accounted for variance in insight impairment. As such, we aimed to test whether similar relationships would be observed in earlier life. A retrospective analysis was performed on 1 large sample of participants (n = 171) with a DSM-IV-TR diagnosis of schizophrenia aged 19 to 79 years acquired from 2 studies: (1) a psychosocial intervention trial for older persons with schizophrenia (June 2008 to May 2014) and (2) a diffusion tensor imaging and genetics study of psychosis across the life span (February 2007 to December 2013). We assessed insight into illness using the Positive and Negative Syndrome Scale (PANSS) item G12 and explored its relationship to illness severity (PANSS total modified), premorbid intellectual function (Wechsler Test of Adult Reading [WTAR]), and cognition. Insight impairment was more severe in later life (≥ 60 years) than in earlier years (t = -3.75, P < .001). Across the whole sample, the variance of impaired insight was explained by PANSS total modified (Exp[B] = 1.070, P < .001) and WTAR scores (Exp[B] = 0.970, P = .028). Although age and cognition were correlated with impaired insight, they did not independently contribute to its variance. However, the relationships between impaired insight and illness severity and between impaired insight and cognition, particularly working memory, were stronger in later life than in earlier life. These results suggest an opportunity for intervention may exist with cognitive-enhancing neurostimulation or medications to improve insight into illness in schizophrenia across the life span. Original study registered on ClinicalTrials.gov (identifier: NCT00832845). © Copyright 2017 Physicians Postgraduate Press, Inc.

Childhood hair product use and earlier age at menarche in a racially diverse study population: a pilot study.

PubMed

James-Todd, Tamarra; Terry, Mary Beth; Rich-Edwards, Janet; Deierlein, Andrea; Senie, Ruby

2011-06-01

Previous studies suggest that hair products containing endocrine disrupting chemicals could alter puberty. We evaluated the association between childhood hair product use and age at menarche in a racially diverse study population. We recruited 300 African-American, African-Caribbean, Hispanic, and white women from the New York City metropolitan area who were between 18-77 years of age. Data were collected retrospectively on hair oil, lotion, leave-in conditioner, perm, and other types of hair products used before age 13. Recalled age at menarche ranged from 8 to 19 years. We used multivariable binomial regression to evaluate the association between hair product use and age at menarche (<12 vs. ≥12), adjusting for potential confounders. African-Americans were more likely to use hair products and reached menarche earlier than other racial/ethnic groups. Women reporting childhood hair oil use had a risk ratio of 1.4 (95% confidence interval [CI]: 1.1-1.9) for earlier menarche, adjusting for race/ethnicity and year of birth. Hair perm users had an increased risk for earlier menarche (adjusted risk ratio = 1.4, 95% CI: 1.1-1.8). Other types of hair products assessed in this study were not associated with earlier menarche. Childhood hair oil and perm use were associated with earlier menarche. If replicated, these results suggest that hair product use may be important to measure in evaluating earlier age at menarche. Copyright © 2011 Elsevier Inc. All rights reserved.

Traumatic brain injury history is associated with an earlier age of dementia onset in autopsy-confirmed Alzheimer's disease.

PubMed

Schaffert, Jeff; LoBue, Christian; White, Charles L; Chiang, Hsueh-Sheng; Didehbani, Nyaz; Lacritz, Laura; Rossetti, Heidi; Dieppa, Marisara; Hart, John; Cullum, C Munro

2018-05-01

To evaluate whether a history of traumatic brain injury (TBI) with reported loss of consciousness (LOC) is a risk factor for earlier onset of Alzheimer's disease (AD) in an autopsy-confirmed sample. Data from 2,133 participants with autopsy-confirmed AD (i.e., at least Braak neurofibrillary tangle stages III to VI and CERAD neuritic plaque score moderate to frequent) were obtained from the National Alzheimer's Coordinating Center (NACC). Participants were categorized by presence/absence of self-reported remote (i.e., >1 year prior to their first Alzheimer's Disease Center visit) history of TBI with LOC (TBI+ vs. TBI-). Analyses of Covariance (ANCOVA) controlling for sex, education, and race compared groups on clinician-estimated age of symptom onset and age of diagnosis. Average age of onset was 2.34 years earlier (p = .01) for the TBI+ group (n = 194) versus the TBI- group (n = 1900). Dementia was diagnosed on average 2.83 years earlier (p = .002) in the TBI+ group (n = 197) versus the TBI- group (n = 1936). Using more stringent neuropathological criteria (i.e., Braak stages V-VI and CERAD frequent), both age of AD onset and diagnosis were 3.6 years earlier in the TBI+ group (both p's < .001). History of TBI with reported LOC appears to be a risk factor for earlier AD onset. This is the first study to use autopsy-confirmed cases, supporting previous investigations that used clinical criteria for the diagnosis of AD. Further investigation as to possible underlying mechanisms of association is needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Floodplains within reservoirs promote earlier spawning of white crappies Pomoxis annularis

USGS Publications Warehouse

Miranda, Leandro E.; Dagel, Jonah D.; Kaczka, Levi J.; Mower, Ethan; Wigen, S. L.

2015-01-01

Reservoirs impounded over floodplain rivers are unique because they may include within their upper reaches extensive shallow water stored over preexistent floodplains. Because of their relatively flat topography and riverine origin, floodplains in the upper reaches of reservoirs provide broad expanses of vegetation within a narrow range of reservoir water levels. Elsewhere in the reservoir, topography creates a band of shallow water along the contour of the reservoir where vegetation often does not grow. Thus, as water levels rise, floodplains may be the first vegetated habitats inundated within the reservoir. We hypothesized that shallow water in reservoir floodplains would attract spawning white crappies Pomoxis annularis earlier than reservoir embayments. Crappie relative abundance over five years in floodplains and embayments of four reservoirs increased as spawning season approached, peaked, and decreased as fish exited shallow water. Relative abundance peaked earlier in floodplains than embayments, and the difference was magnified with higher water levels. Early access to suitable spawning habitat promotes earlier spawning and may increase population fitness. Recognition of the importance of reservoir floodplains, an understanding of how reservoir water levels can be managed to provide timely connectivity to floodplains, and conservation of reservoir floodplains may be focal points of environmental management in reservoirs.

Possible Futures: Using Frameworks of Knowledge to Help Year 9 Connect Past, Present and Future

ERIC Educational Resources Information Center

Nuttall, Dan

2013-01-01

How can we help pupils integrate history into coherent "Big Pictures" or mental frameworks? Building on traditions of classroom research and theorising reported in earlier editions of Teaching History, Dan Nuttall reports how his department set out to help Year 9 build a coherent big picture of twentieth-century history that would…

Earlier Visual N1 Latencies in Expert Video-Game Players: A Temporal Basis of Enhanced Visuospatial Performance?

PubMed Central

Latham, Andrew J.; Patston, Lucy L. M.; Westermann, Christine; Kirk, Ian J.; Tippett, Lynette J.

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction. PMID:24058667

Earlier visual N1 latencies in expert video-game players: a temporal basis of enhanced visuospatial performance?

PubMed

Latham, Andrew J; Patston, Lucy L M; Westermann, Christine; Kirk, Ian J; Tippett, Lynette J

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction.

Screening for Colorectal Cancer in African Americans: Determinants and Rationale for an Earlier Age to Commence Screening

PubMed Central

Carethers, John M.

2014-01-01

Colorectal cancer (CRC) screening is a highly cost-effective approach to reduce morbidity and mortality of patients, as well as reduce the prevalence of CRC in populations. Current recommendations for CRC screening for the asymptomatic general population begin at age 50 years, an age after which ~95% of cancers occur. Determinants that modify the timing and frequency for screening include a personal or family history of adenomatous polyps or CRC, the age of onset of these colonic lesions, and the presence or potential for a patient to harbor a higher-risk syndrome such as inflammatory bowel disease (IBD), familial adenomatous polyposis (FAP), or Lynch syndrome.. Although race, like family history, is a heritable factor, it has not engendered inclusion in the same broad systematic screening recommendations despite multiple studies demonstrating a disparity in the incidence and mortality from CRC, and the potential for targeted screening to reduce the disparity. In particular, African Americans, when compared to Caucasians, (a) have lower CRC screening utilization rates, (b) have an earlier presentation of CRC (0-8 years younger than Caucasians) and, more often have aggressive biological features more prone to metastasis, (c) have a higher CRC prevalence at all ages and a higher proportion of CRCs before 50 years of age (~11% vs 5% in Caucasians), (d) are less likely to know or transmit personal or family history of adenomas or CRC that might change their screening to an earlier age, (e) present with 7-15% excess right-sided CRCs that are not microsatellite unstable, (f) show higher frequencies of high-risk adenomas at every decile of age, and an excess of high-risk proximal adenomas that mirror the excess of proximal CRCs, (g) have cancers that demonstrate lower proportions of good prognostic biomarkers such as MSI and higher proportions of bad prognosticators such as EMAST, (h) may possess gut microbiota more conducive to initiating and/or propagating colonic

Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification?

PubMed

Hope, Kirsty; Durrheim, David N; Muscatello, David; Merritt, Tony; Zheng, Wei; Massey, Peter; Cashman, Patrick; Eastwood, Keith

2008-08-01

To retrospectively review the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System operating in New South Wales for identifying pneumonia outbreaks of public health importance. Retrospective data was obtained from the NSW Emergency Department data collection for a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males in August 2006. ED standard reports were examined for signals in the overall count for each respiratory syndrome, and for elevated counts in individual subgroups including; age, sex and admission to hospital status. Using the current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days. If the ED syndromic surveillance system had been operating it could have identified the outbreak earlier than the paediatrician's notification. This may have permitted an earlier public health response. By understanding the behaviour of syndromes during outbreaks of public health importance, response protocols could be developed to facilitate earlier implementation of control measures.

Tidal Wave II Revisited: A Review of Earlier Enrollment Projections for California Higher Education.

ERIC Educational Resources Information Center

Hayward, Gerald C.; Breneman, David W.; Estrada, Leobardo F.

This report examined enrollment projections for higher education institutions in California in relation to earlier projections conducted in the mid-1990s that forecasted steep declines in enrollment. It notes that California's remarkable economic recovery over the last several years has allowed it to fund higher education enrollment growth at a…

Toward Explaining Earlier Retirement after 1970.

ERIC Educational Resources Information Center

Ippolito, Richard A.

1990-01-01

Rule changes in the social security system and pension plans suggest that labor force participation rates for men aged 55 to 64 fell by 20 percent from 1970 through 1986 because of the increase in social security benefits and a change in private pension rules encouraging earlier retirement. (Author/JOW)

Earlier tachycardia onset in right than left mesial temporal lobe seizures.

PubMed

Kato, Kazuhiro; Jin, Kazutaka; Itabashi, Hisashi; Iwasaki, Masaki; Kakisaka, Yosuke; Aoki, Masashi; Nakasato, Nobukazu

2014-10-07

To clarify whether the presence and timing of peri-ictal heart rate (HR) change is a seizure lateralizing sign in patients with mesial temporal lobe epilepsy (mTLE). Long-term video EEGs were retrospectively reviewed in 21 patients, 7 men and 14 women aged 13 to 67 years, diagnosed as mTLE with MRI lesions in the mesial temporal structures (hippocampal sclerosis in 20 cases, amygdala hypertrophy in 1 case). Seventy-seven partial seizures without secondary generalization were extracted. Peri-ictal HR change was compared between 29 right seizures (9 patients) and 48 left seizures (12 patients). HR abruptly increased in all 29 right seizures and 42 of 48 left seizures. Onset time of HR increase in relation to ictal EEG onset was significantly earlier in right seizures than in left seizures (mean ± SD, -11.5 ± 14.8 vs 9.2 ± 21.7 seconds; p < 0.0001). Time of maximum HR was also significantly earlier in right seizures than in left seizures (36.0 ± 18.1 vs 58.0 ± 28.7 seconds; p < 0.0001). Maximum HR changes from baseline showed no significant difference between right and left seizures (47.5 ± 19.1 vs 40.8 ± 20.0/min). Significantly earlier tachycardia in right than left mTLE seizures supports previous hypotheses that the right cerebral hemisphere is dominant in the sympathetic network. No HR change, or delayed tachycardia possibly due to seizure propagation to the right hemisphere, may be a useful lateralizing sign of left mTLE seizures. © 2014 American Academy of Neurology.

Compulsive Buying: Earlier Illicit Drug Use, Impulse Buying, Depression, and Adult ADHD Symptoms

PubMed Central

Brook, Judith S.; Zhang, Chenshu; Brook, David W.; Leukefeld, Carl G.

2015-01-01

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant’s earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. PMID:26165963

Integrated Tree-Ring-Radiocarbon High-Resolution Timeframe to Resolve Earlier Second Millennium BCE Mesopotamian Chronology.

PubMed

Manning, Sturt W; Griggs, Carol B; Lorentzen, Brita; Barjamovic, Gojko; Ramsey, Christopher Bronk; Kromer, Bernd; Wild, Eva Maria

2016-01-01

500 years of ancient Near Eastern history from the earlier second millennium BCE, including such pivotal figures as Hammurabi of Babylon, Šamši-Adad I (who conquered Aššur) and Zimrilim of Mari, has long floated in calendar time subject to rival chronological schemes up to 150+ years apart. Texts preserved on clay tablets provide much information, including some astronomical references, but despite 100+ years of scholarly effort, chronological resolution has proved impossible. Documents linked with specific Assyrian officials and rulers have been found and associated with archaeological wood samples at Kültepe and Acemhöyük in Turkey, and offer the potential to resolve this long-running problem. Here we show that previous work using tree-ring dating to place these timbers in absolute time has fundamental problems with key dendrochronological crossdates due to small sample numbers in overlapping years and insufficient critical assessment. To address, we have integrated secure dendrochronological sequences directly with radiocarbon (14C) measurements to achieve tightly resolved absolute (calendar) chronological associations and identify the secure links of this tree-ring chronology with the archaeological-historical evidence. The revised tree-ring-sequenced 14C time-series for Kültepe and Acemhöyük is compatible only with the so-called Middle Chronology and not with the rival High, Low or New Chronologies. This finding provides a robust resolution to a century of uncertainty in Mesopotamian chronology and scholarship, and a secure basis for construction of a coherent timeframe and history across the Near East and East Mediterranean in the earlier second millennium BCE. Our re-dating also affects an unusual tree-ring growth anomaly in wood from Porsuk, Turkey, previously tentatively associated with the Minoan eruption of the Santorini volcano. This tree-ring growth anomaly is now directly dated ~1681-1673 BCE (68.2% highest posterior density range), ~20

Integrated Tree-Ring-Radiocarbon High-Resolution Timeframe to Resolve Earlier Second Millennium BCE Mesopotamian Chronology

PubMed Central

Griggs, Carol B.; Lorentzen, Brita; Barjamovic, Gojko; Ramsey, Christopher Bronk; Kromer, Bernd; Wild, Eva Maria

2016-01-01

500 years of ancient Near Eastern history from the earlier second millennium BCE, including such pivotal figures as Hammurabi of Babylon, Šamši-Adad I (who conquered Aššur) and Zimrilim of Mari, has long floated in calendar time subject to rival chronological schemes up to 150+ years apart. Texts preserved on clay tablets provide much information, including some astronomical references, but despite 100+ years of scholarly effort, chronological resolution has proved impossible. Documents linked with specific Assyrian officials and rulers have been found and associated with archaeological wood samples at Kültepe and Acemhöyük in Turkey, and offer the potential to resolve this long-running problem. Here we show that previous work using tree-ring dating to place these timbers in absolute time has fundamental problems with key dendrochronological crossdates due to small sample numbers in overlapping years and insufficient critical assessment. To address, we have integrated secure dendrochronological sequences directly with radiocarbon (14C) measurements to achieve tightly resolved absolute (calendar) chronological associations and identify the secure links of this tree-ring chronology with the archaeological-historical evidence. The revised tree-ring-sequenced 14C time-series for Kültepe and Acemhöyük is compatible only with the so-called Middle Chronology and not with the rival High, Low or New Chronologies. This finding provides a robust resolution to a century of uncertainty in Mesopotamian chronology and scholarship, and a secure basis for construction of a coherent timeframe and history across the Near East and East Mediterranean in the earlier second millennium BCE. Our re-dating also affects an unusual tree-ring growth anomaly in wood from Porsuk, Turkey, previously tentatively associated with the Minoan eruption of the Santorini volcano. This tree-ring growth anomaly is now directly dated ~1681–1673 BCE (68.2% highest posterior density range), ~20

Compulsive buying: Earlier illicit drug use, impulse buying, depression, and adult ADHD symptoms.

PubMed

Brook, Judith S; Zhang, Chenshu; Brook, David W; Leukefeld, Carl G

2015-08-30

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant's earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Earlier Mother's Age at Menarche Predicts Rapid Infancy Growth and Childhood Obesity

PubMed Central

Ong, Ken K; Northstone, Kate; Wells, Jonathan CK; Rubin, Carol; Ness, Andy R; Golding, Jean; Dunger, David B

2007-01-01

Background Early menarche tends to be preceded by rapid infancy weight gain and is associated with increased childhood and adult obesity risk. As age at menarche is a heritable trait, we hypothesised that age at menarche in the mother may in turn predict her children's early growth and obesity risk. Methods and Findings We tested associations between mother's age at menarche, mother's adult body size and obesity risk, and her children's growth and obesity risk in 6,009 children from the UK population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort who had growth and fat mass at age 9 y measured by dual-energy X-ray absorptiometry. A subgroup of 914 children also had detailed infancy and childhood growth data. In the mothers, earlier menarche was associated with shorter adult height (by 0.64 cm/y), increased weight (0.92 kg/y), and body mass index (BMI, 0.51 kg/m2/y; all p < 0.001). In contrast, in her children, earlier mother's menarche predicted taller height at 9 y (by 0.41 cm/y) and greater weight (0.80 kg/y), BMI (0.29 kg/m2/y), and fat mass index (0.22 kg/m2/year; all p < 0.001). Children in the earliest mother's menarche quintile (≤11 y) were more obese than the oldest quintile (≥15 y) (OR, 2.15, 95% CI 1.46 to 3.17; p < 0.001, adjusted for mother's education and BMI). In the subgroup, children in the earliest quintile showed faster gains in weight (p < 0.001) and height (p < 0.001) only from birth to 2 y, but not from 2 to 9 y (p = 0.3–0.8). Conclusions Earlier age at menarche may be a transgenerational marker of a faster growth tempo, characterised by rapid weight gain and growth, particularly during infancy, and leading to taller childhood stature, but likely earlier maturation and therefore shorter adult stature. This growth pattern confers increased childhood and adult obesity risks. PMID:17455989

Trends of earlier palliative care consultation in advanced cancer patients receiving palliative radiation therapy.

PubMed

Chang, Sanders; Sigel, Keith; Goldstein, Nathan E; Wisnivesky, Juan; Dharmarajan, Kavita V

2018-06-06

The American Society of Clinical Oncology recommends that all patients with metastatic disease receive dedicated palliative care (PC) services early in their illness, ideally via interdisciplinary care teams. We investigated the time trends of specialty palliative care consultations from the date of metastatic cancer diagnosis among patients receiving palliative radiation therapy (PRT). A shorter time interval between metastatic diagnosis and first PC consultation suggests earlier involvement of palliative care in a patient's life with metastatic cancer. In this IRB-approved retrospective analysis, patients treated with PRT for solid tumors (bone and brain) at a single tertiary care hospital between 2010 and 2016 were included. Cohorts were arbitrarily established by metastatic diagnosis within approximately two-year intervals: (1) 1/1/2010-3/27/2012; (2) 3/28/2012-5/21/2014; and (3) 5/22/2014-12/31/2016. Cox-proportional hazards regression modelling was used to compare trends of PC consultation among cohorts. Of 284 patients identified, 184 patients received PC consultation, whereas 15 patients died before receiving a PC consult. Median follow-up time until an event or censor was 257 days (range: 1,900). Patients in the most recent cohort had a shorter median time to first PC consult (57 days) compared to those in the first (374 days) and second (186 days) cohorts. On multivariable analysis, patients in the third cohort were more likely to undergo a PC consultation earlier in their metastatic illness (HR: 1.8, 95% CI: 1.2,2.8). Over a six-year period, palliative care consultation occurred earlier for metastatic patients treated with PRT at our institution. Copyright © 2018. Published by Elsevier Inc.

Trend of earlier spring in central Europe continued

NASA Astrophysics Data System (ADS)

Ungersböck, Markus; Jurkovic, Anita; Koch, Elisabeth; Lipa, Wolfgang; Scheifinger, Helfried; Zach-Hermann, Susanne

2013-04-01

Modern phenology is the study of the timing of recurring biological events in the animal and plant world, the causes of their timing with regard to biotic and abiotic forces, and the interrelation among phases of the same or different species. The relationship between phenology and climate explains the importance of plant phenology for Climate Change studies. Plants require light, water, oxygen mineral nutrients and suitable temperature to grow. In temperate zones the seasonal life cycle of plants is primarily controlled by temperature and day length. Higher spring air temperatures are resulting in an earlier onset of the phenological spring in temperate and cool climate. On the other hand changes in phenology due to climate change do have impact on the climate system itself. Vegetation is a dynamic factor in the earth - climate system and has positive and negative feedback mechanisms to the biogeochemical and biogeophysical fluxes to the atmosphere Since the mid of the 1980s spring springs earlier in Europe and autumn is shifting back to the end of the year resulting in a longer vegetation period. The advancement of spring can be clearly attributed to temperature increase in the months prior to leaf unfolding and flowering, the timing of autumn is more complex and cannot easily be attributed to one or some few parameters. To demonstrate that the observed advancement of spring since the mid of 1980s is pro-longed in 2001 to 2010 and the delay of fall and the lengthening of the growing season is confirmed in the last decade we picked out several indicator plants from the PEP725 database www.pep725.eu. The PEP725 database collects data from different European network operators and thus offers a unique compilation of phenological observations; the database is regularly updated. The data follow the same classification scheme, the so called BBCH coding system so they can be compared. Lilac Syringa vulgaris, birch Betula pendula, beech Fagus and horse chestnut Aesculus

Unresolved grief and its consequences. A nationwide follow-up of teenage loss of a parent to cancer 6-9 years earlier.

PubMed

Bylund-Grenklo, T; Fürst, C J; Nyberg, T; Steineck, G; Kreicbergs, U

2016-07-01

The early loss of a parent is a tragedy and a serious life event. This study investigated grief resolution and morbidity in cancer-bereaved teenagers 6 to 9 years after the loss of a parent to cancer. In a nationwide population-based study of 622 of 851 (73 %) youths who as teenagers 6 to 9 years earlier had lost a parent to cancer, we explored the magnitude of unresolved grief and its association with psychological and physiological morbidity. Participants answered a study-specific anonymous questionnaire including questions about if they had worked through their grief and about their current health. Six to nine years post-loss 49 % reported unresolved grief (8 % no and 41 % a little grief resolution). They had, in comparison with youths reporting resolved grief, statistically significantly elevated risks, e.g. for insomnia (sons' relative risk (RR) 2.3, 95 % CI 1.3-4.0; daughters' RR 1.7, 95 % CI 1.1-2.7), fatigue (sons' RR 1.8, 95 % CI 1.3-2.5; daughters' RR 1.4, 95 % CI 1.1-1.7) and moderate to severe depression, i.e. score >9, PHQ-9 (sons' RR 3.6, 95 % CI 1.4-8.8; daughters' RR 1.8, 95 % CI 1.1-3.1). Associations remained for insomnia in sons, exhaustion in daughters and fatigue in both sons and daughters when depression, negative intrusive thoughts and avoiding reminders of the parents' disease or death were included in a model. Approximately half of cancer-bereaved youth report no or little grief resolution 6 to 9 years post-loss, which is associated with fatigue, sleeping problems and depressive symptoms.

A vantage from space can detect earlier drought onset: an approach using relative humidity.

PubMed

Farahmand, Alireza; AghaKouchak, Amir; Teixeira, Joao

2015-02-25

Each year, droughts cause significant economic and agricultural losses across the world. The early warning and onset detection of drought is of particular importance for effective agriculture and water resource management. Previous studies show that the Standard Precipitation Index (SPI), a measure of precipitation deficit, detects drought onset earlier than other indicators. Here we show that satellite-based near surface air relative humidity data can further improve drought onset detection and early warning. This paper introduces the Standardized Relative Humidity Index (SRHI) based on the NASA Atmospheric Infrared Sounder (AIRS) observations. The results indicate that the SRHI typically detects the drought onset earlier than the SPI. While the AIRS mission was not originally designed for drought monitoring, we show that its relative humidity data offers a new and unique avenue for drought monitoring and early warning. We conclude that the early warning aspects of SRHI may have merit for integration into current drought monitoring systems.

A Vantage from Space Can Detect Earlier Drought Onset: An Approach Using Relative Humidity

PubMed Central

Farahmand, Alireza; AghaKouchak, Amir; Teixeira, Joao

2015-01-01

Each year, droughts cause significant economic and agricultural losses across the world. The early warning and onset detection of drought is of particular importance for effective agriculture and water resource management. Previous studies show that the Standard Precipitation Index (SPI), a measure of precipitation deficit, detects drought onset earlier than other indicators. Here we show that satellite-based near surface air relative humidity data can further improve drought onset detection and early warning. This paper introduces the Standardized Relative Humidity Index (SRHI) based on the NASA Atmospheric Infrared Sounder (AIRS) observations. The results indicate that the SRHI typically detects the drought onset earlier than the SPI. While the AIRS mission was not originally designed for drought monitoring, we show that its relative humidity data offers a new and unique avenue for drought monitoring and early warning. We conclude that the early warning aspects of SRHI may have merit for integration into current drought monitoring systems. PMID:25711500

Research promises earlier warning for grapevine canker diseases

USDA-ARS?s Scientific Manuscript database

When it comes to detecting and treating vineyards for grapevine canker diseases (also called trunk diseases), like Botryosphaeria dieback (Bot canker), Esca, Eutypa dieback and Phomopsis dieback, the earlier the better, says plant pathologist Kendra Baumgartner, with the USDA’s Agricultural Research...

An earlier de motu cordis.

PubMed Central

Daly, Walter J.

2004-01-01

Thirteenth century medical science, like medieval scholarship in general, was directed at reconciliation of Greek philosophy/science with prevailing medieval theology and philosophy. Peter of Spain [later Pope John XXI] was the leading medical scholar of his time. Peter wrote a long book on the soul. Imbedded in it was a chapter on the motion of the heart. Peter's De Motu was based on his own medical experience and Galen's De Usu Partium and De Usu Respirationis and De Usu Pulsuum. This earlier De Motu defines a point on the continuum of intellectual development leading to us and into the future. Thirteenth century scholarship relied on past authority to a degree that continues to puzzle and beg explanation. Images Fig. 1 PMID:17060956

The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.

PubMed

Kessler, R C; Aguilar-Gaxiola, S; Alonso, J; Bromet, E J; Gureje, O; Karam, E G; Koenen, K C; Lee, S; Liu, H; Pennell, B-E; Petukhova, M V; Sampson, N A; Shahly, V; Stein, D J; Atwoli, L; Borges, G; Bunting, B; de Girolamo, G; Gluzman, S F; Haro, J M; Hinkov, H; Kawakami, N; Kovess-Masfety, V; Navarro-Mateu, F; Posada-Villa, J; Scott, K M; Shalev, A Y; Ten Have, M; Torres, Y; Viana, M C; Zaslavsky, A M

2017-09-19

Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3-2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5-4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.Molecular Psychiatry advance online publication, 19 September 2017; doi:10.1038/mp.2017.194.

Earlier nesting by generalist predatory bird is associated with human responses to climate change.

PubMed

Smith, Shawn H; Steenhof, Karen; McClure, Christopher J W; Heath, Julie A

2017-01-01

Warming temperatures cause temporal changes in growing seasons and prey abundance that drive earlier breeding by birds, especially dietary specialists within homogeneous habitat. Less is known about how generalists respond to climate-associated shifts in growing seasons or prey phenology, which may occur at different rates across land cover types. We studied whether breeding phenology of a generalist predator, the American kestrel (Falco sparverius), was associated with shifts in growing seasons and, presumably, prey abundance, in a mosaic of non-irrigated shrub/grasslands and irrigated crops/pastures. We examined the relationship between remotely-sensed normalized difference vegetation index (NDVI) and abundance of small mammals that, with insects, constitute approximately 93% of kestrel diet biomass. We used NDVI to estimate the start of the growing season (SoGS) in irrigated and non-irrigated lands from 1992 to 2015 and tested whether either estimate of annual SoGS predicted the timing of kestrel nesting. Finally, we examined relationships among irrigated SoGS, weather and crop planting. NDVI was a useful proxy for kestrel prey because it predicted small mammal abundance and past studies showed that NDVI predicts insect abundance. NDVI-estimated SoGS advanced significantly in irrigated lands (β = -1·09 ± 0·30 SE) but not in non-irrigated lands (β = -0·57 ± 0·53). Average date of kestrel nesting advanced 15 days in the past 24 years and was positively associated with the SoGS in irrigated lands, but not the SoGS in non-irrigated lands. Advanced SoGS in irrigated lands was related to earlier planting of crops after relatively warm winters, which were more common in recent years. Despite different patterns of SoGS change between land cover types, kestrel nesting phenology shifted with earlier prey availability in irrigated lands. Kestrels may preferentially track prey in irrigated lands over non-irrigated lands because of higher quality prey on

The natural history of autoimmune hepatitis presenting with jaundice.

PubMed

Panayi, Vasilis; Froud, Oliver J; Vine, Louisa; Laurent, Paul; Woolson, Kathy L; Hunter, Jeremy G; Madden, Richard G; Miller, Catherine; Palmer, Jo; Harris, Nicola; Mathew, Joe; Stableforth, Bill; Murray, Iain A; Dalton, Harry R

2014-06-01

Forty percent of patients with autoimmune hepatitis (AIH) present with acute jaundice/hepatitis. Such patients, when treated promptly, are thought to have a good prognosis. The objective of this study was to describe the natural history of AIH in patients presenting with jaundice/hepatitis and to determine whether the diagnosis could have been made earlier, before presentation. This study is a retrospective review of 2249 consecutive patients who presented with jaundice to the Jaundice Hotline clinic, Truro, Cornwall, UK, over 15 years (1998-2013) and includes a review of the laboratory data over a 23-year period (1990-2013). Of the 955 patients with hepatocellular jaundice, 47 (5%) had criterion-referenced AIH: 35 female and 12 male, the median age was 65 years (range 15-91 years); the bilirubin concentration was 139 μmol/l (range 23-634 μmol/l) and the alanine transaminase level was 687 IU/l (range 22-2519 IU/l). Among the patients, 23/46 (50%) were cirrhotic on biopsy; 11/47 (23%) died: median time from diagnosis to death, 5 months (range 1-59); median age, 72 years (range 59-91 years). All 8/11 patients who died of liver-related causes were cirrhotic. Weight loss (P=0.04) and presence of cirrhosis (P=0.004) and varices (P=0.015) were more common among those who died. Among patients who died from liver-related causes, 6/8 (75%) died less than 6 months from diagnosis. Cirrhosis at presentation and oesophageal varices were associated with early liver-related deaths (P=0.011, 0.002 respectively). Liver function test results were available in 33/47 (70%) patients before presentation. Among these patients, 16 (49%) had abnormal alanine transaminase levels previously, and eight (50%) were cirrhotic at presentation. AIH presenting as jaundice/hepatitis was mainly observed in older women: 50% of the patients were cirrhotic, and liver-related mortality was high. Some of these deaths were potentially preventable by earlier diagnosis, as the patients had abnormal liver

Travelling for earlier surgical treatment: the patient's view.

PubMed Central

Stewart, M; Donaldson, L J

1991-01-01

As part of the northern region's programme within the national waiting list initiative, schemes have been funded to test the feasibility and acceptability of offering patients the opportunity to travel further afield in order to receive earlier treatment. A total of 484 patients experiencing a long wait for routine surgical operations in the northern region were offered the opportunity to receive earlier treatment outside their local health district; 74% of the patients accepted the offer. The initiative was well received by the participating patients and the majority stated that if the need arose on a future occasion they would prefer to travel for treatment rather than have to wait for lengthy periods for treatment at their local hospital. These findings, interpreted in the light of the National Health Service reforms introduced in April 1991, suggest that for some types of care, patients would welcome greater flexibility in the placing of contracts, not merely reinforcement of historical patterns of referral. PMID:1823553

Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia.

PubMed

Al-Talib, Ayman A

2016-01-01

To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed. Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7%) were older than 35 years, and were nulliparous (45.5%). The commonest symptom was vaginal bleeding (86.4%) followed by hyperemesis gravidarum (41.0%); Hyperthyroidism was seen in 1 patient (4.5%). Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%). The majority of patients (63.6%) had normal BhCG within 9 weeks (63 days) after suction curettage. The majority of the cases followed a benign course. Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear.

Decreased length of stay and earlier oral feeding associated with standardized postoperative clinical care for total gastrectomies at a cancer center.

PubMed

Selby, Luke V; Rifkin, Marissa B; Yoon, Sam S; Ariyan, Charlotte E; Strong, Vivian E

2016-09-01

Standardization of postoperative care has been shown to decrease postoperative length of stay. In June 2009, we standardized postoperative care for all gastrectomies at our institution. Four years' worth of total gastrectomies (2 years prior to standardization and 2 years after standardization) were reviewed to determine the effect of standardization on postoperative care, length of stay, complications, and readmissions. Between June 2007 and July 2011, 99 patients underwent curative intent open total gastrectomy: 51 patients prior to standardization, and 48 patients poststandardization. Patients were predominantly male (70%); median age was 63; and median body mass index was 26. Standardization of postoperative care was associated with a decrease in median time to beginning both clear liquids and a postgastrectomy diet, earlier removal of epidural catheters, earlier use of oral pain medication, less time receiving intravenous fluids, and decreased length of stay (all P < .01). Groups showed no differences in complication rates, complication severity, diet intolerance, return to our Urgent Care Center, or readmission. Institution of standardized postoperative orders for total gastrectomy was associated with a significantly decreased length of stay and earlier oral feeding without increasing postoperative complications, early postoperative outpatient visits, or readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

Earlier adolescent substance use onset predicts stronger connectivity between reward and cognitive control brain networks.

PubMed

Weissman, David G; Schriber, Roberta A; Fassbender, Catherine; Atherton, Olivia; Krafft, Cynthia; Robins, Richard W; Hastings, Paul D; Guyer, Amanda E

2015-12-01

Early adolescent onset of substance use is a robust predictor of future substance use disorders. We examined the relation between age of substance use initiation and resting state functional connectivity (RSFC) of the core reward processing (nucleus accumbens; NAcc) to cognitive control (prefrontal cortex; PFC) brain networks. Adolescents in a longitudinal study of Mexican-origin youth reported their substance use annually from ages 10 to 16 years. At age 16, 69 adolescents participated in a resting state functional magnetic resonance imaging scan. Seed-based correlational analyses were conducted using regions of interest in bilateral NAcc. The earlier that adolescents initiated substance use, the stronger the connectivity between bilateral NAcc and right dorsolateral PFC, right dorsomedial PFC, right pre-supplementary motor area, right inferior parietal lobule, and left medial temporal gyrus. The regions that demonstrated significant positive linear relationships between the number of adolescent years using substances and connectivity with NAcc are nodes in the right frontoparietal network, which is central to cognitive control. The coupling of reward and cognitive control networks may be a mechanism through which earlier onset of substance use is related to brain function over time, a trajectory that may be implicated in subsequent substance use disorders. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Review of Quality of Life after Predictive Testing for and Earlier Identification of Neurodegenerative Diseases

PubMed Central

Paulsen, Jane S.; Nance, Martha; Kim, Ji-In; Carlozzi, Noelle E.; Panegyres, Peter K.; Erwin, Cheryl; Goh, Anita; McCusker, Elizabeth; Williams, Janet K.

2013-01-01

The past decade has witnessed an explosion of evidence suggesting that many neurodegenerative diseases can be detected years, if not decades, earlier than previously thought. To date, these scientific advances have not provoked any parallel translational or clinical improvements. There is an urgency to capitalize on this momentum so earlier detection of disease can be more readily translated into improved health-related quality of life for families at risk for, or suffering with, neurodegenerative diseases. In this review, we discuss health-related quality of life (HRQOL) measurement in neurodegenerative diseases and the importance of these “patient reported outcomes” for all clinical research. Next, we address HRQOL following early identification or predictive genetic testing in some neurodegenerative diseases: Huntington disease, Alzheimer's disease, Parkinson's disease, Dementia with Lewy bodies, frontotemporal dementia, amyotrophic lateral sclerosis, prion diseases, hereditary ataxias, Dentatorubral-pallidoluysian atrophy and Wilson's disease. After a brief report of available direct-to-consumer genetic tests, we address the juxtaposition of earlier disease identification with assumed reluctance towards predictive genetic testing. Forty-one studies examining health related outcomes following predictive genetic testing for neurodegenerative disease suggested that (a) extreme or catastrophic outcomes are rare; (b) consequences commonly include transiently increased anxiety and/or depression; (c) most participants report no regret; (d) many persons report extensive benefits to receiving genetic information; and (e) stigmatization and discrimination for genetic diseases are poorly understood and policy and laws are needed. Caution is appropriate for earlier identification of neurodegenerative diseases but findings suggest further progress is safe, feasible and likely to advance clinical care. PMID:24036231

Extreme life on Earth--past, present and possibly beyond.

PubMed

Javaux, Emmanuelle J

2006-01-01

Life may have been present on Earth since about 3.8 billion years ago or earlier. Multidisciplinary research, especially on the paleobiology and evolution of early microorganisms on Earth and the microbiology of extremophiles in the Earth's environments and under space conditions, enables the defining of strategies for the detection of potential extraterrestrial life by determining biosignatures and the environmental envelope of life.

Light pollution is associated with earlier tree budburst across the United Kingdom.

PubMed

Ffrench-Constant, Richard H; Somers-Yeates, Robin; Bennie, Jonathan; Economou, Theodoros; Hodgson, David; Spalding, Adrian; McGregor, Peter K

2016-06-29

The ecological impact of night-time lighting is of concern because of its well-demonstrated effects on animal behaviour. However, the potential of light pollution to change plant phenology and its corresponding knock-on effects on associated herbivores are less clear. Here, we test if artificial lighting can advance the timing of budburst in trees. We took a UK-wide 13 year dataset of spatially referenced budburst data from four deciduous tree species and matched it with both satellite imagery of night-time lighting and average spring temperature. We find that budburst occurs up to 7.5 days earlier in brighter areas, with the relationship being more pronounced for later-budding species. Excluding large urban areas from the analysis showed an even more pronounced advance of budburst, confirming that the urban 'heat-island' effect is not the sole cause of earlier urban budburst. Similarly, the advance in budburst across all sites is too large to be explained by increases in temperature alone. This dramatic advance of budburst illustrates the need for further experimental investigation into the impact of artificial night-time lighting on plant phenology and subsequent species interactions. As light pollution is a growing global phenomenon, the findings of this study are likely to be applicable to a wide range of species interactions across the world. © 2016 The Authors.

Biological consequences of earlier snowmelt from desert dust deposition in alpine landscapes.

PubMed

Steltzer, Heidi; Landry, Chris; Painter, Thomas H; Anderson, Justin; Ayres, Edward

2009-07-14

Dust deposition to mountain snow cover, which has increased since the late 19(th) century, accelerates the rate of snowmelt by increasing the solar radiation absorbed by the snowpack. Snowmelt occurs earlier, but is decoupled from seasonal warming. Climate warming advances the timing of snowmelt and early season phenological events (e.g., the onset of greening and flowering); however, earlier snowmelt without warmer temperatures may have a different effect on phenology. Here, we report the results of a set of snowmelt manipulations in which radiation-absorbing fabric and the addition and removal of dust from the surface of the snowpack advanced or delayed snowmelt in the alpine tundra. These changes in the timing of snowmelt were superimposed on a system where the timing of snowmelt varies with topography and has been affected by increased dust loading. At the community level, phenology exhibited a threshold response to the timing of snowmelt. Greening and flowering were delayed before seasonal warming, after which there was a linear relationship between the date of snowmelt and the timing of phenological events. Consequently, the effects of earlier snowmelt on phenology differed in relation to topography, which resulted in increasing synchronicity in phenology across the alpine landscape with increasingly earlier snowmelt. The consequences of earlier snowmelt from increased dust deposition differ from climate warming and include delayed phenology, leading to synchronized growth and flowering across the landscape and the opportunity for altered species interactions, landscape-scale gene flow via pollination, and nutrient cycling.

Reducing Older Driver Motor Vehicle Collisions via Earlier Cataract Surgery

PubMed Central

Mennemeyer, Stephen T.; Owsley, Cynthia; McGwin, Gerald

2013-01-01

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual’s complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call “Current Practice” (CP) and “Earlier Surgery” (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost – all MVC costs plus cataract surgery expenditures -- is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60 to 64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences. PMID:23369786

Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion.

PubMed

Lawrence, David Wyndham; Richards, Doug; Comper, Paul; Hutchison, Michael G

2018-01-01

To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work. A total of 253 acute concussions [median (IQR) age, 17.0 (15.0-20.0) years; 148 (58.5%) males] were included in this study. Multivariate Cox regression models identified that earlier time to aerobic exercise was associated with faster return to sport and school/work adjusting for other covariates, including quintile propensity strata. For each successive day in delay to initiation of aerobic exercise, individuals had a less favourable recovery trajectory. Initiating aerobic exercise at 3 and 7 days following injury was associated with a respective 36.5% (HR, 0.63; 95% CI, 0.53-0.76) and 73.2% (HR, 0.27; 95% CI, 0.16-0.45) reduced probability of faster full return to sport compared to within 1 day; and a respective 45.9% (HR, 0.54; 95% CI, 0.44-0.66) and 83.1% (HR, 0.17; 95% CI, 0.10-0.30) reduced probability of faster full return to school/work. Additionally, concussion history, symptom severity, LOC deleteriously influenced concussion recovery. Earlier initiation of aerobic exercise was associated with faster full return to sport and school or work. This study provides greater insight into the benefits and safety of aerobic exercise within the first week of the injury.

Spatial and Temporal Variation in Primary Productivity (NDVI) of Coastal Alaskan Tundra: Decreased Vegetation Growth Following Earlier Snowmelt

NASA Technical Reports Server (NTRS)

Gamon, John A.; Huemmrich, K. Fred; Stone, Robert S.; Tweedie, Craig E.

2015-01-01

In the Arctic, earlier snowmelt and longer growing seasons due to warming have been hypothesized to increase vegetation productivity. Using the Normalized Difference Vegetation Index (NDVI) from both field and satellite measurements as an indicator of vegetation phenology and productivity, we monitored spatial and temporal patterns of vegetation growth for a coastal wet sedge tundra site near Barrow, Alaska over three growing seasons (2000-2002). Contrary to expectation, earlier snowmelt did not lead to increased productivity. Instead, productivity was associated primarily with precipitation and soil moisture, and secondarily with growing degree days, which, during this period, led to reduced growth in years with earlier snowmelt. Additional moisture effects on productivity and species distribution, operating over a longer time scale, were evident in spatial NDVI patterns associated with microtopography. Lower, wetter regions dominated by graminoids were more productive than higher, drier locations having a higher percentage of lichens and mosses, despite the earlier snowmelt at the more elevated sites. These results call into question the oft-stated hypothesis that earlier arctic growing seasons will lead to greater vegetation productivity. Rather, they agree with an emerging body of evidence from recent field studies indicating that early-season, local environmental conditions, notably moisture and temperature, are primary factors determining arctic vegetation productivity. For this coastal arctic site, early growing season conditions are strongly influenced by microtopography, hydrology, and regional sea ice dynamics, and may not be easily predicted from snowmelt date or seasonal average air temperatures alone. Our comparison of field to satellite NDVI also highlights the value of in-situ monitoring of actual vegetation responses using field optical sampling to obtain detailed information on surface conditions not possible from satellite observations alone.

Retrospective study of reasons for improved survival in patients with breast cancer in east Anglia: earlier diagnosis or better treatment.

PubMed Central

Stockton, D.; Davies, T.; Day, N.; McCann, J.

1997-01-01

OBJECTIVES: To investigate the recent fall in mortality from breast cancer in England and Wales, and to determine the relative contributions of improvements in treatment and earlier detection of tumours. DESIGN: Retrospective study of all women with breast cancer registered by the East Anglian cancer registry and diagnosed between 1982 and 1989. SUBJECTS: 3965 patients diagnosed 1982-5 compared with 4665 patients diagnosed 1986-9, in three age groups 0-49, 50-64, > or = 65 years, with information on stage at diagnosis and survival. MAIN OUTCOME MEASURES: Three year relative survival rates by time period, age group, and stage; relative hazard ratios for each time period and age group derived from Cox's proportional hazards model, adjusted for single year of age and stage. RESULTS: Survival improved in the later time period, although there was little stage specific improvement. The proportion of early stage tumours increased especially in the 50-64 year age group, and adjustment for stage accounted for over half of the improvement in survival in women aged under 65 years. CONCLUSION: Over half of the drop in mortality in women aged under 65 years seems to be attributable to earlier detection of tumours, which has been observed since the mid-1980s. This could have resulted from an increase in breast awareness predating the start of the breast screening programme. PMID:9056796

Does Speech Emerge from Earlier Appearing Oral Motor Behaviors?.

ERIC Educational Resources Information Center

Moore, Christopher A.; Ruark, Jacki L.

1996-01-01

This study of the oral motor behaviors of seven toddlers (age 15 months) may be interpreted to indicate that: (1) mandibular coordination follows a developmental continuum from earlier emerging behaviors, such as chewing and sucking, through babbling, to speech, or (2) unique task demands give rise to distinct mandibular coordinative constraints…

Paraganglioma presenting as cholesterol granuloma of the petrous apex.

PubMed

Heman-Ackah, Selena E; Huang, Tina C

2013-09-01

We report the unique finding of a petrous apex cholesterol granuloma associated with a paraganglioma, also known as a glomus jugulare tumor, in a 52-year-old woman who presented to our department with pulsatile tinnitus, hearing loss, aural fullness, and disequilibrium. She had been treated for a petrous apex cholesterol granuloma 20 years earlier, at which time she had undergone drainage of the granuloma via subtotal petrous apicectomy. When she came to our facility approximately 20 years later, she had signs and symptoms consistent with a jugular paraganglioma, which was likely to have been present at the time of her initial presentation for the cholesterol granuloma. In fact, microscopic bleeding from the paraganglioma might have led to the formation of the cholesterol granuloma. The metachronous presentation of these two entities, which to our knowledge has not been reported previously in the literature, indicates the potential association of paragangliomas with the formation of cholesterol granulomas of the petrous apex.

Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion

PubMed Central

Richards, Doug; Comper, Paul; Hutchison, Michael G.

2018-01-01

Objective To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. Methods A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work. Results A total of 253 acute concussions [median (IQR) age, 17.0 (15.0–20.0) years; 148 (58.5%) males] were included in this study. Multivariate Cox regression models identified that earlier time to aerobic exercise was associated with faster return to sport and school/work adjusting for other covariates, including quintile propensity strata. For each successive day in delay to initiation of aerobic exercise, individuals had a less favourable recovery trajectory. Initiating aerobic exercise at 3 and 7 days following injury was associated with a respective 36.5% (HR, 0.63; 95% CI, 0.53–0.76) and 73.2% (HR, 0.27; 95% CI, 0.16–0.45) reduced probability of faster full return to sport compared to within 1 day; and a respective 45.9% (HR, 0.54; 95% CI, 0.44–0.66) and 83.1% (HR, 0.17; 95% CI, 0.10–0.30) reduced probability of faster full return to school/work. Additionally, concussion history, symptom severity, LOC deleteriously influenced concussion recovery. Conclusion Earlier initiation of aerobic exercise was associated with faster full return to sport and school or work. This study provides greater insight into the benefits and safety of aerobic exercise within the first week of the injury. PMID:29668716

Later endogenous circadian temperature nadir relative to an earlier wake time in older people

NASA Technical Reports Server (NTRS)

Duffy, J. F.; Dijk, D. J.; Klerman, E. B.; Czeisler, C. A.

1998-01-01

The contribution of the circadian timing system to the age-related advance of sleep-wake timing was investigated in two experiments. In a constant routine protocol, we found that the average wake time and endogenous circadian phase of 44 older subjects were earlier than that of 101 young men. However, the earlier circadian phase of the older subjects actually occurred later relative to their habitual wake time than it did in young men. These results indicate that an age-related advance of circadian phase cannot fully account for the high prevalence of early morning awakening in healthy older people. In a second study, 13 older subjects and 10 young men were scheduled to a 28-h day, such that they were scheduled to sleep at many circadian phases. Self-reported awakening from scheduled sleep episodes and cognitive throughput during the second half of the wake episode varied markedly as a function of circadian phase in both groups. The rising phase of both rhythms was advanced in the older subjects, suggesting an age-related change in the circadian regulation of sleep-wake propensity. We hypothesize that under entrained conditions, these age-related changes in the relationship between circadian phase and wake time are likely associated with self-selected light exposure at an earlier circadian phase. This earlier exposure to light could account for the earlier clock hour to which the endogenous circadian pacemaker is entrained in older people and thereby further increase their propensity to awaken at an even earlier time.

Cost-Effectiveness of Earlier Initiation of Antiretroviral Therapy for Uninsured HIV-Infected Adults

PubMed Central

Schackman, Bruce R.; Goldie, Sue J.; Weinstein, Milton C.; Losina, Elena; Zhang, Hong; Freedberg, Kenneth A.

2001-01-01

Objectives. This study was designed to examine the societal cost-effectiveness and the impact on government payers of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults. Methods. A state-transition simulation model of HIV disease was used. Data were derived from the Multicenter AIDS Cohort Study, published randomized trials, and medical care cost estimates for all government payers and for Massachusetts, New York, and Florida. Results. Quality-adjusted life expectancy increased from 7.64 years with therapy initiated at 200 CD4 cells/μL to 8.21 years with therapy initiated at 500 CD4 cells/μL. Initiating therapy at 500 CD4/μL was a more efficient use of resources than initiating therapy at 200 CD4/μL and had an incremental cost-effectiveness ratio of $17 300 per quality-adjusted life-year gained, compared with no therapy. Costs to state payers in the first 5 years ranged from $5500 to $24 900 because of differences among the states in the availability of federal funds for AIDS drug assistance programs. Conclusions. Antiretroviral therapy initiated at 500 CD4 cells/μL is cost-effective from a societal perspective compared with therapy initiated later. States should consider Medicaid waivers to expand access to early therapy. PMID:11527782

Perceptual sensitivity to spectral properties of earlier sounds during speech categorization.

PubMed

Stilp, Christian E; Assgari, Ashley A

2018-02-28

Speech perception is heavily influenced by surrounding sounds. When spectral properties differ between earlier (context) and later (target) sounds, this can produce spectral contrast effects (SCEs) that bias perception of later sounds. For example, when context sounds have more energy in low-F 1 frequency regions, listeners report more high-F 1 responses to a target vowel, and vice versa. SCEs have been reported using various approaches for a wide range of stimuli, but most often, large spectral peaks were added to the context to bias speech categorization. This obscures the lower limit of perceptual sensitivity to spectral properties of earlier sounds, i.e., when SCEs begin to bias speech categorization. Listeners categorized vowels (/ɪ/-/ɛ/, Experiment 1) or consonants (/d/-/g/, Experiment 2) following a context sentence with little spectral amplification (+1 to +4 dB) in frequency regions known to produce SCEs. In both experiments, +3 and +4 dB amplification in key frequency regions of the context produced SCEs, but lesser amplification was insufficient to bias performance. This establishes a lower limit of perceptual sensitivity where spectral differences across sounds can bias subsequent speech categorization. These results are consistent with proposed adaptation-based mechanisms that potentially underlie SCEs in auditory perception. Recent sounds can change what speech sounds we hear later. This can occur when the average frequency composition of earlier sounds differs from that of later sounds, biasing how they are perceived. These "spectral contrast effects" are widely observed when sounds' frequency compositions differ substantially. We reveal the lower limit of these effects, as +3 dB amplification of key frequency regions in earlier sounds was enough to bias categorization of the following vowel or consonant sound. Speech categorization being biased by very small spectral differences across sounds suggests that spectral contrast effects occur

Smoking is associated with earlier time to revision of total knee arthroplasty.

PubMed

Lim, Chin Tat; Goodman, Stuart B; Huddleston, James I; Harris, Alex H S; Bhowmick, Subhrojyoti; Maloney, William J; Amanatullah, Derek F

2017-10-01

Smoking is associated with early postoperative complications, increased length of hospital stay, and an increased risk of revision after total knee arthroplasty (TKA). However, the effect of smoking on time to revision TKA is unknown. A total of 619 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to the patient smoking status. Smoking status was then analyzed for associations with time to revision TKA using a Chi square test. The association was also analyzed according to the indication for revision TKA. Smokers (37/41, 90%) have an increased risk of earlier revision for any reason compared to non-smokers (274/357, 77%, p=0.031). Smokers (37/41, 90%) have an increased risk of earlier revision for any reason compared to ex-smokers (168/221, 76%, p=0.028). Subgroup analysis did not reveal a difference in indication for revision TKA (p>0.05). Smokers are at increased risk of earlier revision TKA when compared to non-smokers and ex-smokers. The risk for ex-smokers was similar to that of non-smokers. Smoking appears to have an all-or-none effect on earlier revision TKA as patients who smoked more did not have higher risk of early revision TKA. These results highlight the need for clinicians to urge patients not to begin smoking and encourage smokers to quit smoking prior to primary TKA. Copyright © 2017 Elsevier B.V. All rights reserved.

Worsening of symptoms before presentation with vasovagal syncope.

PubMed

Sheldon, Robert S; Sheldon, Aaron G; Serletis, Anna; Connolly, Stuart J; Morillo, Carlos A; Klingenheben, Thomas; Krahn, Andrew D; Koshman, Mary-Lou; Ritchie, Debbie

2007-09-01

Much of the natural history of vasovagal syncope is unknown. We determined whether patients presenting for care have had a recently worsened syncope frequency. We compared 208 subjects in the referral-based Prevention of Syncope Trial (POST) and 122 subjects who fainted > or =1 in a community survey study. Their mean ages and gender proportions were similar. The POST population had a higher median lifetime syncope frequency (1.16 vs 0.12 spells/year, P < 0.0001) and more subjects began fainting at age > or =35 years (26% vs 6%, P < 0.0001). In POST, the median frequency of syncopal spells in the preceding year was higher than in all previous years (3 vs 0.57, P < 0.0001). POST subjects presented sooner after their first spell (median 11.0 vs 16.8 years, P = 0.0002), and after their last spell (median 0.3 vs 7.4 years, P < 0.0001). POST subjects > or =35 years old had a shorter history than similar community-survey subjects (2.8 vs 14.9 y, P < 0.0001) and presented earlier after their first syncopal spell than POST subjects with a younger onset of syncope (median 2.8 vs 14.7 y, P < 0.0001), despite having fewer faints (median 6 vs 10, P = 0.0002). Many syncope patients present for care after a recent worsening of their frequency of syncope.

View northeast, wharf A, portion AA, details showing earlier piers ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View northeast, wharf A, portion AA, details showing earlier piers and braces sloping toward water, reused charred plates for existing decking - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Number of Diverticulitis Episodes Before Resection and Factors Associated With Earlier Interventions

PubMed Central

Simianu, Vlad V.; Fichera, Alessandro; Bastawrous, Amir L.; Davidson, Giana H.; Florence, Michael G.; Thirlby, Richard C.; Flum, David R.

2016-01-01

IMPORTANCE Despite professional recommendations to delay elective colon resection for patients with uncomplicated diverticulitis, early surgery (after <3 preceding episodes) appears to be common. Several factors have been suggested to contribute to early surgery, including increasing numbers of younger patients, a lower threshold to operate laparoscopically, and growing recognition of “smoldering” (or nonrecovering) diverticulitis episodes. However, the relevance of these factors in early surgery has not been well tested, and most prior studies have focused on hospitalizations, missing outpatient events and making it difficult to assess guideline adherence in earlier interventions. OBJECTIVE To describe patterns of episodes of diverticulitis before surgery and factors associated with earlier interventions using inpatient, outpatient, and antibiotic prescription claims. DESIGN, SETTING, AND PARTICIPANTS This investigation was a nationwide retrospective cohort study from January 1, 2009, to December 31, 2012. The dates of the analysis were July 2014 to May 2015. Participants were immunocompetent adult patients (age range, 18-64 years) with incident, uncomplicated diverticulitis. EXPOSURE Elective colectomy for diverticulitis. MAIN OUTCOMES AND MEASURES Inpatient, outpatient, and antibiotic prescription claims for diverticulitis captured in the MarketScan (Truven Health Analytics) databases. RESULTS Of 87 461 immunocompetent patients having at least 1 claim for diverticulitis, 6.4% (n = 5604) underwent a resection. The final study cohort comprised 3054 nonimmunocompromised patients who underwent elective resection for uncomplicated diverticulitis, of whom 55.6% (n = 1699) were male. Before elective surgery, they had a mean (SD) of 1.0 (0.9) inpatient claims, 1.5 (1.5) outpatient claims, and 0.5 (1.2) antibiotic prescription claims related to diverticulitis. Resection occurred after fewer than 3 episodes in 94.9% (2897 of 3054) of patients if counting inpatient

Assessment of risk factors for earlier onset of sporadic Alzheimer's disease dementia.

PubMed

de Oliveira, Fabricio Ferreira; Bertolucci, Paulo Henrique Ferreira; Chen, Elizabeth Suchi; Smith, Marilia Cardoso

2014-01-01

Pharmacological treatment has mild effects for patients with Alzheimer's disease dementia (AD); therefore, the search for modifiable risk factors is an important challenge. Though risk factors for AD are widely recognized, elements that influence the time of dementia onset have not been comprehensively reported. We aimed to investigate which risk factors might be related to the age of onset of AD in a sample of patients with highly variable educational levels, taking into account the Framingham risk scoring as the sole measure of vascular risk. We included 209 consecutive late-onset AD patients to find out which factors among educational levels, coronary heart disease risk estimated by way of Framingham risk scores, history of head trauma or depression, surgical procedures under general anesthesia, family history of neurodegenerative diseases, gender, marital status and APOE haplotypes might be related to the age of dementia onset in this sample of patients with low mean schooling. Mean age of AD onset was 73.38±6.5 years old, unaffected by schooling or family history of neurodegenerative diseases. Patients who were APOE-ε4 carriers, married, or with history of depression, had earlier onset of AD, particularly when they were women. Coronary heart disease risk was marginally significant for later onset of AD. APOE haplotypes, marital status and history of depression were the most important factors to influence the age of AD onset in this sample. While midlife cerebrovascular risk factors may increase incidence of AD, they may lead to later dementia onset when present in late life.

Comprehensive methods for earlier detection and monitoring of forest decline

Treesearch

Jennifer Pontius; Richard Hallett

2014-01-01

Forested ecosystems are threatened by invasive pests, pathogens, and unusual climatic events brought about by climate change. Earlier detection of incipient forest health problems and a quantitatively rigorous assessment method is increasingly important. Here, we describe a method that is adaptable across tree species and stress agents and practical for use in the...

Earlier Violent Television Exposure and Later Drug Dependence

PubMed Central

Brook, David W.; Katten, Naomi S.; Ning, Yuming; Brook, Judith S.

2013-01-01

This research examined the longitudinal pathways from earlier violent television exposure to later drug dependence. African American and Puerto Rican adolescents were interviewed during three points in time (N = 463). Violent television exposure in late adolescence predicted violent television exposure in young adulthood, which in turn was related to tobacco/marijuana use, nicotine dependence, and later drug dependence. Some policy and clinical implications suggest: a) regulating the times when violent television is broadcast; b) creating developmentally targeted prevention/treatment programs; and c) recognizing that watching violent television may serve as a cue regarding increased susceptibility to nicotine and drug dependence. PMID:18612881

The Psychological Effects of Unemployment and Unsatisfactory Employment on Young Adults: Findings from a 10-Year Longitudinal Study.

PubMed

Winefield, Anthony H; Delfabbro, Paul H; Winefield, Helen R; Duong, David; Malvaso, Catia

2017-01-01

The purpose of the present study was to extend the external validity of an earlier longitudinal study of school leavers by including participants from a representative sample of secondary schools. Questionnaires were administered annually to a sample of South Australian school leavers over a 10-year period. At Time 1 participants were in the last compulsory year of high school aged around 15 years and at Time 10 they were aged around 25 years. Results confirmed those from an earlier longitudinal study showing that the transition from school to satisfactory employment was associated with significant improvements in psychological well-being, whereas transition from school to unemployment or unsatisfactory employment showed no change in psychological well-being. The current findings extended the external validity of the earlier study because whereas participants in the earlier study were sampled from co-educational metropolitan public high schools, the current study included participants from every kind of high school: single sex as well as co-educational, rural as well as metropolitan, and private as well as public.

The association between cannabis use and earlier age at onset of schizophrenia and other psychoses: meta-analysis of possible confounding factors.

PubMed

Myles, Nicholas; Newall, Hannah; Nielssen, Olav; Large, Matthew

2012-01-01

A recent meta-analysis showed that the mean age of onset of psychosis among cannabis users was almost three years earlier than that of non-cannabis users. However, because cannabis users usually smoke tobacco, the use of tobacco might independently contribute to the earlier onset of psychosis. We aimed to use meta-analysis to compare the extent to which cannabis and tobacco use are each associated with an earlier age at onset of schizophrenia and other psychoses. We also examined other factors that might have contributed to the finding of an earlier age of onset among cannabis users, including the proportion of males in the samples, the diagnostic inclusion criteria and aspects of study quality. The electronic databases MEDLINE, EMBASE, PsycINFO and ISI Web of Science, were searched for English-language peer-reviewed publications that reported age at onset of schizophrenia and other psychoses separately for cannabis users and non-users, or for tobaccosmokers and non-smokers. Meta-analysis showed that the age at onset of psychosis for cannabis users was 32 months earlier than for cannabis non-users (SMD=- 0.399, 95%CI -0.493 - -0.306, z=-8.34, p < 0.001), and was two weeks later in tobacco smokers compared with non-smokers (SMD=0.002, 95%CI -0.094 - 0.097, z=0.03, p=0.974). The main results were not affected by subgroup analyses examining studies of a single sex, the methods for making psychiatric diagnoses and measures of study quality. The results suggest that the association between cannabis use and earlier onset of psychosis is robust and is not the result either of tobacco smoking by cannabis using patients or the other potentially confounding factors we examined. This supports the hypothesis that, in some patients, cannabis use plays a causal role in the development of schizophrenia and raises the possibility of treating schizophrenia with new pharmacological treatments that have an affinity for endo-cannabinoid receptors.

M-Mode Ultrasound Reveals Earlier Gluteus Minimus Activity in Individuals With Chronic Hip Pain During a Step-down Task.

PubMed

Dieterich, Angela V; Deshon, Louise; Strauss, Geoffrey R; McKay, Jan; Pickard, Christine M

2016-04-01

Controlled laboratory study. The hip abductor muscles are important hip joint stabilizers. Hip joint pain may alter muscle recruitment. Motion-mode (M-mode) ultrasound enables noninvasive measurements of the onset of deep and superficial muscle motion, which is associated with activation onset. To compare (1) the onset of superficial and deep gluteus medius and gluteus minimus muscle motion relative to the instant of peak ground reaction force and (2) the level of swing-phase muscle motion during step-down between subjects with chronic hip pain and controls using M-mode ultrasound. Thirty-five subjects with anterior, nontraumatic hip pain for more than 6 months (mean ± SD age, 54 ± 9 years) and 35 controls (age, 57 ± 7 years) were scanned on the lateral hip of the leading leg during frontal step-down onto a force platform using M-mode ultrasound. Computerized motion detection with the Teager-Kaiser energy operator was applied on the gluteus minimus and the deep and superficial gluteus medius to determine the time lag between muscle motion onset and instant of peak ground reaction force and the level of gluteus minimus motion during the swing phase. Time lags and motion levels were averaged per subject, and t tests were used to determine between-group differences. In participants with hip pain, gluteus minimus motion onset was 103 milliseconds earlier (P = .002) and superficial gluteus medius motion was 70 milliseconds earlier (P = .047) than those in healthy control participants. The level of gluteus minimus swing-phase motion was higher with pain (P = .006). Increased gluteus minimus motion during the swing phase and earlier gluteus minimus and superficial gluteus medius motion in individuals with hip pain suggest an overall increase of muscle activity, possibly a protective behavior.

Economic Costs Avoided by Diagnosing Melanoma Six Months Earlier Justify >100 Benign Biopsies.

PubMed

Aires, Daniel J; Wick, Jo; Shaath, Tarek S; Rajpara, Anand N; Patel, Vikas; Badawi, Ahmed H; Li, Cicy; Fraga, Garth R; Doolittle, Gary; Liu, Deede Y

2016-05-01

New melanoma drugs bring enormous benefits but do so at significant costs. Because melanoma grows deeper and deadlier over time, deeper lesions are costlier due to increased sentinel lymph node biopsy, chemotherapy, and disease-associated income loss. Prior studies have justified pigmented lesion biopsies on a "value per life" basis; by contrast we sought to assess how many biopsies are justified per melanoma found on a purely economic basis. We modeled how melanomas in the United States would behave if diagnosis were delayed by 6 months, eg, not biopsied, only observed until the next surveillance visit. Economic loss from delayed biopsy is the obverse of economic benefit of performing biopsy earlier. Growth rates were based on Liu et al. The results of this study can be applied to all patients presenting to dermatologists with pigmented skin lesions suspicious for melanoma. In-situ melanomas were excluded because no studies to date have modeled growth rates analogous to those for invasive melanoma. We assume conservatively that all melanomas not biopsied initially will be biopsied and treated 6 months later. Major modeled costs are (1) increased sentinel lymph node biopsy, (2) increased chemotherapy for metastatic lesions using increased 5-yr death as metastasis marker, and (3) income loss per melanoma death at $413,370 as previously published. Costs avoided by diagnosing melanoma earlier justify 170 biopsies per melanoma found. Efforts to penalize "unnecessary" biopsies may be economically counterproductive.

J Drugs Dermatol. 2016;15(5):527-532.

Earlier vegetation green-up has reduced spring dust storms

PubMed Central

Fan, Bihang; Guo, Li; Li, Ning; Chen, Jin; Lin, Henry; Zhang, Xiaoyang; Shen, Miaogen; Rao, Yuhan; Wang, Cong; Ma, Lei

2014-01-01

The observed decline of spring dust storms in Northeast Asia since the 1950s has been attributed to surface wind stilling. However, spring vegetation growth could also restrain dust storms through accumulating aboveground biomass and increasing surface roughness. To investigate the impacts of vegetation spring growth on dust storms, we examine the relationships between recorded spring dust storm outbreaks and satellite-derived vegetation green-up date in Inner Mongolia, Northern China from 1982 to 2008. We find a significant dampening effect of advanced vegetation growth on spring dust storms (r = 0.49, p = 0.01), with a one-day earlier green-up date corresponding to a decrease in annual spring dust storm outbreaks by 3%. Moreover, the higher correlation (r = 0.55, p < 0.01) between green-up date and dust storm outbreak ratio (the ratio of dust storm outbreaks to times of strong wind events) indicates that such effect is independent of changes in surface wind. Spatially, a negative correlation is detected between areas with advanced green-up dates and regional annual spring dust storms (r = −0.49, p = 0.01). This new insight is valuable for understanding dust storms dynamics under the changing climate. Our findings suggest that dust storms in Inner Mongolia will be further mitigated by the projected earlier vegetation green-up in the warming world. PMID:25343265

Earlier vegetation green-up has reduced spring dust storms.

PubMed

Fan, Bihang; Guo, Li; Li, Ning; Chen, Jin; Lin, Henry; Zhang, Xiaoyang; Shen, Miaogen; Rao, Yuhan; Wang, Cong; Ma, Lei

2014-10-24

The observed decline of spring dust storms in Northeast Asia since the 1950s has been attributed to surface wind stilling. However, spring vegetation growth could also restrain dust storms through accumulating aboveground biomass and increasing surface roughness. To investigate the impacts of vegetation spring growth on dust storms, we examine the relationships between recorded spring dust storm outbreaks and satellite-derived vegetation green-up date in Inner Mongolia, Northern China from 1982 to 2008. We find a significant dampening effect of advanced vegetation growth on spring dust storms (r = 0.49, p = 0.01), with a one-day earlier green-up date corresponding to a decrease in annual spring dust storm outbreaks by 3%. Moreover, the higher correlation (r = 0.55, p < 0.01) between green-up date and dust storm outbreak ratio (the ratio of dust storm outbreaks to times of strong wind events) indicates that such effect is independent of changes in surface wind. Spatially, a negative correlation is detected between areas with advanced green-up dates and regional annual spring dust storms (r = -0.49, p = 0.01). This new insight is valuable for understanding dust storms dynamics under the changing climate. Our findings suggest that dust storms in Inner Mongolia will be further mitigated by the projected earlier vegetation green-up in the warming world.

Type IV-a choledochal cyst--a rare adolescent presentation as acute abdomen.

PubMed

Satya, Ramadass; Vijayakumar, Vani

2006-10-01

A 17-year-old adolescent girl from El Salvador presented to the emergency room (ER) with severe abdominal pain associated with one episode of nausea and vomiting. The pain that started 5 days earlier was sharp in nature and epigastric in location with radiation to back and was relieved by half a tablet of Vicodin. The patient has a history of intermittent epigastric pain for the past 2 years and was treated for Helicobacter pylori for 1 year. In the ER, the serum chemistry demonstrated elevated amylase. Further workup with abdominal ultrasonography (US), computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary scintigraphy confirmed a type IV-a choledochal cyst with intra- and extrahepatic dilation of bile ducts. We report an unusual acute abdomen presentation of type IV-a choledochal cyst in a 17-year-old young adult from El Salvador.

Design of Value-Added Models for IMPACT and TEAM in DC Public Schools, 2010-2011 School Year. Final Report

ERIC Educational Resources Information Center

Isenberg, Eric; Hock, Heinrich

2011-01-01

This report presents the value-added models that will be used to measure school and teacher effectiveness in the District of Columbia Public Schools (DCPS) in the 2010-2011 school year. It updates the earlier technical report, "Measuring Value Added for IMPACT and TEAM in DC Public Schools." The earlier report described the methods used…

Effects of earlier sea ice breakup on survival and population size of polar bears in western Hudson Bay

USGS Publications Warehouse

Regehr, E.V.; Lunn, N.J.; Amstrup, Steven C.; Stirling, I.

2007-01-01

Some of the most pronounced ecological responses to climatic warming are expected to occur in polar marine regions, where temperature increases have been the greatest and sea ice provides a sensitive mechanism by which climatic conditions affect sympagic (i.e., with ice) species. Population-level effects of climatic change, however, remain difficult to quantify. We used a flexible extension of Cormack-Jolly-Seber capture-recapture models to estimate population size and survival for polar bears (Ursus maritimus), one of the most ice-dependent of Arctic marine mammals. We analyzed data for polar bears captured from 1984 to 2004 along the western coast of Hudson Bay and in the community of Churchill, Manitoba, Canada. The Western Hudson Bay polar bear population declined from 1,194 (95% CI = 1,020-1,368) in 1987 to 935 (95% CI = 794-1,076) in 2004. Total apparent survival of prime-adult polar bears (5-19 yr) was stable for females (0.93; 95% CI = 0.91-0.94) and males (0.90; 95% CI = 0.88-0.91). Survival of juvenile, subadult, and senescent-adult polar bears was correlated with spring sea ice breakup date, which was variable among years and occurred approximately 3 weeks earlier in 2004 than in 1984. We propose that this correlation provides evidence for a causal association between earlier sea ice breakup (due to climatic warming) and decreased polar bear survival. It may also explain why Churchill, like other communities along the western coast of Hudson Bay, has experienced an increase in human-polar bear interactions in recent years. Earlier sea ice breakup may have resulted in a larger number of nutritionally stressed polar bears, which are encroaching on human habitations in search of supplemental food. Because western Hudson Bay is near the southern limit of the species' range, our findings may foreshadow the demographic responses and management challenges that more northerly polar bear populations will experience if climatic warming in the Arctic continues as

Suprasellar ganglioglioma presenting with diabetes insipidus in a young boy: a rare clinical presentation.

PubMed

Gupta, Ruchika; Suri, Vaishali; Arora, Raman; Sharma, Mehar C; Mishra, Shashwat; Singh, Manmohan; Sarkar, Chitra

2010-02-01

Gangliogliomas are rare tumors composed of an admixture of glial and neuronal components. These usually occur in young patients, who present with therapy-resistant seizures. Clinical presentation of ganglioglioma with diabetes insipidus is extremely rare with only one case reported earlier in the available literature. Due to this rarity, ganglioglioma is not considered in the differential diagnosis in a patient with diabetes insipidus. A 7-year boy presented with polyuria, polydipsia, and progressive visual loss for 18 months. Investigations revealed diabetes insipidus. Radiographic studies of the brain showed a solid and cystic mass in the suprasellar region effacing the third ventricle. Intraoperatively, diffuse thickening of bilateral optic nerves and optic chiasma was noted and a diagnosis of optic glioma was considered. A biopsy of the mass was taken, which on histopathological examination showed features of ganglioglioma. The patient was referred for further radiotherapy but was lost to follow-up. Diabetes insipidus as a presenting symptom of ganglioglioma is extremely rare. This benign tumor should be kept in mind in patients with central diabetes insipidus and a suprasellar mass lesion. This report describes the second such case in the literature.

Giant-Magnetoresistance(GMR) Siegel KEY FIRST Experimental Discovery Decade-Earlier PRE-``Fert"-``Gruenberg" in Nuc"el"ar ``Super"alloys: Science?;``SEANCE!!!; Ethics?; SHMETHICS!!!

NASA Astrophysics Data System (ADS)

Hoffman, R.; Siegel, E.

2010-03-01

(So MIScalled) ``Fert"-``Grunberg"[PRL(1988;1989)] GMR 2007 physics Nobel/Wolf/Japan-Prizes VS. decade-earlier(1973-1977) KEY FIRST Siegel at:Westin"kl"ouse/PSEG/IAEA/ABB[google:``Martin Ebner"(94-04) in financial media]/Vattenfall/Wallenbergs/nuc"el"ar-DoE Labs[at flickr.com, search on ``Giant- Magnotoresistance''; find: Intl.Conf.Mag.Alloys & Oxides(ICMAO), Haifa(Aug./1977); J.Mag.Mag.Mtls,(JMMM)7,312(1978)``unavailable: not yet scanned''/modified(last R(H) GMR Figs(7;8) deleted!!!) on JMMM/Reed-Elsevier website until 7/29/08 conveniently one- half-year after last (Nobel)award(12/2007); conveniently effectively deleted!!!; google: ``If Leaks Could Kill''; many APS/MRS Mtgs(1970s)<<<1988/1989] decade-earlier GMR: (1978)<<< (1988); 1988-1978 =10 years = one full decadeprecedence!!!] first experimental discovery in (so MIScalled) ``super''alloys [182/82, Hastelloy-X, 600, 690(!!!), Stainless-Steels: ANY/ALL!!!] generic endemic Wigner's[JAP,17,857(1946)]- disease/Ostwald-ripening/spinodal-decomposition/overageing- embrittlement/ thermo-mechanical-INstability!

Earlier Vegetation Activity Onset Enhances Springtime Water-use Efficiency in Temperate and Boreal Ecosystems

NASA Astrophysics Data System (ADS)

Jin, J.; Wang, Y.

2017-12-01

Ecosystem-scale water-use efficiency (EWUE), defined as the ratio of gross primary productivity (GPP) to evapotranspiration (ET), is an important indicator for understanding how water couples with the carbon cycle under global change. Relationships between EWUE and abiotic environmental factors (e.g. climatic factors, atmospheric CO2concentration and nitrogen deposition) have been widely investigated, but the variations in EWUE in response to biotic controls remain little understood. Here, we argue that phenology plays an important role in the regulation of EWUE by analyzing springtime EWUE responses to variability of the GPP-based vegetation activity onset (VAO) in temperate and boreal ecosystems using both satellite and flux-tower observations. Based on MODIS productions during 2000-2014, we found that spring EWUE widely significantly increased with the earlier VAO mainly in the mid- and high latitudes (over 50°N), southwestern China and mid-western North America. When AVO advanced a 10-day, the spring EWUE would increase on average by 0.17±0.09 g C kg-1 H2O in temperate and continental climates after removing the effect of environmental factors. The main response patterns of EWUE to phenology suggest that an increase in spring EWUE with an earlier VAO are mainly because the increase in GPP is relatively larger in magnitude compared to that of ET, or due to an increase in GPP accompanied by a decrease in ET, resulting from an advanced VAO. The credibility of the results is also supported by the local-scale observations. By analyzing 66 site-years of flux and meteorological data obtained from 8 temperate deciduous broadleaf forest sites across North America and Europe, spring EWUE increased 0.42±0.08 g C kg-1 H2O with a 10-day advance of VAO across all sites after controlling for environmental factors, mainly because an earlier VAO could lead to a steeper increase in GPP than in ET. Our results and conclusions highlight that phenological factors cannot be

Relief Presentation on US National Park Service Maps

NASA Astrophysics Data System (ADS)

Patterson, Tom

2018-05-01

This paper examines the evolution of relief presentations on maps developed by Harpers Ferry Center, the media service center of the US National Park Service (NPS). Harpers Ferry Center produces the maps used by park visitors. I will discuss five park maps, each with a distinctive relief style and mode of production. They appear in rough chronological order of their development. Recent relief presentations are generally more detailed, colorful, and realistic than those from earlier years. Changing technology is largely responsible for the different relief styles found on park maps. Some relief treatments today were not possible, or imaginable, in 1977 when the NPS established the brochure program in its modern phase. Landscape heterogeneity is another factor behind the development of different relief styles. With over 400 park sites ranging from the glacial mountains of Alaska to the rolling piedmont of Virginia, a one-style-fits-all approach cannot adequately depict all landscapes. NPS maps serve some 300 million park visitors each year. Our ongoing effort to make understandable maps for this diverse audience has further spurred experiments in relief presentation.

Progress in the second year of patients with quiescent pulmonary tuberculosis after a year of domiciliary chemotherapy, and influence of further chemotherapy on the relapse rate*

PubMed Central

Velu, S.; Andrews, R. H.; Angel, J. H.; Devadatta, S.; Fox, Wallace; Gangadharam, P. R. J.; Narayana, A. S. L.; Ramakrishnan, C. V.; Selkon, J. B.; Somasundaram, P. R.

1961-01-01

This study from the Tuberculosis Chemotherapy Centre, Madras, summarizes the progress during the second year of those patients in a 1-year comparison of four domiciliary chemotherapeutic regimens (isoniazid plus PAS and three regimens of isoniazid alone) whose pulmonary tuberculosis had attained bacteriological quiescence at the end of the year of chemotherapy. During the second year, about half of the patients received further chemotherapy, with isoniazid alone, and the remainder received a placebo, calcium gluconate. The main objects of the study were to determine the influence on the progress during the second year of (a) a second year of chemotherapy with isoniazid alone, (b) residual cavitation at the end of the first year, and (c) the chemotherapeutic regimen received during the first year, and to compare the results with those obtained in an earlier study by the Centre of the progress during the second year of patients with quiescent pulmonary tuberculosis after a year's chemotherapy with isoniazid plus PAS at home or in sanatorium. The results of the present study, which was planned on the same lines as the earlier one, showed that relapse in the second year was unrelated to the chemotherapeutic regimen received in the first year, and it was therefore permissible to amalgamate the findings in the two studies. The amalgamated results showed that the relapse rate in the second year was low (5.9%) and that a second year of treatment with isoniazid alone was of definite value for the patients with no residual cavitation at the end of the first year, but had no effect on the relapse rate of those with residual cavitation. The combined data from the two studies have thus clarified the position with regard to the effectiveness of isoniazid in preventing bacteriological relapse in patients without residual cavitation, slight evidence of which was apparent in the earlier study. PMID:13925282

Unusual presentation of calcaneal osteomyelitis. Twenty-five years after inoculation.

PubMed

Rogoff, R S; Tinkle, J D; Bartis, D G

1997-03-01

An unusual presentation of calcaneal osteomyelitis is described, where-by the infection remained undiagnosed for 25 years. The 36-year-old patient recently sought medical treatment for a reported ankle sprain, but the pain was recalcitrant to conservative care. Further investigation yielded a history significant for stepping on a chicken bone as a child, which entered the inferior lateral heel. Magnetic resonance imaging revealed what plain radiographs did not: a well demarcated lytic lesion in the body of the calcaneus. Intraoperative findings were consistent with an abscess of chronic osteomyelitis. The treatment included incision and drainage, antibiotic beads, and a tricortical bone graft.

Quantifying the economic value and quality of life impact of earlier influenza vaccination.

PubMed

Lee, Bruce Y; Bartsch, Sarah M; Brown, Shawn T; Cooley, Philip; Wheaton, William D; Zimmerman, Richard K

2015-03-01

Influenza vaccination is administered throughout the influenza disease season, even as late as March. Given such timing, what is the value of vaccinating the population earlier than currently being practiced? We used real data on when individuals were vaccinated in Allegheny County, Pennsylvania, and the following 2 models to determine the value of vaccinating individuals earlier (by the end of September, October, and November): Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based model (ABM), and FluEcon, our influenza economic model that translates cases from the ABM to outcomes and costs [health care and lost productivity costs and quality-adjusted life-years (QALYs)]. We varied the reproductive number (R0) from 1.2 to 1.6. Applying the current timing of vaccinations averted 223,761 influenza cases, $16.3 million in direct health care costs, $50.0 million in productivity losses, and 804 in QALYs, compared with no vaccination (February peak, R0 1.2). When the population does not have preexisting immunity and the influenza season peaks in February (R0 1.2-1.6), moving individuals who currently received the vaccine after September to the end of September could avert an additional 9634-17,794 influenza cases, $0.6-$1.4 million in direct costs, $2.1-$4.0 million in productivity losses, and 35-64 QALYs. Moving the vaccination of just children to September (R0 1.2-1.6) averted 11,366-1660 influenza cases, $0.6-$0.03 million in direct costs, $2.3-$0.2 million in productivity losses, and 42-8 QALYs. Moving the season peak to December increased these benefits, whereas increasing preexisting immunity reduced these benefits. Even though many people are vaccinated well after September/October, they likely are still vaccinated early enough to provide substantial cost-savings.

Discharging patients earlier in the day: a concept worth evaluating.

PubMed

Kravet, Steven J; Levine, Rachel B; Rubin, Haya R; Wright, Scott M

2007-01-01

Patient discharges from the hospital often occur late in the day and are frequently clustered after 4 PM. When inpatients leave earlier in the day, quality is improved because new admissions awaiting beds are able to leave the emergency department sooner and emergency department waiting room backlog is reduced. Nursing staff, whose work patterns traditionally result in high activity of discharge and admission between 5 PM and 8 PM, benefit by spreading out their work across a longer part of the day. Discharging patients earlier in the day also has the potential to increase patient satisfaction. Despite multiple stakeholders in the discharge planning process, physicians play the most important role. Getting physician buy-in requires an ability to teach physicians about the concept of early-in-the-day discharges and their impact on the process. We defined a new physician-centered discharge planning process and introduced it to an internal medicine team with an identical control team as a comparison. Discharge time of day was analyzed for 1 month. Mean time of day of discharge was 13:39 for the intervention group versus 15:45 for the control group (P<.001). If reproduced successfully, this process could improve quality at an important transition point in patient care.

Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

PubMed

Ryan, Aisling M; Bermingham, Niamh; Harrington, Hugh J; Keohane, Catherine

2006-12-01

Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

A reversal of the shift towards earlier spring phenology in several Mediterranean reptiles and amphibians during the 1998-2013 warming slowdown.

PubMed

Prodon, Roger; Geniez, Philippe; Cheylan, Marc; Devers, Florence; Chuine, Isabelle; Besnard, Aurelien

2017-12-01

Herps, especially amphibians, are particularly susceptible to climate change, as temperature tightly controls many parameters of their biological cycle-above all, their phenology. The timing of herps' activity or migration period-in particular the dates of their first appearance in spring and first breeding-and the shift to earlier dates in response to warming since the last quarter of the 20 th century has often been described up to now as a nearly monotonic trend towards earlier phenological events. In this study, we used citizen science data opportunistically collected on reptiles and amphibians in the northern Mediterranean basin over a period of 32 years to explore temporal variations in herp phenology. For 17 common species, we measured shifts in the date of the species' first spring appearance-which may be the result of current changes in climate-and regressed the first appearance date against temperatures and precipitations. Our results confirmed the expected overall trend towards earlier first spring appearances from 1983 to 1997, and show that the first appearance date of both reptiles and amphibians fits well with the temperature in late winter. However, the trend towards earlier dates was stopped or even reversed in most species between 1998 and 2013. We interpret this reversal as a response to cooling related to the North Atlantic Oscillation (NAO) in the late winter and early spring. During the positive NAO episodes, for certain species only (mainly amphibians), the effect of a warm weather, which tends to advance the phenology, seems to be counterbalanced by the adverse effects of the relative dryness. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Online Instruction, E-Learning, and Student Satisfaction: A Three Year Study

ERIC Educational Resources Information Center

Cole, Michele T.; Shelley, Daniel J.; Swartz, Louis B.

2014-01-01

This article presents the results of a three-year study of graduate and undergraduate students' level of satisfaction with online instruction at one university. The study expands on earlier research into student satisfaction with e-learning. Researchers conducted a series of surveys over eight academic terms. Five hundred and fifty-three students…

Wide-band tracheids are present in almost all species of Cactaceae.

PubMed

Mauseth, James D

2004-02-01

Wide-band tracheids (WBTs) have been found in seedlings of most species of cacti that have fibrous wood in their adult bodies. Consequently, this cell type is now known to be present in almost all cacti. Earlier studies of adult plants revealed WBTs to be present only in cacti with globose or short, broad bodies, whereas all species with large columnar or long slender bodies had fibrous wood without WBTs. However, even these species produce WBTs during the first several months after germination. In species with fibrous wood in their adult bodies (species with large or slender bodies), seedlings undergo a phase transition in wood morphogenesis after a few months and stop producing the juvenile (WBT) wood and begin producing adult (fibrous) wood. If adult plants have an intermediate size, the phase transition is delayed and the plant produces WBT wood for several years. Species with globose bodies repress the phase transition completely and never switch to producing adult (fibrous) wood. Because WBTs are so widespread, they probably originated only once in Cactaceae, not multiple times as suggested earlier, or there may have been just a single origin in the Cactaceae/Portulacaceae clade.

Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers.

PubMed

Rothman, Emily F; Edwards, Erika M; Heeren, Timothy; Hingson, Ralph W

2008-08-01

Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States. In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank. Sixty-six percent of respondents reported >or=1 adverse childhood experiences, and 19% reported experiencing >or=4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at years of age (compared with at >or=21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol. Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be

Self-Competence Mediates Earlier and Later Anxiety in Adolescent Mothers: A 3-Year Longitudinal Perspective

ERIC Educational Resources Information Center

Schiefelbein, Virginia L.; Susman, Elizabeth J.; Dorn, Lorah D.

2005-01-01

Anxiety is prevalent in adolescents and may be particularly problematic in pregnant adolescents. The purpose of this structural equation modeling analysis was to test a biobehavioral model in which postpartum self-competence mediated pathways from anxiety and cortisol during pregnancy to anxiety 3 years later. Self-reports of anxiety and…

Colorectal cancer occurs earlier in those exposed to tobacco smoke: implications for screening

PubMed Central

Mahoney, Martin C.; Cummings, K. Michael; Michalek, Arthur M.; Reid, Mary E.; Moysich, Kirsten B.; Hyland, Andrew

2011-01-01

Background Colorectal cancer (CRC) is the third most common cancer in the USA. While various lifestyle factors have been shown to alter the risk for colorectal cancer, recommendations for the early detection of CRC are based only on age and family history. Methods This case-only study examined the age at diagnosis of colorectal cancer in subjects exposed to tobacco smoke. Subjects included all patients who attended RPCI between 1957 and 1997, diagnosed with colorectal cancer, and completed an epidemiologic questionnaire. Adjusted linear regression models were calculated for the various smoking exposures. Results Of the 3,540 cases of colorectal cancer, current smokers demonstrated the youngest age of CRC onset (never: 64.2 vs. current: 57.4, P < 0.001) compared to never smokers, followed by recent former smokers. Among never smokers, individuals with past second-hand smoke exposure were diagnosed at a significantly younger age compared to the unexposed. Conclusion This study found that individuals with heavy, long-term tobacco smoke exposure were significantly younger at the time of CRC diagnosis compared to lifelong never smokers. The implication of this finding is that screening for colorectal cancer, which is recommended to begin at age 50 years for persons at average risk should be initiated 5–10 years earlier for persons with a significant lifetime history of exposure to tobacco smoke. PMID:18264728

Cholesteatoma has a high prevalence in Turner syndrome, highlighting the need for earlier diagnosis and the potential benefits of otoscopy training for paediatricians.

PubMed

Lim, D B N; Gault, E J; Kubba, H; Morrissey, M S C; Wynne, D M; Donaldson, M D C

2014-07-01

Girls with Turner syndrome are prone to cholesteatoma, a serious suppurative middle ear disease. We aimed to confirm its high prevalence in Turner syndrome, identify risk factors and suggest possible strategies for earlier detection. We reviewed 179 girls with Turner syndrome between 1989 and 2012 to identify cases of cholesteatoma. Seven girls (3.9%) had cholesteatoma (index girls) and each was compared with three age-matched girls without cholesteatoma (comparison girls). All the index girls had either the 45,X or 45,X/46X,i(Xq) karyotypes. Nine ears were initially affected, with three recurrences in two girls. Median age at first cholesteatoma presentation was 11.9 years (range: 7.5-15.2), with otorrhoea for three (range: one to seven) months in all 12 affected ears. Index girls had a significantly higher proportion of previous recurrent acute (p = 0.007) and chronic otitis media (p = 0.008), chronic perforation (p = 0.038) aural polyps (p < 0.0001) and tympanic membrane retraction (p = 0.0001) than comparison girls. Cholesteatoma has a high prevalence in Turner syndrome. Risk factors include 45,X and 46,XiXq karyotypes; a history of chronic otitis media, tympanic membrane retraction and persistent otorrhoea; and older age. Earlier recognition of ear disease is needed and otoscopy training for paediatricians caring for Turner syndrome patients may be beneficial. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

An earlier age of breast cancer diagnosis related to more frequent use of antiperspirants/deodorants and underarm shaving.

PubMed

McGrath, K G

2003-12-01

Breast cancer incidence suggests a lifestyle cause. A lifestyle factor used near the breast is the application of antiperspirants/deodorants accompanied by axillary shaving. A previous study did not support a link with breast cancer. If these habits have a role in breast cancer development, women using antiperspirants/deodorants and shaving their underarms frequently would be expected to have an earlier age of diagnosis than those doing so less often. An earlier age of diagnosis would also be expected in those starting to use deodorants and shaving at an earlier age. This is the first study to investigate the intensity of underarm exposure in a cohort of breast cancer survivors. Four hundred and thirty-seven females diagnosed with breast cancer were surveyed. Once grouped by their frequency of underarm hygiene habits, the mean age of diagnosis was the primary end point. Secondary end points included the overall frequency of these habits, and potential usage group confounding variables were evaluated. All statistical tests were two-sided. Frequency and earlier onset of antiperspirant/deodorant usage with underarm shaving were associated with an earlier age of breast cancer diagnosis. Combined habits are likely for this earlier age of diagnosis. In conclusion, underarm shaving with antiperspirant/deodorant use may play a role in breast cancer. It is not clear which of these components are involved. Reviewed literature insinuates absorption of aluminium salts facilitated by dermal barrier disruption. Case-controlled investigations are needed before alternative underarm hygiene habits are suggested.

Atmospheric oxygenation three billion years ago.

PubMed

Crowe, Sean A; Døssing, Lasse N; Beukes, Nicolas J; Bau, Michael; Kruger, Stephanus J; Frei, Robert; Canfield, Donald E

2013-09-26

It is widely assumed that atmospheric oxygen concentrations remained persistently low (less than 10(-5) times present levels) for about the first 2 billion years of Earth's history. The first long-term oxygenation of the atmosphere is thought to have taken place around 2.3 billion years ago, during the Great Oxidation Event. Geochemical indications of transient atmospheric oxygenation, however, date back to 2.6-2.7 billion years ago. Here we examine the distribution of chromium isotopes and redox-sensitive metals in the approximately 3-billion-year-old Nsuze palaeosol and in the near-contemporaneous Ijzermyn iron formation from the Pongola Supergroup, South Africa. We find extensive mobilization of redox-sensitive elements through oxidative weathering. Furthermore, using our data we compute a best minimum estimate for atmospheric oxygen concentrations at that time of 3 × 10(-4) times present levels. Overall, our findings suggest that there were appreciable levels of atmospheric oxygen about 3 billion years ago, more than 600 million years before the Great Oxidation Event and some 300-400 million years earlier than previous indications for Earth surface oxygenation.

Presentation, diagnosis, and management of popliteal artery entrapment syndrome: 11 years of experience with 61 legs.

PubMed

Corneloup, L; Labanère, C; Chevalier, L; Jaussaud, J; Mignot, A; Gencel, L; Corneloup, O; Midy, D

2018-02-01

Popliteal artery entrapment syndrome (PAES) is still underdiagnosed yet it may significantly interfere with lifestyle, especially among young sportspeople, with symptoms like intermittent claudication. Although case reports and small case series are sometimes published, studies with larger populations are quite rare. This study summarizes our experience with PAES on 61 limbs (35 patients) over a period of 11 years, describing the demographics, the disease, and the diagnostic and therapeutic methods used with PAES patients. In a population of 327 consecutive explored symptomatic sportspersons, PAES was confirmed in 35 patients on 61 pathologic limbs. The median time with the symptoms before diagnosis was 34 months (range, 3-180 months). The mean age of patients was 30.5 years (range, 17-52 years) with 83% of males. The proportion of patients diagnosed with bilateral PAES was 74%. The main sports practiced were running (15 patients, 43%), soccer (nine patients, 26%), rugby (two patients), and athletics (two patients). Among 21 patients, intra-compartmental pressure measurements (ICP) found 18 (86%) to have an associated chronic exertional compartment syndrome (CECS). Among the patients followed up after PAES surgery, 80% were able to resume sport at a level comparable to that before the onset of pain. PAES could be sought earlier in young sportspeople who experience unexplained leg pain during exercise to diagnose the disease and avoid complications in a timely manner. Compartmental pressures should systematically be measured in the search for an associated CECS. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas

PubMed Central

Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bromet, Evelyn J.; Gureje, Oye; Karam, Elie G.; Koenen, Karestan C.; Lee, Sing; Liu, Howard; Pennell, Beth-Ellen; Petukhova, Maria V.; Sampson, Nancy A.; Shahly, Victoria L.; Stein, Dan J.; Atwoli, Lukoye; Borges, Guilherme; Bunting, Brendan; de Girolamo, Giovanni; Gluzman, Semyon; Haro, Josep Maria; Hinkov, Hristo; Kawakami, Norito; Kovess-Masfety, Viviane; Navarro-Mateu, Fernando; Posada-Villa, Jose; Scott, Kate M.; Shalev, Arieh Y.; Have, Margreet ten; Torres, Yolanda; Viana, Maria Carmen; Zaslavsky, Alan M.

2017-01-01

Although earlier trauma exposure is known to predict post-traumatic stress disorder (PTSD) after subsequent traumas, it is unclear if this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pre-trauma vulnerability to PTSD. We examined this issue in the WHO World Mental Health (WMH) Surveys with 34,676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (OR=1.3–2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance disorders prior to random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5–4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization, rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas. PMID:28924183

Quantifying the Economic Value and Quality of Life Impact of Earlier Influenza Vaccination

PubMed Central

Lee, Bruce Y.; Bartsch, Sarah M.; Brown, Shawn T.; Cooley, Philip; Wheaton, William D.; Zimmerman, Richard K.

2015-01-01

Background Influenza vaccination is administered throughout the influenza disease season, even as late as March. Given such timing, what is the value of vaccinating the population earlier than currently being practiced? Methods We used real data on when individuals were vaccinated in Allegheny County, Pennsylvania, and the following 2 models to determine the value of vaccinating individuals earlier (by the end of September, October, and November): Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based model (ABM), and FluEcon, our influenza economic model that translates cases from the ABM to outcomes and costs [health care and lost productivity costs and quality-adjusted life-years (QALYs)]. We varied the reproductive number (R0) from 1.2 to 1.6. Results Applying the current timing of vaccinations averted 223,761 influenza cases, $16.3 million in direct health care costs, $50.0 million in productivity losses, and 804 in QALYs, compared with no vaccination (February peak, R0 1.2). When the population does not have preexisting immunity and the influenza season peaks in February (R0 1.2–1.6), moving individuals who currently received the vaccine after September to the end of September could avert an additional 9634–17,794 influenza cases, $0.6–$1.4 million in direct costs, $2.1–$4.0 million in productivity losses, and 35–64 QALYs. Moving the vaccination of just children to September (R0 1.2–1.6) averted 11,366–1660 influenza cases, $0.6–$0.03 million in direct costs, $2.3–$0.2 million in productivity losses, and 42–8 QALYs. Moving the season peak to December increased these benefits, whereas increasing preexisting immunity reduced these benefits. Conclusion Even though many people are vaccinated well after September/October, they likely are still vaccinated early enough to provide substantial cost-savings. PMID:25590676

9+ The Year-Round School.

ERIC Educational Resources Information Center

American Association of School Administrators, Washington, DC.

The 9-month school year with a 3-month summer vacation had its origin in our earlier agrarian life. Today's teacher shortages, overcrowded schools, and pressures to learn demand extensions of the school year. This publication analyzes five programs: (1) a staggered-vacation school year for all, (2) a full 48-week school year for all, (3) a…

Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

ERIC Educational Resources Information Center

Peterson, Carole; Warren, Kelly L.; Short, Megan M.

2011-01-01

Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories…

Symptomatic Falciparum Malaria After Living in a Nonendemic Area for 10 Years: Recrudescence or Indigenous Transmission?

PubMed

Salas-Coronas, Joaquín; Soriano-Pérez, Manuel Jesús; Lozano-Serrano, Ana B; Pérez-Moyano, Rosario; Porrino-Herrera, Carmen; Cabezas-Fernández, María Teresa

2017-06-01

AbstractWe report the case of a patient from Mali who, after 10 years of living in Spain, presented with symptomatic Plasmodium falciparum malaria without having visited an endemic area during that time. We cannot completely rule out the possibility of indigenous transmission, but this case most likely represents recrudescence of an infection acquired over 10 years earlier.

Unusual presentation of pheochromocytoma: thirteen years of anxiety requiring psychiatric treatment.

PubMed

Alguire, Catherine; Chbat, Jessica; Forest, Isabelle; Godbout, Ariane; Bourdeau, Isabelle

2018-01-01

Pheochromocytoma is a rare tumor of the adrenal gland. It often presents with the classic triad of headache, palpitations and generalized sweating. Although not described as a typical symptom of pheochromocytoma, anxiety is the fourth most common symptom reported by patients suffering of pheochromocytoma. We report the case of a 64 year old man who had severe anxiety and panic disorder as presenting symptoms of pheochromocytoma. After 13 years of psychiatric follow-up, the patient was diagnosed with malignant pheochromocytoma. After surgical resection of his pheochromocytoma and his hepatic metastases, the major panic attacks completely disappeared, the anxiety symptoms improved significantly and the psychiatric medications were stopped except for a very low maintenance dose of venlafaxine. We found in our cohort of 160 patients with pheochromocytoma 2 others cases of apparently benign tumors with severe anxiety that resolved after pheochromocytoma resection. These cases highlight that pheochromocytoma should be included in the differential diagnosis of refractory anxiety disorder. Anxiety and panic disorder may be the main presenting symptoms of pheochromocytoma.The diagnosis of pheochromocytoma should be excluded in cases of long-term panic disorder refractory to medications since the anxiety may be secondary to a catecholamine-secreting tumor.Surgical treatment of pheochromocytoma leads to significant improvement of anxiety disorders.

Three-year-old boy presenting in thyrotoxicosis.

PubMed

Glick, J E; Wright, P E

1998-02-01

Thyrotoxicosis secondary to Graves' disease developed in a 3-year-old black boy with no previous history of thyroid disease. Thyrotoxicosis is a rare disorder of childhood that is characterized by an accelerated metabolism of body tissues which results from the stimulation of thyroid gland activity induced through a variety of autoantibodies. Historically, less than 5% of all incidents of Graves' disease occur in childhood, and recent studies show an incidence as low as 0.000001%. It is three to eight times more prevalent in females than in males and increases in incidence throughout childhood and adolescence. More than two thirds of childhood cases occur between the ages of 10 and 15 years. A review of the medical literature illustrates that less than 2% of hyperthyroid children in recorded cases are younger than 4 years. Records from Children's Hospital of Oklahoma in Oklahoma City support the unusual nature of this case, the hospital having seen only three children younger than 4 years requiring thyroid ablation therapy in 17 years. Physicians should consider Graves' disease in any child with clinical manifestations of hyperthyroidism, regardless of the age.

One-year follow-up of myocardial perfusion and function evaluated by gated SPECT MIBI in patients with earlier myocardial infarction and chronic total occlusion.

PubMed

Pavlovic, Smiljana V; Sobic-Saranovic, Dragana P; Beleslin, Branko D; Ostojic, Miodrag C; Nedeljkovic, Milan A; Giga, Vojislav L; Petrasinovic, Zorica R; Artiko, Vera M; Todorovic-Tirnanic, Mila V; Obradovic, Vladimir B

2009-01-01

Optimal treatment for chronic total occlusion (CTO) in the infarct-related coronary artery is not clear. Our aim was to assess myocardial perfusion, left ventricular ejection fraction (EF), and left ventricular size using gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging with 99mTc-methoxy-isobutyl-isonitrile in patients with CTO before and 1 year after recanalization. Thirty patients with earlier myocardial infarction and at least one CTO underwent percutaneous coronary intervention (PCI) as well as nitrate-enhanced gated SPECT myocardial perfusion and dobutamine stress echocardiography before and 11 +/- 1 months after recanalization. They were divided into three groups based on the outcome of the follow-up angiography: (i) successful recanalization with no evidence of in-stent restenosis (n=13); (ii) successful recanalization with in-stent restenosis (n=7) and (iii) unsuccessful recanalization (n=10). Overall success of recanalization for CTO was 74%. In group 1, myocardial viability was preserved in 11 of 13 (85%) patients at baseline. Gated SPECT at 1 year showed a significant decrease in perfusion abnormalities (29 +/- 12 to 23 +/- 14%, P < 0.05) and left ventricular end-diastolic volume (EDV) (168 +/- 47 to 151 +/- 47 ml, P < 0.05). Improvement in EF (51 +/- 11 to 54 +/- 13%, P > 0.05) and reduction in left ventricular end-systolic volume (ESV) (84 +/- 37 to 77 +/- 40 ml, P > 0.05) did not reach the level of significance. Myocardial viability was preserved in only two of seven patients (28%) in group 2. Neither mean perfusion abnormalities (37 +/- 24 to 35 +/- 22%, P > 0.05) nor global left ventricular parameters (EF 41 +/- 15 vs. 42 +/- 19%, EDV 298 +/- 33 vs. 299 +/- 57 mL, ESV 197 +/- 12 vs. 195 +/- 32 ml; P > 0.05) changed at the follow-up. In group 3, myocardial viability was preserved in seven of 10 patients (70%) at baseline, but no significant changes in perfusion (40 +/- 18 vs. 41 +/- 19%, P > 0.05) and left

A 26-Year-Old Retained Demised Abdominal Pregnancy Presenting with Umbilical Fistula

PubMed Central

Daniel, Nnadi; Bashir, Bello; Ibrahim, Ango; Swati, Singh

2014-01-01

This is a report on a 72-year-old postmenopausal woman who presented with passage of fetal bones through an umbilical fistula. She was diagnosed as a case of demised abdominal pregnancy, which had been retained for 26 years. She subsequently had exploratory laparotomy, evacuation of the abdominal pregnancy, hysterectomy, and bowel resection. The patient's condition remained unstable throughout the postoperative period and she died from septicemia on the eleventh day. PMID:24639908

Pride and Progress? 30 Years of ACPA and NASPA LGBTQ Presentations

ERIC Educational Resources Information Center

Pryor, Jonathan T.; Garvey, Jason C.; Johnson, Shonteria

2017-01-01

The purpose of this article is to examine themes of campus climate, LGBTQ identity construction, and visibility within LGBTQ presentations at ACPA and NASPA national conferences over the last 30 years. The authors frame their analysis utilizing prominent LGBT and queer issues scholarship in higher education research. Findings demonstrate the role…

A Rare Presentation of Isolated CNS Posttransplantation Lymphoproliferative Disorder

PubMed Central

Smith, Casey; Streicher, Andrew; Magnuson, Allison; Newman, Susan; Bertoli, Robert

2017-01-01

Posttransplantation lymphoproliferative disorder (PTLD) is a recognized and extremely morbid complication of solid organ transplantation, but central nervous system involvement, particularly in isolation, is rare. There are no standardized treatment strategies for PTLD, though commonly used strategies include reduction of immunosuppression, chemotherapy, rituximab, radiation, and surgery. We present a case of an unusual morphologic variant of primary central nervous system PTLD with successful response to rituximab and cranial radiation. A 69-year-old Asian male, who underwent postrenal transplant nine years earlier, presented with a one-month history of new onset seizure activity. His evaluation revealed multiple brain lesions on magnetic resonance imaging (MRI), as well as serologic and cerebrospinal fluid studies which were positive for Epstein-Barr Virus (EBV) infection. Ultimately, he underwent craniotomy with tissue biopsy with the final pathology report showing posttransplant lymphoproliferative disorder, polymorphic type. The patient was managed with reduction in immunosuppression, rituximab therapy, and cranial radiation treatments. He had demonstrated marked improvement in his neurologic function and was ultimately discharged to inpatient rehabilitation facility. PMID:28116196

A Rare Presentation of Isolated CNS Posttransplantation Lymphoproliferative Disorder.

PubMed

Morris, Jaime; Smith, Casey; Streicher, Andrew; Magnuson, Allison; Newman, Susan; Bertoli, Robert

2017-01-01

Posttransplantation lymphoproliferative disorder (PTLD) is a recognized and extremely morbid complication of solid organ transplantation, but central nervous system involvement, particularly in isolation, is rare. There are no standardized treatment strategies for PTLD, though commonly used strategies include reduction of immunosuppression, chemotherapy, rituximab, radiation, and surgery. We present a case of an unusual morphologic variant of primary central nervous system PTLD with successful response to rituximab and cranial radiation. A 69-year-old Asian male, who underwent postrenal transplant nine years earlier, presented with a one-month history of new onset seizure activity. His evaluation revealed multiple brain lesions on magnetic resonance imaging (MRI), as well as serologic and cerebrospinal fluid studies which were positive for Epstein-Barr Virus (EBV) infection. Ultimately, he underwent craniotomy with tissue biopsy with the final pathology report showing posttransplant lymphoproliferative disorder, polymorphic type. The patient was managed with reduction in immunosuppression, rituximab therapy, and cranial radiation treatments. He had demonstrated marked improvement in his neurologic function and was ultimately discharged to inpatient rehabilitation facility.

Earlier versus later continuous Kangaroo Mother Care (KMC) for stable low-birth-weight infants: a randomized controlled trial.

PubMed

Nagai, S; Andrianarimanana, D; Rabesandratana, N; Yonemoto, N; Nakayama, T; Mori, R

2010-06-01

The aim of this study was to examine the effectiveness of earlier continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. A randomized controlled trial was performed in LBW infants at a referral hospital in Madagascar. Earlier continuous KMC (intervention) was begun as soon as possible, within 24 h postbirth, and later continuous KMC (control: conventional care) was begun after complete stabilization (generally after 24 h postbirth). Main outcome measure was mortality during the first 28 days postbirth. This trial was registered with ClinicalTrials.gov, NCT00531492. A total of 73 infants (intervention 37, control 36) were included. Earlier continuous KMC had higher but no statistically different mortality in the first 28 days postbirth (1 vs. 2; risk ratio, 1.95; 95% CIs, 0.18-20.53; p = 1.00). There were no differences in incidence of morbidities. Body weight loss from birth to 24 h postbirth was significantly less in earlier KMC infants compared with later KMC infants. (-34.81 g vs. -73.97 g; mean difference, 39.16 g; 95% CIs, 10.30-68.03; p = 0.01; adjusted p = 0.02). Adverse events and duration of hospitalization were not different between the two groups. Further evaluations of earlier continuous KMC including measurement of KMC dose, are needed in resource-limited countries.

Portraits of Learning 2007: We Present This Year's Winning Student Photos

ERIC Educational Resources Information Center

Technology & Learning, 2007

2007-01-01

This year's more than 4,000 Portraits of Learning entries attest to the growing comfort with digital technologies and visual arts that today's kids have. This article presents 12 winning student photos of the Portraits of Learning 2007. The winners emerged from the selection of subjects that varied wildly--from grasshoppers, giraffes, zebras, and…

Earlier Snowmelt Changes the Ratio Between Early and Late Season Forest Productivity

NASA Astrophysics Data System (ADS)

Knowles, J. F.; Molotch, N. P.; Trujillo, E.; Litvak, M. E.

2017-12-01

Future projections of declining snowpack and increasing potential evaporation associated with climate warming are predicted to advance the timing of snowmelt in mountain ecosystems globally. This scenario has direct implications for snowmelt-driven forest productivity, but the net effect of temporally shifting moisture dynamics is unknown with respect to the annual carbon balance. Accordingly, this study uses both satellite- and tower-based observations to document the forest productivity response to snowpack and potential evaporation variability between 1989 and 2012 throughout the southern Rocky Mountain ecoregion, USA. These results show that a combination of low snow accumulation and record high potential evaporation in 2012 resulted in the 34-year minimum ecosystem productivity that could be indicative of future conditions. Moreover, early and late season productivity were significantly and inversely related, suggesting that future shifts toward earlier or reduced snowmelt could increase late-season moisture stress to vegetation and thus restrict productivity despite a longer growing season. This relationship was further subject to modification by summer precipitation, and the controls on the early/late season productivity ratio are explored within the context of ecosystem carbon storage in the future. Any perturbation to the carbon cycle at this scale represents a potential feedback to climate change since snow-covered forests represent an important global carbon sink.

A 47-Year-Old Man With Fever, Dry Cough, and a Lung Mass After Redo Lung Transplantation.

PubMed

Chaddha, Udit; Patil, Pradnya D; Omar, Ashraf; Walia, Rajat; Panchabhai, Tanmay S

2018-06-01

A 47-year-old man who was a redo double lung transplant recipient (cytomegalovirus [CMV] status: donor positive/recipient positive; Epstein-Barr virus status: donor positive/recipient positive) presented to the hospital with 1 week of generalized malaise, low-grade fevers, and dry cough. His redo lung transplantation was necessitated by bronchiolitis obliterans syndrome, and his previous lung transplantation 5 years earlier was for silicosis-related progressive massive fibrosis. He denied any difficulty breathing or chest pain. There was no history of GI or urinary symptoms, and the patient had no anorexia, weight loss, night sweats, sick contacts, or history of travel. He had a history of 1 earlier episode of CMV viremia that was treated with valganciclovir. His immunosuppressive regimen included tacrolimus, mycophenolate mofetil, and prednisone, and his infection prophylaxis included trimethoprim-sulfamethoxazole, itraconazole, and valganciclovir. Results of a chest radiograph 8 weeks earlier were normal. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Specific anti-EL4-lymphoma immunity in mice cured 2 years earlier with doxorubicin and interleukin-2.

PubMed

Ehrke, M J; Verstovsek, S; Zaleskis, G; Ho, R L; Ujházy, P; Maccubbin, D L; Mihich, E

1996-05-01

This laboratory has reported the conditions for an effective, non-toxic, chemoimmunotherapy utilizing doxorubicin in combination with prolonged administration of interleukin-2 and the identification of the critical role of activated CD8+ T cells in the therapeutic effect. Mice (C57BL/6) cured in those studies have been followed for the remainder of their life spans. These mice, approximately 2 months of age when initially inoculated with syngeneic EL4 lymphoma, survived for more than 2 years, the normal life span of C57BL/6 mice. Mice 4 months old reinoculated with the EL4 cells all survived. At about 1 year of age mice were sacrificed and the ability of their thymocytes and splenocytes to develop specific CD8+ anti-EL4 activity was as high as it had been at the time of tumor rejection. At about 2 years of age EL4 was reimplanted into mice; all of them survived. These surviving mice, at 2 years 2 months of age, as well as a group of 2-year-old mice not rechallenged, were killed and functional antitumor activity and phenotype characteristics of various lymphocyte populations were determined in comparison to those of young and age-matched control mice. The phenotyping of the lymphocytes from the cured mice indicated very notable differences in subset distribution and increased CD44 expression. Functionally they developed high levels of anti-EL4 activity, which was ablated by combined treatment with monoclonal antibodies against CD8 and CD44, indicating the role of memory cells. Consistent with cells from aged mice, these same cell populations had a very reduced allogeneic responsiveness. It appears that cured mice have developed an immune memory specific for EL4.

Earlier detection of breast cancer by surveillance of women at familial risk.

PubMed

Tilanus-Linthorst, M M; Bartels, C C; Obdeijn, A I; Oudkerk, M

2000-03-01

A positive family history increases the risk for breast cancer which oft en occurs at a much younger age than in the general population. We stud ied whether surveillance of these women resulted in the detection of bre ast cancer in an earlier stage than in symptomatic patients with a famil y history. Between January 1994 and April 1998, 294 women with 15-25% r isk (moderate), mean age:43.3 (22-75) years, were screened with a yearly physical examination and mammography from 5 years before the youngest ag e of onset in the family and 384 women with >25% risk (high) for breast cancer, mean age: 42.9 (20-74) years were screened with a physical examination every 6 months and yearly mammography. From September 1995 breast magnetic resonance imaging (MRI) was also carried out for 109 high risk women where mammography showed over 50% density. 26 breast cancers detected under surveillance were significantly more often found in an early T1N0 stage than the 24 breast cancers in patients with a family history referred in that period because of symptoms: 81 versus 46% (P=0.018). Patients under surveillance were also less frequently node-positive than the symptomatic group: 19 versus 42% (P=0.12). 20 patients with a family history referred by our national screening programme in that period had 21 breast cancers detected, 81% in stage T1N0 and 5% node-positive, which was comparable to the results in our national screening programme T1N0 66%, N+ 24% resulting in a 30% reduction in mortality. The incidence in women under surveillance was 10.1 per 1000 in the 'high' risk group and 13.3 per 1000 in the 'moderate' risk group. Expected incidence in an average risk population aged 40-50 years is 1.5, expected if the group consisted of only gene carriers 15 per 1000. 23% of the breast cancers in the surveillance group were detected at physical examination, but occult at mammography. 38% were detected at mammography and clinically occult. Breast MRI (in the subgroup) detected 3 occult

Does patient reporting lead to earlier detection of drug safety signals? A retrospective comparison of time to reporting between patients and healthcare professionals in a global database.

PubMed

Rolfes, Leàn; van Hunsel, Florence; Caster, Ola; Taavola, Henric; Taxis, Katja; van Puijenbroek, Eugène

2018-03-09

To explore if there is a difference between patients and healthcare professionals (HCPs) in time to reporting drug-adverse drug reaction (ADR) associations that led to drug safety signals. This was a retrospective comparison of time to reporting selected drug-ADR associations which led to drug safety signals between patients and HCPs. ADR reports were selected from the World Health Organization Global database of individual case safety reports, VigiBase. Reports were selected based on drug-ADR associations of actual drug safety signals. Primary outcome was the difference in time to reporting between patients and HCPs. The date of the first report for each individual signal was used as time zero. The difference in time between the date of the reports and time zero was calculated. Statistical differences in timing were analysed on the corresponding survival curves using a Mann-Whitney U test. In total, 2822 reports were included, of which 52.7% were patient reports, with a median of 25% for all included signals. For all signals, median time to signal detection was 10.4 years. Overall, HCPs reported earlier than patients: median 7.0 vs. 8.3 years (P < 0.001). Patients contributed a large proportion of reports on drug-ADR pairs that eventually became signals. HCPs reported 1.3 year earlier than patients. These findings strengthen the evidence on the value of patient reporting in signal detection and highlight an opportunity to encourage patients to report suspected ADRs even earlier in the future. © 2018 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Does earlier arrival of the retrieval team improve short-term outcomes in outborn extremely premature infants?

PubMed

Sharpe, Janet B; Davies, Mark W

2018-05-31

The risk of mortality and morbidity is increased in outborn, extremely premature infants. We aim to determine whether earlier arrival of the retrieval team after the birth of infants less than 29 weeks gestation improves short-term mortality and morbidity. This is a retrospective analysis of a cohort of infants less than 29 weeks gestation who were retrieved to the Royal Brisbane and Women's Hospital (RBWH) over a 5-year period. Demographic information regarding the infant and mother, retrieval team arrival time and outcome data was collected. Primary outcomes investigated were mortality prior to discharge from hospital or a composite of mortality or severe intraventricular haemorrhage (IVH). Data on 105 infants were analysed; 88 infants (83.8%) survived to discharge home, and 79 (75.2%) survived to discharge without severe IVH. On univariate analysis, there was no significant association between age at arrival of the retrieval team and death prior to discharge (P = 0.94) or death prior to discharge or severe IVH (P = 0.83). On logistic regression analysis, age at arrival of retrieval team remained non-significant for a reduction in death prior to discharge and composite of death or severe IVH (P = 0.70 and P = 0.99, respectively). The earlier arrival of the retrieval team is not associated with improved short-term outcomes in outborn, extremely preterm infants who are retrieved and admitted to a tertiary neonatal intensive care unit - for infants where the retrieval team arrived within about 8 h of birth. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Earlier Pulmonary Valve Replacement in Down Syndrome Patients Following Tetralogy of Fallot Repair.

PubMed

Sullivan, Rachel T; Frommelt, Peter C; Hill, Garick D

2017-08-01

The association between Down syndrome and pulmonary hypertension could contribute to more severe pulmonary regurgitation after tetralogy of Fallot repair and possibly earlier pulmonary valve replacement. We compared cardiac magnetic resonance measures of pulmonary regurgitation and right ventricular dilation as well as timing of pulmonary valve replacement between those with and without Down syndrome after tetralogy of Fallot repair. Review of our surgical database from 2000 to 2015 identified patients with tetralogy of Fallot with pulmonary stenosis. Those with Down syndrome were compared to those without. The primary outcome of interest was time from repair to pulmonary valve replacement. Secondary outcomes included pulmonary regurgitation and indexed right ventricular volume on cardiac magnetic resonance imaging. The cohort of 284 patients included 35 (12%) with Down syndrome. Transannular patch repair was performed in 210 (74%). Down syndrome showed greater degree of pulmonary regurgitation (55 ± 14 vs. 37 ± 16%, p = 0.01) without a significantly greater rate of right ventricular dilation (p = 0.09). In multivariable analysis, Down syndrome (HR 2.3, 95% CI 1.2-4.5, p = 0.02) and transannular patch repair (HR 5.5, 95% CI 1.7-17.6, p = 0.004) were significant risk factors for valve replacement. Those with Down syndrome had significantly lower freedom from valve replacement (p = 0.03). Down syndrome is associated with an increased degree of pulmonary regurgitation and earlier pulmonary valve replacement after tetralogy of Fallot repair. These patients require earlier assessment by cardiac magnetic resonance imaging to determine timing of pulmonary valve replacement and evaluation for and treatment of preventable causes of pulmonary hypertension.

Earlier Parental Set Bedtimes as a Protective Factor Against Depression and Suicidal Ideation

PubMed Central

Gangwisch, James E.; Babiss, Lindsay A.; Malaspina, Dolores; Turner, J. Blake; Zammit, Gary K.; Posner, Kelly

2010-01-01

Study Objectives: To examine the relationships between parental set bedtimes, sleep duration, and depression as a quasi-experiment to explore the potentially bidirectional relationship between short sleep duration and depression. Short sleep duration has been shown to precede depression, but this could be explained as a prodromal symptom of depression. Depression in an adolescent can affect his/her chosen bedtime, but it is less likely to affect a parent's chosen set bedtime which can establish a relatively stable upper limit that can directly affect sleep duration. Design: Multivariate cross-sectional analyses of the ADD Health using logistic regression. Setting: United States nationally representative, school-based, probability-based sample in 1994-96. Participants: Adolescents (n = 15,659) in grades 7 to 12. Measurements and Results: Adolescents with parental set bedtimes of midnight or later were 24% more likely to suffer from depression (OR = 1.24, 95% CI 1.04-1.49) and 20% more likely to have suicidal ideation (1.20, 1.01-1.41) than adolescents with parental set bedtimes of 10:00 PM or earlier, after controlling for covariates. Consistent with sleep duration and perception of getting enough sleep acting as mediators, the inclusion of these variables in the multivariate models appreciably attenuated the associations for depression (1.07, 0.88-1.30) and suicidal ideation (1.09, 0.92-1.29). Conclusions: The results from this study provide new evidence to strengthen the argument that short sleep duration could play a role in the etiology of depression. Earlier parental set bedtimes could therefore be protective against adolescent depression and suicidal ideation by lengthening sleep duration. Citation: Gangwisch JE; Babiss LA; Malaspina D; Turner JB; Zammit GK; Posner K. Earlier parental set bedtimes as a protective factor against depression and suicidal ideation. SLEEP 2010;33(1):97-106. PMID:20120626

40 CFR 87.21 - Exhaust emission standards for Tier 4 and earlier engines.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Emissions (New Aircraft Gas Turbine Engines) § 87.21 Exhaust emission standards for Tier 4 and earlier... standards. (a) Exhaust emissions of smoke from each new aircraft gas turbine engine of class T8 manufactured... from each new aircraft gas turbine engine of class TF and of rated output of 129 kilonewtons thrust or...

40 CFR 87.21 - Exhaust emission standards for Tier 4 and earlier engines.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Emissions (New Aircraft Gas Turbine Engines) § 87.21 Exhaust emission standards for Tier 4 and earlier... standards. (a) Exhaust emissions of smoke from each new aircraft gas turbine engine of class T8 manufactured... from each new aircraft gas turbine engine of class TF and of rated output of 129 kilonewtons thrust or...

2013 Annual Survey of Journalism Mass Communication Enrollments: Enrollments Decline for Third Consecutive Year

ERIC Educational Resources Information Center

Becker, Lee Bernard; Vlad, Tudor; Simpson, Holly Anne

2014-01-01

Enrollments in journalism and mass communication programs in the United States in the fall of 2013 were down from a year earlier for the third year in a row. Enrollments dropped at the bachelor's, master's, and doctoral levels, and the number of freshmen and sophomores were down dramatically from a year earlier. Enrollments in the…

40 CFR 1039.102 - What exhaust emission standards and phase-in allowances apply for my engines in model year 2014...

Code of Federal Regulations, 2010 CFR

2010-07-01

... phase-in allowances apply for my engines in model year 2014 and earlier? 1039.102 Section 1039.102... year 2014 and earlier? The exhaust emission standards of this section apply for 2014 and earlier model... in paragraphs (a) and (b) of this section: (1) For each model year before 2014 noted in Tables 4...

Hepatitis B and C virus prevalence in couples attending an in vitro fertilization clinic in a tertiary care hospital in Saudi Arabia: comparison with ten years earlier.

PubMed

Albadran, Asma; Hibshi, Ali; Saeed, Bahjat; Coskun, Serdar; Awartani, Khalid Arab

2017-01-01

Viral hepatitis B (HBV) and C (HCV) are a major public health problem in Saudi Arabia. Recent data has indicated a major reduction in viral hepatitis prevalence in Saudi population. However, there is limited data for infertile Saudi couples. To determine the prevalence of HCV and HBV attending an in vitro fertilization (IVF) clinic in Saudi Arabia between 2012 and 2015 to compare with the prevalence 10 years earlier in the same center. Retrospective prevalence study. Tertiary care center in Riyadh. Data on the prevalence of HBV and HCV was collected on all couples seen at the IVF unit between 2002-2005 and 2012-2015. Prevalence of HBV and HCV. In 4442 patients during 2002-2005 and 5747 patients during 2012-2015, the prevalence of HBV was significantly less in 2012-2015 compared with 2002-2005 (1.67% [97 patients] vs 4.7% [210 patients], P < .0001), respectively, but HCV prevalence was similar for the two periods (0.7% for both periods) (P=.887). The hepatitis B seroprevalence rate was higher in males compared to females during 2002-2005 (6.3% vs 3.1%) (P < .0001) and 2012-2015 (2.4% vs 1.1% ) (P < .0001), respectively. The significant drop in HBV prevalence was most likely due to the introduction of the vaccination program in 1989, while reasons for HCV prevalence remaining unchanged are unclear. No data on confounding factors that may have affected the prevalence.

150 years since Babbage's ophthalmoscope.

PubMed

Keeler, C R

1997-11-01

The discovery of the ophthalmoscope in 1851 is rightly attributed to Hermann von Helmholtz. However, 4 years earlier, in 1847, Charles Babbage nearly invented the instrument that was to revolutionize ophthalmological examination so dramatically.

Contralateral approach to iliac artery recanalization with kissing nitinol stents present in the aortic bifurcation☆

PubMed Central

Joseph, George; Hooda, Amit; Thomson, Viji Samuel

2015-01-01

A 69-year-old man, who had earlier undergone reconstruction of the aortic bifurcation with kissing nitinol stents, presented with occlusion of the left external iliac artery. The occlusion was successfully and safely recanalized using contralateral femoral approach with passage of interventional hardware through the struts of the stents in the aortic bifurcation. Presence of contemporary flexible nitinol stents with open-cell design in the aortic bifurcation is not a contraindication to the use of the contralateral femoral approach. PMID:26702686

Rectal metastasis from breast cancer: an interval of 17 years.

PubMed

Amin, Aliasger A; Reddy, Anil; Jha, Madan; Prasad, Kolanu

2011-05-12

Metastasis to gastrointestinal (GI) tract from breast cancer is rare. Commonly affected organ in GI tract is stomach, followed by colon and then rectum. The authors report a case of a 61-year-old woman who had a mastectomy for lobular carcinoma of the breast 17 years ago and was referred to colorectal clinic with increased frequency of stools. Colonoscopy showed a stricture in the rectum, but biopsy was inconclusive. As she was symptomatic, she had a Hartmann's resection 5 months after she initially presented to the clinic. Histopathology of the resected specimen showed it to be metastasis from lobular carcinoma of the breast. Awareness of potential long delays in the presentation of metastatic breast cancer especially lobular carcinoma helps in the earlier diagnosis and clinical management.

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.

Antiretroviral treatment-based cost saving interventions may offset expenses for new patients and earlier treatment start.

PubMed

Angeletti, C; Pezzotti, P; Antinori, A; Mammone, A; Navarra, A; Orchi, N; Lorenzini, P; Mecozzi, A; Ammassari, A; Murachelli, S; Ippolito, G; Girardi, E

2014-03-01

Combination antiretroviral therapy (cART) has become the main driver of total costs of caring for persons living with HIV (PLHIV). The present study estimated the short/medium-term cost trends in response to the recent evolution of national guidelines and regional therapeutic protocols for cART in Italy. We developed a deterministic mathematical model that was calibrated using epidemic data for Lazio, a region located in central Italy with about six million inhabitants. In the Base Case Scenario, the estimated number of PLHIV in the Lazio region increased over the period 2012-2016 from 14 414 to 17 179. Over the same period, the average projected annual cost for treating the HIV-infected population was €147.0 million. An earlier cART initiation resulted in a rise of 2.3% in the average estimated annual cost, whereas an increase from 27% to 50% in the proportion of naïve subjects starting cART with a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen resulted in a reduction of 0.3%. Simplification strategies based on NNRTIs co-formulated in a single tablet regimen and protease inhibitor/ritonavir-boosted monotherapy produced an overall reduction in average annual costs of 1.5%. A further average saving of 3.3% resulted from the introduction of generic antiretroviral drugs. In the medium term, cost saving interventions could finance the increase in costs resulting from the inertial growth in the number of patients requiring treatment and from the earlier treatment initiation recommended in recent guidelines. © 2013 British HIV Association.

Facilitating earlier transfer of care from acute stroke services into the community.

PubMed

Robinson, Jennifer

This article outlines an initiative to reduce length of stay for stroke patients within an acute hospital and to facilitate earlier transfer of care. Existing care provision was remodelled and expanded to deliver stroke care to patients within a community bed-based intermediate care facility or intermediate care at home. This new model of care has improved the delivery of rehabilitation through alternative and innovative ways of addressing service delivery that meet the needs of the patients.

Sensory, physical and chemical characteristics of cooked ham manufactured from rapidly chilled and earlier deboned M. semimembranosus.

PubMed

Tomović, Vladimir M; Jokanović, Marija R; Petrović, Ljiljana S; Tomović, Mila S; Tasić, Tatjana A; Ikonić, Predrag M; Sumić, Zdravko M; Sojić, Branislav V; Skaljac, Snežana B; Sošo, Milena M

2013-01-01

Effects of rapid chilling of carcasses (at -31°C in the first 3h of chilling, and then at 2-4°C) and earlier deboning (8h post-mortem), compared to rapid (till 24h post-mortem) and conventional chilling (at 2-4°C, till 24h post-mortem), on quality characteristics of pork M. semimebranosus and cooked ham were investigated. Quality measurements included pH value, colour (CIEL a b values) and total aerobic count of M. semimebranosus, as well as sensory (colour, juiciness, texture, and flavour), physical (pH value, colour - CIEL a b values and texture - Warner-Bratzler shear and penetration forces) and chemical (protein, total fat, and moisture content) characteristics of cooked ham. The cooked ham was manufactured from pieces of M. semimebranosus with ultimate lightness (CIEL value) lower than 50. Rapid chilling and earlier deboning significantly increased quantity of M. semimebranosus desirable for cooked ham manufacturing. Earlier start of pork fabrication did not affect important quality characteristics of cooked ham. Copyright © 2012 Elsevier Ltd. All rights reserved.

Comparing emergency department presentations among children with cerebral palsy with general childhood presentations: a data linkage study.

PubMed

Meehan, Elaine; Williams, Katrina; Reid, Susan M; Freed, Gary L; Babl, Franz E; Sewell, Jillian R; Vidmar, Suzanna; Donath, Susan; Reddihough, Dinah S

2017-11-01

The aims of this study were to estimate the proportion of emergency department presentations attributable to children with cerebral palsy (CP), investigate the frequency of emergency department presentations in a CP cohort, and compare emergency department presentations among children with CP with those of other children. This was a retrospective cohort study. The Victorian Cerebral Palsy Register was linked to the Victorian Emergency Minimum Dataset. Data on emergency department presentations for the CP cohort occurring between 2007 and 2014 and population control data were obtained. The CP cohort (n=1748) had 7015 emergency department presentations during the 7-year period, accounting for 0.4% of the 1.69 million age-specific presentations during that time. The number of annual presentations per 1000 children rose with increasing CP severity. Compared with presentations among the general population, higher proportions of presentations among the CP cohort were preceded by ambulance arrivals (27% vs 8%), triaged as urgent (66% vs 32%), and required hospital admission (38% vs 12%). The marked differences in presentations between the CP cohort and the general population in the proportions that were urgent and required ambulance arrivals and hospital admissions was an important finding. Strategies to ensure appropriate use of services, including encouragement to seek earlier assistance from primary care providers, may prevent problems escalating to the need for urgent care. Children with cerebral palsy (CP) account for 0.4% of childhood emergency department presentations. More emergency department presentations among children with CP require ambulance arrival. More CP emergency department presentations are urgent and require hospital admission. Traditional emergency department triage scales seem less accurate for this group. © 2017 Mac Keith Press.

Specific and Non-specific Clinical Presentations in the Year Before the Diagnosis of Childhood Leukaemia.

PubMed

Yang, TienYu Owen; Liu, Yen-Lin; Huang, Wan-Ting; Chen, Mei-Huei; Chen, Pau-Chung

2016-08-01

Clinical presentations of childhood leukaemia have been reported in case-only studies. The timing when these presentations start to occur prior to diagnosis is less clear. In this nested case-control study, 1,025 and 334 children with lymphoid and myeloid leukaemia, respectively, were matched (1:30) to population-based controls by sex, region and year of birth. An index date was assigned for each control when the matched case was diagnosed. Healthcare access records of cases and controls in the year before the index date were extracted. Children with lymphoid leukaemia started to visit doctors more often at least 2 months before leukaemia diagnosis (P < 0.05). Various presentations were recorded in these visits: rates of haematological presentations, musculoskeletal presentations, and injuries started to increase significantly at least 3 months before diagnosis; rates of respiratory, gastrointestinal and urinary tract presentations did not increase significantly until the last month. The findings for myeloid lymphoma were less clear, but children appeared to visit doctors more often at least 4 months before diagnosis, and the rate of haematological presentations also started to increase at least 4 months before leukaemia diagnosis. Although haematological presentations were most strongly associated with undiagnosed leukaemia (odds ratio > 290 in the last month), the majority (>96%) of children with haematological presentations did not have leukaemia if they had not been diagnosed in their first visit. We described a clinical picture in the year before leukaemia diagnosis. These findings revealed ongoing difficulties in early diagnosis of childhood leukaemia in healthcare settings. © 2016 Wiley Periodicals, Inc.

Alcohol-related emergency department injury presentations in Queensland adolescents and young adults over a 13-year period.

PubMed

Hides, Leanne; Limbong, Jesani; Vallmuur, Kirsten; Barker, Ruth; Daglish, Mark; Young, Ross McD

2015-03-01

The rate of alcohol-related emergency department (ED) presentations in young people has increased dramatically in recent decades. Injuries are the most common type of youth alcohol-related ED presentation, yet little is known about these injuries in young people. This paper describes the characteristics of alcohol-related ED injury presentations in young people over a 13-year period and determines if they differ by gender and/or age group (adolescents: 12-17 years; young adults: 18-24 years). The Queensland Injury Surveillance Unit (QISU) database collects injury surveillance data at triage in participating EDs throughout Queensland, Australia. A total of 4667 cases of alcohol-related injuries in young people (aged 12-24 years) were identified in the QISU database between January 1999 and December 2011, using an injury surveillance code and nursing triage text-based search strategy. Overall, young people accounted for 38% of all QISU alcohol-related ED injury presentations in patients aged 12 years or over. The majority of young adults presented with injuries due to violence and falls, whereas adolescents presented due to self-harm or intoxication without other injury. Males presented with injuries due to violence, whereas females presented with alcohol-related self-harm and intoxication. There is a need for more effective ways of identifying the degree of alcohol involvement in injuries among young people presenting to EDs. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Clinical presentation of children with pulmonary tuberculosis: 25 years of experience in Lima, Peru.

PubMed

Del Castillo-Barrientos, H; Centeno-Luque, G; Untiveros-Tello, A; Simms, B; Lecca, L; Nelson, A K; Lastimoso, C; Shin, S

2014-09-01

To describe clinical presentation across age groups in 2855 children with pulmonary tuberculosis (TB) attending the Children's Hospital, Lima, Peru, to improve the diagnosis, treatment and care of childhood TB. Children aged 0-14 years admitted between 1 January 1973 and 31 December 1997 with active pulmonary TB were enrolled. Demographic information, history, physical examination data, laboratory and microbiological results, chest radiograph data, disease classification, treatment and adverse effect data, and outcome at the time of discharge were recorded by pulmonologists using detailed chart abstractions. Of the 2855 enrollees, 47% were malnourished and 56% had a household contact. Older children presented with classic TB symptoms, while weight loss and anorexia were rare in children aged <5 years. Microbiological or pathologic confirmation was obtained in 71% of children aged 10-14 years compared with 34% of children aged <2 years; however, severe extra-pulmonary TB was most common among children aged <2 years (41%). Classic TB symptoms should be considered when making a diagnosis; however, systematic symptoms among young children are also important. In high-burden settings, clinicians should have a low threshold to diagnose and treat children for TB across all ages, even in the context of a negative tuberculin skin test result and lack of micro-pathological confirmation.

Recent gestational diabetes was associated with mothers stopping predominant breastfeeding earlier in a multi-ethnic population.

PubMed

Baerug, Anne; Sletner, Line; Laake, Petter; Fretheim, Atle; Løland, Beate Fossum; Waage, Christin W; Birkeland, Kåre I; Jenum, Anne Karen

2018-06-01

It has previously been shown that breastfeeding may reduce the risk of type 2 diabetes in mothers with recent gestational diabetes mellitus (GDM). This study compared the cessation of predominant breastfeeding in mothers with and without recent GDM in a multi-ethnic population. From May 2008 to May 2010, healthy pregnant women attending antenatal care provided by community health services in Eastern Oslo, Norway were recruited. We included 616 women-58% non-Western-and interviewed and examined them at a mean of 15 and 28 weeks of gestation and 14 weeks' postpartum. Cox regression models examined the association between GDM, as assessed by the 2013 World Health Organization criteria, and breastfeeding cessation. Overall, 190 of the 616 (31%) mothers had GDM and they ended predominant breastfeeding earlier than mothers without GDM, with an adjusted hazard ratio (aHR) of 1.33 and 95% confidence interval (95% CI) of 1.01-1.77. Mothers of South Asian origin ended predominant breastfeeding earlier than Western European mothers in the adjusted analysis (aHR 1.53, 95% CI: 1.04-2.25), but Middle Eastern mothers did not. Recent gestational diabetes was associated with earlier cessation of predominant breastfeeding in Western European and non-Western women. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Archaeology. Sedimentary DNA from a submerged site reveals wheat in the British Isles 8000 years ago.

PubMed

Smith, Oliver; Momber, Garry; Bates, Richard; Garwood, Paul; Fitch, Simon; Pallen, Mark; Gaffney, Vincent; Allaby, Robin G

2015-02-27

The Mesolithic-to-Neolithic transition marked the time when a hunter-gatherer economy gave way to agriculture, coinciding with rising sea levels. Bouldnor Cliff, is a submarine archaeological site off the Isle of Wight in the United Kingdom that has a well-preserved Mesolithic paleosol dated to 8000 years before the present. We analyzed a core obtained from sealed sediments, combining evidence from microgeomorphology and microfossils with sedimentary ancient DNA (sedaDNA) analyses to reconstruct floral and faunal changes during the occupation of this site, before it was submerged. In agreement with palynological analyses, the sedaDNA sequences suggest a mixed habitat of oak forest and herbaceous plants. However, they also provide evidence of wheat 2000 years earlier than mainland Britain and 400 years earlier than proximate European sites. These results suggest that sophisticated social networks linked the Neolithic front in southern Europe to the Mesolithic peoples of northern Europe. Copyright © 2015, American Association for the Advancement of Science.

Higher Childhood Red Meat Intake Frequency Is Associated with Earlier Age at Menarche.

PubMed

Jansen, Erica C; Marín, Constanza; Mora-Plazas, Mercedes; Villamor, Eduardo

2016-03-09

Early age at menarche is associated with increased breast cancer risk. Red meat consumption in adolescence predicts breast cancer risk, but it is unknown whether it is also related to earlier menarche. We studied the association between intake of red meat at ages 5-12 y and age at menarche in a prospective study. We assessed usual diets with a food-frequency questionnaire in a group of 456 girls aged 8.4 ± 1.7 y and followed them for a median 5.6 y in Bogotá, Colombia. Girls were asked periodically about the occurrence and date of menarche. Median age at menarche was estimated with use of Kaplan-Meier survival probabilities by categories of red meat intake frequency. Cox proportional hazards models were used to compare the incidence of menarche by red meat intake frequency, adjusting for potential sociodemographic and dietary confounders including total energy intake and intake frequency of other animal food groups (dairy, poultry, freshwater fish, tuna/sardines, eggs, and innards). Median age at menarche was 12.4 y. After adjustment for total energy intake, maternal parity, and socioeconomic status, red meat intake frequency was inversely associated with age at menarche. When compared with girls with red meat intake <4 times/wk, those consuming it ≥2 times/d had a significantly earlier age at menarche (HR: 1.64; 95% CI: 1.11, 2.41; P-trend = 0.0009). Incidentally, we found that girls with tuna/sardine intake >1 time/wk had a significantly later age at menarche (HR: 0.62; 95% CI: 0.42, 0.90; P = 0.01) than those with intake <1 time/mo. Intake frequency of other animal food groups was not significantly associated with age at menarche. Higher red meat intake frequency during childhood is associated with an earlier age at menarche, whereas greater fatty fish intake frequency is associated with a later menarcheal age. © 2016 American Society for Nutrition.

Earlier occurrence and increased explanatory power of climate for the first incidence of potato late blight caused by Phytophthora infestans in Fennoscandia.

PubMed

Lehsten, Veiko; Wiik, Lars; Hannukkala, Asko; Andreasson, Erik; Chen, Deliang; Ou, Tinghai; Liljeroth, Erland; Lankinen, Åsa; Grenville-Briggs, Laura

2017-01-01

Late blight (caused by Phytophthora infestans) is a devastating potato disease that has been found to occur earlier in the season over the last decades in Fennoscandia. Up until now the reasons for this change have not been investigated. Possible explanations for this change are climate alterations, changes in potato production or changes in pathogen biology, such as increased fitness or changes in gene flow within P. infestans populations. The first incidence of late blight is of high economic importance since fungicidal applications should be typically applied two weeks before the first signs of late blight and are repeated on average once a week. We use field observations of first incidence of late blight in experimental potato fields from five sites in Sweden and Finland covering a total of 30 years and investigate whether the earlier incidence of late blight can be related to the climate. We linked the field data to meteorological data and found that the previous assumption, used in common late blight models, that the disease only develops at relative humidity levels above 90% had to be rejected. Rather than the typically assumed threshold relationship between late blight disease development and relative humidity we found a linear relationship. Our model furthermore showed two distinct responses of late blight to climate. At the beginning of the observation time (in Sweden until the early 90s and in Finland until the 2000s) the link between climate and first incidence was very weak. However, for the remainder of the time period the link was highly significant, indicating a change in the biological properties of the pathogen which could for example be a change in the dominating reproduction mode or a physiological change in the response of the pathogen to climate. The study shows that models used in decision support systems need to be checked and re-parametrized regularly to be able to capture changes in pathogen biology. While this study was performed with

Climate of the past 2000 years in IPCC AR5 (Invited)

NASA Astrophysics Data System (ADS)

Masson-Delmotte, V.

2013-12-01

Different aspects of the climate of the past 2000 years are covered in several chapters of the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change, including information from paleoclimate archives, changes in the carbon and biogeochemical cycles, changes in sea level, climate model evaluation and detection and attribution. This presentation will summarize the main findings regarding pre-industrial changes in radiative forcings, reconstructed and simulated temperature variations at the hemispheric and regional scales, as well as global sea level for the past 2000 years, in the perspective of the current and earlier interglacial periods.

Student Acceptance and Application of Peer Assessment in a Final Year Genetics Undergraduate Oral Presentation

ERIC Educational Resources Information Center

Verkade, Heather; Bryson-Richardson, Robert J.

2013-01-01

Undergraduate students benefit from observation of each other's oral presentations through both exposure to content and observation of presentation style. In order to increase the engagement and reflection of final year students in an oral presentation task, a peer assessment component was introduced using a rubric that emphasised scientific…

PTC Mid Year Seminar. Collection of Presentations (Yokohama, Japan, June 3-4, 1997).

ERIC Educational Resources Information Center

Ando, Takatoshi

This proceedings volume from the Pacific Telecommunications Council Mid-Year Seminar includes the following presentations: "Platform and Equipment for Access Network" (Yukou Mochida); "Integrated Services Television: Digital Age TV with a Built-in Home Server" (Tatsuhito Nagaya); "Future of the Internet: Future of…

Field evidence for earlier leaf-out dates in alpine grassland on the eastern Tibetan Plateau from 1990 to 2006.

PubMed

Zhou, H K; Yao, B Q; Xu, W X; Ye, X; Fu, J J; Jin, Y X; Zhao, X Q

2014-08-01

Worldwide, many plant species are experiencing an earlier onset of spring phenophases due to climate warming. Rapid recent temperature increases on the Tibetan Plateau (TP) have triggered changes in the spring phenology of the local vegetation. However, remote sensing studies of the land surface phenology have reached conflicting interpretations about green-up patterns observed on the TP since the mid-1990s. We investigated this issue using field phenological observations from 1990 to 2006, for 11 dominant plants on the TP at the levels of species, families (Gramineae-grasses and Cyperaceae-sedges) and vegetation communities (alpine meadow and alpine steppe). We found a significant trend of earlier leaf-out dates for one species (Koeleria cristata). The leaf-out dates of both Gramineae and Cyperaceae had advanced (the latter significantly, starting an average of 9 days later per year than the former), but the correlation between them was significant. The leaf-out dates of both vegetation communities also advanced, but the pattern was only significant in the alpine meadow. This study provides the first field evidence of advancement in spring leaf phenology on the TP and suggests that the phenology of the alpine steppe can differ from that of the alpine meadow. These findings will be useful for understanding ecosystem responses to climate change and for grassland management on the TP. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Can social media data lead to earlier detection of drug‐related adverse events?

PubMed Central

Cremieux, Pierre; Audenrode, Marc Van; Vekeman, Francis; Karner, Paul; Zhang, Haimin; Greenberg, Paul

2016-01-01

Abstract Purpose To compare the patient characteristics and the inter‐temporal reporting patterns of adverse events (AEs) for atorvastatin (Lipitor®) and sibutramine (Meridia®) in social media (AskaPatient.com) versus the FDA Adverse Event Reporting System (FAERS). Methods We identified clinically important AEs associated with atorvastatin (muscle pain) and sibutramine (cardiovascular AEs), compared their patterns in social media postings versus FAERS and used Granger causality tests to assess whether social media postings were useful in forecasting FAERS reports. Results We analyzed 998 and 270 social media postings between 2001 and 2014, 69 003 and 7383 FAERS reports between 1997 and 2014 for atorvastatin and sibutramine, respectively. Social media reporters were younger (atorvastatin: 53.9 vs. 64.0 years, p < 0.001; sibutramine: 36.8 vs. 43.8 years, p < 0.001). Social media reviews contained fewer serious AEs (atorvastatin, pain: 2.5% vs. 38.2%; sibutramine, cardiovascular issues: 7.9% vs. 63.0%; p < 0.001 for both) and concentrated on fewer types of AEs (proportion comprising the top 20 AEs: atorvastatin, 88.7% vs. 55.4%; sibutramine, 86.3% vs. 65.4%) compared with FAERS. While social media sibutramine reviews mentioning cardiac issues helped predict those in FAERS 11 months later (p < 0.001), social media atorvastatin reviews did not help predict FAERS reports. Conclusions Social media AE reporters were younger and focused on less‐serious and fewer types of AEs than FAERS reporters. The potential for social media to provide earlier indications of AEs compared with FAERS is uncertain. Our findings highlight some of the promises and limitations of online social media versus conventional pharmacovigilance sources and the need for careful interpretation of the results. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. PMID:27601271

Can social media data lead to earlier detection of drug-related adverse events?

PubMed

Duh, Mei Sheng; Cremieux, Pierre; Audenrode, Marc Van; Vekeman, Francis; Karner, Paul; Zhang, Haimin; Greenberg, Paul

2016-12-01

To compare the patient characteristics and the inter-temporal reporting patterns of adverse events (AEs) for atorvastatin (Lipitor ® ) and sibutramine (Meridia ® ) in social media (AskaPatient.com) versus the FDA Adverse Event Reporting System (FAERS). We identified clinically important AEs associated with atorvastatin (muscle pain) and sibutramine (cardiovascular AEs), compared their patterns in social media postings versus FAERS and used Granger causality tests to assess whether social media postings were useful in forecasting FAERS reports. We analyzed 998 and 270 social media postings between 2001 and 2014, 69 003 and 7383 FAERS reports between 1997 and 2014 for atorvastatin and sibutramine, respectively. Social media reporters were younger (atorvastatin: 53.9 vs. 64.0 years, p < 0.001; sibutramine: 36.8 vs. 43.8 years, p < 0.001). Social media reviews contained fewer serious AEs (atorvastatin, pain: 2.5% vs. 38.2%; sibutramine, cardiovascular issues: 7.9% vs. 63.0%; p < 0.001 for both) and concentrated on fewer types of AEs (proportion comprising the top 20 AEs: atorvastatin, 88.7% vs. 55.4%; sibutramine, 86.3% vs. 65.4%) compared with FAERS. While social media sibutramine reviews mentioning cardiac issues helped predict those in FAERS 11 months later (p < 0.001), social media atorvastatin reviews did not help predict FAERS reports. Social media AE reporters were younger and focused on less-serious and fewer types of AEs than FAERS reporters. The potential for social media to provide earlier indications of AEs compared with FAERS is uncertain. Our findings highlight some of the promises and limitations of online social media versus conventional pharmacovigilance sources and the need for careful interpretation of the results. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

The HepHIV 2017 Conference in Malta: joining forces for the earlier diagnosis of HIV and viral hepatitis.

PubMed

Raben, D; Hoekstra, M; Sperle, I; Amato Gauci, A J; Gauci, C; West, B; Sullivan, A; Lazarus, J V; Platteau, T; Rockstroh, J K

2018-02-01

The objective of the article is to provide an overview of the results of the HepHIV 2017 Conference organized by the HIV in Europe initiative under the Maltese EU Presidency in January 2017. A thourough review of all conference presentations (oral and poster presentations) was performed to retrieve the key outcomes of the conference. The key result from the conference was a call to action summarising key priorities in HIV and viral hepatitis testing and linkage to care. This included improving monitoring of viral hepatitis and HIV, mixing testing strategies and ensuring policy support. The important contribution and outcomes of EU funded projects OptTEST and EuroHIVEdat was highlighted. An integrated approach to earlier testing and linkage to care across diseases is needed in Europe and the HepHIV conferences create an important forum to reach this aim. © 2018 British HIV Association.

Return of hunger following a relatively high carbohydrate breakfast is associated with earlier recorded glucose peak and nadir

PubMed Central

Chandler-Laney, Paula C.; Morrison, Shannon A.; Goree, Laura Lee T.; Ellis, Amy C.; Casazza, Krista; Desmond, Renee; Gower, Barbara A

2014-01-01

Objective To test the hypothesis that a breakfast meal with high carbohydrate/ low fat results in an earlier increase in postprandial glucose and insulin, a greater decrease below baseline in postprandial glucose, and an earlier return of appetite, compared to a low carbohydrate/high fat meal. Design Overweight but otherwise healthy adults (n=64) were maintained on one of two eucaloric diets: high carbohydrate/low fat (HC/LF; 55:27:18% kcals from carbohydrate: fat: protein) versus low carbohydrate/high fat (LC/HF; 43:39:18% kcals from carbohydrate: fat: protein). After 4 weeks of acclimation to the diets, participants underwent a meal test during which circulating glucose and insulin and self-reported hunger and fullness, were measured before and after consumption of breakfast from their assigned diets. Results The LC/HF meal resulted in a later time at the highest and lowest recorded glucose, higher glucose concentrations at 3 and 4 hours post-meal, and lower insulin incremental area under the curve. Participants consuming the LC/HF meal reported lower appetite 3 and 4 hours following the meal, a response that was associated with the timing of the highest and lowest recorded glucose. Conclusions Modest increases in meal carbohydrate content at the expense of fat content may facilitate weight gain over the long-term by contributing to an earlier rise and fall of postprandial glucose concentrations and an earlier return of appetite. PMID:24819342

Simultaneous colonic adenocarcinoma and medulloblastoma in a 12-year-old with biallelic deletions in PMS2.

PubMed

Lindsay, Holly; Jubran, Rima F; Wang, Larry; Kipp, Benjamin R; May, William A

2013-08-01

We describe a 12-year-old girl, simultaneously presenting with colonic adenocarcinoma and medulloblastoma from bialleic deletions in the mismatch repair gene PMS2. Her distinctive physical and clinical findings are characteristic of constitutional mismatch repair deficiency syndrome. Earlier recognition of such findings may permit better screening and more effective treatment. Copyright © 2013 Mosby, Inc. All rights reserved.

Primary Intestinal Lymphangiectasia (Waldmann's Disease) Presenting with Chylous Effusions in a 15-Year-Old.

PubMed

Surampalli, Vijay; Ramaswamy, Srinath; Surendran, Deepanjali; Bammigatti, Chanaveerappa; Swaminathan, Rathinam Palamalai

2017-08-01

Primary Intestinal Lymphangiectasia (PIL) is a rare disease of unknown aetiology which presents in the paediatric age group with anasarca, diarrhoea, hypoproteinaemia, lymphoedema and chylous effusions. Tuberculosis, filariasis, chest trauma, malignancies and haematological disorders usually contribute to most cases of secondary lymphangiectasia and chylous effusions. We hereby describe a case of PIL presenting with chylous effusions which remained undiagnosed for eight years.

The Magic Shrinking Machine Revisited: The Presence of Props at Recall Facilitates Memory in 3-Year-Olds

ERIC Educational Resources Information Center

Dahl, Jonna J.; Kingo, Osman S.; Krøjgaard, Peter

2015-01-01

In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing…

An 11-Year Analysis of Emergency Presentations of Melioidosis in Northeastern Malaysia.

PubMed

Yazid, Mohd Boniami; Fauzi, Mohd Hashairi; Hasan, Habsah; Md Noh, Abu Yazid; Deris, Zakuan Zainy

2017-06-01

A neglected tropical disease, melioidosis is known to have variability in clinical presentations. Here, we described clinical features that should alert the physicians on the possibility of melioidosis. In this review of 86 cases from 2001 to 2011, the common presentations of melioidosis in the Emergency Department (ED), Hospital Universiti Sains Malaysia were; male gender (79.1 %), in working age group (47.8 ± 15.2 year-old), worked in contact with soil (73.3 %), presented with fever (91.9 %), in rainy season (55.8 %), have underlying diabetes mellitus (79.1 %), have leukocytosis (67.4 %) and high blood glucose (62.8 %) during presentation. In 34.9 % of cases, the antimicrobials were initiated at the ED and only 10.5 % include antimelioid drugs. Thirty-one patients (36.0 %) died due to melioidosis and 51.6 % of this were within 48 h of admission. Despite high mortality rate, the clinical awareness on the possibility of melioidosis among emergency physicians is still low and need to be strengthened.

Ten Years of Using Presentations at a Student Conference as a Final Assessment

ERIC Educational Resources Information Center

Lund, Nick

2013-01-01

The final assessment for all psychology courses in the department of interdisciplinary studies, MMU Cheshire programmes, in the past 10 years has been a presentation of project work at an undergraduate conference. It is argued that this acts as an "authentic" assessment method which helps prepare students for future experiences. Alumni…

Career Decision Status as a Predictor of Resignation Behavior Five Years Later

ERIC Educational Resources Information Center

Earl, Joanne K.; Minbashian, Amirali; Sukijjakhamin, Aun; Bright, Jim E. H.

2011-01-01

This paper extends earlier research exploring the relationship between career decision status and work outcomes by examining resignation behavior in a group of new graduates five years after initial appointment. On appointment various measures were collected including career decision status variables. Earlier research identified a significant…

Realizing the Cognitive Potential of Children 5-7 with a Mathematics Focus: Post-Test and Long-Term Effects of a 2-Year Intervention

ERIC Educational Resources Information Center

Shayer, Michael; Adhami, Mundher

2010-01-01

Background: In the context of the British Government's policy directed on improving standards in schools, this paper presents research on the effects of a programme intended to promote the cognitive development of children in the first 2 years of primary school (Y1 & 2, aged 5-7 years). The programme is based on earlier work dealing with…

College-Adult Reading--Past, Present and Future.

ERIC Educational Resources Information Center

Spache, George D.

College-adult reading research trends are discussed. The reading process; the influence of vision, perception, and personality; and program outcomes are noted as major trends of past studies, and a list of mistaken assumptions in these earlier studies is given. Present research shifts to the study of the role of both teacher and student…

Identified research directions for using manufacturing knowledge earlier in the product lifecycle

PubMed Central

Hedberg, Thomas D.; Hartman, Nathan W.; Rosche, Phil; Fischer, Kevin

2016-01-01

Design for Manufacturing (DFM), especially the use of manufacturing knowledge to support design decisions, has received attention in the academic domain. However, industry practice has not been studied enough to provide solutions that are mature for industry. The current state of the art for DFM is often rule-based functionality within Computer-Aided Design (CAD) systems that enforce specific design requirements. That rule-based functionality may or may not dynamically affect geometry definition. And, if rule-based functionality exists in the CAD system, it is typically a customization on a case-by-case basis. Manufacturing knowledge is a phrase with vast meanings, which may include knowledge on the effects of material properties decisions, machine and process capabilities, or understanding the unintended consequences of design decisions on manufacturing. One of the DFM questions to answer is how can manufacturing knowledge, depending on its definition, be used earlier in the product lifecycle to enable a more collaborative development environment? This paper will discuss the results of a workshop on manufacturing knowledge that highlights several research questions needing more study. This paper proposes recommendations for investigating the relationship of manufacturing knowledge with shape, behavior, and context characteristics of product to produce a better understanding of what knowledge is most important. In addition, the proposal includes recommendations for investigating the system-level barriers to reusing manufacturing knowledge and how model-based manufacturing may ease the burden of knowledge sharing. Lastly, the proposal addresses the direction of future research for holistic solutions of using manufacturing knowledge earlier in the product lifecycle. PMID:27990027

Identified research directions for using manufacturing knowledge earlier in the product lifecycle.

PubMed

Hedberg, Thomas D; Hartman, Nathan W; Rosche, Phil; Fischer, Kevin

2017-01-01

Design for Manufacturing (DFM), especially the use of manufacturing knowledge to support design decisions, has received attention in the academic domain. However, industry practice has not been studied enough to provide solutions that are mature for industry. The current state of the art for DFM is often rule-based functionality within Computer-Aided Design (CAD) systems that enforce specific design requirements. That rule-based functionality may or may not dynamically affect geometry definition. And, if rule-based functionality exists in the CAD system, it is typically a customization on a case-by-case basis. Manufacturing knowledge is a phrase with vast meanings, which may include knowledge on the effects of material properties decisions, machine and process capabilities, or understanding the unintended consequences of design decisions on manufacturing. One of the DFM questions to answer is how can manufacturing knowledge, depending on its definition, be used earlier in the product lifecycle to enable a more collaborative development environment? This paper will discuss the results of a workshop on manufacturing knowledge that highlights several research questions needing more study. This paper proposes recommendations for investigating the relationship of manufacturing knowledge with shape, behavior, and context characteristics of product to produce a better understanding of what knowledge is most important. In addition, the proposal includes recommendations for investigating the system-level barriers to reusing manufacturing knowledge and how model-based manufacturing may ease the burden of knowledge sharing. Lastly, the proposal addresses the direction of future research for holistic solutions of using manufacturing knowledge earlier in the product lifecycle.

Inevitable end-of-21st-century trends toward earlier surface runoff timing in California's Sierra Nevada Mountains

NASA Astrophysics Data System (ADS)

Schwartz, M. A.; Hall, A. D.; Sun, F.; Walton, D.; Berg, N.

2015-12-01

Hybrid dynamical-statistical downscaling is used to produce surface runoff timing projections for California's Sierra Nevada, a high-elevation mountain range with significant seasonal snow cover. First, future climate change projections (RCP8.5 forcing scenario, 2081-2100 period) from five CMIP5 global climate models (GCMs) are dynamically downscaled. These projections reveal that future warming leads to a shift toward earlier snowmelt and surface runoff timing throughout the Sierra Nevada region. Relationships between warming and surface runoff timing from the dynamical simulations are used to build a simple statistical model that mimics the dynamical model's projected surface runoff timing changes given GCM input or other statistically-downscaled input. This statistical model can be used to produce surface runoff timing projections for other GCMs, periods, and forcing scenarios to quantify ensemble-mean changes, uncertainty due to intermodel variability and consequences stemming from choice of forcing scenario. For all CMIP5 GCMs and forcing scenarios, significant trends toward earlier surface runoff timing occur at elevations below 2500m. Thus, we conclude that trends toward earlier surface runoff timing by the end-of-the-21st century are inevitable. The changes to surface runoff timing diagnosed in this study have implications for many dimensions of climate change, including impacts on surface hydrology, water resources, and ecosystems.

Treatment of phosphate retention: The earlier the better?

PubMed Central

Biggar, Patrick; Fung, Samuel K.S.; Ketteler, Markus

2014-01-01

Over the last 15 years, our knowledge and understanding of the underlying mechanisms involved in the regulation of calcium and phosphate homeostasis in chronic kidney disease have advanced dramatically. Contrary to general opinion in the 20th century that moderate hypercalcemia and hyperphosphatemia were acceptable in treating secondary hyperparathyroidism, the calcium and phosphate load is increasingly perceived to be a major trigger of vascular and soft tissue calcification. The current treatment options are discussed in view of historical developments and the expectations of the foreseeable future, focusing on the early treatment of hyperphosphatemia. At present, we lack indisputable evidence that active intervention using currently available drugs is of benefit to patients in chronic kidney disease stages 3 and 4. PMID:26877944

Clinical characteristics and presentation of ameloblastomas: an 8-year retrospective study of 240 cases in Eastern Nigeria.

PubMed

Chukwuneke, F N; Anyanechi, C E; Akpeh, J O; Chukwuka, A; Ekwueme, O C

2016-05-01

Our aim was to summarise the clinical characteristics and presentation of ameloblastomas in eastern Nigeria. We organised a retrospective study of 240 patients who presented with ameloblastomas to the Oral and Maxillofacial Surgery units of five specialist hospitals in the eastern states of Nigeria over an eight-year period (2004-2011). We analysed the casenotes, and categorised the cases by site of tumour, age, sex, and time of presentation. There were 117 men (49%) (mean (SD) age 43 (6.2) years) and 123 women (51%) (mean (SD) age 32 (4.7) years), a male:female ratio of 1:1.1. The largest age group was 20-39 years (n=102, 43%), and the most common site was the anterior mandible (n=140, 58%). Most of the patients presented late. Our results show that the most common site of ameloblastomas in Eastern Nigeria is the anterior mandible and that women are affected more than men, which is at variance with the results of most other studies. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Gastric Metastasis as the First Presentation One Year Before Diagnosis of Primary Breast Cancer.

PubMed

Woo, Joohyun; Lee, Joo-Ho; Lee, Kyoung Eun; Sung, Sun Hee; Lim, Woosung

2018-03-26

BACKGROUND Metastasis to the stomach can be found as the first presentation of breast cancer, although it is very rare. The authors report an unusual case of metastasis to the stomach as the first presentation of breast cancer, which had a good prognosis. CASE REPORT A 51-year-old female underwent radical subtotal gastrectomy and chemotherapy because of gastric cancer with distant metastasis. At the time of diagnosis of gastric cancer, she had a negative result from routine mammography. One year later, a newly detected lesion on routine mammography was confirmed as breast cancer. Initial diagnosis of gastric cancer was changed to metastatic carcinoma from breast cancer through immunohistochemistry after bilateral mastectomy. After the completion of chemotherapy, she is currently receiving treatment with letrozole, without recurrence for 66 months. CONCLUSIONS Considering metastasis from breast cancer might be needed when unusual presentation of gastric cancer is observed even though gastric cancer is still one of the most common malignancies in Korea. Immunohistochemical analysis is helpful for diagnosis. Surgery for metastatic carcinoma of the stomach could be another option for treatment.

Phenotypic and Genotypic Characterisation of Inflammatory Bowel Disease Presenting Before the Age of 2 years

PubMed Central

Dziubak, Robert; Pescarin, Matilde; Drury, Suzanne; Godwin, Heather; Reeve, Kate; Chadokufa, Sibongile; Huggett, Bonita; Sider, Sara; James, Chela; Acton, Nikki; Cernat, Elena; Gasparetto, Marco; Noble-Jamieson, Gabi; Kiparissi, Fevronia; Elawad, Mamoun; Beales, Phil L.; Sebire, Neil J.; Gilmour, Kimberly; Uhlig, Holm H.; Bacchelli, Chiara; Shah, Neil

2017-01-01

Abstract Objectives: Inflammatory bowel disease [IBD] presenting in early childhood is extremely rare. More recently, progress has been made to identify children with monogenic forms of IBD predominantly presenting very early in life. In this study, we describe the heterogeneous phenotypes and genotypes of patients with IBD presenting before the age of 2 years and establish phenotypic features associated with underlying monogenicity. Methods: Phenotype data of 62 children with disease onset before the age of 2 years presenting over the past 20 years were reviewed. Children without previously established genetic diagnosis were prospectively recruited for next-generation sequencing. Results: In all, 62 patients [55% male] were identified. The median disease onset was 3 months of age (interquartile range [IQR]: 1 to 11). Conventional IBD classification only applied to 15 patients with Crohn’s disease [CD]-like [24%] and three with ulcerative colitis [UC]-like [5%] phenotype; 44 patients [71%] were diagnosed with otherwise unclassifiable IBD. Patients frequently required parenteral nutrition [40%], extensive immunosuppression [31%], haematopoietic stem-cell transplantation [29%], and abdominal surgery [19%]. In 31% of patients, underlying monogenic diseases were established [EPCAM, IL10, IL10RA, IL10RB, FOXP3, LRBA, SKIV2L, TTC37, TTC7A]. Phenotypic features significantly more prevalent in monogenic IBD were: consanguinity, disease onset before the 6th month of life, stunting, extensive intestinal disease and histological evidence of epithelial abnormalities. Conclusions: IBD in children with disease onset before the age of 2 years is frequently unclassifiable into Crohn’s disease and ulcerative colitis, particularly treatment resistant, and can be indistinguishable from monogenic diseases with IBD-like phenotype. PMID:27302973

The evaluation of clinical and cost outcomes associated with earlier initiation of insulin in patients with type 2 diabetes mellitus.

PubMed

Smolen, Harry J; Murphy, Daniel R; Gahn, James C; Yu, Xueting; Curtis, Bradley H

2014-09-01

The treatment for patients with type 2 diabetes mellitus (T2DM) follows a stepwise progression. As a treatment loses its effectiveness, it is typically replaced with a more complex and frequently more costly treatment. Eventually this progression leads to the use of basal insulin typically with concomitant treatments (e.g., metformin, a GLP-1 RA [glucagon-like peptide-1 receptor agonist], a TZD [thiazolidinedione] or a DPP-4i [dipeptidyl peptidase 4 inhibitor]) and, ultimately, to basal-bolus insulin in some forms. As the cost of oral antidiabetics (OADs) and noninsulin injectables have approached, and in some cases exceeded, the cost of insulin, we reexamined the placement of insulin in T2DM treatment progression. Our hypothesis was that earlier use of insulin produces clinical and cost benefits due to its superior efficacy and treatment scalability at an acceptable cost when considered over a 5-year period. To (a) estimate clinical and payer cost outcomes of initiating insulin treatment for patients with T2DM earlier in their treatment progression and (b) estimate clinical and payer cost outcomes resulting from delays in escalating treatment for T2DM when indicated by patient hemoglobin A1c levels. We developed a Monte Carlo microsimulation model to estimate patients reaching target A1c, diabetes-related complications, mortality, and associated costs under various treatment strategies for newly diagnosed patients with T2DM. Treatment efficacies were modeled from results of randomized clinical trials, including the time and rate of A1c drift. A typical treatment progression was selected based on the American Diabetes Association and the European Association for the Study of Diabetes guidelines as the standard of care (SOC). Two treatment approaches were evaluated: two-stage insulin (basal plus antidiabetics followed by biphasic plus metformin) and single-stage insulin (biphasic plus metformin). For each approach, we analyzed multiple strategies. For each analysis

Advanced seasonal reproductive development in a male urban bird is reflected in earlier plasma luteinizing hormone rise but not energetic status.

PubMed

Davies, Scott; Behbahaninia, Hirbod; Giraudeau, Mathieu; Meddle, Simone L; Waites, Kyle; Deviche, Pierre

2015-12-01

Urban animals inhabit an environment considerably different than do their non-urban conspecifics, and to persist urban animals must adjust to these novel environments. The timing of seasonal reproductive development (i.e., growth of gonads and secondary sex organs) is a fundamental determinant of the breeding period and is frequently advanced in urban bird populations. However, the underlying mechanism(s) by which birds adjust the timing of reproductive development to urban areas remain(s) largely unknown. Here, we compared the timing of vernal reproductive development in free-ranging urban and non-urban male Abert's Towhees, Melozone aberti, in Phoenix, Arizona, USA, and tested the non-mutually exclusive hypotheses that earlier reproductive development is due to improved energetic status and/or earlier increase in endocrine activity of the reproductive system. We found that urban birds initiated testicular development earlier than non-urban birds, but this disparity was not associated with differences in body condition, fat stores, or innate immune performance. These results provide no support for the hypothesis that energetic constraints are responsible for delayed reproductive development of non-urban relative to urban male Abert's Towhees. Urban birds did, however, increase their plasma luteinizing hormone, but not plasma testosterone, earlier than non-urban birds. These findings suggest that adjustment to urban areas by Abert's Towhees involves increases in the endocrine activity of the anterior pituitary gland and/or hypothalamus earlier than non-urban towhees. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Eye injuries with metal missiles presenting to an emergency center: a three year study.

PubMed

Schwartz, J G; Somerset, J S; Harrison, J M; Garriott, J C; Castorena, J L

1991-07-01

The authors retrospectively evaluated 33 eye injuries due to metal missiles in 31 patients presenting to our emergency center over the last 3 years. Injuries occurred most frequently when the patients were grinding metal or working on their cars. The type of metal involved in the injury often dictates the type of ophthalmic reaction that will occur. A discussion of intraocular metallic foreign bodies with an emphasis on electroretinograms and metal analysis is presented.

A 29-Year-Old Harken Disk Mitral Valve

PubMed Central

Hsi, David H.; Ryan, Gerald F.; Taft, Janice; Arnone, Thomas J.

2003-01-01

An 81-year-old woman was evaluated for prosthetic mitral valve function. She had received a Harken disk mitral valve 29 years earlier due to severe mitral valve disease. This particular valve prosthesis is known for premature disk edge wear and erosion. The patient's 2-dimensional Doppler echocardiogram showed the distinctive appearance of a disk mitral valve prosthesis. Color Doppler in diastole showed a unique crown appearance, with initial flow acceleration around the disk followed by convergence to laminar flow in the left ventricle. Cineradiographic imaging revealed normal valve function and minimal disk erosion. We believe this to be the longest reported follow-up of a surviving patient with a rare Harken disk valve. We present images with unique echocardiographic and cineangiographic features. (Tex Heart Inst J 2003;30:319–21) PMID:14677746

Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus.

PubMed

Heida, Karst Y; Franx, Arie; van Rijn, Bas B; Eijkemans, Marinus J C; Boer, Jolanda M A; Verschuren, Monique W M; Oudijk, Martijn A; Bots, Michiel L; van der Schouw, Yvonne T

2015-12-01

A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of hypertension and T2D. Between 1993 and 1997, 22 265 ever-pregnant women were included from the European Prospective Investigation into Cancer and Nutrition-NL study, aged 20 to 70 years at baseline. Details on complications of pregnancy and known hypertension were obtained by questionnaire. Blood pressure was measured at enrollment. Participants were followed for the occurrence of CVD events. Data were analyzed using ANCOVA, multivariable logistic regression, and Cox proportional hazard (with HDP and GDM as time-dependent variables for T2D and CVD) models. At enrollment, women with a HDP reported diagnosis of hypertension 7.7 years earlier (95% confidence interval [CI] 6.9-8.5) and women with GDM reported diagnosis of T2D 7.7 years earlier (95% CI 5.8-9.6) than women without pregnancy complications. After adjustment for potential confounders, HDP was associated with presence of hypertension at enrollment (odds ratio 2.12, 95% CI 1.98-2.28) and onset of CVD later in life (hazard ratio 1.21, 95% CI 1.10-1.32). After including the intermediates hypertension and T2D in the model, the risk of CVD later in life decreased (hazard ratio 1.09, 95% CI 1.00-1.20). GDM was associated with an increased risk of developing T2D later in life (hazard ratio 3.68, 95% CI 2.77-4.90), but not with risk of CVD. HDP and GDM have a substantial impact on the risk of CVD and are potentially important indicators for preventive cardiovascular risk management. © 2015 American Heart Association, Inc.

Retiform hemangioendothelioma developed on the site of an earlier cystic lymphangioma in a six-year-old girl.

PubMed

Albertini, Anne-Fore; Brousse, Nicole; Bodemer, Christine; Calonje, Eduardo; Fraitag, Sylvie

2011-10-01

Retiform hemangioendothelioma (RH) is a rare low-grade malignancy angiosarcoma, with a high rate of local recurrence and a low metastatic risk. A 6 year-old girl with a large cervical cystic lymphangioma diagnosed by ultrasound and Doppler ultrasound, which showed a large multiloculated anechoic cyst with no flow. The lymphangioma was treated with injections of Picibanil (OK-432). The tumor regressed, but after a year, she developed a poorly limited infiltrated plaque spreading out regularly over her chest, back, and shoulder. The biopsy showed a poorly limited dermal and subcutaneous vascular proliferation composed of elongated arborising vessels lined with ovoid endothelial cells in a hobnail pattern. In addition, the deep part of the lesion showed typical features of a papillary intralymphatic angioendothelioma pattern (PILA) or Dabska tumor. The endothelial cells strongly expressed podoplanin (D2-40). A diagnosis of RH with focal areas of PILA was reached. The girl died 8 months after surgery of hypovolemic shock in a context of diffuse lymphangiomatosis with pulmonary localization. To our knowledge, RH has hardly ever been described in children. This entity exhibits a continuum with the PILA, sharing not only morphological and immunohistochemical similarities but also its ability to develop in a context of a vascular anomaly, particularly a lymphangioma. The role of Picibanil in the development of this tumor can be discussed.

Single Jejunum Metastasis from Breast Cancer Arising Twelve Years after the Initial Treatment.

PubMed

Paiva, Cláudia; Garcia, José; Silva, Cristina; Araújo, Alexandra; Araújo, António; Santos, Marisa D

2016-01-01

Metastatic involvement of gastrointestinal tract from breast cancer is a rare event. We report the case of a 61-year-old woman presenting with bowel obstruction, related to metastasis of a primary breast cancer she had 12 years earlier (a triple-negative invasive ductal carcinoma treated with surgery and chemotherapy). Bowel obstruction was caused by a 20-centimeter tumor in the jejunum, involving also the transverse colon. The patient underwent en bloc resection of tumor with jejunum and transverse bowel segment and received adjuvant chemotherapy with carboplatin and paclitaxel. Twenty months later, she was alive without disease recurrence.

Phenotypic and Genotypic Characterisation of Inflammatory Bowel Disease Presenting Before the Age of 2 years.

PubMed

Kammermeier, Jochen; Dziubak, Robert; Pescarin, Matilde; Drury, Suzanne; Godwin, Heather; Reeve, Kate; Chadokufa, Sibongile; Huggett, Bonita; Sider, Sara; James, Chela; Acton, Nikki; Cernat, Elena; Gasparetto, Marco; Noble-Jamieson, Gabi; Kiparissi, Fevronia; Elawad, Mamoun; Beales, Phil L; Sebire, Neil J; Gilmour, Kimberly; Uhlig, Holm H; Bacchelli, Chiara; Shah, Neil

2017-01-01

Inflammatory bowel disease [IBD] presenting in early childhood is extremely rare. More recently, progress has been made to identify children with monogenic forms of IBD predominantly presenting very early in life. In this study, we describe the heterogeneous phenotypes and genotypes of patients with IBD presenting before the age of 2 years and establish phenotypic features associated with underlying monogenicity. Phenotype data of 62 children with disease onset before the age of 2 years presenting over the past 20 years were reviewed. Children without previously established genetic diagnosis were prospectively recruited for next-generation sequencing. In all, 62 patients [55% male] were identified. The median disease onset was 3 months of age (interquartile range [IQR]: 1 to 11). Conventional IBD classification only applied to 15 patients with Crohn's disease [CD]-like [24%] and three with ulcerative colitis [UC]-like [5%] phenotype; 44 patients [71%] were diagnosed with otherwise unclassifiable IBD. Patients frequently required parenteral nutrition [40%], extensive immunosuppression [31%], haematopoietic stem-cell transplantation [29%], and abdominal surgery [19%]. In 31% of patients, underlying monogenic diseases were established [EPCAM, IL10, IL10RA, IL10RB, FOXP3, LRBA, SKIV2L, TTC37, TTC7A]. Phenotypic features significantly more prevalent in monogenic IBD were: consanguinity, disease onset before the 6th month of life, stunting, extensive intestinal disease and histological evidence of epithelial abnormalities. IBD in children with disease onset before the age of 2 years is frequently unclassifiable into Crohn's disease and ulcerative colitis, particularly treatment resistant, and can be indistinguishable from monogenic diseases with IBD-like phenotype. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Analysis of 22,655 presentations with back pain to Perth emergency departments over five years.

PubMed

Lovegrove, Michael T; Jelinek, George A; Gibson, Nicholas P; Jacobs, Ian G

2011-09-17

Back pain is a significant cause of disability in the community, but the impact on Emergency Departments (EDs) has not been formally studied. Patients with back pain often require significant time and resources in the ED. To examine the characteristics of patients presenting with back pain to the ED, including final diagnosis, demographics of those attending and temporal distribution of presentations. Emergency presentations in the metropolitan area of Perth, Western Australia, for 2000-2004 were searched using a linked database covering all the major hospitals (Emergency Care Hospitalisation and Outcome Study database). All presentations with the triage code for back pain were extracted and analysed. A total of 22,655 presentations with back pain were identified, representing 1.9% of total presentations. Simple muscular or non-specific back pain accounted for only 43.8% of presentations, with other causes such as renal colic and pyelonephritis accounting for the majority. The young (<15 years old) and elderly (>75 years old) were more likely to have non-muscular causes for their back pain. Muscular back pain presentations occurred mostly between 0800 and 1600, with high proportions presenting on the weekends. Patients with simple muscular back pain spent a mean of 4.4 h in the ED, representing a significant outlay of resources. Back pain has a significant impact on EDs, and staff should be alert for another pathology presenting as back pain. There is a need for multidisciplinary back pain teams to be available 7 days a week, but only during the day.

Organized screening detects breast cancer at earlier stage regardless of molecular phenotype.

PubMed

Holloway, Claire M B; Jiang, Li; Whitehead, Marlo; Racz, Jennifer M; Groome, Patti A

2018-06-16

Mortality reduction attributable to organized breast screening is modest. Screening may be less effective at detecting more aggressive cancers at an earlier stage. This study was conducted to determine the relative efficacy of screening mammography to detect cancers at an earlier stage by molecular phenotype. We identified 2882 women with primary invasive breast cancer diagnosed between January 1, 2008 and December 31, 2012 and who had a mammogram through the Ontario Breast Screening Program in the 28 months before diagnosis. Five tumor phenotypes were defined by expression of estrogen (ER) and progesterone (PR) receptors and HER2/neu oncogene. We conducted univariable and multivariable analyses to describe the predictors of detection as an interval cancer. Additional analyses identified predictors of detection at stages II, III, or IV compared with stage I, by phenotype. Analyses were adjusted for the effects of age, grade, and breast density. ER negative and HER2 positive tumors were over-represented among interval cancers, and triple negative cancers were more likely than ER +/HER2 - cancers to be detected as interval cancers OR 2.5 (95% CI 2.0-3.2, p < 0.0001). Method of detection (interval vs. screen) and molecular phenotype were independently associated with stage at diagnosis (p < 0.0001), but there was no interaction between method of detection and phenotype (p = 0.44). In a screened population, triple negative and HER2 + breast cancers are diagnosed at a higher stage but this appears to be due to higher growth rates of these tumors rather than a relative inability of screening to detect them.

Earlier occurrence and increased explanatory power of climate for the first incidence of potato late blight caused by Phytophthora infestans in Fennoscandia

PubMed Central

Wiik, Lars; Hannukkala, Asko; Andreasson, Erik; Chen, Deliang; Ou, Tinghai; Liljeroth, Erland; Lankinen, Åsa

2017-01-01

Background Late blight (caused by Phytophthora infestans) is a devastating potato disease that has been found to occur earlier in the season over the last decades in Fennoscandia. Up until now the reasons for this change have not been investigated. Possible explanations for this change are climate alterations, changes in potato production or changes in pathogen biology, such as increased fitness or changes in gene flow within P. infestans populations. The first incidence of late blight is of high economic importance since fungicidal applications should be typically applied two weeks before the first signs of late blight and are repeated on average once a week. Methods We use field observations of first incidence of late blight in experimental potato fields from five sites in Sweden and Finland covering a total of 30 years and investigate whether the earlier incidence of late blight can be related to the climate. Results We linked the field data to meteorological data and found that the previous assumption, used in common late blight models, that the disease only develops at relative humidity levels above 90% had to be rejected. Rather than the typically assumed threshold relationship between late blight disease development and relative humidity we found a linear relationship. Our model furthermore showed two distinct responses of late blight to climate. At the beginning of the observation time (in Sweden until the early 90s and in Finland until the 2000s) the link between climate and first incidence was very weak. However, for the remainder of the time period the link was highly significant, indicating a change in the biological properties of the pathogen which could for example be a change in the dominating reproduction mode or a physiological change in the response of the pathogen to climate. Conclusions The study shows that models used in decision support systems need to be checked and re-parametrized regularly to be able to capture changes in pathogen biology

Suppurative Meckel Diiverticulum in a 3-Year-Old Girl Presenting with Periumbilical Cellulitis

PubMed Central

Park, Ji Sook; Lim, Chun Woo; Park, Taejin; Cho, Jae-Min; Youn, Hee-Shang

2015-01-01

Meckel diverticulum (MD) is one of the most common congenital gastrointestinal anomalies and occurs in 1.2-2% of the general population. MD usually presents with massive painless rectal bleeding, intestinal obstruction or inflammation in children and adults. Suppurative Meckel diverticulitis is uncommon in children. An experience is described of a 3-year-old girl with suppurative inflammation in a tip of MD. She complained of acute colicky abdominal pain, vomiting and periumbilical erythema. Laparoscopic surgery found a relatively long MD with necrotic and fluid-filled cystic end, which was attatched to abdominal wall caused by inflammation. Herein, we report an interesting and unusual case of a suppurative Meckel diverticulitis presenting as periumbilical cellulitis in a child. Because of its varied presentations, MD might always be considered as one of the differential diagonosis. PMID:25866736

The response of aboveground plant productivity to earlier snowmelt and summer warming in an Arctic ecosystem

NASA Astrophysics Data System (ADS)

Livensperger, C.; Steltzer, H.; Darrouzet-Nardi, A.; Sullivan, P.; Wallenstein, M. D.; Weintraub, M. N.

2012-12-01

Plant communities in the Arctic are undergoing changes in structure and function due to shifts in seasonality from changing winters and summer warming. These changes will impact biogeochemical cycling, surface energy balance, and functioning of vertebrate and invertebrate communities. To examine seasonal controls on aboveground net primary production (ANPP) in a moist acidic tundra ecosystem in northern Alaska, we shifted the growing season by accelerating snowmelt (using radiation absorbing shadecloth) and warming air and soil temperature (using 1 m2 open-top chambers), individually and in combination. After three years, we measured ANPP by harvesting up to 16 individual ramets, tillers and rhizomes for each of 7 plant species, including two deciduous shrubs, two graminoids, two evergreen shrubs and one forb during peak season. Our results show that ANPP per stem summed across the 7 species increased when snow melt occurred earlier. However, standing biomass, excluding current year growth, was also greater. The ratio of ANPP/standing biomass decreased in all treatments compared to the control. ANPP per unit standing biomass summed for the four shrub species decreases due to summer warming alone or in combination with early snowmelt; however early snowmelt alone did not lead to lower ANPP for the shrubs. ANPP per tiller or rhizome summed for the three herbaceous species increased in response to summer warming. Understanding the differential response of plants to changing seasonality will inform predictions of future Arctic plant community structure and function.

A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment.

PubMed

Treweek, Shaun; Francis, Jill J; Bonetti, Debbie; Barnett, Karen; Eccles, Martin P; Hudson, Jemma; Jones, Claire; Pitts, Nigel B; Ricketts, Ian W; Sullivan, Frank; Weal, Mark; MacLennan, Graeme

2016-12-01

Intervention Modeling Experiments (IMEs) are a way of developing and testing behavior change interventions before a trial. We aimed to test this methodology in a Web-based IME that replicated the trial component of an earlier, paper-based IME. Three-arm, Web-based randomized evaluation of two interventions (persuasive communication and action plan) and a "no intervention" comparator. The interventions were designed to reduce the number of antibiotic prescriptions in the management of uncomplicated upper respiratory tract infection. General practitioners (GPs) were invited to complete an online questionnaire and eight clinical scenarios where an antibiotic might be considered. One hundred twenty-nine GPs completed the questionnaire. GPs receiving the persuasive communication did not prescribe an antibiotic in 0.70 more scenarios (95% confidence interval [CI] = 0.17-1.24) than those in the control arm. For the action plan, GPs did not prescribe an antibiotic in 0.63 (95% CI = 0.11-1.15) more scenarios than those in the control arm. Unlike the earlier IME, behavioral intention was unaffected by the interventions; this may be due to a smaller sample size than intended. A Web-based IME largely replicated the findings of an earlier paper-based study, providing some grounds for confidence in the IME methodology. Copyright © 2016 Elsevier Inc. All rights reserved.

The Structure of Infant Cognition at 1 Year

ERIC Educational Resources Information Center

Rose, S.A.; Feldman, J.F.; Jankowski, J.J.

2005-01-01

The present study explored the dimensionality of cognition at 12 months by factor analyzing data from a large cohort of preterm and full-term infants (N=182). Two analyses were done. In the first, using only measures used earlier, when the infants were 7 months of age, the same three factors emerged at 12 months as at the earlier age-namely,…

A case of metastatic hemangiopericytoma occurring 16 years after initial presentation: with special reference to the clinical behavior and treatment of metastatic hemangiopericytoma.

PubMed

Fujita, Itsuo; Kiyama, Teruo; Chou, Kazumitsu; Kanno, Hitoshi; Naito, Zenya; Uchida, Eiji

2009-08-01

A 40-year-old woman was referred to our Department of Surgery because of an abdominal wall mass. Sixteen years earlier, she had undergone surgical resection of an inguinal tumor that had been diagnosed as a hemangiosarcoma. Fourteen months after the initial resection, the tumor recurred locally, and complete resection was performed. Twenty-nine months later, computed tomography showed multiple metastatic tumors in the lung. All these tumors were resected during thoracoscopic surgery. Thirteen years after the patient's 3rd operation, a firm mass was detected in the left lower quadrant of the abdominal wall. Magnetic resonance image showed a well-defined mass with heterogeneous contrast enhancement within the rectus abdominis muscle. Positron emission tomography-computed tomography demonstrated no recurrent tumors other than this mass. Complete resection was performed. Microscopic examination showed that this tumor was composed of hypercellular spindle cells and staghorn-shaped blood vessels. The average number of mitotic figures was 28 per 10 high-power fields. Immunohistochemical examination of the tumor showed focal positivity for CD34. Therefore, the tumor was diagnosed as a metastatic hemangiopericytoma with malignant potential. Careful long-term follow-up is required because metastases can develop after an extended disease-free interval. Aggressive surgical treatment is recommended for distant metastases.

Sarcoidosis presenting as granulomatous myositis in a 16-year-old adolescent.

PubMed

Orandi, Amir B; Eutsler, Eric; Ferguson, Cole; White, Andrew J; Kitcharoensakkul, Maleewan

2016-11-10

Sarcoidosis is a multi-system disease characterized by the presence of non-caseating epithelioid granulomas in affected tissues, including skeletal muscle. These organized collections of immune cells have important pathophysiologic action including cytokine production leading to inflammation as well as enzymatic conversion of cholecalciferol to calcitriol via 1-α hydroxylase. There are limited reports of isolated granulomatous myositis causing hypercalcemia in pediatric patients. Our patient uniquely presented with symptoms from hypercalcemia and renal insufficiency caused by an overwhelming burden of granulomatous myositis in her lower extremities, but was otherwise asymptomatic. A 16 year old Caucasian female presented with protracted symptoms of fatigue, nausea and prominent weight loss with laboratory evidence of hypercalcemia and renal insufficiency. She lacked clinical and physical findings of arthritis, weakness, rash, uveitis, fever, lymphadenopathy or respiratory symptoms. After extensive negative investigations, re-examination yielded subtle soft tissue changes in her lower extremities, with striking MRI findings of extensive myositis without correlative weakness or serum enzyme elevation. Biopsy showed the presence of non-caseating epithelioid granulomas and calcium oxalate crystals. The patient responded well to prednisone and methotrexate but relapsed with weaning of steroids. She reachieved remission with addition of adalimumab. Sarcoidosis should be considered in patients presenting with symptomatic hypercalcemia with no apparent causes and negative routine workup. The absences of decreased muscle strength or elevated muscle enzymes do not preclude the diagnosis of granulomatous myositis.

The cortical representation of the speech envelope is earlier for audiovisual speech than audio speech.

PubMed

Crosse, Michael J; Lalor, Edmund C

2014-04-01

Visual speech can greatly enhance a listener's comprehension of auditory speech when they are presented simultaneously. Efforts to determine the neural underpinnings of this phenomenon have been hampered by the limited temporal resolution of hemodynamic imaging and the fact that EEG and magnetoencephalographic data are usually analyzed in response to simple, discrete stimuli. Recent research has shown that neuronal activity in human auditory cortex tracks the envelope of natural speech. Here, we exploit this finding by estimating a linear forward-mapping between the speech envelope and EEG data and show that the latency at which the envelope of natural speech is represented in cortex is shortened by >10 ms when continuous audiovisual speech is presented compared with audio-only speech. In addition, we use a reverse-mapping approach to reconstruct an estimate of the speech stimulus from the EEG data and, by comparing the bimodal estimate with the sum of the unimodal estimates, find no evidence of any nonlinear additive effects in the audiovisual speech condition. These findings point to an underlying mechanism that could account for enhanced comprehension during audiovisual speech. Specifically, we hypothesize that low-level acoustic features that are temporally coherent with the preceding visual stream may be synthesized into a speech object at an earlier latency, which may provide an extended period of low-level processing before extraction of semantic information.

Delusions and underlying needs in older adults with Alzheimer's disease: influence of earlier life experiences and the current environment.

PubMed

Wang, Jing-Jy; Cheng, Wen-Yun; Lai, Pei-Ru; Pai, Ming-Chyi

2014-12-01

Delusions are one of the most severe psychiatric symptoms of individuals with Alzheimer's disease (AD), which often increase the stress experienced by caregivers. The purpose of this study was to understand the influences of earlier life experiences and the current environment on delusions, as well as the underlying needs of older adults with AD who experience delusions. Using an exploratory research design with a qualitative approach and purposive sampling, 20 family caregivers were interviewed. Two psychosocial types of attributes of delusion were categorized: Type A, the influence of earlier life experiences; and Type B, current environmental influences. The underlying needs of those with delusions include physical comfort, a desire to be secure, and a sense of belonging. The contents of delusions are easily influenced by patients' earlier negative experiences and responsibilities, whereas the current environment exerts a crucial influence on the occurrence, frequency, and severity of specific delusions. These results can facilitate planning for patient-centered care by enhancing health care providers' understanding of the psychosocial and environmental attributes and needs behind delusions. Copyright 2014, SLACK Incorporated.

Urethral Caruncle Presented as Premature Menarche in a 4-Year-Old Girl.

PubMed

Gamage, Manori; Beneragama, D

2018-01-01

Urethral caruncle (UC) is a benign fleshy outgrowth at the urethral meatus. It was first described by Samuel Sharp in 1750 and occurs mainly at the posterior lip of the urethra, and the exact aetiology is still uncertain. More often it was seen in the postmenopausal women, and only few cases are reported in young girls. Patients may be asymptomatic and could find this as an incidental finding or they may present with symptoms such as dysuria, bleeding per vagina, haematuria, a mass protruding through vagina, and acute retention of urine. Here, we report the case history of a 4-year-old girl presented with vaginal bleeding which was taken as she has attended menarche and found to have urethral caruncle which was the cause for bleeding. Histology confirmed the diagnosis, and girl was completely cured following surgical excision.

False-Belief Understanding in 2.5-Year-Olds: Evidence From Violation-of-Expectation Change-of-Location and Unexpected-Contents tasks

ERIC Educational Resources Information Center

He, Zijing; Bolz, Matthias; Baillargeon, Renee

2011-01-01

Until recently, it was generally assumed that the ability to attribute false beliefs did not emerge until about 4 years of age. However, recent reports using spontaneous- as opposed to elicited-response tasks have suggested that this ability may be present much earlier. To date, researchers have employed two kinds of spontaneous-response…

The two faces of selective memory retrieval: Earlier decline of the beneficial than the detrimental effect with older age.

PubMed

Aslan, Alp; Schlichting, Andreas; John, Thomas; Bäuml, Karl-Heinz T

2015-12-01

Recent work with young adults has shown that, depending on study context access, selective memory retrieval can both impair and improve recall of other memories (Bäuml & Samenieh, 2010). Here, we investigated the 2 opposing effects of selective retrieval in older age. In Experiment 1, we examined 64 younger (20-35 years) and 64 older participants (above 60 years), and manipulated study context access using list-method directed forgetting. Whereas both age groups showed a detrimental effect of selective retrieval on to-be-remembered items, only younger but not older adults showed a beneficial effect on to-be-forgotten items. In Experiment 2, we examined 112 participants from a relatively wide age range (40-85 years), and manipulated study context access by varying the retention interval between study and test. Overall, a detrimental effect of selective retrieval arose when the retention interval was relatively short, but a beneficial effect when the retention interval was prolonged. Critically, the size of the beneficial but not the detrimental effect of retrieval decreased with age and this age-related decline was mediated by individuals' working memory capacity, as measured by the complex operation span task. Together, the results suggest an age-related dissociation in retrieval dynamics, indicating an earlier decline of the beneficial than the detrimental effect of selective retrieval with older age. (c) 2015 APA, all rights reserved).

Incidence of three presentations of acute myocarditis in young men in military service. A 20-year experience.

PubMed

Karjalainen, J; Heikkilä, J

1999-08-01

The incidence of myocarditis is uncertain as diagnostic criteria have been vague. We evaluated the incidence of myocarditis presenting in three well defined forms (mimicking myocardial infarction, presenting as dilated cardiomyopathy, and as a cause of sudden death) in young men in military service over a 20-year period. The study population consisted of 672 672 Finnish men at a mean age of 20 years conscripted from 1977-1996. All those suspected of having myocardial disease were studied prospectively in the same institution. A clinical diagnosis of myocarditis mimicking myocardial infarction required ECG signs (ST-segment elevation followed by T-wave inversion) and a simultaneous detection of serum markers of acute myocardial injury (CK-MB and/or troponin T) in an infectious patient with chest pain. This form of myocarditis was diagnosed in 98 men, the incidence being 0.17 (95% CI 0.14-0.21). 1000 man-years(-1). Causative microbes were those commonly infecting the conscripts, but Coxsackievirus aetiology could be confirmed in only 4% of the cases. Nine patients presented with dilated cardiomyopathy of recent origin (incidence 0.02. 1000 man-years(-1)). None had histopathological evidence of myocarditis. Myocarditis caused one of the 10 sudden unexpected deaths (incidence 0.002. 1000 man-years(-1)). The usual presentation of acute myocarditis in young men mimicks alterations evoked by myocardial infarction but not those of dilated cardiomyopathy. Copyright 1999 The European Society of Cardiology.

Spectacle prescribing among 10-year-old children.

PubMed Central

Stewart-Brown, S

1985-01-01

Between 10 and 12% of the 10-year-old children in the 1970 national birth cohort were prescribed a pair of spectacles. One-fifth of these children had no impairment of visual acuity and a further 15-20% had only minimal visual defects. Only two-thirds of children with spectacles could produce them when asked to do so at the survey school medical examination; this was particularly common among those in the lower social classes and among children who had no detectable impairment. The information presented in this paper combined with that from earlier national birth cohort studies suggests that overprescribing of spectacles to school children is very common. The financial implications of this overprescribing are discussed. PMID:4084477

Gemifloxacin-associated neurotoxicity presenting as encephalopathy.

PubMed

Barrett, Matthew J; Login, Ivan S

2009-04-01

To report a case of acute encephalopathy associated with ingestion of gemifloxacin, a fluoroquinolone. A 67-year-old woman presented to the emergency department with an acute alteration in mental status. Twenty-four hours earlier she had taken one 320-mg tablet of her husband's gemifloxacin prescription to treat symptoms of a mild upper respiratory infection. During her initial evaluation at our institution, the woman was dysphasic, unable to follow commands, and agitated, suggesting encephalopathy. A thorough diagnostic investigation did not reveal any structural, metabolic, or infectious etiology. Her mental status returned to normal within 2 days without any definitive treatment. Fluoroquinolone-associated neurotoxicity may manifest as encephalopathy, seizures, confusion, or toxic psychosis. To date, none of these adverse effects, specifically encephalopathy, has been reported with gemifloxacin. An objective causality assessment revealed that encephalopathy was probably associated with gemifloxacin use. Seizures, either convulsive or nonconvulsive, may have contributed to our patient's presentation, but she denied seizures prior to this event and did not suffer a seizure in the 18 months following her discharge. However, her second electroencephalograph revealed an underlying predisposition to seizures, which gemifloxacin may have unmasked. This report illustrates that severe central nervous system adverse effects associated with some fluoroquinolones may also occur with gemifloxacin. Gemifloxacin and other fluoroquinolones should be considered in the etiologic evaluation of patients with acute encephalopathy.

40 CFR 1039.102 - What exhaust emission standards and phase-in allowances apply for my engines in model year 2014...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Requirements § 1039.102 What exhaust emission standards and phase-in allowances apply for my engines in model year 2014 and earlier? The exhaust emission standards of this section apply for 2014 and earlier model years. See § 1039.101 for exhaust emission standards that apply to later model years. See 40 CFR 89.112...

40 CFR 1039.102 - What exhaust emission standards and phase-in allowances apply for my engines in model year 2014...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Requirements § 1039.102 What exhaust emission standards and phase-in allowances apply for my engines in model year 2014 and earlier? The exhaust emission standards of this section apply for 2014 and earlier model years. See § 1039.101 for exhaust emission standards that apply to later model years. See 40 CFR 89.112...

40 CFR 1039.102 - What exhaust emission standards and phase-in allowances apply for my engines in model year 2014...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Requirements § 1039.102 What exhaust emission standards and phase-in allowances apply for my engines in model year 2014 and earlier? The exhaust emission standards of this section apply for 2014 and earlier model years. See § 1039.101 for exhaust emission standards that apply to later model years. See 40 CFR 89.112...

40 CFR 1039.102 - What exhaust emission standards and phase-in allowances apply for my engines in model year 2014...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Requirements § 1039.102 What exhaust emission standards and phase-in allowances apply for my engines in model year 2014 and earlier? The exhaust emission standards of this section apply for 2014 and earlier model years. See § 1039.101 for exhaust emission standards that apply to later model years. See 40 CFR 89.112...

37 CFR 1.78 - Claiming benefit of earlier filing date and cross-references to other applications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Claiming benefit of earlier filing date and cross-references to other applications. 1.78 Section 1.78 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN...

37 CFR 1.78 - Claiming benefit of earlier filing date and cross-references to other applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Claiming benefit of earlier filing date and cross-references to other applications. 1.78 Section 1.78 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN...

Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up.

PubMed

Sarsilmaz, Aysegul; Varer, Makbule; Coskun, Gulten; Apaydın, Melda; Oyar, Orhan

2011-12-01

In the young population, spontaneous rupture of Achilles tendon is very rare. The big hematoma is also rare finding of the Achilles tendon partial rupture. It is usually seen with complete rupture. We presented imaging findings of 4 years follow up of the spontaneous partial rupture of Achilles tendon presenting with giant expanding hematoma and mimicking complete rupture radiologically. We discussed the alterations of tendon signal intensity and result of conservative therapy after partial rupture with big hematoma in the long term. A 29 year-old man, applied with pain and swelling in the retrocalcaneal region of left ankle. He did not have chronic metabolic disease. He was not active in physical activities. X-ray radiograms were normal. At magnetic resonance images (MRI), there was an intratendinous big hematoma, subcutanous fat planes were edematous around tendon. The diagnosis was partial rupture and giant hematoma. Hematoma was drained. The conservative treatment was applied and his complaints disappeared. After treatment, approximately 4 years later, control MRI showed thickened and hypointense tendon in all images. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Residential Transitions among Adults with Intellectual Disability across 20 Years

PubMed Central

Woodman, Ashley C.; Mailick, Marsha R.; Anderson, Kristy A.; Esbensen, Anna J.

2014-01-01

The present study addresses critical gaps in the literature by examining residential transitions among 303 adults with intellectual disability over 10 years (Part 1) and 75 adults with Down syndrome over 20 years (Part 2). All adults lived at home at the start of the study, but many moved to a variety of settings. Several characteristics of the adults with intellectual disability differed across settings, most notably adaptive behavior and the number of residential transitions, while characteristics such as age, type of disability, and behavior problems were less predictive of residential placements. The number of moves over the course of the study varied widely, with critical links to earlier family dynamics, social relationships, and health and adaptive behavior. PMID:25354121

Soils as records of past and present environments

NASA Astrophysics Data System (ADS)

Sauer, Daniela

2015-04-01

(i) rapidly adjusting soil properties (adjusting within some hundreds of years), (ii) slowly adjusting soil properties (adjusting within some thousands of years), and (iii) persistent soil properties (showing no changes over ten thousands to millions of years). In a polygenetic soil, rapidly adjusting soil properties may already be in equilibrium with the present conditions, whereas slowly adjusting soil properties may still reflect past conditions. Thus, the lower the rate at which a certain soil property in a polygenetic soil adjusts, the larger is the extent to which this property is still determined by earlier environmental conditions. Knowledge on the rates at which soil properties adjust may hence be used to estimate the time at which a significant environmental change took place, based on the degree of overprinting of the different kinds of soil properties adjusting at different rates in a polygenetic soil. References: Richter, D. de B., Yaalon, D.H., 2012. "The changing model of soil" revisited. Soil Sci. Soc. Am. J. 76, 766-778. Targulian, V. O., Goryachkin, S. V., 2004. Soil memory: Types of records, carriers, hierarchy and diversity. Revista Mexicana Ciencias Geol. 21, 1-8. Targulian, V.O., Gerasimova, M., 2009. Soil geography: geography of soil systems and soil bodies. Soil Geography: New Horizons. International Conference, 16-20 November 2009 in Huatulco, Mexico. Book of abstracts, 39. Yaalon, D.H., 1971. Soil forming processes in time and space. In: Yaalon, D.H. (Ed.), Paleopedology-origin, nature and dating of paleosols. Int. Soc. Soil Sci. and Israel Univ. Press, Jerusalem, pp. 29-39.

Number of Physics Faculty in Two-Year Colleges: Results from the 2012 Survey of Physics in Two-Year Colleges. Focus On

ERIC Educational Resources Information Center

White, Susan; Chu, Raymond

2013-01-01

In an earlier report, ("Physics Enrollments in Two-Year Colleges," ED547610), Susan White and Raymond Chu examined physics enrollments--both the number of students and the types of classes taught--at the 1,063 two-year college campuses in the US where they believe physics is offered. This "Focus On" considers the faculty…

Do BRCA1/2 mutation carriers have an earlier onset of natural menopause?

PubMed

van Tilborg, Theodora C; Broekmans, Frank J; Pijpe, Anouk; Schrijver, Lieske H; Mooij, Thea M; Oosterwijk, Jan C; Verhoef, Senno; Gómez Garcia, Encarna B; van Zelst-Stams, Wendy A; Adank, Muriel A; van Asperen, Christi J; van Doorn, Helena C; van Os, Theo A; Bos, Anna M; Rookus, Matti A; Ausems, Margreet G

2016-08-01

It has been hypothesized that BRCA1/2 mutation carriers have an earlier age at natural menopause (ANM), although to date findings are inconclusive. This study assessed the influence of BRCA mutation status on ANM, and aimed to explore the reasons of inconsistency in the literature. Cross-sectional assessment from an ongoing nationwide cohort study among members of BRCA1/2 mutated families. Information was obtained by a standardized questionnaire. Kaplan-Meier curves were constructed, and Cox regression was used to assess the association between BRCA1/2 mutation status and ANM. Adjustments were made for birth cohort, family, smoking, use of hormonal contraceptives, and parity. A total of 1,208 BRCA1/2 mutation carriers and 2,211 proven noncarriers were included. Overall, no association was found between BRCA1/2 mutation status and ANM (adjusted hazard ratio [HR] = 1.06 [95% CI, 0.87-1.30]). We examined if the null finding was due to informative censoring by uptake of risk-reducing salpingo-oophorectomy. Indeed, within the oldest birth cohort, in which the percentage of surgical menopause events was lowest and comparable between carriers and noncarriers, the HR for earlier natural menopause in carriers was 1.45 (95% CI, 1.09-1.94). The second oldest birth cohort, however, demonstrated a decreased HR (0.67 [95% CI, 0.46-0.98]), and thus no trend over birth cohorts was found. Various types of selection bias hamper the comparison of ANM between BRCA1/2 mutation carriers and noncarriers, genetically tested in the clinic.

Earlier parental set bedtimes as a protective factor against depression and suicidal ideation.

PubMed

Gangwisch, James E; Babiss, Lindsay A; Malaspina, Dolores; Turner, J Blake; Zammit, Gary K; Posner, Kelly

2010-01-01

To examine the relationships between parental set bedtimes, sleep duration, and depression as a quasi-experiment to explore the potentially bidirectional relationship between short sleep duration and depression. Short sleep duration has been shown to precede depression, but this could be explained as a prodromal symptom of depression. Depression in an adolescent can affect his/her chosen bedtime, but it is less likely to affect a parent's chosen set bedtime which can establish a relatively stable upper limit that can directly affect sleep duration. Multivariate cross-sectional analyses of the ADD Health using logistic regression. United States nationally representative, school-based, probability-based sample in 1994-96. Adolescents (n = 15,659) in grades 7 to 12. Adolescents with parental set bedtimes of midnight or later were 24% more likely to suffer from depression (OR = 1.24, 95% CI 1.04-1.49) and 20% more likely to have suicidal ideation (1.20, 1.01-1.41) than adolescents with parental set bedtimes of 10:00 PM or earlier, after controlling for covariates. Consistent with sleep duration and perception of getting enough sleep acting as mediators, the inclusion of these variables in the multivariate models appreciably attenuated the associations for depression (1.07, 0.88-1.30) and suicidal ideation (1.09, 0.92-1.29). The results from this study provide new evidence to strengthen the argument that short sleep duration could play a role in the etiology of depression. Earlier parental set bedtimes could therefore be protective against adolescent depression and suicidal ideation by lengthening sleep duration.

A Rare Presentation of the Syndrome of Inappropriate Antidiuretic Hormone in a 12-Year-Old Girl as the Initial Presentation of an Immature Ovarian Teratoma.

PubMed

Iqbal, Anoop Mohamed; Schwenk, W Frederick

2018-02-01

Immature ovarian teratoma is very rare in childhood. We report on a 12-year-old girl with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. A 12-year-old girl presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium, 123 mmol/L), that did not respond to fluid management. Computed tomography imaging showed a 15 cm × 9 cm × 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications. She underwent exploratory laparotomy with a right salpingo-oophorectomy, omentectomy, and peritoneal stripping. The pathology revealed metastatic immature teratoma. Hyponatremia resolved soon after the surgery. Although a rare diagnosis, immature ovarian teratoma must be considered in a girl who presents with abdominal mass and hyponatremia. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

The case for earlier cochlear implantation in postlingually deaf adults.

PubMed

Dowell, Richard C

2016-01-01

This paper aimed to estimate the difference in speech perception outcomes that may occur due to timing of cochlear implantation in relation to the progression of hearing loss. Data from a large population-based sample of adults with acquired hearing loss using cochlear implants (CIs) was used to estimate the effects of duration of hearing loss, age, and pre-implant auditory skills on outcomes for a hypothetical standard patient. A total of 310 adults with acquired severe/profound bilateral hearing loss who received a CI in Melbourne, Australia between 1994 and 2006 provided the speech perception data and demographic information to derive regression equations for estimating CI outcomes. For a hypothetical CI candidate with progressive sensorineural hearing loss, the estimates of speech perception scores following cochlear implantation are significantly better if implantation occurs relatively soon after onset of severe hearing loss and before the loss of all functional auditory skills. Improved CI outcomes and quality of life benefit may be achieved for adults with progressive severe hearing loss if they are implanted earlier in the progression of the pathology.

Transitioning From Occupational Therapy Student To Practicing Occupational Therapist: First Year of Employment.

PubMed

McCombie, Randy P; Antanavage, Meredith E

2017-04-01

This research examined the transition from occupational therapy student to practicing occupational therapist over the course of one's first year of professional employment, as recalled by a sample of occupational therapists. Surveys were mailed to 500 occupational therapists randomly selected from membership in the American Occupational Therapy Association resulting in 202 returned surveys. Median year of graduation was 1998, ranging from 1967 to 2014. In general, respondents indicated the transition was positive. Having a mentor was related to high job satisfaction and good clinical fit, while supervising an occupational therapy assistant and low self-confidence were viewed as negative impact factors. Recent graduates presented with lower ratings of a positive transition and higher ratings of likelihood of experiencing burnout and initial job stress than earlier graduates. Recommendations for improving the transition experience are presented.

Understanding Violence in Contemporary and Earlier Gangs: An Exploratory Application of the Theory of Reasoned Action.

ERIC Educational Resources Information Center

Evans, Judy P.; Taylor, Jerome

1995-01-01

Reviews the theory of reasoned action to demonstrate how it can be applied to understanding gang violence, and illustrates its potential applicability to a pilot sample of 30 contemporary and 18 earlier gangs living in a large metropolitan community. Results indicate this theory has been helpful in explaining higher levels of violence in…

Dendrophenology: Inferring the response of North American eastern deciduous forests to an earlier spring from tree rings

NASA Astrophysics Data System (ADS)

Elmore, A. J.; Nelson, D. M.; Craine, J. M.

2016-12-01

There is wide agreement that anthropogenic climate warming has influenced the phenology of forests during the late twentieth and early twenty-first centuries. A critical question for predicting the magnitude of future warming under different emissions scenarios is the degree to which forest productivity responds to longer growing seasons in the face of concurrent changes in other drivers of productivity. Longer growing seasons can lead to increased photosynthesis and productivity, which would represent a negative feedback to rising CO2 and consequently warming. Alternatively, increased demand for soil resources due to a longer photosynthetically active period in conjunction with other global change factors might exacerbate resource limitation, restricting forest productivity response to a longer growing season. In this case, increased spring-time productivity has the potential to increase plant N limitation by increasing plant demand for N more than N supplies, or increasing early-season ecosystem N losses. Long-term direct measurements are not yet available to specifically address this question, but advances in remote sensing and dendroecological methods present opportunities to acquire information retrospectively to advance understanding of how phenological changes and resource availability to trees have been affecting forest productivity. Here we show that for 222 trees representing three species in eastern North America over the past 30 years earlier spring phenology has caused declines in N availability to trees by increasing demand for N relative to supply. The observed decline in N availability is not associated with reduced wood production, suggesting that other environmental changes such as increased atmospheric CO2 and water availability have likely overwhelmed reduced N availability. Given current trajectories of environmental changes, N limitation will likely continue to increase for these forests, possibly further limiting C sequestration potential.

Fiscal Year 2015 Budget of the U.S. Government

ERIC Educational Resources Information Center

Office of Management and Budget, Executive Office of the President, 2014

2014-01-01

For the last several years, manufactured crises in Washington have hindered, rather than helped, economic growth and opportunity. Earlier this year, however, Democrats and Republicans came together to produce a 2014 budget that invests in key areas of innovation, education, and infrastructure--investments that will help grow the nation's economy,…

Motion of Caribbean Plate during last 7 million years and implications for earlier Cenozoic movements

NASA Astrophysics Data System (ADS)

Sykes, Lynn R.; McCann, William R.; Kafka, Alan L.

1982-12-01

The direction and rate of movement of the Caribbean plate with respect to North America are determined from the slip vectors of shallow earthquakes and from the configuration of downgoing seismic zones in the Greater and Lesser Antilles. A calibration of the relative plate motion for the northeastern Caribbean using data from other subduction zones indicates an average rate of 3.7±0.5 cm/yr for the past 7 million years (Ma). The direction of plate motion inferred from focal mechanisms (ENE) is nearly the same as that deduced from the configuration of downgoing seismic zones going around the major bend in the arc. With respect to North America, the Caribbean plate is moving at an angular velocity of 0.36°/Ma about a center of rotation near 66°N, 132°W. Vector addition using those data and that for the relative motion of North and South America indicates that the Caribbean is moving at an angular velocity of 0.47°/Ma about a center of rotation near 60°N, 88°W with respect to South America. The presence of intermediate-depth earthquakes beneath Puerto Rico and the Virgin Islands is ascribed to the curvature of the plate boundary and a component of underthrusting that has been going on for at least the past 7 Ma and is likely occurring today. The alternative hypothesis that earthquakes beneath those areas are occurring in materials that were subducted during the Eocene, the last major episode of magmatism, is not tenable from thermal considerations. The lack of recent magmatism in the eastern Greater Antilles is ascribed to the relatively small component of underthrusting. The 2 cm/yr rate of seafloor creation along the mid-Cayman spreading center for the past 2.4 Ma does not appear to reflect the total Caribbean-North American plate motion while the 4 cm/yr spreading rate from 6.0 to 2.4 Ma does. Between the mid-Cayman spreading center and eastern Guatemala, the northern boundary of the Caribbean plate is narrow and follows the southern margin of the Cayman

Selection of children to provide care: the effect of earlier parental transfers.

PubMed

Henretta, J C; Hill, M S; Li, W; Soldo, B J; Wolf, D A

1997-05-01

We use the first wave of data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) study to examine the effects of past parent-to-child financial transfers on selection of a child to provide assistance with basic personal care for unmarried parents. We estimate a fixed-effects conditional logit model and find a positive and significant association between past financial transfers and a child's current helping behavior. The coefficient of past financial transfers is in the direction hypothesized, and its magnitude is 80% as large as that of gender, a well-documented powerful predictor of parental caregiving. There appears to be substantial evidence that earlier parent-to-child financial gifts play a role in determining which child in the family will provide assistance.

Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation

PubMed Central

Schnabel, Renate B; Pecen, Ladislav; Ojeda, Francisco M; Lucerna, Markus; Rzayeva, Nargiz; Blankenberg, Stefan; Darius, Harald; Kotecha, Dipak; Caterina, Raffaele De; Kirchhof, Paulus

2017-01-01

Objectives Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. Methods In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events – European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. Results Men with AF were on average younger than women (mean±SD: 70.1±10.7 vs 74.1±9.7 years, p<0.0001). Women more frequently had at least one AF-related symptom at least occasionally compared with men (95.4% in women, 89.8% in men, p<0.0001). Prescription of oral anticoagulation was similar, with an increase of non-vitamin K antagonist oral anticoagulants from 5.9% to 12.6% in women and from 6.2% to 12.6% in men, p<0.0001 for both. Men were more frequently treated with electrical cardioversion and ablation (20.6% and 6.3%, respectively) than women (14.9% and 3.3%, respectively), p<0.0001. Women had 65% (OR: 0.35; 95% CI (0.22 to 0.56)) lower age-adjusted and country-adjusted odds of coronary revascularisation, 40% (OR: 0.60; (0.38 to 0.93)) lower odds of acute coronary syndrome and 20% (OR: 0.80; (0.68 to 0.96)) lower odds of heart failure at 1 year. There were no statistically significant gender differences in 1-year stroke/transient ischaemic attack/arterial thromboembolism and major bleeding events. Conclusion In a ‘real-world’ European AF registry, women were more symptomatic but less likely to receive invasive rhythm control therapy such as electrical cardioversion or ablation. Further study is needed to confirm that these differences do not disadvantage women with AF. PMID:28228467

Warmest extreme year in U.S. history alters thermal requirements for tree phenology.

PubMed

Carter, Jacob M; Orive, Maria E; Gerhart, Laci M; Stern, Jennifer H; Marchin, Renée M; Nagel, Joane; Ward, Joy K

2017-04-01

The frequency of extreme warm years is increasing across the majority of the planet. Shifts in plant phenology in response to extreme years can influence plant survival, productivity, and synchrony with pollinators/herbivores. Despite extensive work on plant phenological responses to climate change, little is known about responses to extreme warm years, particularly at the intraspecific level. Here we investigate 43 populations of white ash trees (Fraxinus americana) from throughout the species range that were all grown in a common garden. We compared the timing of leaf emergence during the warmest year in U.S. history (2012) with relatively non-extreme years. We show that (a) leaf emergence among white ash populations was accelerated by 21 days on average during the extreme warm year of 2012 relative to non-extreme years; (b) rank order for the timing of leaf emergence was maintained among populations across extreme and non-extreme years, with southern populations emerging earlier than northern populations; (c) greater amounts of warming units accumulated prior to leaf emergence during the extreme warm year relative to non-extreme years, and this constrained the potential for even earlier leaf emergence by an average of 9 days among populations; and (d) the extreme warm year reduced the reliability of a relevant phenological model for white ash by producing a consistent bias toward earlier predicted leaf emergence relative to observations. These results demonstrate a critical need to better understand how extreme warm years will impact tree phenology, particularly at the intraspecific level.

Trends in the presentation of cutaneous malignant melanoma over three decades at King's College Hospital, London.

PubMed

Harman, K E; Fuller, L C; Salisbury, J R; Higgins, E M; du Vivier, A W P

2004-09-01

The aim of this study was to examine trends in the presentation of cutaneous malignant melanoma at King's College Hospital (KCH) over the last three decades (1970-2000). KCH was one of seven centres that participated in the 1987 Cancer Research Campaign (CRC) publicity campaign aimed at promoting earlier self-recognition of melanoma. Data included patient age at presentation, sex, tumour site, Breslow thickness and histological subtype. The late 1980s saw a threefold increase in the annual number of melanomas and an eightfold increase in thin melanomas compared to the 1970s. The increase occurred in both sexes and was particularly marked after the CRC campaign but numbers had already begun to increase prior to this. The increase has predominantly been thin (Breslow < 1.5 mm) tumours of the superficial spreading variety with a resultant fall in mean Breslow thickness. There has been a decline in the annual number of melanomas since the peak in 1992 which is not explained by increased proportion of in situ tumours. The CRC campaign may have contributed to the documented increase in thin tumours but this trend had begun prior to 1987 suggesting factors other than public awareness and earlier presentation are important. It is encouraging that the number of melanomas has declined over the last 5 years at KCH but it is yet to be seen whether this reflects a real decrease in the incidence of melanoma.

Impact of 6-month earlier versus postponed initiation of rotigotine on long-term outcome: post hoc analysis of patients with early Parkinson's disease with mild symptom severity.

PubMed

Timmermann, Lars; Asgharnejad, Mahnaz; Boroojerdi, Babak; Dohin, Elisabeth; Woltering, Franz; Elmer, Lawrence W

2015-01-01

Investigate impact of 6-month earlier versus postponed initiation of rotigotine in patients with early Parkinson's disease (PD) with mild symptom severity. Long-term benefit of rotigotine in early-PD has been demonstrated: SP702 (NCT00594165) and SP716 (NCT00599196) were long-term, open-label extensions of double-blind, placebo-controlled studies of 6-month maintenance; rotigotine was well tolerated for up to 6 years, and demonstrated efficacy (Unified Parkinson's Disease Rating Scale [UPDRS] II + III below baseline) for ∼ 2 years (SP702) and ∼ 4 years (SP716). Post hoc analysis of patients at Hoehn and Yahr 1-2; groups defined by treatment received in 6-month double-blind studies: 'Rotigotine-Rotigotine' received rotigotine (n = 221), 'Placebo-Rotigotine' received placebo (n = 125). At the start of open-label rotigotine maintenance, UPDRS II + III mean ± SD change from double-blind baseline was: -8.5 ± 10.6 'Rotigotine-Rotigotine', -7.7 ± 9.0 'Placebo-Rotigotine.' After this initial improvement scores gradually increased: It took ∼ 45 months for mean scores to cross baseline in 'Rotigotine-Rotigotine', and ∼ 21 months in 'Placebo-Rotigotine.' At the time mean UPDRS II + III had crossed baseline in 'Placebo-Rotigotine' (open-label week 84; ∼ 21 months), treatment difference (LS-mean) to 'Rotigotine-Rotigotine' change from baseline was -3.89 (95% CI -6.94, -0.84); p = 0.013. In this post hoc analysis, 6-month earlier initiation of rotigotine resulted in slower return to baseline mean UPDRS II + III; initiation of rotigotine in patients with minimal/no functional disability or impairment may lead to an extended benefit.

Presentations of primary hypersomnia in Chinese children.

PubMed

Han, Fang; Lin, Ling; Li, Jing; Aran, Adi; Dong, Song X; An, Pei; Zhao, Long; Li, Ming; Li, Qian Y; Yan, Han; Wang, Jie S; Gao, Hui Y; Li, Mei; Gao, Zhan C; Strohl, Kingman P; Mignot, Emmanuel

2011-05-01

To retrospectively describe childhood presentations of primary hypersomnia with an emphasis on narcolepsy-cataplexy in a Chinese population. A total of 417 children (< 18 years old) successively presenting with complaints of hypersomnia without anatomic cause or sleep apnea risk were evaluated using the Stanford Sleep Inventory, human leukocyte antigen (HLA) DQB1*0602 typing, and MSLT recordings. CSF hypocretin-1 was measured in 47 cases to document hypocretin deficiency. A subgroup ("narcolepsy/hypocretin deficiency") with likely hypocretin deficiency (low hypocretin-1 or HLA positive with clear-cut cataplexy) was further examined for presentations prior to, around, or after puberty. Narcolepsy with (n = 361) or without (n = 17) cataplexy presented at an earlier age and with increased male predominance when compared to idiopathic hypersomnia (n = 39, P < 0.01). Nearly 70% of those with narcolepsy/hypocretin deficiency (n = 271) had disease onset before age 10 y, and 15% had onset before age 6, an unusually young age distribution. Onset was prior to puberty in 78% of cases. Clinical features were similar in presentations across puberty groups except for sleep paralysis, which increased in frequency with age/puberty. Mean sleep latency (MSL) decreased and the number of sleep onset REM periods (SOREMPs) increased with age/puberty, but MSLT diagnosis criteria (MSL ≤ 8 min, ≥ 2 SOREMPs) were similarly positive across groups. Familial clustering was present in only 1.7% of probands. In children presenting with a complaint of primary hypersomnia to a sleep clinic in China, 86% (361/417) meet criteria for narcolepsy with cataplexy. Puberty did not affect positivity on the MSLT as a diagnostic feature. Sleep paralysis was the only symptom that increased with increasing age. In addition, narcolepsy with cataplexy in our clinic population appeared to begin at a younger age than usually reported in other studies.

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers.

PubMed

Cohen, Joshua D; Javed, Ammar A; Thoburn, Christopher; Wong, Fay; Tie, Jeanne; Gibbs, Peter; Schmidt, C Max; Yip-Schneider, Michele T; Allen, Peter J; Schattner, Mark; Brand, Randall E; Singhi, Aatur D; Petersen, Gloria M; Hong, Seung-Mo; Kim, Song Cheol; Falconi, Massimo; Doglioni, Claudio; Weiss, Matthew J; Ahuja, Nita; He, Jin; Makary, Martin A; Maitra, Anirban; Hanash, Samir M; Dal Molin, Marco; Wang, Yuxuan; Li, Lu; Ptak, Janine; Dobbyn, Lisa; Schaefer, Joy; Silliman, Natalie; Popoli, Maria; Goggins, Michael G; Hruban, Ralph H; Wolfgang, Christopher L; Klein, Alison P; Tomasetti, Cristian; Papadopoulos, Nickolas; Kinzler, Kenneth W; Vogelstein, Bert; Lennon, Anne Marie

2017-09-19

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient's primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types.

To achieve an earlier IFN-γ response is not sufficient to control Mycobacterium tuberculosis infection in mice.

PubMed

Vilaplana, Cristina; Prats, Clara; Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

2014-01-01

The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates.

To Achieve an Earlier IFN-γ Response Is Not Sufficient to Control Mycobacterium tuberculosis Infection in Mice

PubMed Central

Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

2014-01-01

The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates. PMID:24959669

Detection, attribution, and sensitivity of trends toward earlier streamflow in the Sierra Nevada

USGS Publications Warehouse

Maurer, E.P.; Stewart, I.T.; Bonfils, Celine; Duffy, P.B.; Cayan, D.

2007-01-01

Observed changes in the timing of snowmelt dominated streamflow in the western United States are often linked to anthropogenic or other external causes. We assess whether observed streamflow timing changes can be statistically attributed to external forcing, or whether they still lie within the bounds of natural (internal) variability for four large Sierra Nevada (CA) basins, at inflow points to major reservoirs. Streamflow timing is measured by "center timing" (CT), the day when half the annual flow has passed a given point. We use a physically based hydrology model driven by meteorological input from a global climate model to quantify the natural variability in CT trends. Estimated 50-year trends in CT due to natural climate variability often exceed estimated actual CT trends from 1950 to 1999. Thus, although observed trends in CT to date may be statistically significant, they cannot yet be statistically attributed to external influences on climate. We estimate that projected CT changes at the four major reservoir inflows will, with 90% confidence, exceed those from natural variability within 1-4 decades or 4-8 decades, depending on rates of future greenhouse gas emissions. To identify areas most likely to exhibit CT changes in response to rising temperatures, we calculate changes in CT under temperature increases from 1 to 5??. We find that areas with average winter temperatures between -2??C and -4??C are most likely to respond with significant CT shifts. Correspondingly, elevations from 2000 to 2800 in are most sensitive to temperature increases, with CT changes exceeding 45 days (earlier) relative to 1961-1990. Copyright 2007 by the American Geophysical Union.

A longitudinal study of grapheme-color synesthesia in childhood: 6/7 years to 10/11 years

PubMed Central

Simner, Julia; Bain, Angela E.

2013-01-01

Grapheme-color synesthesia is a condition characterized by enduring and consistent associations between letter/digits and colors. This study is the continuation of longitudinal research begun by Simner et al. (2009) which aimed to explore the development of this condition in real time within a childhood population. In that earlier study we randomly sampled over 600 children and tested them aged 6/7 and 7/8 years. We identified the child synesthetes within that cohort and measured their development over 1 year, in comparison to a group of non-synesthetic children with both average and superior memories. We were able to show the beginnings of a developmental progression in which synesthetic associations (e.g., A = red) mature over time from relatively chaotic pairings into a system of fixed consistent associations. In the current study we return to this same population three years later when participants are now 10/11 years. We used the same paired-association memory task to determine the synesthetic status of our participants and to also establish synesthetes' inventories of grapheme-color associations. We compared their inventories to those from age 6/7 and 7/8 years to examine how synesthesia matures over time. Together with earlier findings, our study shows that grapheme-color synesthesia emerges with a protracted trajectory, with 34% of letters/digits fixed at age 6/7 years, 48% fixed at 7/8 years and 71% fixed at 10/11 years. We also show several cases where synesthesia is not developing in the same time-frame as peers, either because it has died out at an older age, or because it was slower to develop than other cases. Our study paints the first picture of the emergence of synesthesia in real-time over four years within a randomly sampled population of child synesthetes. PMID:24312035

Predicting re-victimization of battered women 3 years after exiting a shelter program.

PubMed

Bybee, Deborah; Sullivan, Cris M

2005-09-01

This study examined interpersonal and ecological predictors of re-victimization of a sample of women with abusive partners. All women (N = 124) had sought refuge from a battered women's shelter 3 years earlier, and half the sample had been randomly assigned to receive free, short-term advocacy services immediately upon exit from the shelter. Results 2 years post-intervention revealed positive change in the lives of participants (C. M. Sullivan & D. Bybee, 1999), including a decrease in abuse for women who had worked with advocates. The current study examined intervention effects 3 years after the program ended, as well as other predictors of re-abuse. Nineteen percent of the original sample had experienced domestic violence between 2 and 3 years after shelter exit (65% by current partners, 35% by ex-partners). The advocacy program's effect on risk of re-victimization did not continue 3 years post-intervention. However, having worked with an advocate 3 years prior continued to have a positive impact on women's quality of life and level of social support. The risk of being abused 3 years post-shelter stay was exacerbated by a number of factors present 1 year prior, including women's (1) having experienced abuse in the 6 months before that point; (2) having difficulties accessing resources; (3) having problems with the state welfare system; and (4) having people in their social networks who made their lives difficult. Women were at less risk of abuse if, 1 year earlier, they (1) were employed; (2) reported higher quality of life; and (3) had people in their networks who provided practical help and/or were available to talk about personal matters. These findings support the hypothesis that access to resources and social support serve as protective factors against continued abuse.

Women achieve peak freestyle swim speed at earlier ages than men

PubMed Central

Rüst, Christoph Alexander; Knechtle, Beat; Rosemann, Thomas

2012-01-01

Background The age of peak swim performance has been investigated for freestyle swimmers for distances ranging from 50 m to 1500 m among swimmers aged 19 to 99 years. However, studies have yet to investigate the 10 to 19 year-old age group. The aims of the present study were (1) to investigate the age range of peak freestyle swim speed, and (2) to find differences in age range and peak freestyle swim speed between male and female freestyle swimmers from 50 m to 1500 m at a national level. Methods The changes in age range and peak freestyle swim speed among Swiss elite freestyle swimmers aged 0–9 years and 70–79 years who were ranked on the Swiss high score list between 2006 and 2010 were analyzed using linear regression analyses and analysis of variance. Results Men were fastest at ages 22–23 years for 100 m and 200 m; at ages 24–25 years for 400 m and 800 m; and at 26–27 years for 50 m and 1500 m. Women achieved peak freestyle swim speed at ages 20–21 years for all distances with the exception of 800 m. In the 800 m, women were fastest at ages 26–27 years. The difference in peak freestyle swim speed decreased with increasing swim distance from 50 m to 800 m (ie, 13.1% ± 1.3% in 50 m; 13.2% ± 0.9% in 100 m; 10.8% ± 0.9% in 200 m; 7.9% ± 1.3% in 400 m; and 4.2% ± 2.0% in 800 m). For 1500 m, however, the gender difference increased to 6.4% ± 2.3%. Conclusion These findings suggest that peak freestyle swim speed is achieved at lower age ranges in women when compared to men at 50 m to 1500 m, but not at 800 m. The gender difference in peak freestyle swim speed decreased with increasing swim distance from 50 m to 800 m, but not for 1500 m. These data should be confirmed with swimmers at an international level. PMID:24198602

Motor Proficiency Predicts Cognitive Ability in Four-Year-Olds

ERIC Educational Resources Information Center

Hernandez, Amanda Martinez; Caçola, Priscila

2015-01-01

Research has shown links between motor proficiency and cognition in school-age children, however, few have explored earlier ages. We aimed to determine the association between motor proficiency and cognitive ability in four-year-olds. Motor and cognitive skills were examined in 32 (15 males, 17 females) four-year-olds (±5.59 months) using the…

Presentation and Diagnosis of Tuberous Sclerosis Complex in Infants.

PubMed

Davis, Peter E; Filip-Dhima, Rajna; Sideridis, Georgios; Peters, Jurriaan M; Au, Kit Sing; Northrup, Hope; Bebin, E Martina; Wu, Joyce Y; Krueger, Darcy; Sahin, Mustafa

2017-12-01

Tuberous sclerosis complex (TSC) is a neurocutaneous genetic disorder with a high prevalence of epilepsy and neurodevelopmental disorders. TSC can be challenging to diagnose in infants because they often do not show many clinical signs early in life. In this study, we describe the timing and pattern of presenting and diagnostic features in a prospective longitudinal study of infants with TSC. Two multicenter, prospective studies enrolled 130 infants with definite TSC by clinical or genetic criteria and followed them longitudinally up to 36 months of age. Periodic study visits included medical and seizure histories, physical and neurologic examinations, and developmental assessments. Ages at which major and minor features of TSC and seizures were first identified were analyzed. The most common initial presenting features of TSC were cardiac rhabdomyomas (59%) and hypomelanotic macules or other skin findings (39%), and 85% of infants presented with either or both. Ultimately, the most prevalent diagnostic TSC features were hypomelanotic macules (94%), tubers or other cortical dysplasias (94%), subependymal nodules (90%), and cardiac rhabdomyomas (82%). Thirty-five percent of infants presented prenatally, 41% presented at birth or within the first month of life, and 74% met criteria for TSC diagnosis at or within 30 days of presentation. Seizure onset occurred before or at initial presentation in only 15% of infants, but 73% developed epilepsy within the first year of life. Infants with TSC can often be identified early, before the onset of neurologic sequelae, enabling earlier diagnosis, surveillance, and possibly disease-modifying treatment. Copyright © 2017 by the American Academy of Pediatrics.

Teaching Talks: Presents for the New Year

ERIC Educational Resources Information Center

Broderick, Patricia; Raymond, Allen

2006-01-01

The author presents three educational products for kids: (1) "Novel Perspectives" by Shelley Harwayne; (2) "Summarization in Any Subject--50 Techniques to Improve Student Learning" by Rick Wormelt; and (3) Voices Reading, the new comprehensive reading and character development program for Grades K-2 from Zaner-Bloser. "Novel Perspectives" carries…

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier.

PubMed

Ates, Ihsan; Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83.

Present state of knowledge of the upper atmosphere 1990: An assessment report

NASA Technical Reports Server (NTRS)

Watson, R. T.; Kurylo, M. J.; Prather, M. J.; Ormond, F. M.

1990-01-01

NASA is charged with the responsibility to report on the state of the knowledge of the Earth's upper atmosphere, particularly the stratosphere. Part 1 of this report, issued earlier this year, summarized the objectives, status, and accomplishments of the research tasks supported under NASA's Upper Atmosphere Research Program during the last two years. New findings since the last report to Congress was issued in 1988 are presented. Several scientific assessments of the current understanding of the chemical composition and physical structure of the stratosphere are included, in particular how the abundance and distribution of ozone is predicted to change in the future. These reviews include: a summary of the most recent international assessment of stratospheric ozone; a study of future chlorine and bromine loading of the atmosphere; a review of the photochemical and chemical kinetics data that are used as input parameters for the atmospheric models; a new assessment of the impact of Space Shuttle launches on the stratosphere; a summary of the environmental issues and needed research to evaluate the impact of the newly re-proposed fleet of stratospheric supersonic civil aircraft; and a list of the contributors to this report and the science assessments which have formed our present state of knowledge of the upper atmosphere and ozone depletion.

Delayed presentation of a vertebral arterio-venous fistula secondary to penetrating cervical trauma: endovascular management using coil embolisation - a case report

PubMed Central

Mortimer, Alex; Stubbs, Euan; Cookson, Daniel; Dawson, Raymond; Fleet, Mustafa

2009-01-01

Vertebro-vertebral arteriovenous fistulae occur infrequently. We report on such a case with delayed presentation following penetrating neck injury. This was successfully treated via coil embolisation. A 40-year-old woman presented with a subjective tinnitus that was abolished by turning her head to the right. She had sustained penetrating neck trauma 6 months earlier. Doppler Ultrasound and magnetic resonance angiogram confirmed the presence of a vertebral arterio-venous fistula. Using a trans-femoral arterial approach, the left vertebral artery was embolised by deployment of multiple coils. The patient had no return of symptoms at 3 months follow up. Radiological diagnosis and endovascular management of this condition is discussed. PMID:22470664

Delayed presentation of a vertebral arterio-venous fistula secondary to penetrating cervical trauma: endovascular management using coil embolisation - a case report.

PubMed

Mortimer, Alex; Stubbs, Euan; Cookson, Daniel; Dawson, Raymond; Fleet, Mustafa

2009-01-01

Vertebro-vertebral arteriovenous fistulae occur infrequently. We report on such a case with delayed presentation following penetrating neck injury. This was successfully treated via coil embolisation. A 40-year-old woman presented with a subjective tinnitus that was abolished by turning her head to the right. She had sustained penetrating neck trauma 6 months earlier. Doppler Ultrasound and magnetic resonance angiogram confirmed the presence of a vertebral arterio-venous fistula. Using a trans-femoral arterial approach, the left vertebral artery was embolised by deployment of multiple coils. The patient had no return of symptoms at 3 months follow up. Radiological diagnosis and endovascular management of this condition is discussed.

The Earlier the Better? Taking the AP® in 10th Grade. Research Report No. 2012-10

ERIC Educational Resources Information Center

Rodriguez, Awilda; McKillip, Mary E. M.; Niu, Sunny X.

2013-01-01

In this report, the authors examine the impact of scoring a 1 or 2 on an AP® Exam in 10th grade on later AP Exam participation and performance. As access to AP courses increases within and across schools, a growing number of students are taking AP courses and exams in the earlier grades of high school. Using a matched sample of AP and no-AP…

Association between severe dorsolateral prefrontal dysfunction during random number generation and earlier onset in schizophrenia.

PubMed

Koike, Shinsuke; Takizawa, Ryu; Nishimura, Yukika; Marumo, Kohei; Kinou, Masaru; Kawakubo, Yuki; Rogers, Mark A; Kasai, Kiyoto

2011-08-01

Schizophrenia involves impairment in attention, working memory and executive processes associated with prefrontal cortical function, an essential contributor of social functioning. Age at onset is a major factor for predicting social outcome in schizophrenia. In clinical settings, we need an objective assessment tool for evaluating prefrontal function and social outcome. Participants included 22 right-handed patients with schizophrenia and 40 gender- and age-matched healthy controls. We used a 52-channel near-infrared spectroscopy (NIRS) instrument to measure oxygenated haemoglobin ([oxy-Hb]) changes over the prefrontal cortex during a random number generation (RNG) task. In healthy controls, we found significant [oxy-Hb] increase in the bilateral dorsolateral (DLPFC; BA9 and BA46) and ventrolateral prefrontal cortex (VLPFC; BA44, 45 and 47). The patients with schizophrenia showed significantly smaller activation than the healthy controls in the same approximate regions. In the patient group, a smaller [oxy-Hb] increase in the right DLPFC region (BA9) was significantly correlated with earlier age at onset. NIRS can detect prefrontal cortical dysfunction associated with an executive task, which was coupled with earlier age at onset in schizophrenia. Multichannel NIRS, a non-invasive and user-friendly instrument, may be useful in evaluating cognitive function and social outcome in clinical settings in psychiatry. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

PROP1 gene mutations in a 36-year-old female presenting with psychosis

PubMed Central

Rijal, Tshristi; Jha, Kunal Kishor; Saluja, Harpreet

2017-01-01

Summary Combined pituitary hormonal deficiency (CPHD) is a rare disease that results from mutations in genes coding for transcription factors that regulate the differentiation of pituitary cells. PROP1 gene mutations are one of the etiological diagnoses of congenital panhypopituitarism, however symptoms vary depending on phenotypic expression. We present a case of psychosis in a 36-year-old female with congenital panhypopituitarism who presented with paranoia, flat affect and ideas of reference without a delirious mental state, which resolved with hormone replacement and antipsychotics. Further evaluation revealed that she had a homozygous mutation of PROP1 gene. In summary, compliance with hormonal therapy for patients with hypopituitarism appears to be effective for the prevention and treatment of acute psychosis symptoms. Learning points: Patients with PROP1 gene mutation may present with psychosis with no impairment in orientation and memory. There is currently inadequate literature on this topic, and further study on the possible mechanisms of psychosis as a result of endocrine disturbance is required. Compliance with hormonal therapy for patients with hypopituitarism appears to be effective for prevention and treatment of acute psychosis symptoms. PMID:28458894

The Sixth Catalogue of galactic Wolf-Rayet stars, their past and present

NASA Technical Reports Server (NTRS)

Van Der Hucht, K. A.; Conti, P. S.; Lundstrom, I.; Stenholm, B.

1981-01-01

This paper presents the Sixth Catalogue of galactic Wolf-Rayet stars (Pop. I), a short history on the five earlier WR catalogues, improved spectral classification, finding charts, a discussion on related objects, and a review of the current status of Wolf-Rayet star research. The appendix presents a bibliography on most of the Wolf-Rayet literature published since 1867.

Change the Placement, the Pace, and the Preparation for the Oral Presentation

ERIC Educational Resources Information Center

Bayless, Marsha L.

2004-01-01

In this article, the author describes how she changed her process for the oral presentation, which involved looking at its placement in the course, the pace, and the preparation. By moving the team oral presentation earlier in the course, the author hoped to solve two problems. One problem was the increased stress both students and the author…

Waist circumference in 6-12-year-old children: The Health Oriented Pedagogical Project (HOPP).

PubMed

Fredriksen, Per Morten; Skår, Angelica; Mamen, Asgeir

2018-05-01

With overweight and obesity increasing worldwide, it has become ever more important to monitor the development and distribution of adiposity in children. This study investigated how the measurements of waist circumference (WC) and waist-to-height ratio (WHtR) in children 6-12 years old relate to earlier studies. In 2015, 2271 children (boys, n = 1150) were measured for height, weight, and WC. Parental education level was used as a measure of socioeconomic status. A significant increase in WC with age was revealed for both sexes ( p < .0001). Boys at 10 and 12 years had a larger WC than girls; otherwise no difference between sexes was found. The WHtR decreased with age for girls ( p < .0001); 14% of the sample displayed a WHtR ≥ 0.50. Comparison with earlier studies showed a higher WC and WHtR despite no change in weight and body mass index. WC and WHtR are recommended as tools for identifying central obesity in children. The results indicate increased WC in 6-12-year-old children compared with earlier findings.

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers

PubMed Central

Cohen, Joshua D.; Javed, Ammar A.; Thoburn, Christopher; Wong, Fay; Tie, Jeanne; Gibbs, Peter; Schmidt, C. Max; Yip-Schneider, Michele T.; Allen, Peter J.; Schattner, Mark; Brand, Randall E.; Singhi, Aatur D.; Petersen, Gloria M.; Hong, Seung-Mo; Kim, Song Cheol; Falconi, Massimo; Doglioni, Claudio; Weiss, Matthew J.; Ahuja, Nita; He, Jin; Makary, Martin A.; Maitra, Anirban; Hanash, Samir M.; Dal Molin, Marco; Wang, Yuxuan; Li, Lu; Ptak, Janine; Dobbyn, Lisa; Schaefer, Joy; Silliman, Natalie; Popoli, Maria; Goggins, Michael G.; Hruban, Ralph H.; Wolfgang, Christopher L.; Klein, Alison P.; Tomasetti, Cristian; Papadopoulos, Nickolas; Kinzler, Kenneth W.; Vogelstein, Bert; Lennon, Anne Marie

2017-01-01

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient’s primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types. PMID:28874546

Combining in Vitro Diagnostics with in Vivo Imaging for Earlier Detection of Pancreatic Ductal Adenocarcinoma: Challenges and Solutions

PubMed Central

Laeseke, Paul F.; Chen, Ru; Jeffrey, R. Brooke; Brentnall, Teresa A.

2015-01-01

Pancreatic ductal adenocarcinoma (PDAC) is the fourth-leading cause of cancer-related death in the United States and is associated with a dismal prognosis, particularly when diagnosed at an advanced stage. Overall survival is significantly improved if PDAC is detected at an early stage prior to the onset of symptoms. At present, there is no suitable screening strategy for the general population. Available diagnostic serum markers are not sensitive or specific enough, and clinically available imaging modalities are inadequate for visualizing early-stage lesions. In this article, the role of currently available blood biomarkers and imaging tests for the early detection of PDAC will be reviewed. Also, the emerging biomarkers and molecularly targeted imaging agents being developed to improve the specificity of current imaging modalities for PDAC will be discussed. A strategy incorporating blood biomarkers and molecularly targeted imaging agents could lead to improved screening and earlier detection of PDAC in the future. © RSNA, 2015 PMID:26599925

Earlier disability of the patients followed in Multiple Sclerosis centers compared to outpatients.

PubMed

Debouverie, M; Laforest, L; Van Ganse, E; Guillemin, F

2009-02-01

The currently published works regarding the multiple sclerosis (MS) natural history report data were collected most often on population of patients recruited in MS centers. The aim was to compare the natural history of a population of patients followed in a MS centre (MSC) with patients followed outside a MS centre (NMSC). Cases were identified through the LORSEP cohort, a network of neurologists (private ambulatory practice, hospitals, and MS centers) in France. A total of 3602 patients had been analyzed: 1036 MSC patients and 2566 NMSC patients. No difference was observed regarding gender and initial symptoms. Conversely, MSC patients were younger at MS onset and were more likely to have a primary progressive initial form. Median times (years) to the EDSS scores of 3, 4, and 6 were 5.8 (5.0-6.8), 8.4 (7.9-9.0), 16.0 (14.8-18.1) in the MSC group, respectively, whereas corresponding times were 8.4 (7.9-9.0), 12.3 (11.4-13.4), 19.1 (18.0-20.2) in the NMSC group. These differences according to the type of MS supervision were statistically significant for EDSS3 (P < 0.0001), EDSS4 (P < 0.0001), and EDSS6 (P = 0.01), respectively. These findings were confirmed in Cox multivariate models. The patients followed in a MS centre had earlier disability than patients managed otherwise. Analyses exclusively conducted in patients with MS supervised in specialized centers may falsely misestimate the times needed to reach major disability landmarks. Before using registries to study the natural history of MS, efforts should be performed to verify in how far data are exhaustive and to understand the local health care system.

Verbal abuse, like physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder.

PubMed

Post, Robert M; Altshuler, Lori L; Kupka, Ralph; McElroy, Susan L; Frye, Mark A; Rowe, Michael; Leverich, Gabriele S; Grunze, Heinz; Suppes, Trisha; Keck, Paul E; Nolen, Willem A

2015-05-01

Physical or sexual abuse in childhood is known to have an adverse effect on the course of bipolar disorder, but the impact of verbal abuse has not been well elucidated. We examined the occurrence and frequency (never to frequently) of each type of abuse in childhood in 634 US adult outpatients (average age 40 years). Patients gave informed consent and provided information about their age of onset and course of illness prior to study entry. Verbal abuse alone occurred in 24% of the patients. Similar to a history of physical or sexual abuse, a history of verbal abuse was related to an earlier age of onset of bipolar disorder and other poor prognosis characteristics, including anxiety and substance abuse comorbidity, rapid cycling, and a deteriorating illness course as reflected in ratings of increasing frequency or severity of mania and depression. A lasting adverse impact of the experience of verbal abuse in childhood is suggested by its relationship to an earlier age of onset of bipolar disorder, other poor prognosis factors, and a deteriorating course of illness. Verbal abuse is a common confound in comparison groups defined by a lack of physical or sexual abuse. Ameliorating the impact of verbal abuse on the unfolding course of bipolar disorder appears to be an important target of therapeutics and worthy of attempts at primary and secondary prophylaxis. Family-based treatments that focus on psychoeducation, enhancing intra-family communication, and coping skills may be particularly helpful. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A partial ban on sales to reduce high-risk drinking South of the border: seven years later.

PubMed

Voas, Robert B; Romano, Eduardo; Kelley-Baker, Tara; Tippetts, A Scott

2006-09-01

On weekend evenings, thousands of youths (ages 20 and younger) and young adults (ages 21-25) residing in communities along the U.S. border cross into Mexico to patronize all-night bars where the drinking age is 18, rather than 21, and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, implemented a 2 AM (instead of 5 AM) bar-closing policy. The number of crossers and their blood alcohol concentration levels on return were reduced in the year following this policy change. The present study's objective was to determine the long-term (7-year) effect of the earlier-closing bar policy on cross-border drinking in Mexico. Analyzed data (1998 to August 2005) were from quarterly breath-test surveys at the El Paso (Texas)/Juárez (Mexico) border, bar observations in Juárez, and trauma data in El Paso. Bar surveys in Juárez show that the 2 AM closing policy, initiated 7 years ago, continues to be enforced, as has the reduction (89%) in youthful crossers returning after 3 AM. The number of underage youths returning earlier in the evening (before 3 AM), however, unchanged for 2 years after the policy change, has doubled recently. The early closing of bars in Juárez has a continuing positive impact on the reduction of the number of those returning after 3 AM. Although initially there appeared to be no displacement of the late returnees into the early hours (before 3 AM), the number of bar visitors crossing and returning earlier has been steadily increasing. Suggestions for reducing cross-border heavy episodic drinking are described.

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier

PubMed Central

Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

ABSTRACT Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. How to cite this article Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83. PMID:29201732

Empirical corroboration of an earlier theoretical resolution to the UV paradox of insect polarized skylight orientation.

PubMed

Wang, Xin; Gao, Jun; Fan, Zhiguo

2014-02-01

It is surprising that many insect species use only the ultraviolet (UV) component of the polarized skylight for orientation and navigation purposes, while both the intensity and the degree of polarization of light from the clear sky are lower in the UV than at longer (blue, green, red) wavelengths. Why have these insects chosen the UV part of the polarized skylight? This strange phenomenon is called the "UV-sky-pol paradox". Although earlier several speculations tried to resolve this paradox, they did this without any quantitative data. A theoretical and computational model has convincingly explained why it is advantageous for certain animals to detect celestial polarization in the UV. We performed a sky-polarimetric approach and built a polarized skylight sensor that models the processing of polarization signals by insect photoreceptors. Using this model sensor, we carried out measurements under clear and cloudy sky conditions. Our results showed that light from the cloudy sky has maximal degree of polarization in the UV. Furthermore, under both clear and cloudy skies the angle of polarization of skylight can be detected with a higher accuracy. By this, we corroborated empirically the soundness of the earlier computational resolution of the UV-sky-pol paradox.

Empirical corroboration of an earlier theoretical resolution to the UV paradox of insect polarized skylight orientation

NASA Astrophysics Data System (ADS)

Wang, Xin; Gao, Jun; Fan, Zhiguo

2014-02-01

It is surprising that many insect species use only the ultraviolet (UV) component of the polarized skylight for orientation and navigation purposes, while both the intensity and the degree of polarization of light from the clear sky are lower in the UV than at longer (blue, green, red) wavelengths. Why have these insects chosen the UV part of the polarized skylight? This strange phenomenon is called the "UV-sky-pol paradox". Although earlier several speculations tried to resolve this paradox, they did this without any quantitative data. A theoretical and computational model has convincingly explained why it is advantageous for certain animals to detect celestial polarization in the UV. We performed a sky-polarimetric approach and built a polarized skylight sensor that models the processing of polarization signals by insect photoreceptors. Using this model sensor, we carried out measurements under clear and cloudy sky conditions. Our results showed that light from the cloudy sky has maximal degree of polarization in the UV. Furthermore, under both clear and cloudy skies the angle of polarization of skylight can be detected with a higher accuracy. By this, we corroborated empirically the soundness of the earlier computational resolution of the UV-sky-pol paradox.

Intracranial phosphaturic mesenchymal tumor, mixed connective tissue variant presenting without oncogenic osteomalacia.

PubMed

Bower, Regina S; Daugherty, Wilson P; Giannini, Caterina; Parney, Ian F

2012-01-01

Phosphaturic mesenchymal tumor, mixed connective tissue variant (PMTMCT) is a rare tumor typically occurring in soft tissues and bone, causing oncogenic (tumor-induced) osteomalacia (TIO) through secretion of the phosphaturic hormone, fibroblast growth factor-23 (FGF-23). Rare tumors identical to PMTMCT occur without known TIO. Intracranial localization of PMTMCT is extremely rare, with only two cases reported in the literature. We present a very unusual case of a patient with an intracranial PMTMCT that presented with neurologic changes without osteomalacia. A 67-year-old woman presented with progressive incontinence, apathy, and abulia after having undergone a total knee replacement 1 month earlier. Imaging disclosed a large left frontal anterior fossa mass. She underwent uncomplicated surgical resection of this tumor. Surprisingly, histopathology suggested PMTMCT. Reverse transcription polymerase chain reaction (RT-PCR) assay demonstrating FGF-23 expression in the tumor confirmed the diagnosis. Serum FGF-23 levels postoperatively were normal and she had no clinical or laboratory evidence of osteomalacia or phosphaturia. This report should serve to alert clinicians to the possibility that PMTMCT can be included in the differential diagnosis of intracranial masses even in the absence of tumor-induced osteomalacia.

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer.

PubMed

Lin, Yan; Ma, Changchun; Liu, Chengkang; Wang, Zhening; Yang, Jurong; Liu, Xinmu; Shen, Zhiwei; Wu, Renhua

2016-05-17

Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients.

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer

PubMed Central

Lin, Yan; Ma, Changchun; Liu, Chengkang; Wang, Zhening; Yang, Jurong; Liu, Xinmu; Shen, Zhiwei; Wu, Renhua

2016-01-01

Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients. PMID:27107423

Sex differences in the clinical presentation of eating disorders in youth

PubMed Central

Kinasz, Kathryn; Accurso, Erin C.; Kass, Andrea E.; Le Grange, Daniel

2016-01-01

Purpose Eating disorders (EDs) impact both males and females, but little is known about sex differences in ED psychopathology and overall clinical presentation. This study compared demographic and clinical characteristics of child and adolescent males and females who presented for ED treatment. Methods Participants included 619 youth (59 males and 560 females) ages 6 to 18 years who presented for treatment between 1999 and 2011. Results Males presented for ED treatment at a significantly younger age (p < .001), earlier age of onset (p = .004), and were more likely to be non-White (p = .023). Females showed more severe eating disorder pathology across the Eating Disorder Examination subscales (weight concern: p < .001, eating concern: p < .001, restraint: p = .001, and shape concern: p = .019) and global score (p < .001). Males were more likely to present with an ED other than anorexia nervosa or bulimia nervosa (p = .002). Females presented with significantly higher rates of mood disorders (p = .027) and had a lower average percent of expected body weight (p = .020). Males and females did not differ in duration of illness, prior hospitalization or treatment, binging and purging episodes, anxiety disorders, behavioral disorders, or self-esteem. All analyses were controlled for age. Conclusion Results indicate that further exploration into why the sexes present differently may be warranted. Developing ED psychopathology assessments that better capture nuances particular to males and reevaluating criteria to better categorize male ED diagnoses may allow for more targeted treatment. PMID:26830976

Earlier surgical intervention in congenital heart disease results in better outcome and resource utilization.

PubMed

Panni, Roheena Z; Ashfaq, Awais; Amanullah, Muhammad M

2011-12-29

Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively; among patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan. A prevalence based cost of illness study design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children ≤ 5 years of age from June 2006 to June 2009. A total of 120 patients were enrolled after obtaining an informed consent and the data was collected using a pre-tested questionnaire. The mean age at the time of surgery in group A (1-12 mo age) was 6.08 ± 2.80 months and in group B (1-5 yrs) was 37.10 ± 19.94 months. The cost of surgical admission was found to be significantly higher in the older group, p = 0.001. The total number and cost of post-operative outpatient visits was also higher in group B, p = 0.003. Pre and post operative hospital admissions were not found to be significantly different among the two groups, p = 0.166 and 0.627, respectively. The number of complications were found to be different between the two groups (p = 0.019). Majority of these were contributed by hemorrhage and post-operative seizures. This study concluded that significant expenditure is incurred by people with CHD; with the implication that resources could be saved by earlier detection and awareness campaigns.

That's Not What You Said Earlier: Preschoolers Expect Partners to be Referentially Consistent

ERIC Educational Resources Information Center

Graham, Susan A.; Sedivy, Julie; Khu, Melanie

2014-01-01

In a conversation, adults expect speakers to be consistent in their use of a particular expression. We examine whether four-year-olds expect speakers to use consistent referential descriptions and whether these expectations are partner-specific. Using an eye-tracking paradigm, we presented four-year-olds with arrays of objects on a screen. During…

[The first film presentation of REM sleep behavior disorder precedes its scientific debut by 35 years].

PubMed

Janković, Slavko M; Sokić, Dragoslav V; Vojvodić, Nikola M; Ristić, Aleksandar J

2006-01-01

The perplexing and tantalizing disease of rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by peculiar, potentially dangerous behavior during REM sleep. It was described both in animals and humans. RBD in mammals was first described by Jouvet and Delorme in 1965, based on an experimental model induced by lesion in pontine region of cats. In 1972, Passouant et al. described sleep with eye movements and persistent tonic muscle activity induced by tricyclic antidepressant medication, and Tachibana et al., in 1975, the preservation of muscle tone during REM sleep in the acute psychosis induced by alcohol and meprobamate abuse. wever, the first formal description of RBD in humans as new parasomnia was made by Schenck et al in 1986. Subsequently, in 1990, the International Classification of Sleep Disorders definitely recognized RBD as new parasomnia. To our knowledge, arts and literature do not mention RBD. Except for the quotation, made by Schenck et al [n 2002, of Don Quixote de la Mancha whose behavior in sleep strongly suggested that Miguel de Servantes actually described RBD, no other artistic work has portrayed this disorder. Only recently we become aware of the cinematic presentation of RBD which by decades precedes the first scientific description. The first presentation of RBD on film was made prior to the era of advanced electroencephalography and polysomnography, and even before the discovery of REM sleep by Aserinsky and Kleitman in 1953. The artistic and intuitive presentation of RBD was produced in Technicolor in a famous film "Cinderella" created by Walt Disney in 1950, some 35 years prior to its original publication in the journal "Sleep". Since there is an earlier version of the film initially produced in 1920, presumably containing this similar scene, we can only speculate that the first cinematic presentation of RBD might precede its scientific debut by 65 years. In a scene in a barn, clumsy and goofy dog Bruno is, as dogs

Kindergartners’ Fluent Processing of Symbolic Numerical Magnitude is Predicted by Their Cardinal Knowledge and Implicit Understanding of Arithmetic Two Years Earlier

PubMed Central

Moore, Alex M.; vanMarle, Kristy; Geary, David C.

2016-01-01

Fluency in first graders’ processing of the magnitudes associated with Arabic numerals, collections of objects, and mixtures of objects and numerals predicts current and future mathematics achievement. The quantitative competencies that support the development of fluent processing of magnitude are not fully understood, however. At the beginning and end of preschool (M = 3 years, 9 months at first assessment; range 3 years, 3 months to 4years, 3 months), 112 (51 boys) children completed tasks measuring numeral recognition and comparison, acuity of the approximate number system, and knowledge of counting principles, cardinality, and implicit arithmetic, and completed a magnitude processing task (number sets test) in kindergarten. Use of Bayesian and linear regression techniques revealed that two measures of preschoolers’ cardinal knowledge and their competence at implicit arithmetic predicted later fluency of magnitude processing, controlling domain general factors, preliteracy skills, and parental education. The results help to narrow the search for the early foundation of children’s emerging competence with symbolic mathematics and provide direction for early interventions. PMID:27236038

Kindergartners' fluent processing of symbolic numerical magnitude is predicted by their cardinal knowledge and implicit understanding of arithmetic 2years earlier.

PubMed

Moore, Alex M; vanMarle, Kristy; Geary, David C

2016-10-01

Fluency in first graders' processing of the magnitudes associated with Arabic numerals, collections of objects, and mixtures of objects and numerals predicts current and future mathematics achievement. The quantitative competencies that support the development of fluent processing of magnitude, however, are not fully understood. At the beginning and end of preschool (M=3years 9months at first assessment, range=3years 3months to 4years 3months), 112 children (51 boys) completed tasks measuring numeral recognition and comparison, acuity of the approximate number system, and knowledge of counting principles, cardinality, and implicit arithmetic and also completed a magnitude processing task (number sets test) in kindergarten. Use of Bayesian and linear regression techniques revealed that two measures of preschoolers' cardinal knowledge and their competence at implicit arithmetic predicted later fluency of magnitude processing, controlling domain-general factors, preliteracy skills, and parental education. The results help to narrow the search for the early foundation of children's emerging competence with symbolic mathematics and provide direction for early interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Chemistry, physiology and neuropsychology of schizophrenia: towards an earlier diagnosis of schizophrenia I.

PubMed

Kornhuber, H H

1983-01-01

Data supporting the glutamate hypothesis of schizophrenia are presented. The glutamate hypothesis is linked to the dopamine hypothesis by the fact that dopamine synapses inhibit the release of glutamate in the striate and mesolimbic system. The glutamate hypothesis of schizophrenia may open a way to find better drugs for treatment. The concept of schizophrenia I is described. It consists of "negative symptoms" such as disconcentration or reduction of energy. Schizophrenia I precedes and follows schizophrenia II with "positive symptoms," e.g. hallucinations and delusions. Schizophrenia I so far cannot be diagnosed as schizophrenia unless schizophrenia II appears. Chemical, physiological or neuropsychological methods for the diagnosis of schizophrenia I would render an earlier treatment of schizophrenia possible and thus make social and occupational rehabilitation more efficient. An objective diagnosis of schizophrenia I may also elucidate the mode of genetic transmission of schizophrenia. Several neuropsychological methods distinguish schizophrenic patients as a group from normals. Some of them are based on a specific disturbance of long term concentration. The EEG also distinguishes schizophrenics from normals when analyzed during voluntary movement. For schizophrenics it takes more effort to initiate a voluntary movement, and there are several features of the EEG correlated to this. Moreover, the longer motor reaction time of schizophrenics is paralleled by a longer duration of the Bereitschaftspotential in schizophrenia. Furthermore, there is a difference in the theta rhythm between schizophrenic patients and normals in a task which requires concentration. Some of the children of schizophrenic parents show a disturbance of concentration in both reaction time tasks and the d 2 test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult bacterial meningitis-a quality registry study: earlier treatment and favourable outcome if initial management by infectious diseases physicians.

PubMed

Grindborg, Ö; Naucler, P; Sjölin, J; Glimåker, M

2015-06-01

Acute bacterial meningitis (ABM) is challenging for the admitting physician because it is a rare but fulminant disease, usually presenting without typical symptoms, and rapid treatment is pivotal. The purpose of this study was to evaluate the effect of initial management by infectious diseases (ID) physicians vs. non-ID physicians. A total of 520 consecutive adults (>17 years old), 110 with initial ID management and 410 with non-ID management, registered in the Swedish quality registry for community-acquired ABM January 2008 to December 2013, were analysed retrospectively. Primary outcome was appropriate treatment with antibiotics and corticosteroids <1 hour from admission. Secondary analyses were mortality during hospital stay and persisting neurological and hearing deficits at follow-up after 2 to 6 months. Differences in diagnostic treatment sequences also were analysed. Appropriate treatment <1 hour from admission was achieved significantly more often (41%) by ID physicians vs. non-ID physicians (24%) with an odds ratio (OR) of 2.4 (95% confidence interval [CI]: 1.40 to 4.14; p < 0.01) adjusted for confounders. The door-to-antibiotic time was significantly shorter, and significantly more patients were administered corticosteroids together with the first doses of antibiotics in the ID group. A trend of decreased mortality (4.5% vs. 8.0%) and sequelae at follow-up (24% vs. 44%; adjusted OR 0.55: 95% CI 0.31 to 1.00; p 0.05) were observed in the ID group vs. the non-ID group. Antibiotics were started without prior neuroimaging more often in the ID group (86% vs. 57%; p < 0.001). Initial management at the emergency department by ID physicians is associated with earlier appropriate treatment, more appropriate diagnostic treatment sequences and favourable outcome. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Presentation of Original Research at the European Congress of Radiology 2010: Frequency of Publication in Medline-Indexed Journals Within 5 Years After Presentation.

PubMed

Dollinger, Marco; Zeman, Florian; Müller-Wille, René; Beyer, Lukas Philipp; Stroszczynski, Christian; Bley, Thorsten Alexander; Wiggermann, Philipp

2018-04-01

 To determine the rate at which original studies presented orally at the European Congress of Radiology (ECR) 2010 were published in Medline-indexed journals and to identify factors predictive of publication.  A total of 869 abstracts were included in the study. A Medline search of articles published between March 2010 and February 2015 was conducted to identify articles written by the first, second, and/or last authors of all abstracts published in the Scientific Program of ECR 2010. The publication year, journal, country of origin, subspecialty and nature of the research (i. e., human, animal or technical) were recorded.  Between March 2010 and February 2015 a total of 450 abstracts (publication rate, 51.8 %) were subsequently published in 125 Medline-indexed journals, chiefly in European Radiology (11.1 %). 443/450 (98.4 %) articles were published in English language. The subspecialties of molecular imaging and cardiac imaging had the highest publication rates (75.0 % and 62.0 %, respectively), while computer application studies had the lowest (27.6 %). The nature of research, origin of the abstract and subspecialty significantly influenced the subsequent publication rate.  More than half of the original studies presented orally at ECR 2010 were subsequently published in Medline-indexed journals. More articles were published in the journal European Radiology than in any other identified journal.   · ECR 2010 had a high subsequent publication rate. · Most subsequently published articles were published in radiology journals. · Nearly all articles were published in the English language. · Dollinger M, Zeman F, Müller-Wille R et al. Presentation of Original Research at the European Congress of Radiology 2010: Frequency of Publication in Medline-Indexed Journals Within 5 Years After Presentation. Fortschr Röntgenstr 2017; 190: 327 - 333. © Georg Thieme Verlag KG Stuttgart · New York.

The effect of trampoline parks on presentations to the Christchurch Emergency Department.

PubMed

Roffe, Lloyd; Pearson, Scott; Sharr, Johnathan; Ardagh, Michael

2018-01-19

To analyse trampoline-related injuries suffered after the opening of two new trampoline parks in Christchurch. Data was collected from three 90-day periods. All trampoline-related injuries were collected from electronic documentation and coding. Those injured after both arenas opened were contacted and a semi-structured interview performed. In the 90 days after both parks opened there were 602 claims for trampoline-related injuries with 106 hospital presentations (55% male). This was a significant increase (p<0.01) from one year earlier (333 claims, 37 hospital presentations) and the 90 days prior to their opening (201 claims, 15 hospital presentations). Most injuries affected an older group of children, aged between 10-14 years (26%, n=28), compared to the other two periods (p<0.01). There was also a greater proportion of lower-limb injuries (52%, n=55) compared to the other two periods (p<0.01). Thirty-six required hospital admission, with 29 operations and an average length of stay of 2.11 days. One trampoline park allowed two or more people to use the same trampoline at the same time, and had over twice as many presentations (33%, n=35) than the other trampoline park (14%, n=15). Christchurch saw a significant increase in trampoline-related injuries after the opening of two new parks. These injuries involved an older group of children, affected predominantly the lower limbs and were more severe than those reported from the use of domestic trampolines. Consistent with past research, the trampoline park allowing multiple users had a higher proportion of presentations and more injuries requiring operative intervention.

Body Representation in the First Year of Life

ERIC Educational Resources Information Center

Zieber, Nicole; Bhatt, Ramesh S.; Hayden, Angela; Kangas, Ashley; Collins, Rebecca; Bada, Henrietta

2010-01-01

Like faces, bodies are significant sources of social information. However, research suggests that infants do not develop body representation (i.e., knowledge about typical human bodies) until the second year of life, although they are sensitive to facial information much earlier. Yet, previous research only examined whether infants are sensitive…

Onset of rigor mortis is earlier in red muscle than in white muscle.

PubMed

Kobayashi, M; Takatori, T; Nakajima, M; Sakurada, K; Hatanaka, K; Ikegaya, H; Matsuda, Y; Iwase, H

2000-01-01

Rigor mortis is thought to be related to falling ATP levels in muscles postmortem. We measured rigor mortis as tension determined isometrically in three rat leg muscles in liquid paraffin kept at 37 degrees C or 25 degrees C--two red muscles, red gastrocnemius (RG) and soleus (SO) and one white muscle, white gastrocnemius (WG). Onset, half and full rigor mortis occurred earlier in RG and SO than in WG both at 37 degrees C and at 25 degrees C even though RG and WG were portions of the same muscle. This suggests that rigor mortis directly reflects the postmortem intramuscular ATP level, which decreases more rapidly in red muscle than in white muscle after death. Rigor mortis was more retarded at 25 degrees C than at 37 degrees C in each type of muscle.

Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia

PubMed Central

Cheung, Doug H.; Suharlim, Christian; Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2014-01-01

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past six months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the six months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health. PMID:24920344

Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia.

PubMed

Cheung, Doug H; Suharlim, Christian; Guadamuz, Thomas E; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2014-12-01

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past 6 months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the 6 months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health.

Radiographic evaluation of third molar development in 6- to 24-year-olds

PubMed Central

Jung, Yun-Hoa

2014-01-01

Purpose This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. Materials and Methods A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. Results The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. Conclusion The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females. PMID:25279338

Small bowel injury after suprapubic catheter insertion presenting 3 years after initial insertion

PubMed Central

Gallagher, Kevin M; Good, Daniel W; Brush, John P; Al-hasso, Ammar; Stewart, Grant D

2013-01-01

A 77-year-old woman was referred to urology with blockages of her suprapubic catheter (SPC). The catheter was replaced easily in the emergency department, however, no urine was draining, only a cloudy green fluid was visible. On cystoscopy bilious material was identified in the bladder. There was no catheter visible. There seemed to be a fistulous tract entering the bladder at the left dome. The urethra was dilated, a urethral catheter was placed and the SPC was removed. A CT demonstrated that the SPC tract transfixed a loop of pelvic small bowel and entered the bladder with no intraperitoneal contrast leak. The patient recovered well and did not require laparotomy. This case emphasises that bowel perforation, although rare, must be considered as a complication of SPC placement even years after initial insertion when catheter problems arise. Unusually, we learn that this complication may not present with abdominal pain or peritonism. PMID:24326435

Technology and Occupation: Past, Present, and the Next 100 Years of Theory and Practice.

PubMed

Smith, Roger O

During the first 100 years of occupational therapy, the profession developed a remarkable practice and theory base. All along, technology was an active and core component of practice, but often technology was mentioned only as an adjunct component of therapy and as if it was a specialty. This lecture proposes a new foundational theory that places technology at the heart of occupational therapy as a fundamental part of human occupation and the human experience. Moreover, this new Metaphysical Physical-Emotive Theory of Occupation pushes the occupational therapy profession and the occupational science discipline to overtly consider occupation on the level of a metaphysical-level reality. The presentation of this theory at the Centennial of the profession charges the field to test and further define the theory over the next 100 years and to leverage technology and its role in optimizing occupational performance into the future. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Attachment-Based Family Therapy with a 13-Year-Old Girl Presenting with High Risk for Suicide

PubMed Central

Krauthamer Ewing, E. Stephanie; Levy, Suzanne A.; Boamah-Wiafe, Linda; Kobak, Roger; Diamond, Guy

2014-01-01

This paper describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The paper begins with an overview of ABFT, including 1) how attachment theory guides treatment; 2) the structure of the clinical model; and 3) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The paper concludes with a discussion about implications for family-based treatment of suicidal youth. PMID:25329356

76 FR 52539 - Federal Employees' Retirement System; Present Value Conversion Factors for Spouses of Deceased...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... OFFICE OF PERSONNEL MANAGEMENT 5 CFR Part 843 RIN 3206-AM29 Federal Employees' Retirement System; Present Value Conversion Factors for Spouses of Deceased Separated Employees AGENCY: Office of Personnel... Subpart C of Part 843--Present Value Conversion Factors for Earlier Commencing Date of Annuities of...

Presentation and outcome of clinical poor performance in one health district over a 5-year period: 2002-2007.

PubMed

Cox, Stephen J; Holden, John D

2009-05-01

The detection, assessment, and management of primary care poor performance raise difficult issues for all those involved. Guidance has largely focused on managing the most serious cases where patient safety is severely compromised. The management of primary care poor performance has become an increasingly important part of primary care trust (PCT) work, but its modes of presentation and prevalence are not well known. To report the prevalence, presentation modes, and management of primary care poor performance cases presenting to one PCT over a 5-year period. A retrospective review of primary care poor performance cases in one district. St Helens PCT administered 35 practices with 130 GPs on the performers list, caring for 190 110 patients in North West England, UK. Cases presenting during 2002-2007 were initially reviewed by the chair of the PCT clinical executive committee. Anonymised data were then jointly reviewed by the assessor and another experienced GP advisor. There were 102 individual presentations (20 per year or one every 2-3 weeks) where clinician performance raised significant cause for concern occurred over the 5-year period. These concerns related to 37 individual clinicians, a range of 1-14 per clinician (mean 2.7). Whistleblowing by professional colleagues on 43 occasions was the most common presentation, of which 26 were from GPs about GPs. Patient complaints (18) were the second most common presentation. Twenty-seven clinicians were GPs, of whom the General Medical Council (GMC) were notified or involved in 13 cases. Clinicians were supported locally, and remedying was exclusively locally managed in 14 cases, and shared with an external organisation (such as the GMC or deanery) in another 12. Professional whistleblowing and patient complaints were the most common sources of presentation. Effective PCT teams are needed to manage clinicians whose performance gives cause for concern. Sufficient resources and both formal and informal ways of

Earlier flowering did not alter pollen limitation in an early flowering shrub under short-term experimental warming.

PubMed

Pan, Cheng-Chen; Feng, Qi; Zhao, Ha-Lin; Liu, Lin-De; Li, Yu-Lin; Li, Yu-Qiang; Zhang, Tong-Hui; Yu, Xiao-Ya

2017-06-05

In animal pollinated plants, phenological shifts caused by climate change may have important ecological consequences. However, no empirical evidence exists at present on the consequences that flowering phenology shifts have on the strength of pollen limitation under experimental warming. Here, we investigated the effects of experimental warming on flowering phenology, flower density, reproductive success, and pollen limitation intensity in Caragana microphylla and evaluated whether earlier flowering phenology affected plant reproduction and the level of pollen limitation using warmed and unwarmed open top chambers in the Horqin Sandy Land of Inner Mongolia, northern China. The results of this study indicated that artificial warming markedly advanced flower phenology rather than extending the duration of the flowering. Additionally, warming was found to significantly reduce flower density which led to seed production reduction, since there were insignificant effects observed on fruit set and seed number per fruit. Experimental floral manipulations showed that warming did not affect pollen limitation. These results revealed the negative effects of advanced phenology induced by warming on flower density and reproductive output, as well as the neutral effects on reproductive success and pollen limitation intensity of long surviving plants.

Patients presenting with acute poisoning to an outpatient emergency clinic: a one-year observational study in Oslo, Norway.

PubMed

Vallersnes, Odd Martin; Jacobsen, Dag; Ekeberg, Øivind; Brekke, Mette

2015-08-13

In Oslo, the majority of patients with acute poisoning are treated in primary care, at an emergency outpatient clinic with limited diagnostic and treatment resources. We describe the poisonings currently seen in this setting. We compare our findings with previous studies, with special concern for the appearance of new toxic agents, and changes in overall numbers and patterns of poisoning. Observational study. Patients above the age of 12 years presenting at Oslo Accident and Emergency Outpatient Clinic (Oslo Legevakt) with acute poisoning were included consecutively from October 2011 through September 2012. Physicians and nurses registered data on preset forms. Main outcome measures were toxic agents, age, sex, intention, referral and time of presentation. There were 2923 episodes of acute poisoning in 2261 patients. Median age of the patients was 32 years, and 1430 (63%) were males. The most frequent toxic agents were ethanol in 1684 (58%) episodes, heroin in 542 (19 %), benzodiazepines in 521 (18%), amphetamine in 275 (9%), fire smoke in 192 (7%), gamma-hydroxybutyrate (GHB) in 144 (5%), and cannabis in 143 (5%). In 904 (31%) poisonings there were more than one toxic agent. In 493 episodes (17%), the patient was hospitalised, and in 60 episodes (2%) admitted to a psychiatric ward. Most poisonings, 2328 (80%), were accidental overdoses with substances of abuse, 276 (9%) were suicide attempts, and 312 (11%) were accidents. Among ethanol poisonings in patients above the age of 26 years, 685/934 (73%) were in males, and 339/934 (36%) presented during weekends. However, among ethanol poisonings in patients under the age of 26 years, 221/451 (49 ) were in females, and 297/451 (66%) presented during weekends. The poisonings treated in this primary care setting were mostly due to accidental overdoses with ethanol or other substances of abuse. There is a disconcerting weekend drinking pattern among adolescents and young adults, with young females presenting as often as

Annual Progress Report - Fiscal Year 1982

DTIC Science & Technology

1982-10-01

activity . A published method developed in our laboratory for determining tne antibacterial activity of mouse peritoneal phagocytes in vivo (1) has been...EDITOR’S NOTE This FY 1982 Annual Progress report is a general review of research activities of the U. S. Army Medical Research Institute of Infectious...years earlier. Passive immunization, active immunization using killed or living attenuated whole agent, or immunization with sub-unit antigens achieved

The Gravity Field, Orientation, and Ephemeris of Mercury from MESSENGER Observations After Three Years in Orbit

NASA Technical Reports Server (NTRS)

Mazarico, Erwan M.; Genova, Antonio; Goossens, Sander; Lemoine, Gregory; Neumann, Gregory A.; Zuber, Maria T.; Smith, David E.; Solomon, Sean C.

2014-01-01

We have analyzed three years of radio tracking data from the MESSENGER spacecraft in orbit around Mercury and determined the gravity field, planetary orientation, and ephemeris of the innermost planet. With improvements in spatial coverage, force modeling, and data weighting, we refined an earlier global gravity field both in quality and resolution, and we present here a spherical harmonic solution to degree and order 50. In this field, termed HgM005, uncertainties in low-degree coefficients are reduced by an order of magnitude relative to the earlier global field, and we obtained a preliminary value of the tidal Love number k(sub 2) of 0.451+/-0.014. We also estimated Mercury's pole position, and we obtained an obliquity value of 2.06 +/- 0.16 arcmin, in good agreement with analysis of Earth-based radar observations. From our updated rotation period (58.646146 +/- 0.000011 days) and Mercury ephemeris, we verified experimentally the planet's 3: 2 spin-orbit resonance to greater accuracy than previously possible. We present a detailed analysis of the HgM005 covariance matrix, and we describe some near-circular frozen orbits around Mercury that could be advantageous for future exploration.

Four Generations of Maintenance Resource Management Programs in the United States: An Analysis of the Past, Present, and Future

NASA Technical Reports Server (NTRS)

Taylor, James C.; Patankar, Manoj S.

2001-01-01

This paper analyzes four generations of Maintenance Resource Management (MRM) programs implemented by aviation maintenance organizations in the United States. Data collected from over ten years of survey research and field observations are used for this analysis; they are presented in a case-study format. The first three generations of MRM programs were episodic efforts to increase safety through teamwork, focus group discussions, and awareness courses, respectively. Now, the fourth generation programs, characterized by a commitment to long-term communication and behavioral changes in maintenance, are set to build on those earlier generations, toward a culture of mutual trust between mechanics, their managers, and regulators.

Attachment-Based Family Therapy With a 13-Year-Old Girl Presenting With High Risk for Suicide.

PubMed

Krauthamer Ewing, E Stephanie; Levy, Suzanne A; Boamah-Wiafe, Linda; Kobak, Roger; Diamond, Guy

2016-01-01

This article describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year-old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family-based treatment of suicidal youth. © 2015 American Association for Marriage and Family Therapy.

Resurgence of Acanthamoeba keratitis in Auckland, New Zealand: a 7-year review of presentation and outcomes.

PubMed

Patel, Dipika V; Rayner, Sandra; McGhee, Charles N J

2010-01-01

To investigate the presentation, clinical characteristics and outcomes of Acanthamoeba keratitis (AK) in Auckland, New Zealand over a 7-year period. Retrospective analysis of all cases of AK treated by the tertiary corneal service at Auckland City Hospital/ University of Auckland Department of Ophthalmology (August 2001 to May 2008). Data were collected regarding age, gender, contact lens history, presenting signs and symptoms, diagnosis at first presentation, time to final diagnosis, identifiable risk factors, presenting and final visual acuity, results of microbiological testing, medical treatment, surgical interventions, recurrence of disease and length of follow up. All photographs and in vivo confocal microscopy images were reviewed. Twenty-five eyes of 25 patients were identified with a diagnosis of AK (mean age 40 +/- 13 years). Ninety-six per cent were contact lens wearers. Mean time to diagnosis was 41 +/- 49 days (range 0-181 days, median 21 days). Fourteen patients (56%) had been treated with topical corticosteroids prior to the diagnosis. Early diagnosis of AK (<21 days) was associated with significantly better final visual acuity and did not require any surgical intervention compared with those diagnosed at a later stage. Six patients, all in the late diagnosis group, required surgical intervention. AK has become significantly more common in New Zealand in the current decade. This study highlights the fundamental importance of early diagnosis and appropriate management in ensuring favourable outcomes. Practitioners should maintain a clinical suspicion of AK, especially as 96% of the subjects in this study were contact lens wearers.

Accessing Real-Life Episodic Information from Minutes versus Hours Earlier Modulates Hippocampal and High-Order Cortical Dynamics

PubMed Central

Chen, J.; Honey, C. J.; Simony, E.; Arcaro, M. J.; Norman, K. A.; Hasson, U.

2016-01-01

It is well known that formation of new episodic memories depends on hippocampus, but in real-life settings (e.g., conversation), hippocampal amnesics can utilize information from several minutes earlier. What neural systems outside hippocampus might support this minutes-long retention? In this study, subjects viewed an audiovisual movie continuously for 25 min; another group viewed the movie in 2 parts separated by a 1-day delay. Understanding Part 2 depended on retrieving information from Part 1, and thus hippocampus was required in the day-delay condition. But is hippocampus equally recruited to access the same information from minutes earlier? We show that accessing memories from a few minutes prior elicited less interaction between hippocampus and default mode network (DMN) cortical regions than accessing day-old memories of identical events, suggesting that recent information was available with less reliance on hippocampal retrieval. Moreover, the 2 groups evinced reliable but distinct DMN activity timecourses, reflecting differences in information carried in these regions when Part 1 was recent versus distant. The timecourses converged after 4 min, suggesting a time frame over which the continuous-viewing group may have relied less on hippocampal retrieval. We propose that cortical default mode regions can intrinsically retain real-life episodic information for several minutes. PMID:26240179

Analysis of the publication rate of the abstracts presented at a national gastroenterology meeting after 6 years

PubMed Central

Gandhi, Divyangkumar; Mclean, Richard W.; Laiyemo, Adeyinka O.

2017-01-01

Background/Aims Abstract presentations at scientific meetings provide an opportunity to convey the results of important research. Unfortunately, many abstracts are not eventually published as full manuscripts. We evaluated factors associated with publication of abstracts as manuscripts up to 6.5 years after presentation at the 73rd scientific meeting of the American College of Gastroenterology in 2008. Methods All abstracts, excluding case reports, presented at the meeting were evaluated. We systematically searched for matching manuscripts indexed in PubMed or EMBASE up till May 2015. We used logistic regression models to determine factors associated with manuscript publication and calculated odds ratios (OR) and 95% confidence intervals (CI). Results Of included 791 abstracts, 249 (31.5%) were published as manuscripts within 6.5 years. Oral presentation (OR=2.11; 95%CI: 1.15-3.87), multicenter studies (OR=2.67; 95%CI: 1.44-4.95), abstracts by University-based authors (OR=1.80; 95%CI: 1.20-2.72), and funded research (OR=2.15; 95%CI: 1.43-3.23) were more likely to be published. Winning an award at the meeting was not associated with manuscript publication (OR=1.09; 95%CI: 0.57-2.06). Conclusions There is an urgent need to improve dissemination of scientific knowledge through publication of abstracts presented at gastroenterology meetings as manuscripts. Mentors should endeavor to encourage their mentees to complete this final stage of their scholarly activities. PMID:27931019

Phaeochromocytoma in a 86-year-old patient presenting with reversible myocardial dysfunction.

PubMed

Szwench, Elżbieta; P Czkowska, Mariola; Marczewski, Krzysztof; Klisiewicz, Anna; Micha Owska, Ilona; Ciuba, Iwona; Januszewicz, Magdalena; Prejbisz, Aleksander; Hoffman, Piotr; Januszewicz, Andrzej

2011-12-01

BACKGROUND. Phaeochromocytomas and paragangliomas are rare, mostly benign catecholamine-producing tumours of chromaffin cells of the adrenal medulla or of extra-adrenal paraganglia. Phaeochromocytoma may occur at any age, the greatest frequency being in the fourth and fifth decades. Only on extremely rare occasions does the tumour develop in the very old patients. METHODS. We are describing an 86-year-old patient with phaeochromocytoma, presenting with reversible myocardial dysfunction. RESULTS. This very old patient with phaeochromocytoma had hypertension characterized by labile blood pressure values and increased daytime blood pressure variability. This patient exhibited reversible myocardial dysfunction suggestive for "catecholaminergic cardiomyopathy", as the complication of phaeochromocytoma. After surgical removal of the tumour, recovery of left ventricular function was documented by echocardiography showing normalization of systolic function and improvement of diastolic function. CONCLUSION. Phaeochromocytomas are rare forms of secondary hypertension, but should be considered in the differential diagnosis, regardless of age, even in very old patients.

Immunity to rubella before and after vaccination against measles, mumps and rubella (MMR) at 12 years of age of the first generation offered MMR vaccination in Sweden at 18 months.

PubMed

Böttiger, M

1995-12-01

In 1982, a two-dose programme of vaccination against measles, mumps and rubella (MMR) at the ages of 18 months and 12 years was introduced in Sweden. In 1992-3, the first group of children vaccinated at 18 months reached the age of 12, i.e. the time for a second dose. In connection with this 12-year vaccination, 376 children were recruited, investigated concerning earlier MMR vaccination and bled prior to and 2 months after the immunization. Two hundred and twenty of them had a documented, earlier MMR vaccination and 156 had not. The latter were classified as unvaccinated. The antibody status against rubella was measured by the haemolysis-in-gel method. Prior to the present vaccination, 3% of the earlier vaccinated group totally lacked any sign of antibodies. In the presumably unvaccinated group, this figure was 76%. After the vaccination all children showed signs of antibody activity and reached the antibody level of > or = 15 international units, i.e. in our tests a zone dia. of approx 8 mm. However, the secondly vaccinated children ended up with a mean antibody level of 10.7 mm which was slightly lower than the level, i.e. 11.0 mm of those lacking earlier vaccination history and prevaccination seronegative. The earlier unvaccinated but pre-immune children reached a mean level of 11.2 mm. In general, those with relatively high, pre-vaccination, antibody levels reacted less to the booster than those with low or no pre-vaccination immunity. The booster thus appeared to restore the antibody levels of the low-titre children.

Patients presenting to an outpatient sport medicine clinic with concussion

PubMed Central

Ouellet, Jérôme; Boisvert, Leslie; Fischer, Lisa

2016-01-01

Abstract Objective To describe the characteristics of patients who presented to outpatient sport and exercise medicine clinics with concussion. Design Retrospective chart review of electronic medical records. Setting Three specialized sport and exercise medicine clinics in London, Ont. Participants A total of 283 patients presenting with concussion. Main outcome measures Data collected included demographic variables (age and sex), sport participation at the time of injury, previous medical history (including history of concussion), Post-Concussion Symptom Scale (PCSS) scores, and return-to-play (RTP) variables (delay and outcome). Results The mean age of patients presenting for care was 17.6 years; 70.9% of patients were younger than 18 years of age (considered pediatric patients); 58.8% of patients were male; and 31.7% of patients had a previous history of concussion. The main sports associated with injury were hockey (40.0%), soccer (12.6%), and football (11.7%). Return to play was granted to 50.9% of patients before the 3-week mark and 80.2% of patients before 8 weeks. Total PCSS scores (maximum score was 132) and neck scores (part of the PCSS, maximum score was 6) were significantly higher in adults compared with pediatric patients (36.2 vs 27.6, P = .02, and 1.8 vs 1.2, P = .02, respectively). A significant difference was seen in RTP, with pediatric patients returning earlier than adults did (P = .04). This difference was not seen when comparing males with females (P = .07). Longer duration of follow-up did not influence RTP outcomes. Previous history of concussion was associated with restriction from contact or collision sports (P < .001). Conclusion Given the age and sex variability found in this study, as well as in previous published reports, it is important to manage each patient individually using current best available practice strategies to optimize long-term outcomes.

One-year prospective replication study of an untreated sample of community dysthymia subjects.

PubMed

McCullough, J P; McCune, K J; Kaye, A L; Braith, J A; Friend, R; Roberts, W C; Belyea-Caldwell, S; Norris, S L; Hampton, C

1994-07-01

This study replicates an earlier naturalistic-prospective investigation of nontreatment, community DSM-III-R dysthymia subjects. Major goals were to determine spontaneous remission rates and monitor the stability of psychosocial functioning levels over time. Twenty-four dysthymia subjects were followed for 1 year. Three remissions (13%) were diagnosed at the final interview. At a 4-year diagnostic follow-up contact with the remitters only, one remitter had relapsed and two remained in remission. Subjects were monitored for depressive symptom intensity, personality functioning, general medical distress, cognitive functioning, coping stylistics, interpersonal functioning, quality of their social support resources, and general family functioning. Stable levels of psychosocial functioning were maintained across all measures over the 1-year period. Current psychometric findings confirm the conclusions of the earlier nontreatment prospective study that dysthymia is a chronic mood disorder with stable psychosocial features and is unlikely to remit spontaneously over time.

Predictors of Close Family Relationships over One Year among Homeless Young People

ERIC Educational Resources Information Center

Milburn, N.G.; Jane Rotheram-Borus, M.; Batterham, P.; Brumback, B.; Rosenthal, D.; Mallett, S.

2005-01-01

Predictors of perceived family bonds were examined among homeless young people who initially left home one year earlier. Newly homeless young people aged 12-20 years who had recently left home were recruited in Los Angeles County, United States (n=201) and Melbourne, Australia (n=124) and followed longitudinally at 3, 6, and 12 months (follow-up…

Predictors of Reading Development in Deaf Children: A 3-Year Longitudinal Study

ERIC Educational Resources Information Center

Kyle, Fiona E.; Harris, Margaret

2010-01-01

The development of reading ability in a group of deaf children was followed over a 3-year period. A total of 29 deaf children (7-8 years of age at the first assessment) participated in the study, and every 12 months they were given a battery of literacy, cognitive, and language tasks. Earlier vocabulary and speechreading skills predicted…

An unusual presentation of a chronic ingested foreign body in an adult.

PubMed

Kropf, Jesse A H; Jeanmonod, Rebecca; Yen, David M

2013-01-01

Sore throat is a common complaint for patients presenting to the emergency department (ED). Although most are caused by viral and bacterial sources, an ingested foreign body must be considered in the right patient population. Retained foreign bodies occur in both children and adults. In children, the objects are usually non-food items, whereas adults are more likely to have impacted food boluses. Typically, patients present acutely, and chronic foreign bodies are rare, especially in adults. We use an unusual presentation of a retained foreign body in a previously undiagnosed Zenker diverticulum to review ingested foreign bodies and Zenker diverticuli. We report the case of an 82-year-old woman who presented to the ED with a chief complaint of 12 h of worsening pharyngitis and odynophagia. She reported she had a capsule endoscopy performed approximately 4 months earlier during which the device had malfunctioned and no images were transmitted from beyond the esophagus. A soft tissue film of the neck showed the endoscopic capsule retained at the level of the clavicles. Esophagogastroduodenoscopy demonstrated a previously undiagnosed Zenker diverticulum containing the endoscope capsule. This was subsequently removed with laryngoscopy. Complaints related to sore throat commonly have a simple explanation. Recurrent symptoms and a physical examination inconsistent with common explanations require the differential to be broadened and less common causes considered. Copyright © 2013 Elsevier Inc. All rights reserved.

Presentations of Primary Hypersomnia in Chinese Children

PubMed Central

Han, Fang; Lin, Ling; Li, Jing; Aran, Adi; Dong, Song X.; An, Pei; Zhao, Long; Li, Ming; Li, Qian Y.; Yan, Han; Wang, Jie S.; Gao, Hui Y.; Li, Mei; Gao, Zhan C.; Strohl, Kingman P.; Mignot, Emmanuel

2011-01-01

Objective: To retrospectively describe childhood presentations of primary hypersomnia with an emphasis on narcolepsy-cataplexy in a Chinese population. Methods: A total of 417 children (< 18 years old) successively presenting with complaints of hypersomnia without anatomic cause or sleep apnea risk were evaluated using the Stanford Sleep Inventory, human leukocyte antigen (HLA) DQB1*0602 typing, and MSLT recordings. CSF hypocretin-1 was measured in 47 cases to document hypocretin deficiency. A subgroup (“narcolepsy/hypocretin deficiency”) with likely hypocretin deficiency (low hypocretin-1 or HLA positive with clear-cut cataplexy) was further examined for presentations prior to, around, or after puberty. Results: Narcolepsy with (n = 361) or without (n = 17) cataplexy presented at an earlier age and with increased male predominance when compared to idiopathic hypersomnia (n = 39, P < 0.01). Nearly 70% of those with narcolepsy/hypocretin deficiency (n = 271) had disease onset before age 10 y, and 15% had onset before age 6, an unusually young age distribution. Onset was prior to puberty in 78% of cases. Clinical features were similar in presentations across puberty groups except for sleep paralysis, which increased in frequency with age/puberty. Mean sleep latency (MSL) decreased and the number of sleep onset REM periods (SOREMPs) increased with age/puberty, but MSLT diagnosis criteria (MSL ≤ 8 min, ≥ 2 SOREMPs) were similarly positive across groups. Familial clustering was present in only 1.7% of probands. Conclusion: In children presenting with a complaint of primary hypersomnia to a sleep clinic in China, 86% (361/417) meet criteria for narcolepsy with cataplexy. Puberty did not affect positivity on the MSLT as a diagnostic feature. Sleep paralysis was the only symptom that increased with increasing age. In addition, narcolepsy with cataplexy in our clinic population appeared to begin at a younger age than usually reported in other studies. Citation: Han

COGNITIVE FUNCTION IN A MIDDLE AGED COHORT IS RELATED TO HIGHER QUALITY DIETARY PATTERN 5 AND 25 YEARS EARLIER: THE CARDIA STUDY

PubMed Central

ZHU, N.; JACOBS, D.R.; MEYER, K.A.; HE, K.; LAUNER, L.; REIS, J.P.; YAFFE, K.; SIDNEY, S.; WHITMER, R.A.; STEFFEN, L.M.

2017-01-01

Background Preserving cognitive function is an important public health issue. We investigated whether dietary pattern associates with cognitive function in middle-age. Methods We studied 2435 participants in the community-based Coronary Artery Risk Development in Young Adults (CARDIA) study of black and white men and women aged 18–30 in 1985–86 (year 0, Y0). We hypothesized that a higher A Priori Diet Quality Score, measured at Y0 and Y20, is associated with better cognitive function measured at Y25. The diet score incorporated 46 food groups (each in servings/day) as the sum of quintile ranks of food groups rated beneficial, 0 for food groups rated neutral, and reversed quintile ranks for food groups rated adverse; higher score indicated better diet quality. Y25 cognitive testing included verbal memory (Rey Auditory-Verbal Learning Test (RAVLT)), psychomotor speed (Digit Symbol Substitution Test (DSST)) and executive function (Stroop). Results Per 10-unit higher diet score at Y20, the RAVLT was 0.32 words recalled higher, the DSST was 1.76 digits higher, and the Stroop was 1.00 seconds+errors lower (better performance) after adjusting for race, sex, age, clinic, and energy intake. Further adjustment for physical activity, smoking, education, and body mass index attenuated the association slightly. Diet score at Y0 and increase in diet score over 20 years were also positively associated with each cognitive test. Conclusions A higher quality dietary pattern was associated with better cognitive function 5 years and even 25 years later in apparently healthy middle-aged adults. PMID:25560814

False-belief understanding i 2.5-year-olds: evidence for violation-of-expectation change-of-location and unexpected-contents tasks.

PubMed

He, Zijing; Bolz, Matthias; Baillargeon, Renée

2011-03-01

Until recently, it was generally assumed that the ability to attribute false beliefs did not emerge until about 4 years of age. However, recent reports using spontaneous- as opposed to elicited-response tasks have suggested that this ability may be present much earlier. To date, researchers have employed two kinds of spontaneous-response false-belief tasks: violation-of-expectation tasks have been used with infants in the second year of life, and anticipatory-looking tasks have been used with toddlers in the third year of life. In the present research, 2.5-year-old toddlers were tested in violation-of-expectation tasks involving a change-of-location situation (Experiment 1) and an unexpected-contents situation (Experiment 2). Results were positive in both situations, providing the first demonstrations of false-belief understanding in toddlers using violation-of-expectation tasks and, as such, pointing to a consistent and continuous picture of early false-belief understanding.

False-belief understanding in 2.5-year-olds: evidence from violation-of-expectation change-of-location and unexpected-contents tasks

PubMed Central

He, Zijing; Bolz, Matthias; Baillargeon, Renée

2012-01-01

Until recently, it was generally assumed that the ability to attribute false beliefs did not emerge until about 4 years of age. However, recent reports using spontaneous- as opposed to elicited-response tasks have suggested that this ability may be present much earlier. To date, researchers have employed two kinds of spontaneous-response false-belief tasks: violation-of-expectation tasks have been used with infants in the second year of life, and anticipatory-looking tasks have been used with toddlers in the third year of life. In the present research, 2.5-year-old toddlers were tested in violation-of-expectation tasks involving a change-of-location situation (Experiment 1) and an unexpected-contents situation (Experiment 2). Results were positive in both situations, providing the first demonstrations of false-belief understanding in toddlers using violation-of-expectation tasks and, as such, pointing to a consistent and continuous picture of early false-belief understanding. PMID:22213902

Early-Years Swimming: Creating Opportunities for Adding Mathematical Capital to Under 5s

ERIC Educational Resources Information Center

Jorgensen, Robyn

2013-01-01

Drawing on survey data from over 2000 parents, this paper explores the possibility of early-years swimming to add mathematical capital to young children. Using developmental milestones as the basis, it was found that parents reported significantly earlier achievement on many of these milestones. Such data suggest that the early years swim…

Clinical presentation and epidemiology of brain tumors firstly diagnosed in adults in the Emergency Department: a 10-year, single center retrospective study.

PubMed

Comelli, Ivan; Lippi, Giuseppe; Campana, Valentina; Servadei, Franco; Cervellin, Gianfranco

2017-07-01

Several patients with new onset brain tumors present to the Emergency Department (ED) complaining for new symptoms. Although information exists on symptom prevalence in the entire population of patients with brain tumors, little is known about the clinical presentation in ED. This retrospective study was planned to investigate clinical presentation and epidemiology of brain tumors firstly diagnosed in a large urban ED throughout a 10-year period. All medical records of patients aged ≥18 years, discharged from our ED with a diagnosis of brain tumor were retrieved from the electronic hospital database during a 10-year period (2006 to 2015). The records were reassessed for selecting only brain tumors firstly diagnosed in the ED. The symptoms at presentation were divided in six categories: (I) headache; (II) seizures; (III) focal signs; (IV) altered mental status; (V) nausea/vomiting/dizziness; (VI) trauma. For all cases, the hospital record was retrieved, to obtain histologic classification of tumors. Patients with inflammatory neoformations were excluded from the study. Overall, 205 patients with firstly diagnosed brain tumor were identified among 870,135 ED visits (i.e., <1%). Glial tumors were the most frequent (50% of the entire sample). No significant differences were found between mean age of patients in the different histologically based groups (meningiomas 66±14; glioblastomas 65±16 years; metastases 66±13 years; other miscellaneous 66±19 years). Focal signs accounted for more than 50% of all presentation signs/symptoms. First presentation of brain tumor in the ED is not a rare occurrence, so that the emergency physicians should be aware of this possibility.

Transcriptional analysis of micronutrient zinc-associated response for enhanced carbohydrate utilization and earlier solventogenesis in Clostridium acetobutylicum.

PubMed

Wu, You-Duo; Xue, Chuang; Chen, Li-Jie; Wan, Hui-Hui; Bai, Feng-Wu

2015-11-20

The micronutrient zinc plays vital roles in ABE fermentation by Clostridium acetobutylicum. In order to elucidate the zinc-associated response for enhanced glucose utilization and earlier solventogenesis, transcriptional analysis was performed on cells grown in glucose medium at the exponential growth phase of 16 h without/with supplementary zinc. Correspondingly, the gene glcG (CAC0570) encoding a glucose-specific PTS was significantly upregulated accompanied with the other two genes CAC1353 and CAC1354 for glucose transport in the presence of zinc. Additionally, genes involved in the metabolisms of six other carbohydrates (maltose, cellobiose, fructose, mannose, xylose and arabinose) were differentially expressed, indicating that the regulatory effect of micronutrient zinc is carbohydrate-specific with respects to the improved/inhibited carbohydrate utilization. More importantly, multiple genes responsible for glycolysis (glcK and pykA), acidogenesis (thlA, crt, etfA, etfB and bcd) and solventogenesis (ctfB and bdhA) of C. acetobutylicum prominently responded to the supplementary zinc at differential expression levels. Comparative analysis of intracellular metabolites revealed that the branch node intermediates such as acetyl-CoA, acetoacetyl-CoA, butyl-CoA, and reducing power NADH remained relatively lower whereas more ATP was generated due to enhanced glycolysis pathway and earlier initiation of solventogenesis, suggesting that the micronutrient zinc-associated response for the selected intracellular metabolisms is significantly pleiotropic.

[30 years since the first AIDS cases were reported: history and the present. Part I].

PubMed

Brůcková, Marie

2012-05-01

The 30-year natural history of AIDS disease is presented from the first clinical cases reported in 1981 to the identification of the HIV as the etiological agent of the disease. The priority dispute between Robert C. Gallo and Luc Montagnier over the discovery of the human immunodeficiency virus is briefly addressed. The final confirmation of the French priority was provided by the fact that the Nobel Prize in Medicine 2008 was awarded to Luc Montagnier and Francoise Barré--Sinoussi from the Pasteur Institute in Paris.

40 CFR 1039.101 - What exhaust emission standards must my engines meet after the 2014 model year?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission standards must my engines meet after the 2014 model year? The exhaust emission standards of this section apply after the 2014 model year. Certain of these standards also apply for model year 2014 and... emission standards that apply to 2014 and earlier model years. Section 1039.105 specifies smoke standards...

40 CFR 1039.101 - What exhaust emission standards must my engines meet after the 2014 model year?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission standards must my engines meet after the 2014 model year? The exhaust emission standards of this section apply after the 2014 model year. Certain of these standards also apply for model year 2014 and... emission standards that apply to 2014 and earlier model years. Section 1039.105 specifies smoke standards...

40 CFR 1039.101 - What exhaust emission standards must my engines meet after the 2014 model year?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission standards must my engines meet after the 2014 model year? The exhaust emission standards of this section apply after the 2014 model year. Certain of these standards also apply for model year 2014 and... emission standards that apply to 2014 and earlier model years. Section 1039.105 specifies smoke standards...

40 CFR 1039.101 - What exhaust emission standards must my engines meet after the 2014 model year?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission standards must my engines meet after the 2014 model year? The exhaust emission standards of this section apply after the 2014 model year. Certain of these standards also apply for model year 2014 and... emission standards that apply to 2014 and earlier model years. Section 1039.105 specifies smoke standards...

The association between peer, parental influence and tobacco product features and earlier age of onset of regular smoking among adults in 27 European countries.

PubMed

Filippidis, Filippos T; Agaku, Israel T; Vardavas, Constantine I

2015-10-01

Factors that influence smoking initiation and age of smoking onset are important considerations in tobacco control. We evaluated European Union (EU)-wide differences in the age of onset of regular smoking, and the potential role of peer, parental and tobacco product design features on the earlier onset of regular smoking among adults <40 years old in 27 EU countries. We analysed data from 4442 current and former smokers aged 15-39 years, collected for the Eurobarometer 77.1 survey (2012). Respondents reported their age at regular smoking onset and factors that influenced their decision to start smoking, including peer influence, parental influence and features of tobacco products. Multi-variable logistic regression, adjusted for age; geographic region; education; difficulty to pay bills; and gender, was used to assess the role of the various pro-tobacco influences on early onset of regular smoking (i.e. <18 years). Among ever smokers, the mean age of onset of regular smoking was 16.6 years, ranging from 15.8 to 18.8 years in member countries. 68.1% responded that they started smoking regularly when they were <18 years old. Ever smokers who reported they were influenced by peers (OR = 1.70; 95%CI 1.30-2.20) or parents (OR = 1.60; 95%CI 1.21-2.12) were more likely to have started smoking regularly <18 years old. No significant association between design and marketing features of tobacco products and an early initiation of regular smoking was observed (OR = 1.04; 95%CI 0.83-1.31). We identified major differences in smoking initiation patterns among EU countries, which may warrant different approaches in the prevention of tobacco use. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Presentation and outcome of clinical poor performance in one health district over a 5-year period: 2002–2007

PubMed Central

Cox, Stephen J; Holden, John D

2009-01-01

Background The detection, assessment, and management of primary care poor performance raise difficult issues for all those involved. Guidance has largely focused on managing the most serious cases where patient safety is severely compromised. The management of primary care poor performance has become an increasingly important part of primary care trust (PCT) work, but its modes of presentation and prevalence are not well known. Aim To report the prevalence, presentation modes, and management of primary care poor performance cases presenting to one PCT over a 5-year period. Design of study A retrospective review of primary care poor performance cases in one district. Setting St Helens PCT administered 35 practices with 130 GPs on the performers list, caring for 190 110 patients in North West England, UK. Method Cases presenting during 2002–2007 were initially reviewed by the chair of the PCT clinical executive committee. Anonymised data were then jointly reviewed by the assessor and another experienced GP advisor. Results There were 102 individual presentations (20 per year or one every 2–3 weeks) where clinician performance raised significant cause for concern occurred over the 5-year period. These concerns related to 37 individual clinicians, a range of 1–14 per clinician (mean 2.7). Whistleblowing by professional colleagues on 43 occasions was the most common presentation, of which 26 were from GPs about GPs. Patient complaints (18) were the second most common presentation. Twenty-seven clinicians were GPs, of whom the General Medical Council (GMC) were notified or involved in 13 cases. Clinicians were supported locally, and remedying was exclusively locally managed in 14 cases, and shared with an external organisation (such as the GMC or deanery) in another 12. Conclusion Professional whistleblowing and patient complaints were the most common sources of presentation. Effective PCT teams are needed to manage clinicians whose performance gives cause for

Optics workshops designed to preschool children (age 3 to 6 years)

NASA Astrophysics Data System (ADS)

Lopez, Charvel; Solano, Cristina

2016-09-01

Since 2005, it was decided in Mexico that children have to start their formal education at the age of 3 years, two years earlier that in many other countries. This change was done to increase activities that enhance the social interaction and stimulus (knowledge and skills) of the students to prepare them to the next academic level. The main drawback of the developed curriculum for the younger children is that it does not include enough scientific activities. The work presented here is the answer of a particular initiative of some teachers to implement scientific workshops in optics. We have found that preschoolers are attracted to scientific activities if the material is presented in the right way. While design any scientific activity it is important to remember that young children want to know about their world without changing it, they have to experience the principle without memorizing, therefore the language used to describe concepts, ideas or terms has to be carefully chosen to avoid confuse preschoolers that can lose track of the activity. The scientific information has to be very clear and limited to a single physical principle and the concepts have to be presented in a way to include games as a learning activity that allow them to experience with the results.

Comorbidity is more common and occurs earlier in persons living with HIV than in HIV-uninfected matched controls, aged 50 years and older: A cross-sectional study.

PubMed

Maciel, Rafael Aguiar; Klück, Helena Moreira; Durand, Madeleine; Sprinz, Eduardo

2018-05-01

At present, data are limited on the comorbidity profiles associated with aging people with HIV in the developing world, where most such people live. The aim of this study was to compare the disease burden between older HIV-positive subjects and HIV-negative matched controls in Brazil. This was a cross-sectional analysis of the South Brazilian HIV Cohort. Individuals aged 50 years and older were enrolled at Hospital de Clínicas de Porto Alegre and matched with HIV-negative controls from the primary practice unit of the same hospital. Multimorbidity (the presence of two or more comorbid conditions) and the number of non-infectious comorbidities were compared. Poisson regression was used to identify factors associated with multimorbidity. A total of 208 HIV-positive subjects were matched to 208 HIV-negative controls. Overall, the median age was 57 years and 56% were male. The prevalence of multimorbidity was higher in HIV-positive subjects than in HIV-negative controls (63% vs. 43%, p<0.001), and the median number of comorbidities was 2, compared to 1 in controls (p<0.001). The duration of HIV infection (p=0.02) and time on treatment in years (p=0.015) were associated with greater multimorbidity in HIV-positive persons. In this large cohort from the developing world, multimorbidity was found to be more common in HIV-positive subjects than in HIV-negative controls. The duration of HIV and time on antiretrovirals were associated with multimorbidity. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Surgical Approach, Findings, and Eight-Year Follow-Up in a Twenty-Nine Year Old Female With Freeman-Sheldon Syndrome Presenting With Blepharophimosis Causing Near-Complete Visual Obstruction.

PubMed

Portillo, Augusto L; Poling, Mikaela I; McCormick, Rodger J

2016-07-01

The authors describe the surgical approach, findings, and 8-year follow-up in a 29-year-old woman, with severe Freeman-Sheldon syndrome, presenting with congenital blepharophimosis of both upper eyelids resulting in near-complete functional visual obstruction. To avoid possible Freeman-Sheldon syndrome-associated complications of malignant hyperthermia, difficult vascular access, and challenging endotracheal intubation, the surgery was completed under local anesthesia without sedation, and anatomical and functional correction was immediate and remained stable at 8-year follow-up. Unlike many congenital craniofacial syndromes, which frequently involve life-long impairments, important implications exist for plastic surgeons to facilitate opportunities for patients to overcome functional limitations.

Water year 2004: Western water managers feel the heat

USGS Publications Warehouse

Pagano, Thomas; Pasteris, Phil; Dettinger, Michael; Cayan, Daniel; Redmond, Kelly

2004-01-01

With much of the western U.S. already in its fifth year of drought, an above-average western snowpack on 1 March 2004 provided hope for much-needed abundant runoff. Unfortunately snowmelt began far earlier than anticipated, resulting in dramatic declines in seasonal spring-summer streamflow forecasts as the month proceeded, declines more rapid by some measures than ever before in the past 75 years. With reservoirs near historic lows, many water users have been hard pressed to deal with the continuing drought.

Being Alive to the Present: Perceiving Meaning on a Wilderness River Journey

ERIC Educational Resources Information Center

Morse, Marcus

2015-01-01

In an earlier paper I identified two key forms of "meaningful experience" for participants on a wilderness river rafting journey, namely a feeling of humility and being alive to the present. However, space considerations led me to describe only the first of these forms in any detail. In this paper I identify and describe the qualities of…

Darwin and sexual selection: One hundred years of misunderstanding.

PubMed

Veuille, Michel

2010-02-01

Darwin's book on the Descent of Man and Selection in Relation to Sex (1871) is often viewed as the continuation of The Origin of Species published 12 years earlier (1859), both because of the implicit parallelism between natural selection and sexual selection, and because Darwin himself presents the book as developing a subject (man) which he intentionally omitted in the Origin. But the Descent can also be viewed as the continuation of his book on Variation published three years earlier (1868). Firstly because Darwin's hypothesis of pangenesis links the selection process to the origin of variation through use and disuse, an idea underlying his speculations on the origin of moral sense in humans. Second because like the action of the horticulturist on his domestic crops, sexual selection exerted by one sex on the other sex can develop fancy traits that are not easily accounted for by their utility to the selected organism itself, such as artistic taste, pride, courage, and the morphological differences between human populations. These traits are difficult to reconcile with pangenesis. They add up to other contradictions of the book possibly resulting from Darwin's erroneous inference about the mechanism of inheritance, like those on the determination of sex-ratio, or the confusion between individual adaptation and the advantage to the species. These inconsistencies inaugurate a weakening of the Darwinian message, which will last 50 years after his death. They contributed to the neglect of sexual selection for a century. Darwin however maintained a logical distinction between evolutionary mechanisms and hereditary mechanisms, and an epistemological distinction between evolutionary theory and Pangenesis hypothesis. In the modern context of Mendelian genetics, Darwin's sexual selection retrospectively appears as luminous an idea in its pure principle as natural selection, even though the mechanisms governing the evolution of sexual choice in animals remain largely

Variation in leaf flushing date influences autumnal senescence and next year's flushing date in two temperate tree species.

PubMed

Fu, Yongshuo S H; Campioli, Matteo; Vitasse, Yann; De Boeck, Hans J; Van den Berge, Joke; AbdElgawad, Hamada; Asard, Han; Piao, Shilong; Deckmyn, Gaby; Janssens, Ivan A

2014-05-20

Recent temperature increases have elicited strong phenological shifts in temperate tree species, with subsequent effects on photosynthesis. Here, we assess the impact of advanced leaf flushing in a winter warming experiment on the current year's senescence and next year's leaf flushing dates in two common tree species: Quercus robur L. and Fagus sylvatica L. Results suggest that earlier leaf flushing translated into earlier senescence, thereby partially offsetting the lengthening of the growing season. Moreover, saplings that were warmed in winter-spring 2009-2010 still exhibited earlier leaf flushing in 2011, even though the saplings had been exposed to similar ambient conditions for almost 1 y. Interestingly, for both species similar trends were found in mature trees using a long-term series of phenological records gathered from various locations in Europe. We hypothesize that this long-term legacy effect is related to an advancement of the endormancy phase (chilling phase) in response to the earlier autumnal senescence. Given the importance of phenology in plant and ecosystem functioning, and the prediction of more frequent extremely warm winters, our observations and postulated underlying mechanisms should be tested in other species.

Discovery: Faculty Publications and Presentations, Fiscal Year 1981

DTIC Science & Technology

1982-01-01

advanced composite forward swept wings. b. "Measurements of the Wake Interactions of a Canard and a Forward Swept Wing." (Research in progress) I made...Exposition, SAE, Wichita, KS. 7-10 April 1981. (Presentation) New Technologies, including new airfoils and composite structures, are suggested for...Symposium." See B7b. 23. WIT1", William P., 111, Captain and Instructor a. Also with A. N. Palazotto. "Nonlinear Analysis of Laminated Composite Plates

Attachment styles, earlier interpersonal relationships and schizotypy in a non-clinical sample.

PubMed

Berry, Katherine; Band, Rebecca; Corcoran, Rhiannon; Barrowclough, Christine; Wearden, Alison

2007-12-01

This paper investigates associations between adult attachment style, relationships with significant others during childhood, traumatic life-events and schizotypy. Relationships between attachment and hypothesized correlates were investigated in a cross-sectional design using an analogue sample. The reliability of the attachment and trauma measures was investigated using a test-retest design. Three hundred and four students completed the self-report version of the Psychosis Attachment Measure (PAM), maternal and paternal versions of the Parental Bonding Instrument, the Attachment History Questionnaire, a measure of trauma and the Oxford-Liverpool Inventory of Feelings and Experiences scale through an internet website. As predicted, there were statistically significant associations between insecure attachment in adult relationships and experiences of negative interpersonal events. Both earlier interpersonal experiences and adult attachment style predicted schizotypy, and adult attachment style emerged as an independent predictor of positive schizotypal characteristics. The findings support associations between adult attachment style and previous interpersonal experiences and between adult attachment and schizotypy. The PAM is a reliable and valid instrument that can be used to explore attachment styles in analogue samples and associations between attachment styles and psychotic symptoms in clinical samples.

Thirty-Seven-Year Durability of a Starr-Edwards Aortic Prosthesis

PubMed Central

Ozkokeli, Mehmet; Ates, Mehmet; Ekinci, Abdurrahman; Akcar, Murat

2005-01-01

We report the case of a patient who was diagnosed with prosthetic valve endocarditis caused by Staphylococcus aureus. He had undergone aortic valve replacement with a Starr-Edwards prosthesis 37 years earlier. Because of uncontrolled infection despite antibiotic treatment, the patient underwent successful surgical replacement of the prosthetic valve. PMID:15902834

Clinical Characteristics of Adult Dogs More Than 5 Years of Age at Presentation for Patent Ductus Arteriosus.

PubMed

Boutet, B G; Saunders, A B; Gordon, S G

2017-05-01

The median age at presentation for dogs with patent ductus arteriosus (PDA) is <6 months of age, and closure is associated with a decrease in heart size and increased survival time, which are not well described in older dogs. To describe the clinical characteristics of dogs with PDA ≥5 years of age at the time of presentation to a veterinary referral hospital. 35 client-owned dogs. Retrospective case series. PDA was diagnosed at a median age of 7.4 years (range, 5.1-12.3 years). Females represented 23/35 (65.7%) of the patients. Concurrent heart disease included degenerative mitral valve disease (DMVD; 13), arrhythmias (11), pulmonary hypertension (7), and other congenital defects (2). Cardiomegaly was documented in the majority of dogs consisting of left ventricular enlargement (91%) and left atrial enlargement (86%). Median vertebral heart size in 24 dogs was 12.9 (range, 10.7-18.2). The PDA shunt direction was left-to-right in 33 and bidirectional in 2 dogs. Closure was performed in 26 dogs, including 4 with pulmonary hypertension. In 10 dogs receiving furosemide pre-operatively for management of heart failure, furosemide was discontinued (8) or the dosage decreased (2) at the time of discharge. Adult dogs can present with a left-to-right shunting PDA that results in cardiomegaly and clinical signs that can improve or resolve with PDA closure. This improvement is also apparent in dogs with PDA complicated by DMVD. Pulmonary hypertension that does not result in complete right-to-left shunting should not be considered a contraindication to closure. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

The First-Year Urban High School Teacher: Holding the Torch, Lighting the Fire

ERIC Educational Resources Information Center

Weinberg, Paul J.; Weinberg, Carl

2008-01-01

The book tracks co-author Paul Weinberg during his first year of teaching as he is introduced to the daily tribulations of an urban Los Angeles high school. Paul's father Carl Weinberg, who fifty years earlier himself began his career in education an urban secondary school teacher, shares his experiences side-by-side with those of his son.…

Coping and emotional distress during acute hospitalization in older persons with earlier trauma: the case of Holocaust survivors.

PubMed

Kimron, Lee; Cohen, Miri

2012-06-01

Older persons with earlier trauma are often more vulnerable to stresses of old age. To examine the levels of emotional distress in relation to cognitive appraisal of acute hospitalization and coping strategies in Holocaust survivors compared with an age- and education-matched group of elderly persons without Holocaust experience. This is a cross-sectional study of 63 Holocaust survivors, 65 years and older, hospitalized for an acute illness, and 57 age-, education- and hospital unit-matched people without Holocaust experience. Participants completed appraisal and coping strategies (COPE) questionnaires, and the brief symptoms inventory (BSI-18). Holocaust survivors reported higher levels of emotional distress, appraised the hospitalization higher as a threat and lower as a challenge, and used more emotion-focused and less problem-focused or support-seeking coping strategies than the comparison group. Study variables explained 65% of the variance of emotional distress; significant predictors of emotional distress in the final regression model were not having a partner and more use of emotion-focused coping. The latter mediated the relation of group variable and challenge appraisal to emotional distress. Health professionals must be aware of the potential impact of the hospital environment on the survivors of Holocaust as well as survivors of other trauma. Being sensitive to their specific needs may reduce the negative impact of hospitalization.

Hemodynamic parameters change earlier than tissue oxygen tension in hemorrhage.

PubMed

Pestel, Gunther J; Fukui, Kimiko; Kimberger, Oliver; Hager, Helmut; Kurz, Andrea; Hiltebrand, Luzius B

2010-05-15

Untreated hypovolemia results in impaired outcome. This study tests our hypothesis whether general hemodynamic parameters detect acute blood loss earlier than monitoring parameters of regional tissue beds. Eight pigs (23-25 kg) were anesthetized and mechanically ventilated. A pulmonary artery catheter and an arterial catheter were inserted. Tissue oxygen tension was measured with Clark-type electrodes in the jejunal and colonic wall, in the liver, and subcutaneously. Jejunal microcirculation was assessed by laser Doppler flowmetry (LDF). Intravascular volume was optimized using difference in pulse pressure (dPP) to keep dPP below 13%. Sixty minutes after preparation, baseline measurements were taken. At first, 5% of total blood volume was withdrawn, followed by another 5% increment, and then in 10% increments until death. After withdrawal of 5% of estimated blood volume, dPP increased from 6.1% +/- 3.0% to 20.8% +/- 2.7% (P < 0.01). Mean arterial pressure (MAP), mean pulmonary artery pressure (PAP) and pulmonary artery occlusion pressure (PAOP) decreased with a blood loss of 10% (P < 0.01). Cardiac output (CO) changed after a blood loss of 20% (P < 0.05). Tissue oxygen tension in central organs, and blood flow in the jejunal muscularis decreased (P < 0.05) after a blood loss of 20%. Tissue oxygen tension in the skin, and jejunal mucosa blood flow decreased (P < 0.05) after a blood loss of 40% and 50%, respectively. In this hemorrhagic pig model systemic hemodynamic parameters were more sensitive to detect acute hypovolemia than tissue oxygen tension measurements or jejunal LDF measurements. Acute blood loss was detected first by dPP. Copyright (c) 2010 Elsevier Inc. All rights reserved.

4th Stage Transvaginal omental herniation during VBAC complicated by shoulder dystocia: a unique presentation of uterine rupture

PubMed Central

2013-01-01

Background Uterine rupture is a common complication in women attempting their first virginal birth after caesarean section (VBAC) but the risk diminishes with subsequent VBACs. It occurs in rates of 0.5-9% and is influenced by various factors. Case presentation A unique case of uterine rupture in a Kenyan woman of African descent during a repeat VBAC complicated by shoulder dystocia was discovered during the 4th stage of labour when omentum was noted protruding through the vagina. She had delivered 4 years earlier by caesarean section. Conclusion It is not common to experience uterine rupture among women attempting repeat VBAC. When it occurs, it may not always follow the known pattern intra-partum and is often associated with poor foetal outcome. PMID:23521920

The importance of record length in estimating the magnitude of climatic changes: an example using 175 years of lake ice-out dates in New England

USGS Publications Warehouse

Hodgkins, Glenn A.

2013-01-01

Many studies have shown that lake ice-out (break-up) dates in the Northern Hemisphere are useful indicators of late winter/early spring climate change. Trends in lake ice-out dates in New England, USA, were analyzed for 25, 50, 75, 100, 125, 150, and 175 year periods ending in 2008. More than 100 years of ice-out data were available for 19 of the 28 lakes in this study. The magnitude of trends over time depends on the length of the period considered. For the recent 25-year period, there was a mix of earlier and later ice-out dates. Lake ice-outs during the last 50 years became earlier by 1.8 days/decade (median change for all lakes with adequate data). This is a much higher rate than for longer historical periods; ice-outs became earlier by 0.6 days/decade during the last 75 years, 0.4 days/ decade during the last 100 years, and 0.6 days/decade during the last 125 years. The significance of trends was assessed under the assumption of serial independence of historical ice-out dates and under the assumption of short and long term persistence. Hypolimnion dissolved oxygen (DO) levels are an important factor in lake eutrophication and coldwater fish survival. Based on historical data available at three lakes, 32 to 46 % of the interannual variability of late summer hypolimnion DO levels was related to ice-out dates; earlier ice-outs were associated with lower DO levels.

A 29-year-old Harken disk mitral valve: long-term follow-up by echocardiographic and cineradiographic imaging.

PubMed

Hsi, David H; Ryan, Gerald F; Taft, Janice; Arnone, Thomas J

2003-01-01

An 81-year-old woman was evaluated for prosthetic mitral valve function. She had received a Harken disk mitral valve 29 years earlier due to severe mitral valve disease. This particular valve prosthesis is known for premature disk edge wear and erosion. The patients 2-dimensional Doppler echocardiogram showed the distinctive appearance of a disk mitral valve prosthesis. Color Doppler in diastole showed a unique crown appearance, with initial flow acceleration around the disk followed by convergence to laminar flow in the left ventricle. Cineradiographic imaging revealed normal valve function and minimal disk erosion. We believe this to be the longest reported follow-up of a surviving patient with a rare Harken disk valve. We present images with unique echocardiographic and cineangiographic features.

Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman

PubMed Central

Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Keohane, Catherine; Bermingham, Niamh; Kaar, George

2011-01-01

The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient’s age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with ‘red flag’ symptoms. PMID:22674960

An 8-year old boy with continuous spikes and waves during slow sleep presenting with positive onconeuronal antibodies.

PubMed

Hu, Lin-Yan; Shi, Xiu-Yu; Feng, Chen; Wang, Jian-Wen; Yang, Guan; Lammers, Stephen H T; Yang, Xiao Fan; Ebrahimi-Fakhari, Darius; Zou, Li-Ping

2015-03-01

To determine the etiology of epilepsy with continuous spikes and waves during slow sleep (CSWS)/electrical status epilepticus during sleep (ESES) in an 8-year old boy with a history of neuroblastoma and opsoclonus-myoclonus. A combination of clinical characterization and follow-up, video EEG and laboratory investigations. We report the case of an 8-year old boy with a history of neuroblastoma and opsoclonus-myoclonus, who presented with intellectual disability, pharmacotherapy-resistant epilepsy and CSWS/ESES. Although the patient's neuroblastoma had been successfully treated 8 years prior to presentation and an extensive workup did not show a tumor reoccurrence, testing for onconeuronal antibodies was positive for anti-Ma2 and anti-CV2/CRMP5 antibodies. High-dose intravenous methylprednisolone and a taper of oral methylprednisolone were given, leading to a significant clinical improvement. During the taper the patient's condition and EEG manifestations deteriorated again necessitating another cycle of steroid therapy, which lead to a stable improvement. During a 6-month follow-up no CSWS/ESES was seen on EEG and anti-Ma2 and anti-CV2/CRMP5 antibodies remained undetectable. This case suggests that onconeuronal antibodies may be involved in the pathogenesis of CSWS/ESES. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

An inhibitor of polyamine synthesis arrests cells at an earlier stage of G1 than does calcium deprivation.

PubMed Central

Cheetham, B F

1983-01-01

Methylglyoxal bis(guanylhydrazone) completely inhibits the induction of thymidine kinase after serum stimulation of quiescent fibroblasts only if added within 3 h after serum, whereas calcium deprivation blocks this induction up to 12 h after serum stimulation. Experiments in which one of these blocks was imposed as the other was released confirmed that cells blocked by methylglyoxal bis(guanylhydrazone) are arrested at an earlier stage in G1 than cells blocked by calcium deprivation. PMID:6843551

The magic shrinking machine revisited: The presence of props at recall facilitates memory in 3-year-olds.

PubMed

Dahl, Jonna J; Kingo, Osman S; Krøjgaard, Peter

2015-12-01

In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing 33-and 39-month-olds (n = 180), but with props present at recall while controlling for potential online reasoning. The results revealed that the children did use newly acquired words to describe their preverbal memory. Thus, the present study shows that nonverbal memories can be verbalized if the recall setting provides a high level of contextual support, a finding relevant to researchers investigating the offset of childhood amnesia. (c) 2015 APA, all rights reserved).

Landsat 8 OLI radiometric calibration performance after three years (Conference Presentation)

NASA Astrophysics Data System (ADS)

Morfitt, Ron A.

2016-09-01

The Landsat 8 Operational Land Imager (OLI) impressed science users soon after launch in early 2013 with both its radiometric and geometric performance. After three years on-orbit, OLI continues to exceed expectations with its high signal-to-noise ratio, low striping, and stable response. The few artifacts that do exist, such as ghosting, continue to be minimal and show no signs of increasing. The on-board calibration sources showed a small decrease in response during the first six months of operations in the coastal aerosol band, but that decrease has stabilized to less than a half percent per year since that time. The other eight bands exhibit very little change over the past three years and have remained well within a half percent of their initial response to all on-board calibration sources. Analysis of lunar acquisitions also agree with the on-board calibrators. Overall, the OLI on-board the Landsat 8 spacecraft continues to provide exceptional measurements of the Earth's surface to continue the long tradition of Landsat.

Management of a rare presentation of Vogt-Koyanagi-Harada disease in human immunodeficiency virus/acquired immunodeficiency disease syndrome patient.

PubMed

Priya, D; Sudharshan, S; Biswas, Jyotirmay

2017-05-01

Vogt-Koyanagi-Harada (VKH), a multisystem autoimmune bilateral panuveitis with systemic manifestations, is uncommon in immunocompromised patients such as human immunodeficiency virus (HIV)/acquired immunodeficiency disease syndrome (AIDS). We report a rare presentation of VKH in a 45-year-old HIV-positive female on highly active antiretroviral therapy (HAART) who presented with a history of recurrent panuveitis. A diagnosis of probable VKH was made based on ocular and systemic signs and symptoms. She was treated with topical and systemic steroids with close monitoring of CD4 counts and viral loads. After inflammation control, complicated cataract was managed surgically under perioperative steroid cover. VKH in HIV/AIDS has not been reported earlier. This case shows that significant inflammation can be seen even in HIV/AIDS patients on HAART with VKH in spite of moderate CD4 counts. Management is a challenge considering the systemic risks with long-term use of steroids.

Diabetes Prevalence in Sweden at Present and Projections for Year 2050

PubMed Central

Andersson, Tomas; Ahlbom, Anders; Carlsson, Sofia

2015-01-01

Background Data on the future diabetes burden in Scandinavia is limited. Our aim was to project the future burden of diabetes in Sweden by modelling data on incidence, prevalence, mortality, and demographic factors. Method To project the future burden of diabetes we used information on the prevalence of diabetes from the national drug prescription registry (adults ≥20 years), previously published data on relative mortality in people with diabetes, and population demographics and projections from Statistics Sweden. Alternative scenarios were created based on different assumptions regarding the future incidence of diabetes. Results Between 2007 and 2013 the prevalence of diabetes rose from 5.8 to 6.8% in Sweden but incidence remained constant at 4.4 per 1000 (2013). With constant incidence and continued improvement in relative survival, prevalence will increase to 10.4% by year 2050 and the number of afflicted individuals will increase to 940 000. Of this rise, 30% is accounted for by changes in the age structure of the population and 14% by improved relative survival in people with diabetes. A hypothesized 1% annual rise in incidence will result in a prevalence of 12.6% and 1 136 000 cases. Even with decreasing incidence at 1% per year, prevalence of diabetes will continue to increase. Conclusion We can expect diabetes prevalence to rise substantially in Sweden over the next 35 years as a result of demographic changes and improved survival among people with diabetes. A dramatic reduction in incidence is required to prevent this development. PMID:26619340

DG's New Year's presentation

ScienceCinema

Heuer, R.-D.

2018-05-22

CERN general staff meeting. Looking back at key messages: Highest priority: LHC physics in 2009; Increase diversity of the scientific program; Prepare for future projects; Establish open and direct communication; Prepare CERN towards a global laboratory; Increase consolidation efforts; Financial situation--tight; Knowledge and technology transfer--proactive; Contract policy and internal mobility--lessons learned.

Safety and immune response to a challenge dose of hepatitis B vaccine in healthy children primed 10years earlier with hexavalent vaccines in a 3, 5, 11-month schedule: An open-label, controlled, multicentre trial in Italy.

PubMed

Zanetti, Alessandro; Desole, Maria Giuseppina; Romanò, Luisa; d'Alessandro, Antonio; Conversano, Michele; Ferrera, Giuseppe; Panico, Maria Grazia; Tomasi, Alberto; Zoppi, Giorgio; Zuliani, Massimo; Thomas, Stéphane; Soubeyrand, Benoît; Eymin, Cécile; Lockhart, Stephen

2017-07-13

The strategy of vaccinating infants to prevent hepatitis B virus infection in adolescence or adulthood requires durable immunity. This study investigated responses to a challenge dose of monovalent hepatitis B vaccine in children primed with three doses of either Hexavac® or Infanrix hexa® 10years earlier during infancy. This open-label, controlled, multicentre study conducted in Italy, enrolled 751 healthy pre-adolescents (aged 11-13years) who were given either Hexavac (n=409) or Infanrix hexa (n=342) at 3, 5 and 11months of life. All participants received a challenge dose of a monovalent hepatitis B vaccine (HBVaxPro® 5µg). The concentrations of antibodies to hepatitis B surface antigen (anti-HBs) were measured before and 1month after the challenge dose. The analysis was descriptive and no formal hypothesis was tested. One month post-challenge, 331 participants in the Hexavac cohort [83.6%, 95% CI: 79.6; 87.1] and 324 in the Infanrix hexa cohort [96.4%, 95% CI: 93.8; 98.1] had anti-HBs concentrations ≥10mIU/mL. Before the challenge dose, an anti-HBs concentration of ≥10mIU/mL was found in 94 children in the Hexavac cohort [23.9%, 95% CI: 19.7; 28.4] and in 232 children in the Infanrix hexa cohort [69%, 95% CI: 63.8; 74.0]. Among children with a pre-challenge anti-HBs concentration of <10mIU/mL, 236 [78.7%, 95% CI: 73.6; 83.2] in the Hexavac cohort and 92 [88.5%, 95% CI: 80.7; 93.9] in the Infanrix hexa cohort achieved protective anti-HBs antibody concentrations. No evidence of active hepatitis B disease was observed in either group, and the HBVaxPro challenge dose was well tolerated. These data confirm that immune memory persists in a high percentage of children (>80%) at least 10years after a two-dose primary and booster vaccination schedule with a hexavalent vaccine (Hexavac or Infanrix hexa). EudraCT Number: 2013-001602-28; clinicaltrials.gov: NCT02012998. Copyright © 2017 Elsevier Ltd. All rights reserved.

Profiles of Social-Emotional Readiness for 4-Year-Old Kindergarten

PubMed Central

Miller, Michele M.; Goldsmith, H. Hill

2017-01-01

Children who are viewed as ready for kindergarten and/or first grade typically exhibit high attention, approach, and adaptability coupled with low activity and reactivity. These characteristics tend to be especially valued by teachers and describe a child who is “teachable,” or school ready. Since many children enter formal schooling earlier by attending pre-K for 4-year olds, often called 4-year-old kindergarten, there is a need to examine school readiness earlier than kindergarten, which may look very different developmentally. If we expect children to enter formal schooling at age 4, then it should be clear what we expect of them in order to succeed. We explored which temperament, behavior, and cognitive items teachers of 4-year-old kindergarten (N = 29) rated as highly characteristic versus uncharacteristic of ready 4-year-olds. This teacher-generated data identified five clusters of children who were deemed ready for 4-year-old kindergarten. Teachers noted high cognitive skills and following directions as salient in many of the clusters, which aligns with the readiness expectations for kindergarten and first grade. However, items that distinguished the five clusters from one another referenced differences in activity level, sociability, shyness, enthusiasm, and patience that were not expected based on the previous literature with slightly older children. Given that some of the children teachers identified as especially ready for 4-year-old kindergarten did not fit this static model of a “teachable” child, a single profile of school readiness at an early age may be inappropriate. PMID:28197124

Recurrent dermatofibrosarcoma protuberans with pulmonary metastases presenting twelve years after initial diagnosis: 18F-FDG PET/CT imaging findings.

PubMed

Suman, Sudhir; Sharma, Punit; Jain, Tarun Kumar; Sahoo, Manas Kumar; Bal, Chandrasekhar; Kumar, Rakesh

2014-01-01

Dermatofibrosarcoma protuberans is a rare cutaneous tumor that is locally aggressive and has a high rate of recurrence after surgical excision. The tumor grows slowly, typically over years. On rare occasions, metastasis to distant sites (especially the lung) or regional lymph nodes may occur. Here, we present F-FDG PET/CT imaging findings of a 52-year-old man with a local recurrence of dermatofibrosarcoma protuberans in the anterior abdominal wall with metastases to bilateral lungs.

The present triumphs and future problems with wave soldering

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

Vianco, P.T.

1993-10-01

Nearly 40 years of experience with wave soldering have resulted in processes that routinely produce several thousand, defect-free solder joints per minute. However, the climate of electronics manufacturing has changed significantly over the past 10 to 15 years. Environmental restrictions as well as the high quality of products made offshore has placed new demands and challenges on the electronics industry, right down to the assembly process. The impact on wave soldering by environmental regulations and a need for more cost-competitive manufacturing processes has become a serious issue in terms of the economical well-being of the industry. In order to obtainmore » a clearer understanding of the situation, however, it is first most appropriate and necessary to examine the technology of wave soldering. Historically, wave soldering was developed as a refinement of the dip and drag soldering processes with the objective of reducing or eliminating many of the associated defects often present in these earlier processes. Wave soldering reduces the area of contact between the circuit board and the solder. This characteristic, coupled with the agitation generated in the solder, allows flux and its volatile by-products to readily escape from under the board, decreasing the number of skips, unfilled holes, and solder joint voids. The reduced contact area also lessens the potential for thermal damage to the circuit board laminate. Control of the wave profile at the exit point of the circuit board lessens the likelihood of icicles and bridges forming on the solder joints; this latitude is not available in the dip soldering process.« less

Presetting ECG electrodes for earlier heart rate detection in the delivery room.

PubMed

Gulati, Rashmi; Zayek, Michael; Eyal, Fabien

2018-07-01

To determine whether heart rate (HR) could be detected earlier than by pulse oximeter (POX), using a novel method of application of electrocardiogram (ECG) electrodes during neonatal resuscitation in the delivery room. ECG electrodes were set before delivery to be applied to the back of infants' thorax. Time to detect HR was recorded as soon as a numerical HR along with a recognizable and persistent QRS complex was observed on ECG monitor (HRECG) and a plethysmographic waveform was seen on POX monitor (HRPOX). Out of 334 infants, 49 were <31 weeks of gestational age. Overall, the median (interquartile range, IQR) time to detect HRECG was significantly shorter [29 (5, 60) seconds] than time by POX [60 (45,120) seconds], (p < 0.001). Similarly, in <31-week infants, the median (IQR) time to detect HRECG was 10 (2, 40) seconds compared to 60 (30,120) seconds by POX, (p < 0.001). Failure to have HR detected by 1 minute occurred in 30%, 54% and 20% of infants by ECG, POX and either of the devices, respectively. In the delivery room, electrodes applied by the study method are more effective than pulse oximetry in providing the neonatal team with timely HR information that is necessary for proper resuscitative actions. Published by Elsevier B.V.

Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment.

PubMed

Jabre, Patricia; Tazarourte, Karim; Azoulay, Elie; Borron, Stephen W; Belpomme, Vanessa; Jacob, Line; Bertrand, Lionel; Lapostolle, Frederic; Combes, Xavier; Galinski, Michel; Pinaud, Virginie; Destefano, Carla; Normand, Domitille; Beltramini, Alexandra; Assez, Nathalie; Vivien, Benoit; Vicaut, Eric; Adnet, Frederic

2014-07-01

To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option. Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief. Among the 570 family members [intention to treat (ITT) population], 408 (72%) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95% confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95% CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23%; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24%; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21%; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23%; P = 0.003). At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest.

Health Disparities in Mid-to-Late Life: The Role of Earlier Life Family and Neighborhood Socioeconomic Conditions

PubMed Central

Johnson, Rucker C.; Schoeni, Robert F.; Rogowski, Jeannette A.

2012-01-01

The relationship between neighborhoods of residence in young adulthood and health in mid to late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2,730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid to late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late-life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid to late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood. PMID:22212443

Symptoms, disability and handicap in unilateral peripheral vestibular disorders. Effects of early presentation and initiation of balance exercises.

PubMed

Bamiou, D E; Davies, R A; McKee, M; Luxon, L M

2000-01-01

The aim of this study was to obtain a profile of disability and handicap in patients with unilateral peripheral vestibular disorders presenting to a specialist tertiary care unit. Two validated questionnaires were sent to patients who had a unilateral peripheral vestibular disorder as defined by strict criteria. Some patients still suffered moderate handicap and disability 5 years after the initial symptoms related to a unilateral vestibular disorder, although the duration of symptoms (onset to questionnaire completion) did not correlate with severity of disability and handicap, as judged by questionnaire scores. However, patients presenting to the unit within 6 months of onset of vertigo commenced balance exercises significantly earlier and had significantly lower disability scores than patients presenting later. A high proportion of non-compliance with, and delay in initiation of, vestibular rehabilitation exercises was noted in the total patient sample, while compliance with, and early initiation of, Cooksey Cawthorne exercises were significantly correlated with low disability and questionnaire scores. These findings suggest that early referral to a specialist balance unit for patients with persistent dizziness is associated with better outcome.

[Vomiting as main symptom: unusual presentation of a hyperthyroidism in a 12-year-old boy].

PubMed

Müller-Michaels, J; Bürk, G; Andler, W

1997-01-01

A twelve year old boy presented with a sudden onset of recurrent nausea and vomiting. During the past six weeks he had a weight loss of 13 kg. While he was in the hospital, persistent tachycardia and a slightly elevated blood pressure were noted. The gastroenterologic, cardiologic and neuropediatric examinations were normal. To exclude the differential diagnosis of hyperthyroidism, thyroid hormones were checked. They showed clearly elevated levels of tri-iodothyronine and thyroxine, while thyrotropin was suppressed. The boy did not have a goiter. Under thyrostatic therapy his clinical condition improved quickly. Among our 20 patients with hyperthyroidism he was the only one whose main symptom was severe vomiting.

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

PubMed

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

2018-03-01

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

Cerebral candidiasis in a 4-year-old boy after intestinal surgery.

PubMed

Zhang, Shu-Cheng

2015-03-01

Cerebral candidiasis is a devastating disease which contributes to a high mortality. Most of the cerebral candidiasis are never microbiologically or radiologically confirmed. In this case, a 4-year-old boy who developed cerebral candidiasis was successfully rescued and presented. The diagnosis of cerebral candidiasis was established based on both microbiologic and radiologic examinations. The pathogen was revealed to be Candida albicans by cerebrospinal fluid and central venous catheter cultures, and the cerebral involvement was recorded by series head magnetic resonance imaging (MRI) with an appearance of special encephalitis demonstrated. The imaging studies played a critical role throughout the diagnosis and treatment. Familiarity with the imaging findings in the appropriate clinical setting may result in a heightened level of awareness of this infection and, consequently, in earlier diagnosis and treatment. © The Author(s) 2014.

Investigating Parental Acceptability of the Incredible Years Self-Administered Parent Training Program for Children Presenting Externalizing Behavior Problems

ERIC Educational Resources Information Center

Stewart, Latoya S.; Carlson, John S.

2010-01-01

This study takes an in-depth look at parental acceptability (i.e., the ability to meet parent needs) of an intervention that has shown strong empirical support for treating and preventing childhood conduct disorder. The authors obtained acceptability data from 30 parents of children ages 5 to 12 years presenting externalizing behavior problems…

Early Cognitive and Linguistic Profiles of Different Types of 7- to 8-Year-Old Readers

ERIC Educational Resources Information Center

Potocki, Anna; Ecalle, Jean; Magnan, Annie

2017-01-01

The aim of this study was to investigate the early characteristics of four profiles of readers established in second grade (7-8 years of age): good readers, specific poor decoders, specific poor comprehenders and general poor readers. These profiles were compared retrospectively on a range of measures administered 2 years earlier, in kindergarten.…

Giant inframuscular lipoma disclosed 14 years after a blunt trauma: A case report

PubMed Central

Nigri, Giuseppe; Dente, Mario; Valabrega, Stefano; Beccaria, Giacomo; Aurello, Paolo; D'Angelo, Francesco; Di Marzo, Francesco; Ramacciato, Giovanni

2008-01-01

Introduction Lipoma is the most frequent benign tumor of the soft tissue. This lesion is often asymptomatic except in cases of enormous masses compressing nervous-vascular structures. Although the diagnosis is mostly clinical, imaging tools are useful to confirm the adipose nature of the lesion and to define its anatomic border. Sometimes, lipomas may be the result of a previous trauma, such as in this patient. Case presentation A 45-year-old man presented at our institution with a giant hard firm mass in the upper external quadrant of the right buttock disclosed after a weight loss diet. Subsequent magnetic resonance imaging showed a giant adipose mass developed beneath the large gluteal muscle and among the fibers of the medium and small gluteal muscles. When questioned on his medical history, the patient reported a blunt trauma of the lower back 14 years earlier. He underwent surgery and histological examination confirmed a giant lipoma. Conclusion Lipomas might result from a previous trauma. It is hypothesized that the trigger mechanism is activated by cytokine and growth factors released after the trauma. We herein present an exceptional case of a giant post-traumatic lipoma which caused a painful compression on the right sciatic nerve. PMID:18826615

Atypical presentation of perforated peptic ulcer disease in a 12-year-old boy.

PubMed

Mbarushimana, Simon; Morris-Stiff, Gareth; Thomas, George

2014-06-27

A 12-year-old boy was referred to the surgical unit with 4 h history of severe lower abdominal pain and bilious vomiting. No other symptoms were reported and there was no significant medical or family history. Examination revealed tenderness in the lower abdomen, in particular the left iliac fossa. His white cell count was elevated at 19.6×10(9)/L, with a predominant neutrophilia of 15.8×10(9)/L and a C reactive protein of <0.3 mg/L. An abdominal X-ray revealed intraperitoneal gas and a chest X-ray identified free air under both hemidiaphragms. Subsequent diagnostic laparoscopy identified a perforated duodenal ulcer that was repaired by means of an omental patch. The case illustrates that although uncommon, alternate diagnoses must be borne in mind in children presenting with lower abdominal pain and diagnostic laparoscopy is a useful tool in children with visceral perforation as it avoids treatment delays and exposure to excess radiation. 2014 BMJ Publishing Group Ltd.

Addison's Disease and Possible Cannabis Withdrawal Syndrome Presenting as an Eating Disorder in a Thirty-Year-Old Female

PubMed Central

2017-01-01

A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms. This case elucidates the importance of ruling out other biologic and psychologic causes of clinical presentations before an eating disorder diagnosis can be made. PMID:28348901

Addison's Disease and Possible Cannabis Withdrawal Syndrome Presenting as an Eating Disorder in a Thirty-Year-Old Female.

PubMed

Lazare, Kimberly

2017-01-01

A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms. This case elucidates the importance of ruling out other biologic and psychologic causes of clinical presentations before an eating disorder diagnosis can be made.

Earlier Is Better: Learning English in Saudi Arabia

ERIC Educational Resources Information Center

Alsairi, Meshari A.

2018-01-01

Various studies have been carried out in order to find out the suitable age for foreign language acquisition. Every research study has had a different Critical Period (CP) and most of them have not been really close together in terms of years. Critical Period refers to the actual time frame during which foreign language acquisition should take…

Use of the FAR Guide to Present a Pedagogical Analogical Model of Gel Electrophoresis in Year 10 Science

ERIC Educational Resources Information Center

Davis, James

2013-01-01

This paper is a qualitative, practice based study describing the use of the Focus-Action-Reflection (FAR) Guide (Harrison & Treagust, 2000) to address the shortcomings of a pedagogical analogical model in Year 10 Science. The aim of this paper is to present my experience of the FAR Guide in relation to an analogical model that gave rise to…

Stress in air traffic controllers : a restudy of 32 controllers 5 to 9 years later.

DOT National Transportation Integrated Search

1978-10-01

Thirty-two subjects who had participated in air traffic controller stress studies 5-9 years earlier were restudied with regard to urinary excretion of 17-ketogenic steroids, epinephrine, and norepinephrine. All subjects showed decreases in excretion ...

Transient climate simulations of the deglaciation 21-9 thousand years before present; PMIP4 Core experiment design and boundary conditions

NASA Astrophysics Data System (ADS)

Ivanovic, Ruza; Gregoire, Lauren; Kageyama, Masa; Roche, Didier; Valdes, Paul; Burke, Andrea; Drummond, Rosemarie; Peltier, W. Richard; Tarasov, Lev

2016-04-01

The last deglaciation, which marked the transition between the last glacial and present interglacial periods, was punctuated by a series of rapid (centennial and decadal) climate changes. Numerical climate models are useful for investigating mechanisms that underpin the events, especially now that some of the complex models can be run for multiple millennia. We have set up a Paleoclimate Modelling Intercomparison Project (PMIP) working group to coordinate efforts to run transient simulations of the last deglaciation, and to facilitate the dissemination of expertise between modellers and those engaged with reconstructing the climate of the last 21 thousand years. Here, we present the design of a coordinated Core simulation over the period 21-9 thousand years before present (ka) with time varying orbital forcing, greenhouse gases, ice sheets, and other geographical changes. A choice of two ice sheet reconstructions is given. Additional focussed simulations will also be coordinated on an ad-hoc basis by the working group, for example to investigate the effect of ice sheet and iceberg meltwater, and the uncertainty in other forcings. Some of these focussed simulations will concentrate on shorter durations around specific events to allow the more computationally expensive models to take part. Ivanovic, R. F., Gregoire, L. J., Kageyama, M., Roche, D. M., Valdes, P. J., Burke, A., Drummond, R., Peltier, W. R., and Tarasov, L.: Transient climate simulations of the deglaciation 21-9 thousand years before present; PMIP4 Core experiment design and boundary conditions, Geosci. Model Dev. Discuss., 8, 9045-9102, doi:10.5194/gmdd-8-9045-2015, 2015.

How to Develop Critical Thinking Skills Within the Armys Officer Education System (OES) Earlier in an Officer’s Career

DTIC Science & Technology

2016-02-13

thinking emerges.”31 Military leaders should minimize bureaucracy when possible in an attempt to facilitate creative thinking . Consequently, a...AIR WAR COLLEGE AIR UNIVERSITY HOW TO DEVELOP CRITICAL THINKING SKILLS WITHIN THE ARMY’S OFFICER EDUCTION SYSTEM (OES) EARLIER IN AN...Force Dragon’s Heart.” iv Abstract Critical thinking skills are required by strategic leaders to solve complex problems in an environment

Long-Term Follow-Up in a Girl with Cystic Fibrosis and Diabetes Since the First Year of Life.

PubMed

Fattorusso, Valentina; Casale, Alida; Raia, Valeria; Mozzillo, Enza; Franzese, Adriana

2017-10-01

Diabetes mellitus is the most common comorbidity in cystic fibrosis (CF). Recently, more attention has been paid to early glucose metabolism derangements (GMDs). The subject of this report is a female patient, affected by CF since 3 months of age. She presented with intermittent diabetes during early childhood. At the age of 10 years, oral glucose tolerance test (OGTT) was performed and showed glucose intolerance (IGT) status; glargine insulin therapy was started. At the age of 13 years, CF-related diabetes with fasting hyperglycemia occurred, so rapid insulin at meals was added. During the following year, clinical and nutritional status improved. Stable clinical conditions were observed in the following 3 years. This is the first case of very long-term follow-up concerning a CF patient with GMDs. Our case confirms the importance of paying attention to early GMDs in very young CF patients and seems to suggest that earlier therapy could ameliorate CF natural history.

Earlier reperfusion in patients with ST-elevation Myocardial infarction by use of helicopter

PubMed Central

2012-01-01

Background In patients with ST-elevation myocardial infarction (STEMI) reperfusion therapy should be initiated as soon as possible. This study evaluated whether use of a helicopter for transportation of patients is associated with earlier initiation of reperfusion therapy. Material and methods A prospective study was conducted, including patients with STEMI and symptom duration less than 12 hours, who had primary percutaneous coronary intervention (PPCI) performed at Aarhus University Hospital in Skejby. Patients with a health care system delay (time from emergency call to first coronary intervention) of more than 360 minutes were excluded. The study period ran from 1.1.2011 until 31.12.2011. A Western Denmark Helicopter Emergency Medical Service (HEMS) project was initiated 1.6.2011 for transportation of patients with time-critical illnesses, including STEMI. Results The study population comprised 398 patients, of whom 376 were transported by ambulance Emergency Medical Service (EMS) and 22 by HEMS. Field-triage directly to the PCI-center was used in 338 of patients. The median system delay was 94 minutes among those field-triaged, and 168 minutes among those initially admitted to a local hospital. Patients transported by EMS and field-triaged were stratified into four groups according to transport distance from the scene of event to the PCI-center: ≤25 km., 26–50 km., 51–75 km. and > 75 km. For these groups, the median system delay was 78, 89, 99, and 141 minutes. Among patients transported by HEMS and field-triaged the estimated median transport distance by ground transportation was 115 km, and the observed system delay was 107 minutes. Based on second order polynomial regression, it was estimated that patients with a transport distance of >60 km to the PCI-center may benefit from helicopter transportation, and that transportation by helicopter is associated with a system delay of less than 120 minutes even at a transport distance up to 150 km

Earlier reperfusion in patients with ST-elevation myocardial infarction by use of helicopter.

PubMed

Knudsen, Lars; Stengaard, Carsten; Hansen, Troels Martin; Lassen, Jens Flensted; Terkelsen, Christian Juhl

2012-10-04

In patients with ST-elevation myocardial infarction (STEMI) reperfusion therapy should be initiated as soon as possible. This study evaluated whether use of a helicopter for transportation of patients is associated with earlier initiation of reperfusion therapy. A prospective study was conducted, including patients with STEMI and symptom duration less than 12 hours, who had primary percutaneous coronary intervention (PPCI) performed at Aarhus University Hospital in Skejby. Patients with a health care system delay (time from emergency call to first coronary intervention) of more than 360 minutes were excluded. The study period ran from 1.1.2011 until 31.12.2011. A Western Denmark Helicopter Emergency Medical Service (HEMS) project was initiated 1.6.2011 for transportation of patients with time-critical illnesses, including STEMI. The study population comprised 398 patients, of whom 376 were transported by ambulance Emergency Medical Service (EMS) and 22 by HEMS. Field-triage directly to the PCI-center was used in 338 of patients. The median system delay was 94 minutes among those field-triaged, and 168 minutes among those initially admitted to a local hospital. Patients transported by EMS and field-triaged were stratified into four groups according to transport distance from the scene of event to the PCI-center: ≤25 km., 26-50 km., 51-75 km. and > 75 km. For these groups, the median system delay was 78, 89, 99, and 141 minutes. Among patients transported by HEMS and field-triaged the estimated median transport distance by ground transportation was 115 km, and the observed system delay was 107 minutes. Based on second order polynomial regression, it was estimated that patients with a transport distance of >60 km to the PCI-center may benefit from helicopter transportation, and that transportation by helicopter is associated with a system delay of less than 120 minutes even at a transport distance up to 150 km. The present study indicates that use of a

Central Tendency and Dispersion Measures of the Fundamental Frequencies of Four Vowels as Produced by Two Year-Old and Four-Year Children.

NASA Astrophysics Data System (ADS)

Monroe, Roberta Lynn

The intrinsic fundamental frequency effect among vowels is a vocalic phenomenon of adult speech in which high vowels have higher fundamental frequencies in relation to low vowels. Acoustic investigations of children's speech have shown that variability of the speech signal decreases as children's ages increase. Fundamental frequency measures have been suggested as an indirect metric for the development of laryngeal stability and coordination. Studies of the intrinsic fundamental frequency effect have been conducted among 8- and 9-year old children and in infants. The present study investigated this effect among 2- and 4-year old children. Eight 2-year old and eight 4-year old children produced four vowels, /ae/, /i/, /u/, and /a/, in CVC syllables. Three measures of fundamental frequency were taken. These were mean fundamental frequency, the intra-utterance standard deviation of the fundamental frequency, and the extent to which the cycle-to-cycle pattern of the fundamental frequency was predicted by a linear trend. An analysis of variance was performed to compare the two age groups, the four vowels, and the earlier and later repetitions of the CVC syllables. A significant difference between the two age groups was detected using the intra-utterance standard deviation of the fundamental frequency. Mean fundamental frequencies and linear trend analysis showed that voicing of the preceding consonant determined the statistical significance of the age-group comparisons. Statistically significant differences among the fundamental frequencies of the four vowels were not detected for either age group.

Epidemiology and recent trends of geriatric fractures presenting to the emergency department for United States population from year 2004-2014.

PubMed

Baidwan, N K; Naranje, S M

2017-01-01

Fractures in geriatric age group (over 65 years of age) are an important public health issue and frequent causes of emergency room visits. The purpose of this descriptive epidemiological study was to present the epidemiology of geriatric fractures and their trends in the USA using National Electronic Injury Surveillance System (NEISS) database from year 2004-2014. National Electronic Injury Surveillance System (NEISS) Database was queried for all fracture injuries from 2004 to 2014 for ages 65 years and above. The proportions of fractures based on NEISS national estimates were calculated and their trends using linear regression over last 11 years were studied. Lower trunk (pelvis, hip and lower spine) fractures were the most common (34% for year 2014) type of fractures in this age group. Upper trunk (upper spine, clavicle and ribs) fractures were the second most common type of fractures (13% for year 2014). Other body parts commonly fractured involved the upper arm and wrist with an average of 7% fractures in both during the study period. About 5% of geriatric fractures pertained to shoulder and upper leg. Although less common, there was also about 2% increase in fractures to face and neck in 2014 as compared to about 3.2% and 1% respectively in 2004. Fractures to other body parts were less common with no major variations during the study period. Overall, lower trunk (hip, pelvic and lower spine) fractures were the most common geriatric fractures followed by upper trunk (upper spine, clavicle and rib) fractures. We suggest that there were decreasing trends for incidence of lower trunk, wrist and upper body fractures over the last 11 years (2004-2014). Approximately half of the geriatric fractures presenting to Emergency Department needed hospitalizations. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Retroperitoneal Angiomatoid Fibrous Histiocytoma Presenting as a Recurrent Spontaneous Retroperitoneal Hemorrhage in a 9-Year-Old Boy.

PubMed

Slack, Jonathan C; Sanchez-Glanville, Carlos; Steele, MacGregor; Wong, Andrew L; Bründler, Marie-Anne

2018-05-01

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor that typically presents in children and young adults. Occurrence outside of the extremities and the head and neck region is exceedingly rare. We report the case of a 9-year-old boy who presented with recurrent retroperitoneal hemorrhage initially thought to be a manifestation of an underlying bleeding disorder. After comprehensive diagnostic work-up, including multiple negative biopsies, the patient underwent surgical resection of an extensively hemorrhagic intramuscular mass and to date remains well. Pathologic examination confirmed AFH with EWSR1 gene rearrangement. This first documented report of an AFH in a retroperitoneal location in a child highlights the diagnostic difficulties and clinical challenges of AFH arising in an atypical location.

A 35-year-old woman presenting with an unusual post-traumatic leiomyoma of the nipple: a case report.

PubMed

Pavlidis, Leonidas; Vakirlis, Efstratios; Spyropoulou, Georgia-Alexandra; Pramateftakis, Manousos Georgios; Dionyssiou, Dimitris; Demiri, Efterpi

2013-02-19

Leiomyoma of the mammary papilla is one of the most uncommon nipple tumors with only 50 cases reported in the literature until now. To the best of our knowledge we present the first report of a nipple leiomyoma that originated from a traumatic abrasion caused by breastfeeding. A 35-year-old healthy Caucasian female with a cauliflower-like tender and pink nodular mass that was approximately 10mm in diameter presented to our out-patients department. The patient suggested that the mass originated from a traumatic abrasion caused by breastfeeding three years ago and it has been slowly growing ever since.An excision biopsy was performed. The histological and immunohistochemical examination confirmed the diagnosis of leiomyoma. There were no postoperative complications or any sign of local recurrence four years postoperatively. Leiomyoma of the mammary papilla is a rare benign neoplasm that usually appears as a solid tender nodule. Differential diagnosis comprises breast carcinoma, leiomyosarcoma and myoid hamartoma. The recommended treatment is complete excision of the tumor with histologically confirmed tumor-free margins otherwise recurrence is possible. A detailed history of the patient's disease can reveal the original etiology. This is an original case report that will have particular interest to plastic surgeons, dermatologists, and pathologists. The pathogenetic mechanism was trauma of the nipple. According to our review of the literature this particular information has never been reported and we think that it may advance our knowledge of this very infrequent tumor.

Quality of Life in South Africa--The First Ten Years of Democracy

ERIC Educational Resources Information Center

Moller, Valerie

2007-01-01

South Africa celebrated ten years of democracy in 2004. This special issue of "Social Indicators Research" ("SIR") reviews developments that have impacted on the quality of life of ordinary South Africans during the transition period. The issue updates an earlier volume of "SIR" (Volume 41) published in 1997 and as a…

Combining qualitative and quantitative evidence to determine factors leading to late presentation for antiretroviral therapy in Malawi.

PubMed

Parrott, Fiona R; Mwafulirwa, Charles; Ngwira, Bagrey; Nkhwazi, Sothini; Floyd, Sian; Houben, Rein M G J; Glynn, Judith R; Crampin, Amelia C; French, Neil

2011-01-01

Treatment seeking delays among people living with HIV have adverse consequences for outcome. Gender differences in treatment outcomes have been observed in sub-Saharan Africa. To better understand antiretroviral treatment (ART) seeking behaviour in HIV-infected adults in rural Malawi. Qualitative interviews with male and female participants in an ART cohort study at a treatment site in rural northern Malawi triangulated with analysis of baseline clinical and demographic data for 365 individuals attending sequentially for ART screening between January 2008 and September 2009. 43% of the cohort presented with late stage HIV disease classified as WHO stage 3/4. Respondents reported that women's frequency of testing, health awareness and commitment to children led to earlier ART uptake and that men's commitment to wider social networks of influence, masculine ideals of strength, and success with sexual and marital partners led them to refuse treatment until they were sick. Quantitative analysis of the screening cohort provided supporting evidence for these expressed views. Overall, male gender (adjusted OR 2.3, 95% CI1.3-3.9) and never being married (adjusted OR 4.1, 95% CI1.5-11.5) were risk factors for late presentation, whereas having ≥3 dependent children was associated with earlier presentation (adjusted OR 0.31, 95% CI0.15-0.63), compared to those with no dependent children. Gender-specific barriers and facilitators operate throughout the whole process of seeking care. Further efforts to enrol men into care earlier should focus on the masculine characteristics that they value, and the risks to these of severe health decline. Our results emphasise the value of exploring as well as identifying behavioural correlates of late presentation.

Body Art Education: The Earlier, the Better

ERIC Educational Resources Information Center

Armstrong, Myrna L.; Tustin, Jane; Owen, Donna C.; Koch, Jerome R.; Roberts, Alden E.

2014-01-01

Using the major format identified for successful prevention and intervention work, five "W" questions: what, why, whom, where, and who, plus one: how, this article first summarizes the current body art literature. Then, educational strategies specifically regarding the topic of tattoos and body piercing are presented for school nurses.…

Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

PubMed Central

Profit, J; Zupancic, J A F; McCormick, M C; Richardson, D K; Escobar, G J; Tucker, J; Tarnow‐Mordi, W; Parry, G

2006-01-01

Objective To compare gestational age at discharge between infants born at 30–34+6 weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design Prospective observational cohort study. Setting Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures Gestational age at discharge home. Results The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p  =  0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI −1.2 to 3.0) days earlier in Massachusetts. Conclusions Infants of 30–34+6 weeks gestation at birth admitted and cared for in hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants. PMID:16449257

An unusual subcutaneous breast cancer metastasis in a 86-year-old woman.

PubMed

Metere, A; Di Cosimo, C; Chiesa, C; Esposito, A; Giacomelli, L; Redler, A

2012-04-01

The most common metastasis site of breast cancer are the local and distant lymph nodes, bone, lungs, liver and brain. We report a 86-year-old woman with an unusual abdominal subcutaneous metastasis of breast cancer. The patient was diagnosed with invasive lobular breast cancer and had been treated six months earlier with modified radical mastectomy. Later she presented a painless mass on the middle upper abdominal wall. She was subsequently admitted to the hospital to perform a whole body CT scan, confirming the presence of the abdominal mass in epigastric region, causing a partial compression of the stomach. Histopathological studies confirmed that the abdominal mass was a rare subcutaneous metastatic lesion of breast origin. The patient underwent a surgical intervention to remove the metastasis and she recovered fully.

An earlier origin for the Acheulian.

PubMed

Lepre, Christopher J; Roche, Hélène; Kent, Dennis V; Harmand, Sonia; Quinn, Rhonda L; Brugal, Jean-Philippe; Texier, Pierre-Jean; Lenoble, Arnaud; Feibel, Craig S

2011-08-31

The Acheulian is one of the first defined prehistoric techno-complexes and is characterized by shaped bifacial stone tools. It probably originated in Africa, spreading to Europe and Asia perhaps as early as ∼1 million years (Myr) ago. The origin of the Acheulian is thought to have closely coincided with major changes in human brain evolution, allowing for further technological developments. Nonetheless, the emergence of the Acheulian remains unclear because well-dated sites older than 1.4 Myr ago are scarce. Here we report on the lithic assemblage and geological context for the Kokiselei 4 archaeological site from the Nachukui formation (West Turkana, Kenya) that bears characteristic early Acheulian tools and pushes the first appearance datum for this stone-age technology back to 1.76 Myr ago. Moreover, co-occurrence of Oldowan and Acheulian artefacts at the Kokiselei site complex indicates that the two technologies are not mutually exclusive time-successive components of an evolving cultural lineage, and suggests that the Acheulian was either imported from another location yet to be identified or originated from Oldowan hominins at this vicinity. In either case, the Acheulian did not accompany the first human dispersal from Africa despite being available at the time. This may indicate that multiple groups of hominins distinguished by separate stone-tool-making behaviours and dispersal strategies coexisted in Africa at 1.76 Myr ago.

Low protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.

PubMed

Olgac, Guven; Cosgun, Tugba; Vayvada, Mustafa; Ozdemir, Atilla; Kutlu, Cemal Asim

2014-10-01

Owing to the great absorption capability of the pleura for transudates, the protein content of draining pleural fluid may be considered as a more adequate determinant than its daily draining amount in the decision-making for earlier chest tube removal. In an a priori pilot study, we observed that the initially draining protein-rich exudate converts to a transudate quickly in most patients after lobectomies. Thus, chest tubes draining high-volume but low-protein fluids can safely be removed earlier in the absence of an air leak. This randomized study aims to investigate the validity and clinical applicability of this hypothesis as well as its influence on the timing for chest tube removal and earlier discharge after lobectomy. Seventy-two consecutive patients undergoing straightforward lobectomy were randomized into two groups. Patients with conditions affecting postoperative drainage and with persisting air leaks beyond the third postoperative day were excluded. Drains were removed if the pleural fluid to blood protein ratio (PrRPl/B) was ≤0.5, regardless of its daily draining amount in the study arm (Group S; n = 38), and patients in the control arm (Group C; n = 34) had their tubes removed if daily drainage was ≤250 ml regardless of its protein content. Patients were discharged home immediately or the following morning after removal of the last drain. All cases were followed up regarding the development of symptomatic pleural effusions and hospital readmissions for a redrainage procedure. Demographic and clinical characteristics as well as the pattern of decrease in PrRPl/B were the same between groups. The mean PrRPl/B was 0.65 and 0.67 (95% CI = 0.60-0.69 and 0.62-0.72) on the first postoperative day, and it remarkably dropped down to 0.39 and 0.33 (95% CI = 0.33-0.45 and 0.27-0.39) on the second day in Groups S and C, respectively, and remained below 0.5 on the third day (repeated-measures of ANOVA design, post hoc 'within-group' comparison of the first

Determinants of severe dehydration from diarrheal disease at hospital presentation: Evidence from 22 years of admissions in Bangladesh

PubMed Central

Andrews, Jason R.; Leung, Daniel T.; Ahmed, Shahnawaz; Malek, Mohammed Abdul; Ahmed, Dilruba; Begum, Yasmin Ara; Qadri, Firdausi; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Nelson, Eric J.

2017-01-01

Background To take advantage of emerging opportunities to reduce morbidity and mortality from diarrheal disease, we need to better understand the determinants of life-threatening severe dehydration (SD) in resource-poor settings. Methodology/findings We analyzed records of patients admitted with acute diarrheal disease over twenty-two years at the International Centre for Diarrhoeal Disease Research, Bangladesh (1993–2014). Patients presenting with and without SD were compared by multivariable logistic regression models, which included socio-demographic factors and pathogens isolated. Generalized additive models evaluated non-linearities between age or household income and SD. Among 55,956 admitted patients, 13,457 (24%) presented with SD. Vibrio cholerae was the most common pathogen isolated (12,405 patients; 22%), and had the strongest association with SD (AOR 4.77; 95% CI: 4.41–5.51); detection of multiple pathogens did not exacerbate SD risk. The highest proportion of severely dehydrated patients presented in a narrow window only 4–12 hours after symptom onset. Risk of presenting with SD increased sharply from zero to ten years of age and remained high throughout adolescence and adulthood. Adult women had a 38% increased odds (AOR 1.38; 95% CI: 1.30–1.46) of SD compared to adult men. The probability of SD increased sharply at low incomes. These findings were consistent across pathogens. Conclusions/significance There remain underappreciated populations vulnerable to life-threatening diarrheal disease that include adult women and the very poor. In addition to efforts that address diarrheal disease in young children, there is a need to develop interventions for these other high-risk populations that are accessible within 4 hours of symptom onset. PMID:28448489

Determinants of severe dehydration from diarrheal disease at hospital presentation: Evidence from 22 years of admissions in Bangladesh.

PubMed

Andrews, Jason R; Leung, Daniel T; Ahmed, Shahnawaz; Malek, Mohammed Abdul; Ahmed, Dilruba; Begum, Yasmin Ara; Qadri, Firdausi; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Nelson, Eric J

2017-04-01

To take advantage of emerging opportunities to reduce morbidity and mortality from diarrheal disease, we need to better understand the determinants of life-threatening severe dehydration (SD) in resource-poor settings. We analyzed records of patients admitted with acute diarrheal disease over twenty-two years at the International Centre for Diarrhoeal Disease Research, Bangladesh (1993-2014). Patients presenting with and without SD were compared by multivariable logistic regression models, which included socio-demographic factors and pathogens isolated. Generalized additive models evaluated non-linearities between age or household income and SD. Among 55,956 admitted patients, 13,457 (24%) presented with SD. Vibrio cholerae was the most common pathogen isolated (12,405 patients; 22%), and had the strongest association with SD (AOR 4.77; 95% CI: 4.41-5.51); detection of multiple pathogens did not exacerbate SD risk. The highest proportion of severely dehydrated patients presented in a narrow window only 4-12 hours after symptom onset. Risk of presenting with SD increased sharply from zero to ten years of age and remained high throughout adolescence and adulthood. Adult women had a 38% increased odds (AOR 1.38; 95% CI: 1.30-1.46) of SD compared to adult men. The probability of SD increased sharply at low incomes. These findings were consistent across pathogens. There remain underappreciated populations vulnerable to life-threatening diarrheal disease that include adult women and the very poor. In addition to efforts that address diarrheal disease in young children, there is a need to develop interventions for these other high-risk populations that are accessible within 4 hours of symptom onset.

New quasar survey with WIRO: The light curves of quasars over ~15 year timescales

NASA Astrophysics Data System (ADS)

Griffith, Emily; Bassett, Neil; Deam, Sophie; Dixon, Don; Harvey, William; Lee, Daniel; Lyke, Bradley; Haze Nunez, Evan; Parziale, Ryan; Witherspoon, Catherine; Myers, Adam D.; Findlay, Joseph; Kobulnicky, Henry A.; Dale, Daniel A.

2017-01-01

Quasars, a type of active galactic nuclei (AGN), are known to vary in brightness on 10 day to 7 year timescales. While it has been proposed that this variability is caused by instability in the accretion disk, Poisson processes, or microlensing, the exact cause remains mysterious. Understanding the physical mechanisms that drive quasar variability will require imaging of quasars over a wide range of timescales. In particular, the observations required to constrain longer timescales can be difficult to conduct. This summer ~1000 quasars in Stripe 82 were observed in ugriz wavelength bands using WIRO, the University of Wyoming’s 2.3-meter telescope. Using these images, earlier data from the Sloan Digital Sky Survey's observations of Stripe 82, as well as various data reduction methods, the quasars’ magnitude can be studied on our extended 3 day to 15 year timescale. Here, we present the light curves of ~1000 quasars in ugriz bands as observed over the last 15 years. Thiswork is supported by the National Science Foundation under REU grant AST 1560461.

A 4-year-old boy presenting with persistent urinary incontinence: Questions.

PubMed

Keenswijk, Werner; Walle, Johan Vande

2017-05-01

A 4-year-old boy was referred to the nephrologist with daytime urinary incontinence and suspicion of an overactive bladder. At the age of 17 months he had been referred to the pediatric endocrinologist because of polyuria and polydipsia in order to exclude diabetes insipidus. Repeated water deprivation tests and a magnetic resonance imaging scan of the brain were normal. Diabetes insipidus was excluded, and primary polydipsia was thought to be most likely since diabetes mellitus also had been excluded. At the current presentation, he drank up to 3 L a day and quite often had wet diapers. He also seemed to pass stools infrequently and with difficulty. Curiously his grandmother had similar symptoms of polyuria and polydipsia since childhood and had been diagnosed with primary polydipsia. The physical examination of our pediatric patient was normal. In the differential diagnosis we included diabetes insipidus but also contemplated other possibilities, such as nephronophthisis, tubulopathies and hypercalciuria. Laboratory results including urinalysis and an ultrasound of the kidney did not show any abnormalities, making a tubulopathy or hypercalciuria unlikely. A desmopressin test by the intravenous route came back completely normal, pointing to another cause than diabetes insipidus. Genetic testing for the nephronophthisis came back negative but was positive for a missense mutation in the AVPR2 gene (p.Arg104Cys) associated with partial nephrogenic diabetes insipidus. He was started on daily desmopressin. Within 3 days the urinary incontinence resolved as did the polyuria and faecal incontinence. His grandmother was referred to the geneticist and eventually the adult nephrologist. This case highlights the importance of being thorough when confronted with a difficult diagnosis. It also emphasizes that a test result does not necessarily equate to the presence or absence of a condition since the test with 100 % sensitivity and specificity has yet to be discovered.

Floristic diversity, stand structure, and composition 11 years after herbicide site preparation

Treesearch

James H. Miller; Robert S. Boyd; M. Boyd Edwards

1999-01-01

This study tested for effects of site preparation herbicides applied at high labeled rates 11 years earlier on plant species richness, diversity, and stand structure and composition. Four study sites in three physiographic provinces were established in central Georgia in 1984. Six herbicide treatments were included on each site: hexazinone liquid, hexazinone pellets,...

New Mexico Public Education Department K-3 Plus Annual Report for School Year 2015-2016

ERIC Educational Resources Information Center

New Mexico Public Education Department, 2016

2016-01-01

K-3 Plus was established in 2007 as a six-year pilot project that permitted schools with high numbers of at-risk students to begin the school year 25 days earlier for kindergarten through third grade. The purpose of the K-3 Plus program is to demonstrate that increased instructional time in kindergarten and the early grades narrows the achievement…

Clinicopathological Diversity of Canine Mammary Gland Tumors in Sri Lanka: A One-Year Survey on Cases Presented to Two Veterinary Practices.

PubMed

Ariyarathna, Harsha; de Silva, Niranjala; Aberdein, Danielle; Kodikara, Dayananda; Jayasinghe, Manjula; Adikari, Ranjith; Munday, John S

2018-04-27

Mammary gland tumors (MGTs) are one of the most common neoplasms among dogs in Sri Lanka. However, the clinicopathological diversity of MGTs in Sri Lanka is largely unknown, impeding accurate diagnosis and effective treatment of the disease. The present study investigated the clinicopathological features of MGTs in 74 dogs presented to two veterinary practices in Sri Lanka treated surgically, over a one-year period. Information regarding the patient signalment, clinical presentation, and reproductive history were collected, and each neoplasm was examined histologically. Forty-one (54.4%) dogs were primarily presented for mammary neoplasia, while a MGT was an incidental finding in 33 (44.6%) dogs. The majority of tumors were histologically malignant (n = 65, 87.8%), and 18 malignant tumor sub-types were identified. A significantly higher proportion of malignant tumors were large (>3 cm diameter) and observed in inguinal mammary glands. Nulliparous (n = 42, 55.3%) dogs predominated in the group, and the mean age of MGT diagnosis was 8.0 ± 2.41 years. The present study identified tumor location and size to be predictive of malignancy. A high histological diversity of MGTs was observed. Overall, the present findings emphasize the necessity of improving awareness of MGTs among Sri Lankan clinicians as well as dog owners.

Five-Year Risk of Interval-Invasive Second Breast Cancer

PubMed Central

Buist, Diana S. M.; Houssami, Nehmat; Dowling, Emily C.; Halpern, Elkan F.; Gazelle, G. Scott; Lehman, Constance D.; Henderson, Louise M.; Hubbard, Rebecca A.

2015-01-01

Background: Earlier detection of second breast cancers after primary breast cancer (PBC) treatment improves survival, yet mammography is less accurate in women with prior breast cancer. The purpose of this study was to examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. Methods: We evaluated a prospective cohort of 15 114 women with 47 717 surveillance mammograms diagnosed with stage 0-II unilateral PBC from 1996 through 2008 at facilities in the Breast Cancer Surveillance Consortium. We used discrete time survival models to estimate the association between odds of an interval-invasive second breast cancer and candidate predictors, including demographic, PBC, and imaging characteristics. All statistical tests were two-sided. Results: The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. Conclusions: PBC diagnosis and treatment characteristics contribute to variation in subsequent-interval second breast cancer risk. Consideration of these factors may be useful in developing tailored post-treatment imaging surveillance plans. PMID:25904721

Soil Chemistry Still Affected 23 Years After Large Application of Fluidized Bed Material

USDA-ARS?s Scientific Manuscript database

This study was conducted to assess the movement of arsenic, aluminum, calcium, copper, iron, lead, magnesium, manganese, mercury and zinc in an old apple (Malus domestica Borkh) orchard that received a one time application of 36 kg/ m2 of fluidized bed combustion material (FBCM) 23 years earlier. S...

Estimating numbers of females with cubs-of-the-year in the Yellowstone grizzly bear population

USGS Publications Warehouse

Keating, K.A.; Schwartz, C.C.; Haroldson, M.A.; Moody, D.

2001-01-01

For grizzly bears (Ursus arctos horribilis) in the Greater Yellowstone Ecosystem (GYE), minimum population size and allowable numbers of human-caused mortalities have been calculated as a function of the number of unique females with cubs-of-the-year (FCUB) seen during a 3- year period. This approach underestimates the total number of FCUB, thereby biasing estimates of population size and sustainable mortality. Also, it does not permit calculation of valid confidence bounds. Many statistical methods can resolve or mitigate these problems, but there is no universal best method. Instead, relative performances of different methods can vary with population size, sample size, and degree of heterogeneity among sighting probabilities for individual animals. We compared 7 nonparametric estimators, using Monte Carlo techniques to assess performances over the range of sampling conditions deemed plausible for the Yellowstone population. Our goal was to estimate the number of FCUB present in the population each year. Our evaluation differed from previous comparisons of such estimators by including sample coverage methods and by treating individual sightings, rather than sample periods, as the sample unit. Consequently, our conclusions also differ from earlier studies. Recommendations regarding estimators and necessary sample sizes are presented, together with estimates of annual numbers of FCUB in the Yellowstone population with bootstrap confidence bounds.

Fiscal year 1977 scientific and technical reports, articles, papers, and presentations

NASA Technical Reports Server (NTRS)

White, O. L. (Compiler)

1977-01-01

This bibliography lists 78 NASA technical memoranda, notes, papers, and reports presented by Marshall Space Flight Center personnel in FY 1977. In addition, 525 papers by contractors to that facility are cited along with 129 papers cleared for presentation.

The Timing of Pertussis Cases in Unvaccinated Children in an Outbreak Year: Oregon 2012.

PubMed

Robison, Steve G; Liko, Juventila

2017-04-01

To assess whether, during a 2012 pertussis outbreak, unvaccinated and poorly vaccinated cases occurred earlier on a community level. Pediatric pertussis among children 2 months to 10 years of age in the Oregon Sentinel Surveillance region during an epidemic starting at the beginning of 2012 were stratified by immunization status, age, zip code, and calendar date of disease onset. Differences in median onset as days between fully or mostly vaccinated, poorly vaccinated, and unvaccinated cases were examined overall and within local zip code areas. Disease clusters also were examined using SatScan analysis. Overall, 351 pertussis cases occurred among children aged 2 months to 10 years of age residing in 72 distinct zipcodes. Among unvaccinated or poorly vaccinated cases, their median date of onset was at calendar day 117 (April 26, 2012), whereas for those who were fully or mostly vaccinated the median date of onset was 41 days later, at day 158 (June 6, 2012). Within each local zip code area, the unvaccinated cases were 3.2 times more likely than vaccinated cases to have earlier median dates of onset (95% CI 2.9-3.6). In this outbreak, pertussis cases among unvaccinated children represented an earlier spread of disease across local areas. Controlling outbreaks may require attention to the composition and location of the unvaccinated. Copyright © 2016 Elsevier Inc. All rights reserved.

[Pannus Formation Six-years after Aortic and Mitral Valve Replacement with Tissue Valves;Report of a Case].

PubMed

Nakamura, Makoto; Muraoka, Arata; Aizawa, Kei; Akutsu, Hirohiko; Kurumisawa, Soki; Misawa, Yoshio

2015-07-01

A 77-year-old man presented with exertional dyspnea. He had undergone aortic and mitral valve replacement with tissue valves 6-years earlier. The patient's hemoglobin level was 9.8 g/dl and serum aspartate aminotransferase (70 mU/ml) and lactate dehydrogenase (1,112 mU/ml) were elevated. Echocardiography revealed stenosis of the prosthetic valve in the aortic position with peak flow velocity of 3.8 m/second and massive mitral regurgitation. The patient underwent repeat valve replacement. Pannus formation around both implanted valves was observed. The aortic valve orifice was narrowed by the pannus, and one cusp of the prosthesis in the mitral position was fixed and caused the regurgitation, but they were free from cusp laceration or calcification. The patient's postoperative course was uneventful, and he continues to do well 14 months after surgery.

Risk factors for depressive disorders in very old age: a population-based cohort study with a 5-year follow-up.

PubMed

Petersson, Sofia; Mathillas, Johan; Wallin, Karin; Olofsson, Birgitta; Allard, Per; Gustafson, Yngve

2014-05-01

Depressive disorders are common among the very old, but insufficiently studied. The present study aims to identify risk factors for depressive disorders in very old age. The present study is based on the GERDA project, a population-based cohort study of people aged ≥85 years (n = 567), with 5 years between baseline and follow-up. Factors associated with the development of depressive disorders according to DSM-IV criteria at follow-up were analysed by means of a multivariate logistic regression. At baseline, depressive disorders were present in 32.3 % of the participants. At follow-up, 69 % of those with baseline depressive disorders had died. Of the 49 survivors, 38 still had depressive disorders. Of the participants without depressive disorders at baseline, 25.5 % had developed depressive disorders at follow-up. Baseline factors independently associated with new cases of depressive disorders after 5 years were hypertension, a history of stroke and 15-item Geriatric Depression Scale score at baseline. The present study supports the earlier findings that depressive disorders among the very old are common, chronic and malignant. Mild depressive symptoms as indicated by GDS-15 score and history of stroke or hypertension seem to be important risk factors for incident depressive disorders in very old age.

Educational Attainment of 10-Year-Old Children with Treated and Untreated Visual Defects.

ERIC Educational Resources Information Center

Stewart-Brown, Sarah; And Others

1985-01-01

Children with visual impairments who participated in a 10-year survey were compared with peers on measures of intelligence, reading, mathematics, and sporting ability. Results are consistent with earlier findings of increased intelligence among Ss with myopia and slightly reduced intelligence among Ss with amblyopia. It was concluded that the…

Biotinidase deficiency presenting as recurrent myelopathy in a 7-year-old boy and a review of the literature.

PubMed

Raha, Sarbani; Udani, Vrajesh

2011-10-01

Biotinidase deficiency may produce variable neurologic manifestations. Brainstem and spinal cord disease comprises an uncommon presentation of biotinidase deficiency. We describe a 7-year old boy with subacute progressive quadriplegia and "sighing" respirations. Severe biotinidase deficiency was established, and the patient demonstrated complete recovery with biotin supplementation. Genetic studies revealed presence of homozygous mutation in the BTD gene [c.133C>T (p.H447Y)]. Biotinidase deficiency should be considered in the differential diagnosis for subacute, long segment myelopathy, particularly with brainstem involvement. This entity is treatable; a high index of suspicion can be life-saving. We also review the literature on biotinidase deficiency presenting as spinal cord demyelinating disease. Copyright © 2011 Elsevier Inc. All rights reserved.

An uncommon presentation of non-small-cell lung cancer with acrometastases to the great toe and index finger.

PubMed

Reynolds, Jamie; Skandan, Savitri P

2016-03-01

Acrometastasis as initial presentation of metastatic cancer is an extremely rare finding. We describe an unusual case of late-stage non-small-cell lung cancer with metastatic lesions to the great toe and index fnger with associated pain in those areas as the only presenting symptom. A 71-year-old white woman was referred to the emergency department by her primary care physician for necrosis and swelling of the left great toe for work-up of possible osteomyelitis (Figure 1). Before she presented to her physician, she had been complaining of severe pain, swelling, and erythema of the left great toe that had lasted for 1-2 months. Infection was initially suspected. She completed 2 courses of oral antibiotics with no improvement. She was also complaining of similar symptoms on the left index finger and attributed her symptoms to an injury a month earlier (Figure 2). The pain was so severe that she was not able to bear weight on her left foot. An outpatient X-ray of her left great toe raised her physician's concerns that it might be osteomyelitis so she was referred to the emergency department. ©2016 Frontline Medical Communications.

A 250,000-year climatic record from great basin vein calcite: Implications for Milankovitch theory

USGS Publications Warehouse

Winograd, I.J.; Szabo, B. J.; Coplen, T.B.; Riggs, A.C.

1988-01-01

A continuous record of oxygen-18 (??18O) variations in the continental hydrosphere during the middle-to-late Pleistocene has been obtained from a uranium-series dated calcitic vein in the southern Great Basin. The vein was deposited from ground water that moved through Devils Hole - an open fault zone at Ash Meadows, Nevada - between 50 and 310 ka (thousand years ago). The configuration of the ??18O versus time curve closely resembles the marine and Antarctic ice core (Vostok) ??18O curves; however, the U-Th dates indicate that the last interglacial stage (marine oxygen isotope stage 5) began before 147 ?? 3 ka, at least 17,000 years earlier than indicated by the marine ??18O record and 7,000 years earlier than indicated by the less well dated Antarctic ??18O record. This discrepancy and other differences in the timing of key climatic events suggest that the indirectly dated marine ??18O chronology may need revision and that orbital forcing may not be the principal cause of the Pleistocene ice ages.

A pseudoleukemic blood differentiation in a 13-year-old child: an extraordinary presentation of Churg-Strauss syndrome.

PubMed

Mutsaers, E R; Witteveen, R; van den Bosch-Ruis, W; Kuijpers, T W; van Houten, M A; van den Berg, J M

2013-03-01

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis of the small- and medium-size vessels. It is mostly seen in elderly patients presenting as de novo asthma, eosinophilia, and vasculitic organ involvement. In childhood, CSS is extremely rare. The course of pediatric CSS is usually severe and often lethal. We present a case of a 13-year-old girl with a short history of asthma, marked eosinophilia, and multiorgan involvement. The extremely high level of blood eosinophilic granulocytes (51.6 × 10(9)/L) prompted a workup for eosinophilic leukemia before the diagnosis CSS could be made. Subsequently, the disease was successfully treated. This case report shows a classical case of childhood CSS, remarkable because of the presence of extreme hypereosinophilia. It underlines the importance of CSS as a life-threatening cause of hypereosinophilia in children.

Comparing Ultraviolet Spectra against Calculations: Year 2 Results

NASA Technical Reports Server (NTRS)

Peterson, Ruth C.

2004-01-01

The five-year goal of this effort is to calculate high fidelity mid-W spectra for individual stars and stellar systems for a wide range of ages, abundances, and abundance ratios. In this second year, the comparison of our calculations against observed high-resolution mid- W spectra was extended to stars as metal-rich as the Sun, and to hotter and cooler stars, further improving the list of atomic line parameters used in the calculations. We also published the application of our calculations based on the earlier list of line parameters to the observed mid-UV and optical spectra of a mildly metal-poor globular cluster in the nearby Andromeda galaxy, Messier 3 1.

DNA analysis of a 30,000-year-old Urocitellus glacialis from northeastern Siberia reveals phylogenetic relationships between ancient and present-day arctic ground squirrels

PubMed Central

Faerman, Marina; Bar-Gal, Gila Kahila; Boaretto, Elisabetta; Boeskorov, Gennady G.; Dokuchaev, Nikolai E.; Ermakov, Oleg A.; Golenishchev, Fedor N.; Gubin, Stanislav V.; Mintz, Eugenia; Simonov, Evgeniy; Surin, Vadim L.; Titov, Sergei V.; Zanina, Oksana G.; Formozov, Nikolai A.

2017-01-01

In contrast to the abundant fossil record of arctic ground squirrels, Urocitellus parryii, from eastern Beringia, only a limited number of fossils is known from its western part. In 1946, unnamed GULAG prisoners discovered a nest with three mummified carcasses of arctic ground squirrels in the permafrost sediments of the El’ga river, Yakutia, Russia, that were later attributed to a new species, Citellus (Urocitellus) glacialis Vinogr. To verify this assignment and to explore phylogenetic relationships between ancient and present-day arctic ground squirrels, we performed 14C dating and ancient DNA analyses of one of the El’ga mummies and four contemporaneous fossils from Duvanny Yar, northeastern Yakutia. Phylogenetic reconstructions, based on complete cytochrome b gene sequences of five Late Pleistocene arctic ground squirrels and those of modern U. parryii from 21 locations across western Beringia, provided no support for earlier proposals that ancient arctic ground squirrels from Siberia constitute a distinct species. In fact, we observed genetic continuity of the glacialis mitochondrial DNA lineage in modern U. parryii of the Kamchatka peninsula. When viewed in a broader geographic perspective, our findings provide new insights into the genetic history of U. parryii in Late Pleistocene Beringia. PMID:28205612

Ginkgo biloba's footprint of dynamic Pleistocene history dates back only 390,000 years ago.

PubMed

Hohmann, Nora; Wolf, Eva M; Rigault, Philippe; Zhou, Wenbin; Kiefer, Markus; Zhao, Yunpeng; Fu, Cheng-Xin; Koch, Marcus A

2018-04-27

At the end of the Pliocene and the beginning of Pleistocene glaciation and deglaciation cycles Ginkgo biloba went extinct all over the world, and only few populations remained in China in relict areas serving as sanctuary for Tertiary relict trees. Yet the status of these regions as refuge areas with naturally existing populations has been proven not earlier than one decade ago. Herein we elaborated the hypothesis that during the Pleistocene cooling periods G. biloba expanded its distribution range in China repeatedly. Whole plastid genomes were sequenced, assembled and annotated, and sequence data was analyzed in a phylogenetic framework of the entire gymnosperms to establish a robust spatio-temporal framework for gymnosperms and in particular for G. biloba Pleistocene evolutionary history. Using a phylogenetic approach, we identified that Ginkgoatae stem group age is about 325 million years, whereas crown group radiation of extant Ginkgo started not earlier than 390,000 years ago. During repeated warming phases, Gingko populations were separated and isolated by contraction of distribution range and retreated into mountainous regions serving as refuge for warm-temperate deciduous forests. Diversification and phylogenetic splits correlate with the onset of cooling phases when Ginkgo expanded its distribution range and gene pools merged. Analysis of whole plastid genome sequence data representing the entire spatio-temporal genetic variation of wild extant Ginkgo populations revealed the deepest temporal footprint dating back to approximately 390,000 years ago. Present-day directional West-East admixture of genetic diversity is shown to be the result of pronounced effects of the last cooling period. Our evolutionary framework will serve as a conceptual roadmap for forthcoming genomic sequence data, which can then provide deep insights into the demographic history of Ginkgo.

CALL--Past, Present, and Future.

ERIC Educational Resources Information Center

Bax, Stephen

2003-01-01

Provides a critical examination and reassessment of the history of computer assisted language learning (CALL), and argues for three new strategies--restricted, open, and integrated. Offers definitions and descriptions of the three approaches and argues that they allow a more detailed analysis of institutions and classrooms than earlier analyses.…

Nuclear Power; Past, present and future

NASA Astrophysics Data System (ADS)

Elliott, David

2017-04-01

This book looks at the early history of nuclear power, at what happened next, and at its longer-term prospects. The main question is: can nuclear power overcome the problems that have emerged? It was once touted as the ultimate energy source, freeing mankind from reliance on dirty, expensive fossil energy. Sixty years on, nuclear only supplies around 11.5% of global energy and is being challenged by cheaper energy options. While the costs of renewable sources, like wind and solar, are falling rapidly, nuclear costs have remained stubbornly high. Its development has also been slowed by a range of other problems, including a spate of major accidents, security concerns and the as yet unresolved issue of what to do with the wastes that it produces. In response, a new generation of nuclear reactors is being developed, many of them actually revised versions of the ideas first looked at in the earlier phase. Will this new generation of reactors bring nuclear energy to the forefront of energy production in the future?

Sialolipoma of parotid gland in a 1-year-old male child: A case report and review of literature.

PubMed

Arakeri, Surekha Ulhas; Banga, Shilpi

2018-01-01

Sialolipoma is a recently described rare histological variant of lipoma, characterized by well-demarcated proliferation of mature adipocytes with secondary entrapment of salivary gland elements. Less than forty cases of sialolipoma have been reported in English literature. This tumor has been reported both in major and minor salivary glands, with the parotid gland being the most common site. Age incidence in this tumor varies from 0 month to 84 years. However, the occurrence of this tumor in an infant is very rare. In the published literature, the size of this tumor varied from 1 to 7 cm. In the present case, the tumor size was >7 cm. To the best of our knowledge, congenital sialolipoma >7 cm has been rarely reported earlier. Hence, this case is presented because of its rarity and unusual gross appearance.

Nursing Taxonomies in Spain: Research Themes Presented at the AENTDE Conferences Over a 16-Year Period.

PubMed

Guirao-Goris, Silamani J Adolf; Lluch-Canut, Maria Teresa; Martín-Iglesias, Susana; Quero-Rufián, Aurora; Roldán Merino, Juan Francisco

2017-10-01

To identify the types of studies of nursing taxonomies and priority research themes presented at AENTDE conferences between 1996 and 2012. Four hundred oral communications and posters and 27 lectures presented at the AENTDE meetings were reviewed by means of a descriptive analysis of the types of studies conducted and a content analysis of priority research themes. The most commonly presented studies were descriptions of the implementation of nursing taxonomies, which accounted for 27.4% of the total over the 16-year period. However, their prevalence fell from 31.8% in 1996 to 9.1% in 2012. Basic research studies accounted for 17.4% of studies overall but were the most frequent in 2012, when their proportion had risen to 37.5%. The prevalence of basic research studies increased notably over the 16-year period. Content validity studies rose in number, while face validity studies fell. Studies of the practical implementation of taxonomies also declined. Identificar los tipos de estudios de taxonomías enfermeras y los temas de investigación prioritarios presentados en las convenciones de AENTDE desde 1996 a 2012. MÉTODO: Se revisaron 400 comunicaciones y 27 ponencias presentadas a 9 simposiums de AENTDE realizando un análisis del tipo de estudio y un análisis de contenido de los temas. Los estudios más frecuentes son las experiencias de implantación de las taxonomías enfermeras con un porcentaje medio de un 27.4% que partiendo de un 31.8% en 1996 disminuyó a un 9,1% en 2012. La investigación básica tienen un porcentaje medio del 17.4% obteniéndose el mayor porcentaje en 2012 con un 37,5%. CONCLUSIÓN: La prevalencia de los estudios de investigación básica se incrementó notablemente durante el período de 16 años. Los estudios de validez de contenido aumentaron en número, mientras que los estudios de validez aparente cayeron. Los estudios sobre la aplicación práctica de las taxonomías también disminuyeron. © 2016 NANDA International, Inc.

Continuity and Admixture in the Last Five Millennia of Levantine History from Ancient Canaanite and Present-Day Lebanese Genome Sequences.

PubMed

Haber, Marc; Doumet-Serhal, Claude; Scheib, Christiana; Xue, Yali; Danecek, Petr; Mezzavilla, Massimo; Youhanna, Sonia; Martiniano, Rui; Prado-Martinez, Javier; Szpak, Michał; Matisoo-Smith, Elizabeth; Schutkowski, Holger; Mikulski, Richard; Zalloua, Pierre; Kivisild, Toomas; Tyler-Smith, Chris

2017-08-03

The Canaanites inhabited the Levant region during the Bronze Age and established a culture that became influential in the Near East and beyond. However, the Canaanites, unlike most other ancient Near Easterners of this period, left few surviving textual records and thus their origin and relationship to ancient and present-day populations remain unclear. In this study, we sequenced five whole genomes from ∼3,700-year-old individuals from the city of Sidon, a major Canaanite city-state on the Eastern Mediterranean coast. We also sequenced the genomes of 99 individuals from present-day Lebanon to catalog modern Levantine genetic diversity. We find that a Bronze Age Canaanite-related ancestry was widespread in the region, shared among urban populations inhabiting the coast (Sidon) and inland populations (Jordan) who likely lived in farming societies or were pastoral nomads. This Canaanite-related ancestry derived from mixture between local Neolithic populations and eastern migrants genetically related to Chalcolithic Iranians. We estimate, using linkage-disequilibrium decay patterns, that admixture occurred 6,600-3,550 years ago, coinciding with recorded massive population movements in Mesopotamia during the mid-Holocene. We show that present-day Lebanese derive most of their ancestry from a Canaanite-related population, which therefore implies substantial genetic continuity in the Levant since at least the Bronze Age. In addition, we find Eurasian ancestry in the Lebanese not present in Bronze Age or earlier Levantines. We estimate that this Eurasian ancestry arrived in the Levant around 3,750-2,170 years ago during a period of successive conquests by distant populations. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Morbus Wilson: Case report of a two-year-old child as first manifestation.

PubMed

Beyersdorff, Anke; Findeisen, Annette

2006-04-01

Morbus Wilson, or Wilson's disease, is a genetic disease of copper metabolism. Usually the disease is detected when the first clinical symptoms appear, generally not before 5 years of age. This case report shows that the disease can be detected much earlier if abnormal laboratory findings in the patient's history prompt further investigations.

POEMS Syndrome Presentation with an Abscess within the Plasmacytoma—A Rare Case Report

PubMed Central

Agarwal, Rishi; Abidi, Muneer H.; Grandhi, Bala

2011-01-01

POEMS Syndrome is a rare cause of demyelinating and axonal mixed neuropathy. Plasmacytomas are usually seen in POEMS syndrome and can be osseous or extramedullary. Plasmacytomas presenting as an abscess has not been noted earlier. Our patient presented with localized hyperpigmented patch on the back and later developed progressive weakness in upper and lower limbs. Initially serum and urine protein electrophoresis were normal. The patient was thought to have Chronic Inflammatory Demyelinating Polyneuropathy and was treated accordingly without any improvement. Repeat serum protein electrophoresis showed monoclonal gammopathy. MRI of the back revealed an abscess in the paravertebral soft tissues reaching up to the skin. Needle biopsy was consistent with plasmacytoma. Later, he developed a purulent fungating lesion in the lower midback. Antibiotics were started and local resection was done followed by radiation. Pathology of the resected mass showed plasmacytoma extensively involving subcutaneous soft tissue and bone. The patient improved with the treatment. Cystic plasmacytomas and abscess within the plasmacytoma has not been reported earlier. Whether abscess formation is part of the disease spectrum due to infiltration of overlying tissue or is secondary to localized immunosuppression is unknown. Local treatment of a single plasmacytoma is useful in ameliorating systemic symptoms. PMID:22084694

A 5-year study of patients with pulmonary tuberculosis treated at home in a controlled comparison of isoniazid plus PAS with 3 regimens of isoniazid alone*

PubMed Central

Evans, C.; Devadatta, S.; Fox, Wallace; Gangadharam, P. R. J.; Menon, N. K.; Ramakrishnan, C. V.; Sivasubramanian, S.; Somasundaram, P. R.; Stott, H.; Velu, S.

1969-01-01

This report from the Tuberculosis Chemotherapy Centre, Madras, describes the progress, over a 5-year period, of 341 patients with newly diagnosed, sputum-positive tuberculosis. All the patients were treated on a domiciliary basis. In the first year, the patients received, on the basis of random allocation, a standard regimen of isoniazid plus PAS or 1 of 3 regimens of isoniazid alone. Previous reports have shown that the response in the first year was substantially superior with the standard regimen, and that the bacteriological relapse rates in the second year were fairly similar for the 4 regimens. The findings in the present report extend the latter conclusion to the end of 5 years. Further, when considered together with the findings in an earlier study, they have shown that isoniazid, given as maintenance chemotherapy in the second year, was highly effective in preventing bacteriological relapse in patients who, at 1 year, had bacteriologically quiescent disease and no residual cavitation; the effect was, however, less marked in patients with residual cavitation at 1 year. Patients who were clear-cut failures of the allocated chemotherapy and those who had a bacteriological relapse in the second or subsequent years were usually re-treated with streptomycin plus PAS or streptomycin plus pyrazinamide, and if this was ineffective, with cycloserine plus thioacetazone or cycloserine plus ethionamide. Considering the findings over the 5-year period for all patients, 16 died from non-tuberculous causes and 1 took his discharge prematurely. Of the remainder, 86% had bacteriologically quiescent disease at 5 years, 6% had bacteriologically active disease and 8% had died of tuberculosis. These findings confirm the value of well-organized domiciliary chemotherapy, which was established by an earlier report from the Centre, and are particularly encouraging for developing countries such as India, where tuberculosis is a major problem and resources are limited. PMID:5309083

Longitudinal Development of Secondary Sexual Characteristics in Girls and Boys Between Ages 9½ and 15½ Years

PubMed Central

Susman, Elizabeth J.; Houts, Renate M.; Steinberg, Laurence; Belsky, Jay; Cauffman, Elizabeth; DeHart, Ganie; Friedman, Sarah L.; Roisman, Glenn I.; Halpern-Felsher, Bonnie L.

2010-01-01

Objectives To identify ages when adolescents were in sexual maturity stages 2 through 5; to explain the relations between breast (girls), genital (boys), and pubic hair (girls and boys) development between ages 9½ and 15½ years; and to evaluate synchrony of pubertal development across characteristics. Design Annual pubertal assessments. Setting Ten locations in the United States. Participants A total of 859 adolescents (427 boys [49.7%] and 432 girls [50.3%]; 737 white [85.8%] and 122 black [14.2%]). Main Outcome Measures Changes in the 5 stages of breast, genital, and pubic hair development. Results Girls were in breast maturity stages 2 and 3 earlier than comparable pubic hair stages. Although breast development in girls started earlier than pubic hair development, girls completed breast and pubic hair development at approximately the same age. Black girls were in all stages of breast and pubic hair development earlier than white girls. Boys were in stages 2, 3, 4, and 5 of genital development before the comparable pubic hair stage. In boys, genital development started earlier than pubic hair development, but pubic hair development was completed in less time. Black boys were in genital and pubic hair development about 7 months earlier than white boys. Black and white boys completed genital development in approximately 4½ years, but black boys took approximately 6 months longer than white boys to complete pubic hair development. At stage 2, for 66.2% of girls, breast development preceded their pubic hair development; for 91.1% of boys, genital development preceded their pubic hair development. Conclusions The results of this study are useful in understanding normative variation in the timing and change in the development of secondary sexual characteristics at puberty. They will help identify adolescents with atypical changes in sexual maturation and unusual progression of sexual maturation and growth disorders. PMID:20124146

Longitudinal development of secondary sexual characteristics in girls and boys between ages 91/2 and 151/2 years.

PubMed

Susman, Elizabeth J; Houts, Renate M; Steinberg, Laurence; Belsky, Jay; Cauffman, Elizabeth; Dehart, Ganie; Friedman, Sarah L; Roisman, Glenn I; Halpern-Felsher, Bonnie L

2010-02-01

To identify ages when adolescents were in sexual maturity stages 2 through 5; to explain the relations between breast (girls), genital (boys), and pubic hair (girls and boys) development between ages 9(1/2) and 15(1/2) years; and to evaluate synchrony of pubertal development across characteristics. Annual pubertal assessments. Ten locations in the United States. A total of 859 adolescents (427 boys [49.7%] and 432 girls [50.3%]; 737 white [85.8%] and 122 black [14.2%]). Changes in the 5 stages of breast, genital, and pubic hair development. Girls were in breast maturity stages 2 and 3 earlier than comparable pubic hair stages. Although breast development in girls started earlier than pubic hair development, girls completed breast and pubic hair development at approximately the same age. Black girls were in all stages of breast and pubic hair development earlier than white girls. Boys were in stages 2, 3, 4, and 5 of genital development before the comparable pubic hair stage. In boys, genital development started earlier than pubic hair development, but pubic hair development was completed in less time. Black boys were in genital and pubic hair development about 7 months earlier than white boys. Black and white boys completed genital development in approximately 4(1/2) years, but black boys took approximately 6 months longer than white boys to complete pubic hair development. At stage 2, for 66.2% of girls, breast development preceded their pubic hair development; for 91.1% of boys, genital development preceded their pubic hair development. The results of this study are useful in understanding normative variation in the timing and change in the development of secondary sexual characteristics at puberty. They will help identify adolescents with atypical changes in sexual maturation and unusual progression of sexual maturation and growth disorders.

Endocrine surgery fellowship graduates past, present, and future: 8 years of early job market experiences and what program directors and trainees can expect.

PubMed

Krishnamurthy, Vikram D; Gutnick, Jesse; Slotcavage, Rachel; Jin, Judy; Berber, Eren; Siperstein, Allan; Shin, Joyce J

2017-01-01

Given the increasing number of endocrine surgery fellowship graduates, we investigated if expectations and job opportunities changed over time. American Association of Endocrine Surgeons (AAES) fellowship graduates, surgery department chairs, and physician recruiters were surveyed. Univariate analysis was performed with JMP Pro 12 software. We identified 141 graduates from 2008-2015; survey response rate was 72% (n = 101). Compared to earlier graduates, fewer academic opportunities were available for the recent graduates who intended to join them (P = .001). Unlike earlier graduates, recent graduates expected to also perform elective general surgery, which ultimately represented a greater percentage of their practices (both P < .05). Interview offers increased for recent graduates, but job offers decreased. Overall, 84% of graduates matched their intended practice type and 98% reported being satisfied. Reponses from graduates, department chairs, and physician recruiters highlighted opportunities to improve mentor involvement, job search strategies, and online job board utilization. The endocrine surgery job market has diversified resulting in more graduates entering nonacademic practices and performing general surgery. This rapid evolution supports future analyses of the job market and opportunities for job creation. Almost every graduate reported job satisfaction, which encourages graduates to consider joining both academic and nonacademic practices equally. Copyright © 2016 Elsevier Inc. All rights reserved.

A short history of Japanese historical seismology: past and the present

NASA Astrophysics Data System (ADS)

Matsu'ura, Ritsuko S.

2017-12-01

Since seismicity in Japan is fairly high, Japanese interest in historical seismicity can be traced back to the nineth century, only a few centuries after the formation of the ancient ruling state. A 1000 years later, 2 years earlier than the modern seismological society was founded, the research on historical seismology started in Japan in 1878. By the accumulation for the recent 140 years, the present Japanese seismologists can read many historical materials without reading cursive scripts. We have a convenient access to the historical information related to earthquakes, in the modern characters of 27,759 pages. We now have 214 epicenters of historical earthquakes from 599 ad to 1872. Among them, 134 events in the early modern period were assigned hypocentral depths and proper magnitudes. The intensity data of 8700 places by those events were estimated. These precise intensity data enabled us to compare the detailed source areas of pairs of repeated historical earthquakes, such as the 1703 Genroku earthquake with the 1923 Kanto earthquake, and the 1707 Hoei earthquake with the summation of the 1854 Ansei Tokai and Ansei Nankai earthquakes. It is revealed that the focal area of the former larger event cannot completely include those of the latter smaller earthquakes, although those were believed to be typical sets of characteristic interplate earthquakes at the Sagami trough and at the Nankai trough. Research on historical earthquakes is very important to assess the seismic hazard in the future. We still have one-fifth events of the early modern period to be analyzed in detail. The compilation of places experienced high intensities in the modern events is also necessary. For the ancient and medieval periods, many equivocal events are still left. The further advance of the interdisciplinary research on historical seismology is necessary.

The Fischa-Dagnitz spring, Southern Vienna Basin: a multi tracer time series study re-assessing earlier conceptual assumptions.

NASA Astrophysics Data System (ADS)

Suckow, Axel; Gerber, Christoph; Kralik, Martin; Sültenfuss, Jürgen; Purtschert, Roland

2013-04-01

The gravel aquifer of the Southern Vienna Basin is a very important backup drinking water resource for the city of Vienna. A discharge location, the Fischa-Dagnitz spring in the Southern Vienna Basin, Austria, was re-investigated in 2011, five years after the gas exchange tracer test published in (Stolp et al., 2010), and sampled for stable isotopes 18O/2H, tritium, 3He, SF6 and 85Kr (Gerber et al., 2012). Additionally, new tritium time series data (Davis et al., 1967), previously not considered in Stolp et al. (2010), were included. These show a higher and earlier tritium peak of >300 TU in 1965 in the discharge of the Fischa-Dagnitz spring as compared to 221 TU in 1972 considered in Stolp et al. (2010). The new 3He, SF6 and 85Kr gas tracer data from 2011 confirm the earlier finding for 3He of Stolp et al. (2010) and indicate a more recent equilibration with the atmosphere than the water bound tracers 18O, 2H and tritium. A new modelling attempt using the Lumpy code (Suckow, 2012) confirmed the discrepancy between the tritium data and the gaseous tracers 3He, SF6 and 85Kr. No steady-state combination of local recharge (represented by an exponential model) and Schwarza river infiltration flowing through the gravel aquifer (represented by a parallel dispersion model) can equally well explain both the tritium time series and the gas tracer results. A revised conceptual model proposes that a pinching of the aquifer at unconformities in the gravel body or a fault zone known in the gravel body forces groundwater along the flow path closer to the surface and exposes it to the atmosphere. This would tend to reset the "dating" clock for the gaseous tracers 3He, SF6 and 85Kr, which can equilibrate quickly with the atmosphere, but not for tritium, which marks the transport behaviour of the water itself. These findings are of importance also for other multi-tracer assessments of groundwater movement in phreatic aquifer systems. References: Davis, G.H., Payne, B.R., Dincer, T

Design a Fuzzy Rule-based Expert System to Aid Earlier Diagnosis of Gastric Cancer.

PubMed

Safdari, Reza; Arpanahi, Hadi Kazemi; Langarizadeh, Mostafa; Ghazisaiedi, Marjan; Dargahi, Hossein; Zendehdel, Kazem

2018-01-01

Screening and health check-up programs are most important sanitary priorities, that should be undertaken to control dangerous diseases such as gastric cancer that affected by different factors. More than 50% of gastric cancer diagnoses are made during the advanced stage. Currently, there is no systematic approach for early diagnosis of gastric cancer. to develop a fuzzy expert system that can identify gastric cancer risk levels in individuals. This system was implemented in MATLAB software, Mamdani inference technique applied to simulate reasoning of experts in the field, a total of 67 fuzzy rules extracted as a rule-base based on medical expert's opinion. 50 case scenarios were used to evaluate the system, the information of case reports is given to the system to find risk level of each case report then obtained results were compared with expert's diagnosis. Results revealed that sensitivity was 92.1% and the specificity was 83.1%. The results show that is possible to develop a system that can identify High risk individuals for gastric cancer. The system can lead to earlier diagnosis, this may facilitate early treatment and reduce gastric cancer mortality rate.

Primary Lung Signet Ring Cell Carcinoma Presenting as a Cavitary Pancoast Tumor in a 32-Year-Old Man.

PubMed

Corvini, Michael; Koorji, Alysha; Sgroe, Erica; Nguyen, Uyen

2018-06-01

Signet ring cell carcinoma, a subtype of adenocarcinoma, is a rare cause of primary lung cancer. The authors report a case of primary lung signet ring cell carcinoma presenting as a cavitary Pancoast tumor in a 32-year-old male smoker. Beyond the rarity of primary lung signet ring cell carcinoma itself, the youth of the patient, his smoking status, the presence of cavitation, and the location of the tumor in the superior sulcus make it especially atypical.

Transmutation Fuel Fabrication-Fiscal Year 2016

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

Fielding, Randall Sidney; Grover, Blair Kenneth

ABSTRACT Nearly all of the metallic fuel that has been irradiated and characterized by the Advanced Fuel Campaign, and its earlier predecessors, has been arc cast. Arc casting is a very flexible method of casting lab scale quantities of materials. Although the method offers flexibility, it is an operator dependent process. Small changes in parameter space or alloy composition may affect how the material is cast. This report provides a historical insight in how the casting process has been modified over the history of the advanced fuels campaign as well as the physical parameters of the fuels cast in fiscalmore » year 2016.« less

Historical Improvements in Well-Being Do Not Hold in Late Life: Birth- and Death-Year Cohorts in the US and Germany

PubMed Central

Hülür, Gizem; Ram, Nilam; Gerstorf, Denis

2015-01-01

One key objective of lifespan research is to examine how individual development is shaped by the historical time people live in. Secular trends favoring later-born cohorts on fluid cognitive abilities have been widely documented, but findings are mixed for well-being. It remains an open question whether secular increases in well-being seen in earlier phases of life also manifest in the last years of life. To examine this possibility, we made use of longitudinal data obtained from the mid 1980s until the late 2000s in two large national samples in the US (Health and Retirement Study, HRS) and Germany (German Socio-Economic Panel, SOEP). We operationally defined historical time from two complementary perspectives: birth-year cohorts based on the years people were born (earlier: 1930s vs. later: 1940s); and death-year cohorts based on the years people died (earlier: 1990s vs. later: 2000s). To control for relevant covariates, we used case-matched groups based on age (at death) and education and covaried for gender, health, and number of observations. Results from both countries revealed that well-being in old age was indeed developing at higher levels among later-born cohorts. However, for later-deceased cohorts, no evidence for secular increases in well-being was found. To the contrary, later-dying SOEP participants reported lower levels of well-being at age 75 years and 2 years prior to death and experienced steeper late-life declines. Our results suggest that secular increases in well-being observed in old age do not manifest in late-life where “manufactured” survival may be exacerbating age- and mortality-related declines. PMID:26098582

Revisiting the southern pine growth decline: Where are we 10 years later?

Treesearch

Gary L. Gadbury; Michael S. Williams; Hans T. Schreuder

2004-01-01

This paper evaluates changes in growth of pine stands in the state of Georgia, U.S.A., using USDA Forest Service Forest Inventory and Analysis (FIA) data. In particular, data representing an additional 10-year growth cy-cle has been added to previously published results from two earlier growth cycles. A robust regression procedure is combined with a bootstrap technique...

A 72-year-old woman with an uncorrected tetralogy of Fallot presenting with possible pulmonary endocarditis: a case report

PubMed Central

2013-01-01

Introduction Tetralogy of Fallot is one of the most common forms of cyanotic congenital heart disease and in the absence of surgical correction it has an elevated early mortality, with most patients dying in childhood. The authors reported this case because of the unusual course of an uncorrected tetralogy of Fallot. There are only a few reports of patients with an uncorrected tetralogy of Fallot who reach an advanced age and to the best of our knowledge this is the first case report of a possible endocarditis in a patient with an uncorrected tetralogy of Fallot who is older than 70 years. Case presentation The authors present a case of a 72-year-old Caucasian woman with uncorrected tetralogy of Fallot who was admitted with fever and heart failure to our Cardiology Department with possible infective endocarditis. Conclusions The longevity of this patient is probably due to the association between a large ventricular septal defect, a balanced subpulmonary stenosis and to the presence of systemic hypertension. After empiric antibiotic therapy, the patient was discharged and no surgical intervention was performed due to her previous benign evolution. PMID:23725101

Rathke cleft cyst in seven-year-old girl presenting with central diabetes insipidus and review of literature.

PubMed

Evliyaoglu, Olcay; Evliyaoglu, Cetin; Ayva, Sebnem

2010-05-01

Rathke cleft cysts (RCC) are benign cysts derived from remnants of Rathke cleft, and are rarely symptomatic in children. Symptoms due to RCC are associated with mass effect and pituitary hormone deficiencies. Slow growth rate of the cyst makes its incidence increase with aging. Here we report on a seven-year-old girl who presented with central diabetes insipidus (CDI). Her sella MRI revealed a lesion in the sellar region which grew rapidly in follow-up. She underwent microneurosurgical operation and the lesion was totally excised. Pathologic examination revealed RCC with degenerative changes. In her follow-up, growth hormone deficiency developed in addition to arginine vasopressin deficiency. Rapid growth of the cyst is not the usual course of RCC's. Mechanisms regarding the cyst growth are unclear as they are in this case. This is the youngest child to date presenting with central diabetes insipidus due to RCC. Rapid growth of RCC can cause CDI in young children.

Adiposity, Dysmetabolic Traits, and Earlier Onset of Female Puberty in Adolescent Offspring of Women With Gestational Diabetes Mellitus: A Clinical Study Within the Danish National Birth Cohort.

PubMed

Grunnet, Louise G; Hansen, Susanne; Hjort, Line; Madsen, Camilla M; Kampmann, Freja B; Thuesen, Anne Cathrine B; Granstrømi, Charlotta; Strøm, Marin; Maslova, Ekaterina; Frikke-Schmidt, Ruth; Damm, Peter; Chavarro, Jorge E; Hu, Frank B; Olsen, Sjurdur F; Vaag, Allan

2017-12-01

Offspring of pregnancies affected by gestational diabetes mellitus (GDM) are at increased risk of the development of type 2 diabetes. However, the extent to which these dysmetabolic traits may be due to offspring and/or maternal adiposity is unknown. We examined body composition and associated cardiometabolic traits in 561 9- to 16-year-old offspring of mothers with GDM and 597 control offspring. We measured anthropometric characteristics; puberty status; blood pressure; and fasting glucose, insulin, C-peptide, and lipid levels; and conducted a DEXA scan in a subset of the cohort. Differences in the outcomes between offspring of mothers with GDM and control subjects were examined using linear and logistic regression models. After adjustment for age and sex, offspring of mothers with GDM displayed higher weight, BMI, waist-to-hip ratio (WHR), systolic blood pressure, and resting heart rate and lower height. Offspring of mothers with GDM had higher total and abdominal fat percentages and lower muscle mass percentages, but these differences disappeared after correction for offspring BMI. The offspring of mothers with GDM displayed higher fasting plasma glucose, insulin, C-peptide, HOMA-insulin resistance (IR), and plasma triglyceride levels, whereas fasting plasma HDL cholesterol levels were decreased. Female offspring of mothers with GDM had an earlier onset of puberty than control offspring. Offspring of mothers with GDM had significantly higher BMI, WHR, fasting glucose, and HOMA-IR levels after adjustment for maternal prepregnancy BMI, and glucose and HOMA-IR remained elevated in the offspring of mothers with GDM after correction for both maternal and offspring BMIs. In summary, adolescent offspring of women with GDM show increased adiposity, an adverse cardiometabolic profile, and earlier onset of puberty among girls. Increased fasting glucose and HOMA-IR levels among the offspring of mothers with GDM may be explained by the programming effects of hyperglycemia

Embryo recovery from mares exposed to a year-to-year artificially prolonged daylength.

PubMed

Kot, K; Tischner, M

1991-09-01

The aim of the experiment was to determine the effect of a year-to-year prolonged daylength on the patterns of equine reproductive activity and results of embryo recovery. Experiments using Konik Polski mares were conducted over four reproduction seasons. Five mares were exposed to a regimen of artificially prolonged daylength (APD) and another five mares in a control group were kept under conditions of natural daylight. Both the control and experimental groups were examined for appearance of estrus, ovulation and also for the state of their coats. A single stallion was used for breeding all of the mares. The embryos were recovered nonsurgically 6 to 9 days after ovulation. All of the mares exposed to APD showed increased ovarian activity, which commenced earlier than in the control group. About 19% more ovulations were detected in the experimental group. The average number of ovulations per lighted mare per year was 15.3, while in the control group it was 12.4 ovulations (P<0.05). However, the embryo recovery rate and total number of embryos obtained from the mares exposed to APD did not exceed the number of embryos collected from the control mares (P<0.05). Modification of daylength had a visible effect on the mares by producing a change in their coats.

Challenging a dogma: five-year survival does not equal cure in all colorectal cancer patients.

PubMed

Abdel-Rahman, Omar

2018-02-01

The current study tried to evaluate the factors affecting 10- to 20- years' survival among long term survivors (>5 years) of colorectal cancer (CRC). Surveillance, Epidemiology and End Results (SEER) database (1988-2008) was queried through SEER*Stat program.Univariate probability of overall and cancer-specific survival was determined and the difference between groups was examined. Multivariate analysis for factors affecting overall and cancer-specific survival was also conducted. Among node positive patients (Dukes C), 34% of the deaths beyond 5 years can be attributed to CRC; while among M1 patients, 63% of the deaths beyond 5 years can be attributed to CRC. The following factors were predictors of better overall survival in multivariate analysis: younger age, white race (versus black race), female gender, Right colon location (versus rectal location), earlier stage and surgery (P <0.0001 for all parameters). Similarly, the following factors were predictors of better cancer-specific survival in multivariate analysis: younger age, white race (versus black race), female gender, Right colon location (versus left colon and rectal locations), earlier stage and surgery (P <0.0001 for all parameters). Among node positive long-term CRC survivors, more than one third of all deaths can be attributed to CRC.

Does objectively assessed sleep at five years predict sleep and psychological functioning at 14 years? - Hmm, yes and no!

PubMed

Brand, Serge; Hatzinger, Martin; Stadler, Christina; Bolten, Margarete; von Wyl, Agnes; Perren, Sonja; von Klitzing, Kai; Stadelmann, Stephanie; Holsboer-Trachsler, Edith

2015-01-01

We tested the hypothesis that objectively assessed sleep at kindergarten level predicts sleep and psychological functioning in adolescence. Thirty-seven adolescents aged 14 years (SD = 1.3), of 67 participants assessed as preschoolers, took part in a follow-up study nine years later. Participants completed a series of questionnaires related to sleep and psychological functioning. Sleep-EEG clusters of poor, normal and good sleepers assessed as children nine years earlier were used as predictors for subjective sleep and psychological functioning in adolescence. At the age of 14, those who were normal and good sleepers rather than poor sleepers at the age of five had more positive psychological functioning on dimensions including mental toughness, peer relationship, self-esteem, and perceived stress, but did not differ in current sleep patterns. Objectively assessed sleep patterns at the age of five are predictive of aspects of psychological functioning during adolescence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Can maintaining cognitive function at 65 years old predict successful ageing 6 years later? The PROOF study.

PubMed

Castro-Lionard, Karine; Thomas-Antérion, Catherine; Crawford-Achour, Emilie; Rouch, Isabelle; Trombert-Paviot, Béatrice; Barthélémy, Jean-Claude; Laurent, Bernard; Roche, Frédéric; Gonthier, Régis

2011-03-01

preservation of cognitive abilities is required to have a good quality of life. The predictive value of cognitive functioning at 65 years old on successful ageing 6 years later is not established. nine hundred and seventy-six questionnaires were sent by mail to a sample of healthy and voluntary French pensioners. Successful ageing was defined through health status and well-being. Cognitive abilities had been assessed 6 years earlier according to an objective method (Free and Cued Selective Recall Reminding Test (FCSRT), the Benton visual retention test and the similarities subtest of the Wechsler Adult Intelligence Scale-Revised) and a subjective one (Goldberg's anxiety scale, Mac Nair's scale and a Visual Analogue Scale to evaluate memory abilities change in the last 5 years). six hundred and eighty-six questionnaires could be analysed. The mean age was 72.9 ± 1.2 years old with 59% of women and 99% lived at home. Well-being was negatively correlated with the FCSRT (r = -0.08, P = 0.0318) but positively related with the Benton (r = 0.09, P = 0.0125) and the similarities tests (r = 0.09, P = 0.0118). There is a negative correlation between anxious and cognitive complaints measured at baseline, and successful ageing indicators 6 years later. preservation of cognitive abilities at the age of retirement can predict a successful ageing 6 years later. ClinicalTrials.gov Identifier: NCT00759304.

Ravitch Lays Out Change of Heart on Earlier Ideas

ERIC Educational Resources Information Center

Viadero, Debra

2010-01-01

Once a passionate advocate for injecting greater competition and accountability into the U.S. education system, the New York University scholar Diane Ravitch realized three years ago that her views had evolved to a point where she was contradicting herself on a regular basis. Like any good historian, she decided to set the record straight. Her…

Reanalysis of the occurrence of back pain among construction workers: modelling for the interdependent effects of heavy physical work, earlier back accidents, and aging.

PubMed

Nurminen, M

1997-11-01

To re-examine the relation between heavy physical work and the occurrence of sciatic pain among construction workers reported previously to be absent in an epidemiological study. METHODS-Poisson log linear regression was used to model for the frequency of sciatic pain among concrete reinforcement workers and maintenance house painters with adjustment for the interactive effects of earlier back accidents and aging that modified the relation. Concrete reinforcement work not only had a direct effect on the frequency of sciatic pain, but it also contributed significantly to the risk indirectly through earlier back accidents. The risk of sciatic pain increased from age 25 to 54 in a different manner for a worker depending on his occupational group and record of back accidents. Epidemiological studies on low back pain need to be analysed with sound methodology. This is important in view of future meta-analyses that will be performed for the purpose of providing guidelines on the prevention of back disorders in heavy physical work.

Fiscal year 1993 scientific and technical reports, articles, papers, and presentations

NASA Technical Reports Server (NTRS)

Turner, Joyce E. (Compiler)

1993-01-01

This document presents formal NASA technical reports, papers published in technical journals, and presentations by MSFC personnel in FY93. It also includes papers of MSFC contractors. After being announced in STAR, all of the NASA series reports may be obtained from the National Technical Information Service, 5285 Port Royal Road, Springfield, VA 22161. The information in this report may be of value to the scientific and engineering community in determining what information has been published and what is available.

Do Autistic Symptoms Persist across Time? Evidence of Substantial Change in Symptomatology over a 3-Year Period in Cognitively Able Children with Autism

ERIC Educational Resources Information Center

Pellicano, Elizabeth

2012-01-01

This study investigated the extent and nature of changes in symptomatology in cognitively able children with autism over a 3-year period. Thirty-seven children diagnosed with an autism spectrum condition involved in an earlier study (M age = 5 years, 7 months) were followed and reassessed 3 years later (M age = 8 years, 4 months). Scores on the…

Cell refractive index for cell biology and disease diagnosis: past, present and future.

PubMed

Liu, P Y; Chin, L K; Ser, W; Chen, H F; Hsieh, C-M; Lee, C-H; Sung, K-B; Ayi, T C; Yap, P H; Liedberg, B; Wang, K; Bourouina, T; Leprince-Wang, Y

2016-02-21

Cell refractive index is a key biophysical parameter, which has been extensively studied. It is correlated with other cell biophysical properties including mechanical, electrical and optical properties, and not only represents the intracellular mass and concentration of a cell, but also provides important insight for various biological models. Measurement techniques developed earlier only measure the effective refractive index of a cell or a cell suspension, providing only limited information on cell refractive index and hence hindering its in-depth analysis and correlation. Recently, the emergence of microfluidic, photonic and imaging technologies has enabled the manipulation of a single cell and the 3D refractive index of a single cell down to sub-micron resolution, providing powerful tools to study cells based on refractive index. In this review, we provide an overview of cell refractive index models and measurement techniques including microfluidic chip-based techniques for the last 50 years, present the applications and significance of cell refractive index in cell biology, hematology, and pathology, and discuss future research trends in the field, including 3D imaging methods, integration with microfluidics and potential applications in new and breakthrough research areas.

Fiscal Year 2001 Medicaid Home and Community-Based Services Expenditures Exceed Those of ICFs/MR.

ERIC Educational Resources Information Center

Lakin, K. Charlie; Prouty, Robert; Smith, Jerra; Polister, Barb; Smith, Gary

2002-01-01

This article reports that in 2001, for the first time since its creation 20 years earlier, Medicaid Home and Community-Based Services (HCBS) Waiver programs for persons with intellectual and developmental disabilities had Federal and state expenditures that exceeded those for Medicaid Intermediate Care Facilities for Persons with Mental…

Three-year-olds obey the sample size principle of induction: the influence of evidence presentation and sample size disparity on young children's generalizations.

PubMed

Lawson, Chris A

2014-07-01

Three experiments with 81 3-year-olds (M=3.62years) examined the conditions that enable young children to use the sample size principle (SSP) of induction-the inductive rule that facilitates generalizations from large rather than small samples of evidence. In Experiment 1, children exhibited the SSP when exemplars were presented sequentially but not when exemplars were presented simultaneously. Results from Experiment 3 suggest that the advantage of sequential presentation is not due to the additional time to process the available input from the two samples but instead may be linked to better memory for specific individuals in the large sample. In addition, findings from Experiments 1 and 2 suggest that adherence to the SSP is mediated by the disparity between presented samples. Overall, these results reveal that the SSP appears early in development and is guided by basic cognitive processes triggered during the acquisition of input. Copyright © 2013 Elsevier Inc. All rights reserved.

prevalence and causes of blindness and low vision revisited after 5 years of eye care in Timor-Leste.

PubMed

Ramke, Jacqueline; Brian, Garry; Naduvilath, Thomas; Lee, Lucy; Qoqonokana, Mundi Qalo

2012-04-01

To estimate the 2010 prevalence and causes of blindness and low vision among Timor-Leste adults aged ≥40 years, and compare these to the results of a survey conducted 5 years previously. A population-based cross-sectional survey used multistage cluster random sampling proportionate to size to identify 50 clusters of 45 people each. Cause of vision loss was determined for each eye with presenting visual acuity worse than 6/18. A participation rate of 89.5% (n = 2014) was achieved. The gender-age-domicile adjusted prevalence was 7.7% (95% confidence interval [CI] 6.5, 8.8) for 6/60, and 3.6% (95% CI 2.7, 4.4) for 3/60 blindness (better eye presenting vision worse than 6/60 and 3/60, respectively) among Timorese aged ≥40 years. Cataract caused most blindness (69.3% at 6/60). The population prevalence of low vision (better eye presenting vision of 6/60 or better, but worse than 6/18) was 13.6% (95%CI 12.1, 15.1), most caused by uncorrected refractive error (57.4%) or cataract (39.5%). The prevalence and causes of blindness were unchanged compared with 5 years earlier, but low vision was less common. Unusually for a developing country, Timor-Leste has initiated a cycle of evidence-based eye care in which, although with limitations, population data are periodically available for monitoring and planning.

Complementary functions of the two brain hemispheres: comparisons with earlier conceptions and implications for individual and society.

PubMed

Zeier, H

1989-07-01

The concept of different functions for the left and right cerebral hemispheres coincides in an astonishing way with earlier philosophical and psychological work which divided the human mind into two complementary functions without having a neurophysiological explanation. Representative are the ideas of Fichte, Hegel and Jung. The latter postulated the two subsystems Ego and Self and associated the conscious functions of the Ego with the intellect, the capacity for rational thought, and the Self with the mind, which also includes the emotional feelings. For the harmonic development and self-realization of man the functions of both systems in complementary interaction are required. Therefore, the current overaccentuation of the intellect and of progress directed technical-scientific thinking should be corrected by making better use of the much neglected functions of the right hemisphere.

Clinical presentation of intraocular retinoblastoma; 5-year hospital-based registry in Egypt.

PubMed

El Zomor, Hossam; Nour, Radwa; Alieldin, Adel; Taha, Hala; Montasr, Mohamed M; Moussa, Emad; El Nadi, Enas; Ezzat, Sameera; Alfaar, Ahmad S

2015-12-01

To study the presenting signs of Retinoblastoma in Egypt at Egypt's main pediatric oncology referral center. This is a prospective descriptive study (hospital-based registry) conducted at Children's Cancer Hospital Egypt between July 2007 and December 2012. Out of 262 patients diagnosed with retinoblastoma, 244 were suffering from intra-ocular disease at presentation. One hundred thirty-nine (57%) patients presented with unilateral disease, while 105 (43%) suffered bilateral disease. The mean age at presentation was 20.6 ± 17 months, averaging 18.87 ± 11.76 months for bilateral and 25.72 ± 18.78 months for unilateral disease. The most common clinical presentation was leukocoria in 180 (73.8%) patients, strabismus in 32 (13.1%) patients and decreased visual acuity in 12 (4.9%) patients. Group D and E disease represented 62% of all affected eyes. Patients with advanced disease (Group C-E) had longer duration of symptoms. In Egypt, retinoblastoma patients present more frequently with advanced disease. There is an ever-increasing need to develop a national team dedicated to studying disease significance and formulating a national awareness program. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Heuweltjies (earth mounds) in the Clanwilliam district, Cape Province, South Africa: 4000-year-old termite nests.

PubMed

Moore, J M; Picker, M D

1991-05-01

Examination of eroded and intact earth mounds in the Clanwilliam district, South Africa, indicates that they are well-established active termitaria of the harvester termite Microhodotermes viator. Unoccupied lower portions of the mounds contain ubiquitous trace-fossil evidence of earlier inhabitation by the same species. Previous studies indicating that fossorial molerats played a major role in the formation of the mounds are not supported by the observations presented here. Calcretization of the basal parts of the earth mounds has been caused by groundwater interaction with the more alkaline mound soil. 14 C dating of this calcrete indicates that the earth mounds have been in existence for at least 4000 years, an order of magnitude greater than any previously recorded longevity for termitarium inhabitation.

Calcified Suprasellar Xanthogranuloma Presenting with Primary Amenorrhea in a 17-Year-Old Girl: Case Report and Literature Review.

PubMed

Ben Nsir, Atef; Thai, Quoc-Anh; Chaieb, Larbi; Jemel, Hafedh

2015-09-01

Xanthogranuloma, also known as cholesterol granuloma, is an extremely rare intracranial neoplasm most commonly located in the middle ear, petrous apex, or choroid plexus. Exclusively suprasellar xanthogranulomas are exceptional and this report presents a very rare case in the pediatric population, particularly unique due to the presence of calcification. A 17-year-old girl presented with primary amenorrhea with computed tomography and magnetic resonance imaging showing a large calcified enhancing suprasellar mass, which was presumptively diagnosed as a craniopharyngioma on the basis of its clinical and radiologic appearance. Gross total resection of a well-encapsulated, exclusively suprasellar tumor was achieved, without postoperative neurologic deficits. Histologic examination found fibrous tissue with abundant cholesterol clefts, multinucleated giant cells, and hemosiderin deposits but no epithelial cells. The final histologic diagnosis was a xanthogranuloma. Xanthogranuloma, although extremely rare in the pediatric population, may present as a calcified suprasellar mass and manifest with primary amenorrhea. The prognosis after gross total resection is likely favorable; however, long-term follow-up is indicated for these rare neoplasms. Copyright © 2015 Elsevier Inc. All rights reserved.

Incidence of right-sided colonic tumors (non-appendiceal) in patient's ≥40 years of age presenting with features of acute appendicitis.

PubMed

Khan, Suhail Aslam; Khokhar, Haseeb Anwar; Nasr, A R H; Carton, Eleanor

2013-01-01

Non-appendiceal tumors can mimic and present with clinical features of acute appendicitis in patients of age 40 years or above. The aim of this prospective study is to investigate the incidence of right-sided (non-appendiceal) colonic tumors in patients presenting with clinical features of acute appendicitis. A prospective data analysis of 1662 patients using appendectomy database was performed from 2005 to 2011. Patients above age 40 years or older were included. Patients were compared for demographic data, clinical presentation, radiological findings, operative technique & findings, histo-pathological findings and postoperative complications. The primary outcome was incidence of right-sided colonic (non-appendiceal) tumors presenting with features of acute appendicitis. Secondary outcomes measured were, role of diagnostic radiology, negative appendectomy rate, length of stay and changing trends in operative techniques. From 1662 patients initially reviewed, only 179 patients (10.77%) age 40 years or above mean (56 ± 11.75), median 54 (40-89), with clinical features of acute appendicitis were included in the final analysis. F:M ratio was (1:1.06). CT scan showed in only 1 patient (1.25%, OR = 0.806, p = 0.695), suspicion of cecal tumor and underwent right hemicolectomy. Histological examination of specimen showed, 2 patients (1.11%, OR = 1.10, p = 0.47) had primary appendiceal tumors, in which one patient was histologically reported as appendiceal mucocele (mucinous cystadenoma with low-grade dysplasia), while the other one had appendeceal carcinoid (Goblet cell carcinoid). In the other tumor group one patient had metastatic involvement of appendix from ovarian tumor. The time to appendectomy in radiological group was delayed by (9.2 ± 3.7 h). 131 (73.1%) had laparoscopic while 48 (26.81%) underwent open appendectomy. The negative appendectomy rate was (1.12%) and 30 days complication rate was (11.73%, p = 0.27). Mean length of stay was 3.54�

Analysis of 3800-year-old Yersinia pestis genomes suggests Bronze Age origin for bubonic plague.

PubMed

Spyrou, Maria A; Tukhbatova, Rezeda I; Wang, Chuan-Chao; Valtueña, Aida Andrades; Lankapalli, Aditya K; Kondrashin, Vitaly V; Tsybin, Victor A; Khokhlov, Aleksandr; Kühnert, Denise; Herbig, Alexander; Bos, Kirsten I; Krause, Johannes

2018-06-08

The origin of Yersinia pestis and the early stages of its evolution are fundamental subjects of investigation given its high virulence and mortality that resulted from past pandemics. Although the earliest evidence of Y. pestis infections in humans has been identified in Late Neolithic/Bronze Age Eurasia (LNBA 5000-3500y BP), these strains lack key genetic components required for flea adaptation, thus making their mode of transmission and disease presentation in humans unclear. Here, we reconstruct ancient Y. pestis genomes from individuals associated with the Late Bronze Age period (~3800 BP) in the Samara region of modern-day Russia. We show clear distinctions between our new strains and the LNBA lineage, and suggest that the full ability for flea-mediated transmission causing bubonic plague evolved more than 1000 years earlier than previously suggested. Finally, we propose that several Y. pestis lineages were established during the Bronze Age, some of which persist to the present day.

Sialolipoma of parotid gland in a 1-year-old male child: A case report and review of literature

PubMed Central

Arakeri, Surekha Ulhas; Banga, Shilpi

2018-01-01

Sialolipoma is a recently described rare histological variant of lipoma, characterized by well-demarcated proliferation of mature adipocytes with secondary entrapment of salivary gland elements. Less than forty cases of sialolipoma have been reported in English literature. This tumor has been reported both in major and minor salivary glands, with the parotid gland being the most common site. Age incidence in this tumor varies from 0 month to 84 years. However, the occurrence of this tumor in an infant is very rare. In the published literature, the size of this tumor varied from 1 to 7 cm. In the present case, the tumor size was >7 cm. To the best of our knowledge, congenital sialolipoma >7 cm has been rarely reported earlier. Hence, this case is presented because of its rarity and unusual gross appearance. PMID:29491607

Life: the first two billion years

PubMed Central

Bergmann, Kristin D.; Strauss, Justin V.

2016-01-01

Microfossils, stromatolites, preserved lipids and biologically informative isotopic ratios provide a substantial record of bacterial diversity and biogeochemical cycles in Proterozoic (2500–541 Ma) oceans that can be interpreted, at least broadly, in terms of present-day organisms and metabolic processes. Archean (more than 2500 Ma) sedimentary rocks add at least a billion years to the recorded history of life, with sedimentological and biogeochemical evidence for life at 3500 Ma, and possibly earlier; phylogenetic and functional details, however, are limited. Geochemistry provides a major constraint on early evolution, indicating that the first bacteria were shaped by anoxic environments, with distinct patterns of major and micronutrient availability. Archean rocks appear to record the Earth's first iron age, with reduced Fe as the principal electron donor for photosynthesis, oxidized Fe the most abundant terminal electron acceptor for respiration, and Fe a key cofactor in proteins. With the permanent oxygenation of the atmosphere and surface ocean ca 2400 Ma, photic zone O2 limited the access of photosynthetic bacteria to electron donors other than water, while expanding the inventory of oxidants available for respiration and chemoautotrophy. Thus, halfway through Earth history, the microbial underpinnings of modern marine ecosystems began to take shape. This article is part of the themed issue ‘The new bacteriology’. PMID:27672146

CLINICAL PRESENTATION AND DISEASE COURSE OF USHER SYNDROME BECAUSE OF MUTATIONS IN MYO7A OR USH2A.

PubMed

Testa, Francesco; Melillo, Paolo; Bonnet, Crystel; Marcelli, Vincenzo; de Benedictis, Antonella; Colucci, Raffaella; Gallo, Beatrice; Kurtenbach, Anne; Rossi, Settimio; Marciano, Elio; Auricchio, Alberto; Petit, Christine; Zrenner, Eberhart; Simonelli, Francesca

2017-08-01

To evaluate differences in the visual phenotype and natural history of Usher syndrome caused by mutations in MYO7A or USH2A, the most commonly affected genes of Usher syndrome Type I (USH1) and Type II (USH2), respectively. Eighty-eight patients with a clinical diagnosis of USH1 (26 patients) or USH2 (62 patients) were retrospectively evaluated. Of these, 48 patients had 2 disease-causing mutations in MYO7A (10 USH1 patients), USH2A (33 USH2 patients), and other USH (5 patients) genes. Clinical investigation included best-corrected visual acuity, Goldmann visual field, fundus photography, electroretinography, and audiologic and vestibular assessments. Longitudinal analysis was performed over a median follow-up time of 3.5 years. Patients carrying mutations in MYO7A had a younger age of onset of hearing and visual impairments than those carrying mutations in USH2A, leading to an earlier diagnosis of the disease in the former patients. Longitudinal analysis showed that visual acuity and visual field decreased more rapidly in subjects carrying MYO7A mutations than in those carrying USH2A mutations (mean annual exponential rates of decline of 3.92 vs. 3.44% and of 8.52 vs. 4.97%, respectively), and the former patients reached legal blindness on average 15 years earlier than the latter. The current study confirmed a more severe progression of the retinal disease in USH1 patients rather than in USH2 patients. Furthermore, most visual symptoms (i.e., night blindness, visual acuity worsening) occurred at an earlier age in USH1 patients carrying mutations in MYO7A.

Retained Textile Foreign Bodies: Experience of 27 Years.

PubMed

Arikan, Soykan; Kocakusak, Ahmet

2015-01-01

Retained intracorporeal textile products (gossypiboma-textiloma) are undesired and accidental surgical results for both patients and surgeons, which are underreported because of medicolegal remifications. Fourteen textiloma cases, who had been treated or whose treatment procedures had been followed-up personally by two general surgeons in a period of 27 years almost during their whole professional lives were presented to describe and define the clinical and pathological characteristics. Patient characteristics including gender and age, areas of location within the body, time intervals until diagnosis, clinical presentations and complaints, treatment modalities, complications, causative surgical interventions, and diagnostic approaches were retrospectively evaluated. Nine female and five male patients with a mean age of 43.07 ± 15.23 (median: 45) years at diagnosis were enrolled in the study. Cesarean section in three, inguinal hernioraphy in four, explorative laparotomy because of acute abdomen in one, sigmoid colon resection in one, appendectomy and right salpingoophorectomy in one, etrangulated incisional hernia after a previous surgical intervention because of an ovarian mass in one, thyroidectomy in one, epigastric hernioraphy in one, and bilateral segmental mastectomy with bilateral axillary sentinal lymph node dissection in one were the causative surgical interventions. Locations of textilomas were the abdominal cavity in seven, inguinal surgical wound in four, epigastric surgical wound in one, thyroidectomy lodge in one, and bilateral axillary cavities in one patient. The mean time interval until diagnosis was 14.48 (median: 5.5) months. Earlier recognition of foreign bodies can provide a better outcome. Gossypibomas are preventable iatrogenic faults which create severe problems. Strict adherence to the rules of the operation room is a must to keep the tip of the iceberg shut in the Pandora's box.

Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience.

PubMed

Tang, I P; Lee, S C; Shashinder, S; Raman, R

2009-06-01

This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.

Diagnosis of a 64-year-old patient presenting with suspected lumbar spinal stenosis: an evidence-based case report

PubMed Central

Emary, Peter C.

2015-01-01

Objective: To present an evidence-based case report on the diagnosis of a patient with suspected lumbar spinal stenosis (LSS). Case: A 64-year-old man presented with signs and symptoms suggestive of LSS, but physical examination and diagnostic imaging findings were inconclusive. Other co-morbidities included diabetes, congestive heart failure, and left hip joint osteoarthritis. Outcome: PubMed was searched for systematic reviews of diagnostic studies on LSS. Two recent articles were found and appraised with respect to their validity, importance, and applicability in diagnosing the current patient. Copies of his magnetic resonance imaging were also obtained and used in combination with the appraised literature, including diagnostic test specificities and likelihood ratios, to confirm an LSS diagnosis. Summary: This case illustrates how research evidence can be used in clinical practice, particularly in the diagnosis of an individual patient. PMID:25729085

Effects of soil and foliar applications of nitrogen fertilizers on a 20-year-old Douglas-fir stand

Treesearch

Richard E. Miller; Steve. Wert

1979-01-01

We compared growth and cone production of Douglas-fir treated 4 years earlier with ISO pounds N per acre applied as urea prill by hand and as a 32-percent N solution applied by helicopter. Nitrogen fertilization increased growth by 3 88 ft per acre during the 4 years after treatment; this 3S-percent gain was similar for both soil (prill) and foliar (solution)...

Infliximab for uveitis of Behçet's syndrome: a trend for earlier initiation.

PubMed

Guzelant, Gul; Ucar, Didar; Esatoglu, Sinem Nihal; Hatemi, Gulen; Ozyazgan, Yilmaz; Yurdakul, Sebahattin; Seyahi, Emire; Yazici, Hasan; Hamuryudan, Vedat

2017-01-01

The prognosis of uveitis in Behçet's syndrome (BS) has improved over decades. Whether this is related to the use of more aggressive management strategies is not known. This is a retrospective study of BS patients who received infliximab (IFX) for refractory eye disease between 2003-2015. The patients were divided into two groups according to the date of onset of in IFX treatment as before and after 2013. We compared the two groups in terms of disease characteristics at the onset of IFX treatment and response to treatment. There were 43 patients in the old and 14 patients in the new group. The duration of uveitis and previous immunosuppressive treatment before the initiation of IFX were significantly shorter in the new group compared to the old group (p=0.043 and p=0.028, respectively). The baseline visual acuity (VA) at the initiation of IFX was better in the new group, but this was only significant for the left eye. Treatment with IFX was effective in both groups in preserving VA and this was more pronounced in the new group. Attack frequency under IFX was significantly lower in the new group (p<0.001). IFX seems to be initiated earlier and also in less severe cases during the course of BS uveitis than before. Despite the few numbers of patients and relatively short duration of follow-up, our results give a hint that this change has improved the outcome.

Syphilis during 1900-1910: similarities to present-day AIDS.

PubMed

Krause, R M

1991-01-01

At the beginning of the 20th century, despite 20 years of intensive bacteriologic research, the cause of syphilis was unknown; no diagnostic test and no treatment had been found. Syphilis was one of the leading causes of morbidity and mortality, and those who had the disease were burdened with a social stigma. It was considered a disease of "bad blood." But success was soon to follow. In only 10 years, from 1900 to 1910, the Treponema pallidum was discovered as the cause of syphilis. Animal models were developed for research. The Wassermann test was "invented" for serologic diagnosis, and Paul Ehrlich proved that salvarsan, or 606, was effective for the treatment of syphilis. This success was preceded by 300 failures with related arsenical compounds. The scientific, medical, social, ethical, and economic issues of that day have recurred again with the AIDS epidemic. This earlier drama, therefore, is reflected in the current decade, but the success of Ehrlich, Wassermann, and others in the fight against syphilis is an optimistic omen that researchers will be equally successful in the fight against acquired immune deficiency syndrome (AIDS).

The Sooner, the Worse? Association between Earlier Age of Sexual Initiation and Worse Adolescent Health and Well-being Outcomes

PubMed Central

Osorio, Alfonso; Lopez-del Burgo, Cristina; Carlos, Silvia; de Irala, Jokin

2017-01-01

This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n = 1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure (“Most of my friends already had sex”), because of partner pressure (“I was afraid to lose him/her,” “My partner told me he/she would leave me” or “I did not know how to say no to a person who insisted”), or as a consequence of different forms of impaired autonomy (“I was under the influence of alcohol or drugs” or “As a consequence of seeing sexual images”). Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes. PMID:28798715

Five-year risk of interval-invasive second breast cancer.

PubMed

Lee, Janie M; Buist, Diana S M; Houssami, Nehmat; Dowling, Emily C; Halpern, Elkan F; Gazelle, G Scott; Lehman, Constance D; Henderson, Louise M; Hubbard, Rebecca A

2015-07-01

Earlier detection of second breast cancers after primary breast cancer (PBC) treatment improves survival, yet mammography is less accurate in women with prior breast cancer. The purpose of this study was to examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. We evaluated a prospective cohort of 15 114 women with 47 717 surveillance mammograms diagnosed with stage 0-II unilateral PBC from 1996 through 2008 at facilities in the Breast Cancer Surveillance Consortium. We used discrete time survival models to estimate the association between odds of an interval-invasive second breast cancer and candidate predictors, including demographic, PBC, and imaging characteristics. All statistical tests were two-sided. The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. PBC diagnosis and treatment characteristics contribute to variation in subsequent-interval second breast cancer risk. Consideration of these factors may be useful in developing tailored post-treatment imaging surveillance plans. © The Author 2015. Published by Oxford University Press. All rights reserved

The onset of star formation 250 million years after the Big Bang

NASA Astrophysics Data System (ADS)

Hashimoto, Takuya; Laporte, Nicolas; Mawatari, Ken; Ellis, Richard S.; Inoue, Akio K.; Zackrisson, Erik; Roberts-Borsani, Guido; Zheng, Wei; Tamura, Yoichi; Bauer, Franz E.; Fletcher, Thomas; Harikane, Yuichi; Hatsukade, Bunyo; Hayatsu, Natsuki H.; Matsuda, Yuichi; Matsuo, Hiroshi; Okamoto, Takashi; Ouchi, Masami; Pelló, Roser; Rydberg, Claes-Erik; Shimizu, Ikkoh; Taniguchi, Yoshiaki; Umehata, Hideki; Yoshida, Naoki

2018-05-01

A fundamental quest of modern astronomy is to locate the earliest galaxies and study how they influenced the intergalactic medium a few hundred million years after the Big Bang1-3. The abundance of star-forming galaxies is known to decline4,5 from redshifts of about 6 to 10, but a key question is the extent of star formation at even earlier times, corresponding to the period when the first galaxies might have emerged. Here we report spectroscopic observations of MACS1149-JD16, a gravitationally lensed galaxy observed when the Universe was less than four per cent of its present age. We detect an emission line of doubly ionized oxygen at a redshift of 9.1096 ± 0.0006, with an uncertainty of one standard deviation. This precisely determined redshift indicates that the red rest-frame optical colour arises from a dominant stellar component that formed about 250 million years after the Big Bang, corresponding to a redshift of about 15. Our results indicate that it may be possible to detect such early episodes of star formation in similar galaxies with future telescopes.

The onset of star formation 250 million years after the Big Bang.

PubMed

Hashimoto, Takuya; Laporte, Nicolas; Mawatari, Ken; Ellis, Richard S; Inoue, Akio K; Zackrisson, Erik; Roberts-Borsani, Guido; Zheng, Wei; Tamura, Yoichi; Bauer, Franz E; Fletcher, Thomas; Harikane, Yuichi; Hatsukade, Bunyo; Hayatsu, Natsuki H; Matsuda, Yuichi; Matsuo, Hiroshi; Okamoto, Takashi; Ouchi, Masami; Pelló, Roser; Rydberg, Claes-Erik; Shimizu, Ikkoh; Taniguchi, Yoshiaki; Umehata, Hideki; Yoshida, Naoki

2018-05-01

A fundamental quest of modern astronomy is to locate the earliest galaxies and study how they influenced the intergalactic medium a few hundred million years after the Big Bang 1-3 . The abundance of star-forming galaxies is known to decline 4,5 from redshifts of about 6 to 10, but a key question is the extent of star formation at even earlier times, corresponding to the period when the first galaxies might have emerged. Here we report spectroscopic observations of MACS1149-JD1 6 , a gravitationally lensed galaxy observed when the Universe was less than four per cent of its present age. We detect an emission line of doubly ionized oxygen at a redshift of 9.1096 ± 0.0006, with an uncertainty of one standard deviation. This precisely determined redshift indicates that the red rest-frame optical colour arises from a dominant stellar component that formed about 250 million years after the Big Bang, corresponding to a redshift of about 15. Our results indicate that it may be possible to detect such early episodes of star formation in similar galaxies with future telescopes.

Earlier response assessment in invasive aspergillosis based on the kinetics of serum Aspergillus galactomannan: proposal for a new definition.

PubMed

Nouér, Simone A; Nucci, Marcio; Kumar, Naveen Sanath; Grazziutti, Monica; Barlogie, Bart; Anaissie, Elias

2011-10-01

Current criteria for assessing treatment response of invasive aspergillosis (IA) rely on nonspecific subjective parameters. We hypothesized that an Aspergillus-specific response definition based on the kinetics of serum Aspergillus galactomannan index (GMI) would provide earlier and more objective response assessment. We compared the 6-week European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) response criteria with GMI-based response among 115 cancer patients with IA. Success according to GMI required survival with repeatedly negative GMI for ≥2 weeks. Time to response and agreement between the 2 definitions were the study endpoints. Success according to EORTC/MSG and GMI criteria was observed in 73 patients (63%) and 83 patients (72%), respectively. The GMI-based response was determined at a median of 21 days after treatment initiation (range, 15-41 days), 3 weeks before the EORTC/MSG time point, in 72 (87%) of 83 responders. Agreement between definitions was shown in all 32 nonresponders and in 73 of the 83 responders (91% overall), with an excellent κ correlation coefficient of 0.819. Among 10 patients with discordant response (EORTC/MSG failure, GMI success), 1 is alive without IA 3 years after diagnosis; for the other, aspergillosis could not be detected at autopsy. The presence of other life-threatening complications in the remaining 8 patients indicates that IA had resolved. The Aspergillus-specific GMI-based criteria compare favorably to current response definitions for IA and significantly shorten time to response assessment. These criteria rely on a simple, reproducible, objective, and Aspergillus-specific test and should serve as the primary endpoint in trials of IA.

The understanding and experience of mixed emotions in 3-5-year-old children.

PubMed

Smith, Joshua P; Glass, Daniel J; Fireman, Gary

2015-01-01

The term mixed emotions refers to the presence of two opposite-valence emotions toward a single target. Identifying when children begin to report experiencing and understanding mixed emotions is critical in identifying how skills such as adaptive functioning, coping strategies, environmental understanding, and socioemotional competence emerge. Prior research has shown that children as young as 5 years old can understand and experience mixed emotion, but perhaps appropriately sensitive methodologies can reveal these abilities in younger children. The present study evaluated 57 children between 3 and 5 years old for mixed emotion experience and understanding using an animated video clip in which a character experiences a mixed emotional episode. Ordinal logistic regression was utilized to examine the relation of gender, attention, and understanding of content to experience and understanding of mixed emotion. While only 12% of children reported experiencing mixed emotion while watching the clip, 49% of children-some as young as 3 years old-were able to recognize the mixed emotional experience of the character. Thus, mixed emotion understanding emerges earlier than previously identified and the expression of understanding may develop independently of the ability to report mixed emotion experience. These findings are discussed in relation to cognitive and developmental considerations.

Longer Duration and Earlier Age of Onset of Paternal Betel Chewing and Smoking Increase Metabolic Syndrome Risk in Human Offspring, Independently, in a Community-Based Screening Program in Taiwan.

PubMed

Yen, Amy Ming-Fang; Boucher, Barbara J; Chiu, Sherry Yueh-Hsia; Fann, Jean Ching-Yuan; Chen, Sam Li-Sheng; Huang, Kuo-Chin; Chen, Hsiu-Hsi

2016-08-02

Transgenerational effects of paternal Areca catechu nut chewing on offspring metabolic syndrome (MetS) risk in humans, on obesity and diabetes mellitus experimentally, and of paternal smoking on offspring obesity, are reported, likely attributable to genetic and epigenetic effects previously reported in betel-associated disease. We aimed to determine the effects of paternal smoking, and betel chewing, on the risks of early MetS in human offspring. The 13 179 parent-child trios identified from 238 364 Taiwanese aged ≥20 years screened at 2 community-based integrated screening sessions were tested for the effects of paternal smoking, areca nut chewing, and their duration prefatherhood on age of detecting offspring MetS at screen by using a Cox proportional hazards regression model. Offspring MetS risks increased with prefatherhood paternal areca nutusage (adjusted hazard ratio, 1.77; 95% confidence interval [CI], 1.23-2.53) versus nonchewing fathers (adjusted hazard ratio, 3.28; 95% CI, 1.67-6.43) with >10 years paternal betel chewing, 1.62 (95% CI, 0.88-2.96) for 5 to 9 years, and 1.42 (95% CI, 0.80-2.54) for <5 years betel usage prefatherhood (Ptrend=0.0002), with increased risk (adjusted hazard ratio, 1.95; 95% CI, 1.26-3.04) for paternal areca nut usage from 20 to 29 years of age, versus from >30 years of age (adjusted hazard ratio,1.61; 95% CI, 0.22-11.69). MetS offspring risk for paternal smoking increased dosewise (Ptrend<0.0001) with earlier age of onset (Ptrend=0.0009), independently. Longer duration of paternal betel quid chewing and smoking, prefatherhood, independently predicted early occurrence of incident MetS in offspring, corroborating previously reported transgenerational effects of these habits, and supporting the need for habit-cessation program provision. © 2016 American Heart Association, Inc.

Selection for Earlier Flowering Crop Associated with Climatic Variations in the Sahel

PubMed Central

Vigouroux, Yves; Mariac, Cédric; De Mita, Stéphane; Pham, Jean-Louis; Gérard, Bruno; Kapran, Issoufou; Sagnard, Fabrice; Deu, Monique; Chantereau, Jacques; Ali, Abdou; Ndjeunga, Jupiter; Luong, Viviane; Thuillet, Anne-Céline; Saïdou, Abdoul-Aziz; Bezançon, Gilles

2011-01-01

Climate changes will have an impact on food production and will require costly adaptive responses. Adapting to a changing environment will be particularly challenging in sub-Saharan Africa where climate change is expected to have a major impact. However, one important phenomenon that is often overlooked and is poorly documented is the ability of agro-systems to rapidly adapt to environmental variations. Such an adaptation could proceed by the adoption of new varieties or by the adaptation of varieties to a changing environment. In this study, we analyzed these two processes in one of the driest agro-ecosystems in Africa, the Sahel. We performed a detailed study in Niger where pearl millet is the main crop and covers 65% of the cultivated area. To assess how the agro-system is responding to recent recurrent drought, we analyzed samples of pearl millet landraces collected in the same villages in 1976 and 2003 throughout the entire cultivated area of Niger. We studied phenological and morphological differences in the 1976 and 2003 collections by comparing them over three cropping seasons in a common garden experiment. We found no major changes in the main cultivated varieties or in their genetic diversity. However, we observed a significant shift in adaptive traits. Compared to the 1976 samples, samples collected in 2003 displayed a shorter lifecycle, and a reduction in plant and spike size. We also found that an early flowering allele at the PHYC locus increased in frequency between 1976 and 2003. The increase exceeded the effect of drift and sampling, suggesting a direct effect of selection for earliness on this gene. We conclude that recurrent drought can lead to selection for earlier flowering in a major Sahelian crop. Surprisingly, these results suggest that diffusion of crop varieties is not the main driver of short term adaptation to climatic variation. PMID:21573243

Delayed Effects of Proton Irradiation in Macaca Mulatta. II. Mortality (15-Year Report).

DTIC Science & Technology

1983-01-01

Fig. 9) had significantly (p=.lO) earlier deaths in the combined sexes and the females. In these cases, death rates increased at -2 and -6 years post...while significance occurred in only the combined sexes (p<.lO). All 32-MeV males are alive. This fact increases the ability to detect higher death rates in...where the 55-MeV death rate exceeded the 32-MeV death rate after 4 years. Figures 12 and 13 indicate higher death rates in 138- and 400-MeV males (p<.lO

Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

PubMed

Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

2017-08-01

To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer

Thoracoscopic decortication for the management of trapped lung caused by 14-year pneumothorax: A case report.

PubMed

Tian, Yan; Zheng, Wenqi; Zha, Nashunbayaer; Wang, Yufei; Huang, Shaojun; Guo, Zhanlin

2018-05-26

Trapped lung is defined by the lung's inability to expand and fill the thoracic cavity because of a restricting "peel" caused by benign or malignant pleural disease. However, trapped lung secondary to pneumothorax is rarely reported. We present a case of trapped lung caused by a pneumothorax that occurred some 14 years before the patient presented to our hospital with a complaint of incapacitating dyspnea. Computed tomography (CT) scans revealed trapping of the right lung with abnormal thickening of the visceral pleura. In view of the patient's history of pneumothorax, we concluded that his dyspnea was attributable mainly to the trapping of his lung by the earlier pneumothorax. We therefore scheduled thoracoscopic decortication, which was successfully completed. The patient's recovery after the operation was uneventful, and seven weeks after surgery the right lung had re-expanded well. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Clinical presentation and outcome of riboflavin transporter deficiency: mini review after five years of experience.

PubMed

Jaeger, Bregje; Bosch, Annet M

2016-07-01

Riboflavin (vitamin B2) is absorbed in the small intestine by the human riboflavin transporters RFVT1 and RFVT3. A third riboflavin transporter (RFVT2) is expressed in the brain. In 2010 it was demonstrated that mutations in the riboflavin transporter genes SLC52A2 (coding for RFVT2) and SLC52A3 (coding for RFVT3) cause a neurodegenerative disorder formerly known as Brown-Vialetto-Van Laere (BVVL) syndrome, now renamed to riboflavin transporter deficiency. Five years after the diagnosis of the first patient we performed a review of the literature to study the presentation, treatment and outcome of patients with a molecularly confirmed diagnosis of a riboflavin transporter deficiency. A search was performed in Medline, Pubmed using the search terms 'Brown-Vialetto-Van Laere syndrome' and 'riboflavin transporter' and articles were screened for case reports of patients with a molecular diagnosis of a riboflavin transporter deficiency. Reports on a total of 70 patients with a molecular diagnosis of a RFVT2 or RTVT3 deficiency were retrieved. The riboflavin transporter deficiencies present with weakness, cranial nerve deficits including hearing loss, sensory symptoms including sensory ataxia, feeding difficulties and respiratory difficulties which are caused by a sensorimotor axonal neuropathy and cranial neuropathy. Biochemical abnormalities may be absent and the diagnosis can only be made or rejected by molecular analysis of all genes. Treatment with oral supplementation of riboflavin is lifesaving. Therefore, if a riboflavin transporter deficiency is suspected, treatment must be started immediately without first awaiting the results of molecular diagnostics.

What Happened on 9/11? Nine Years of Polling College Undergraduates: "It Was Always Just a Fact That It happened."

ERIC Educational Resources Information Center

Alkana, Linda Kelly

2011-01-01

Over nine years earlier, on September 11, 2001, the author was concerned about how young people would come to understand what came to be called "9/11." The particular history class she was teaching then and for the nine years following is a Critical thinking history class that stresses the facts and evidence that historians use, and emphasizes the…

Present principles of workers' health care organization in Poland and directions of future changes.

PubMed

Dawydzik, L; Izycki, J; Kopias, J

1993-01-01

The present-day legal regulations on workers' health care are far from satisfactory. The work on the modification of the occupational health service has been carried out for the last two years although the preparatory activities started much earlier. In May 1991, under the initiative of the Nofer Institute of Occupational Medicine in Lodz, the bill on the Labor Code has been amended so that it would regulate the employer's responsibilities with respect to providing health care for workers and to participating in respective costs. These activities have overrun the more general ones pertaining to the reform of the national health service in Poland. Under conditions of the growing free market economy the previously operated organizational system of health care for workers has become out-of-date and needs immediate modification to adjust it to the new economic situation. Evidently, the trends and rate of the policy in this respect have been considerably influenced by the more general activities to make Poland associated with the European Community and hence to develop an occupational health care system which would take into consideration the principles of the Charter of Social Rights of the EEC as well as of the ILO Conventions.

Couples groups for parents of preschoolers: ten-year outcomes of a randomized trial*

PubMed Central

Cowan, Carolyn Pape; Cowan, Philip A.; Barry, Jason

2011-01-01

This paper reports the results of a 10-year follow-up of two variations of a couples group preventive intervention offered to couples in the year before their oldest child made the transition to kindergarten. 100 couples were randomly assigned to (1) a low-dose control condition, (2) a couples group meeting for 16 weeks that focused more on couple relationship issues among other family topics, or (3) a couples group meeting for 16 weeks that focused more on parenting issues among other family issues, with an identical curriculum to condition (2). Earlier papers reported that both variations of the intervention produced positive results on parent-child relationships and on the children’s adaptation to kindergarten and 1st grade, and that the groups emphasizing couple relationships also had additional positive effects on couple interaction quality. The present paper uses growth curve analyses to examine intervention effects extending from the children’s transition to kindergarten to the transition to high school – ten years after the couples groups ended. There were 6-year positive effects of the pre-kindergarten interventions on observed couple interaction and 10-year positive effects on both parents’ marital satisfaction and the children’s adaptation (hyperactivity and aggression). Discussion includes a focus on the implications of these results for family policy, clinical practice, and the need to include a couples focus in preventive interventions to strengthen family relationships and enhance children’s adaptation to school. PMID:21480703

Occipital Condyle Syndrome as an Initial Presentation of Lung Cancer: A Case Report.

PubMed

Liu, Meng-Ta; Lin, Guan-Yu; Lin, Chun-Chieh; Cheng, Chun-An; Chen, Ming-Hua; Lee, Jiunn-Tay

2015-03-01

Occipital condyle syndrome (OCS) is a rare cause of headache. This study herein reports a case in which a unique headache and tongue deviation appear as symptoms of the first presentation of a malignant tumor. A healthy 67-year-old male presented with a unilateral shooting pain in the occipital region, accompanied by slurred speech and difficulty swallowing. Neurological examinations later revealed atrophy and mild fasciculation of the tongue. The clinical symptoms and MRI results suggested OCS. Screening for tumor markers showed an elevated CEA. The chest CT revealed a lobulated soft-tissue mass in the lower left lobe, and a CTguided biopsy confirmed the diagnosis of adenocarcinoma. A whole body bone scan found multiple foci. The adenocarcinoma was graded pT2bN3M1b, stage IV. The headache improved with a prescription of prednisone, 60 mg to be taken daily. With three months of treatment, clinical examinations showed that the patient was free of pain and that there had been no progression of the atrophy or deviation of the tongue. The possible etiology of OCS includes a primary tumor or metastatic lesion that directly invades the base of the skull. Determining the underlying causes of OCS can be challenging, but MR imaging is currently the diagnostic tool of choice. An awareness of the features of OCS in healthy adults may be able to lead to earlier diagnosis of the underlying etiology and efficient relief of the symptoms.

The Chinese Visible Human (CVH) datasets incorporate technical and imaging advances on earlier digital humans

PubMed Central

Zhang, Shao-Xiang; Heng, Pheng-Ann; Liu, Zheng-Jin; Tan, Li-Wen; Qiu, Ming-Guo; Li, Qi-Yu; Liao, Rong-Xia; Li, Kai; Cui, Gao-Yu; Guo, Yan-Li; Yang, Xiao-Ping; Liu, Guang-Jiu; Shan, Jing-Lu; Liu, Ji-Jun; Zhang, Wei-Guo; Chen, Xian-Hong; Chen, Jin-Hua; Wang, Jian; Chen, Wei; Lu, Ming; You, Jian; Pang, Xue-Li; Xiao, Hong; Xie, Yong-Ming; Cheng, Jack Chun-Yiu

2004-01-01

We report the availability of a digitized Chinese male and a digitzed Chinese female typical of the population and with no obvious abnormalities. The embalming and milling procedures incorporate three technical improvements over earlier digitized cadavers. Vascular perfusion with coloured gelatin was performed to facilitate blood vessel identification. Embalmed cadavers were embedded in gelatin and cryosectioned whole so as to avoid section loss resulting from cutting the body into smaller pieces. Milling performed at −25 °C prevented small structures (e.g. teeth, concha nasalis and articular cartilage) from falling off from the milling surface. The male image set (.tiff images each of 36 Mb) has a section resolution of 3072 × 2048 pixels (∼170 μm, the accompanying magnetic resonance imaging and computer tomography data have a resolution of 512 × 512, i.e. ∼440 μm). The Chinese Visible Human male and female datasets are available at http://www.chinesevisiblehuman.com. (The male is 90.65 Gb and female 131.04 Gb). MPEG videos of direct records of real-time volume rendering are at: http://www.cse.cuhk.edu.hk/~crc PMID:15032906

Survival and Competitiveness of Bradyrhizobium japonicum Strains 20 Years after Introduction into Field Locations in Poland

PubMed Central

Narożna, Dorota; Pudełko, Krzysztof; Króliczak, Joanna; Golińska, Barbara; Sugawara, Masayuki; Mądrzak, Cezary J.

2015-01-01

It was previously demonstrated that there are no indigenous strains of Bradyrhizobium japonicum forming nitrogen-fixing root nodule symbioses with soybean plants in arable field soils in Poland. However, bacteria currently classified within this species are present (together with Bradyrhizobium canariense) as indigenous populations of strains specific for nodulation of legumes in the Genisteae tribe. These rhizobia, infecting legumes such as lupins, are well established in Polish soils. The studies described here were based on soybean nodulation field experiments, established at the Poznań University of Life Sciences Experiment Station in Gorzyń, Poland, and initiated in the spring of 1994. Long-term research was then conducted in order to study the relation between B. japonicum USDA 110 and USDA 123, introduced together into the same location, where no soybean rhizobia were earlier detected, and nodulation and competitive success were followed over time. Here we report the extra-long-term saprophytic survival of B. japonicum strains nodulating soybeans that were introduced as inoculants 20 years earlier and where soybeans were not grown for the next 17 years. The strains remained viable and symbiotically competent, and molecular and immunochemical methods showed that the strains were undistinguishable from the original inoculum strains USDA 110 and USDA 123. We also show that the strains had balanced numbers and their mobility in soil was low. To our knowledge, this is the first report showing the extra-long-term persistence of soybean-nodulating strains introduced into Polish soils and the first analyzing the long-term competitive relations of USDA 110 and USDA 123 after the two strains, neither of which was native, were introduced into the environment almost 2 decades ago. PMID:26048934

A Mixed Presentation of Serotonin Syndrome vs Neuroleptic Malignant Syndrome in a 12-Year-Old Boy.

PubMed

Sun, Christie; Sweet, Hannah; Minns, Alicia B; Shapiro, Desiree; Jenkins, Willough

2018-04-24

Neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) are serious medical conditions associated with commonly prescribed psychiatric medications. Although the mechanisms differ, they can be clinically difficult to distinguish. We report a case of a pediatric patient with complicated psychiatric history that developed features of both syndromes in the setting of polypharmacy. A 12-year-old boy with a history of developmental delay, attention-deficit hyperactivity disorder, and posttraumatic stress disorder presented to the emergency department with behavior changes consisting of delayed reactions, gait instability, drooling, and slowed movements. Ten days before presentation, his outpatient psychiatrist had made multiple medication changes including discontinuation of cyproheptadine (an appetite stimulant) and initiation of aripiprazole. On arrival, the patient was noted to be tachycardia and hypertensive for age. He was disoriented, intermittently agitated, and tremulous with increased tonicity, clonus in the lower extremities, and mydriasis. He was supportively treated with lorazepam and intravenous fluids while discontinuing potential offending agents. His course was complicated by hypertension and agitation managed with dexmedetomidine infusion and benzodiazepines. His mental status, tremors, and laboratory values began to improve over the next 2 days, and eventually transitioned to the inpatient psychiatric unit on hospital day 7. Diagnosis of NMS or SS can be difficult when there is overlap between syndromes, particularly in the setting of multiple potential offending agents or underlying developmental delay. In addition, pediatric patients may present atypically as compared with adult patients with the same condition. The use of antipsychotic medications for young children with behavioral problems has risen dramatically in the last decade, increasing their risk for developing SS or NMS.

Self- and Peer Assessments of Oral Presentations by First-Year University Students

ERIC Educational Resources Information Center

Aryadoust, Vahid

2015-01-01

Forty science students received training for 12 weeks on delivering effective presentations and using a tertiary-level English oral presentation scale comprising three subscales (Verbal Communication, Nonverbal Communication, and Content and Organization) measured by 18 items. For their final project, each student was given 10 to 12 min to present…

Sibling Conflict in Middle Childhood: Influence of Maternal Context and Mother-Sibling Interaction over Four Years.

ERIC Educational Resources Information Center

Howe, Nina; Fiorentino, Lisa M.; Gariepy, Nadine

2003-01-01

Investigated: (1) influence of maternal context on frequency and types of conflicts of sibling dyads in middle childhood, and (2) the stability of maternal and sibling interaction over 4 years. Found that maternal presence depressed conflict frequency and aggression. Earlier patterns of family interaction were related to later indices of sibling…

Atopic conditions and mental health problems: a 3-year follow-up study.

PubMed

Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen

2010-09-01

The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.

Family-Based Treatment of a 17-Year-Old Twin Presenting with Emerging Anorexia Nervosa: A Case Study Using the "Maudsley Method"

ERIC Educational Resources Information Center

Loeb, Katharine L.; Hirsch, Alicia M.; Greif, Rebecca; Hildebrandt, Thomas B.

2009-01-01

This article describes the successful application of family-based treatment (FBT) for a 17-year-old identical twin presenting with a 4-month history of clinically significant symptoms of anorexia nervosa (AN). FBT is a manualized treatment that has been studied in randomized controlled trials for adolescents with AN. This case study illustrates…

Fiscal year 1979 scientific and technical reports, articles, papers and presentations

NASA Technical Reports Server (NTRS)

White, O. L. (Compiler)

1979-01-01

This bibliography lists approximately 590 formal NASA technical reports, papers published in technical journals, presentations by MSFC personnel, and reports of MSFC contractors introduced into the NASA scientific and technical information system in 1979.

Incidence, clinical presentation and mortality of liver cirrhosis in Southern Sweden: a 10-year population-based study.

PubMed

Nilsson, E; Anderson, H; Sargenti, K; Lindgren, S; Prytz, H

2016-06-01

In Sweden, the most common causes of liver cirrhosis are alcohol overconsumption and hepatitis C. However, recent data on the clinical characteristics of Swedish patients with cirrhosis are scarce. To determine the incidence, clinical presentation, aetiological spectrum and survival rates of liver cirrhosis in Southern Sweden from 2001 to 2011. We used population-based medical registries to conduct a cohort study of all patients with liver cirrhosis in the southernmost region of Sweden with a population of 1.17 million. Medical records and histopathology data were reviewed. Patients were classified according to aetiology, and clinical parameters were registered. Patients were followed until death or December 2014. A total of 1317 patients with cirrhosis were identified. The crude annual incidence of cirrhosis was estimated at 14.1/100 000. The most common aetiology was alcohol overconsumption with or without additional causes of cirrhosis (58%) followed by HCV alone (13%) and cryptogenic cirrhosis (12%). At diagnosis, ascites occurred in 43%, variceal bleeding in 6% and overt encephalopathy in 4%. The median follow-up was 4.3 years. The total 1-, 5- and 10-year survival rates were 79%, 47% and 27% respectively. Survival rates were better for women than for men. A 10-year cumulative incidence of transplantation was 7.3%. Mortality was worst for alcoholic cirrhosis with concomitant HCV when adjusted for age and gender. Sweden continues to have a low incidence of cirrhosis compared with other European countries. Mortality varies with gender, aetiology and severity at diagnosis. Patients with alcoholic cirrhosis with concomitant HCV infection fare worst. © 2016 John Wiley & Sons Ltd.

Are we seeing the effects of public awareness campaigns? A 10-year analysis of Breslow thickness at presentation of malignant melanoma in the South West of England.

PubMed

Armstrong, A; Powell, C; Powell, R; Hallam, N; Taylor, J; Bird, J; Sarran, C; Oliver, D

2014-03-01

The last 20 years has seen a marked improvement in skin cancer awareness campaigns. We sought to establish whether this has affected the presenting Breslow thickness of malignant melanoma in the South West. This is a retrospective study looking at the first presentation of melanomas from 2003 to 2011. Data was accessed using the local online melanoma database. A total of 2001 new melanomas presented from 2003 to 2012 (Male:Female = 1:1.062). The average yearly number of melanomas was 200.1 (range = 138-312). The mean age was 62.5 years (range 12-99). Data was analysed using a Chi² test. For 0-1 mm melanomas, there is a significant difference in the observed versus expected values over the 10 years (p = 0.0018). There is an increasing proportion of 0-1 mm (thin) melanomas presenting year on year, with a positive linear trend. This is very statistically significant (p < 0.0001). The 1-2 mm melanomas are decreasing in proportion with a negative linear trend (p = 0.0013). The 2-4 mm are also decreasing in proportion (p = 0.0253). There is no significant change in the thick >4 mm melanomas (p = 0.1456). The proportion of thin 0-1 mm melanomas presenting in South West England has significantly increased from 2003 to 2012. There is no significant change in the thick >4 mm melanomas. This may be a result of increased public awareness due to effective public health campaigns which has significant prognostic and financial implications. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Synchronous male breast and colon cancer presenting with ileus: A case report.

PubMed

Ari, Aziz; Tatar, Cihad; Buyukasik, Kenan; Segmen, Ozgur; Cakir, Coskun; Arikan, Soykan

2016-01-01

Cancer developing from more than one origin is called multiple primary cancer (MPC) and is a rare situation. In this article, we report a case presenting to the Emergency Clinic with symptoms of ileus who was diagnosed with synchronous colon and breast cancer. A 57year old male patient presented to the Emergency Clinic with abdominal pain, vomiting, constipation and lack of flatulence. The patient was taken to the operating room for emergency surgery with the diagnosis of intestinal obstruction. While still hospitalized, breast ultrasound was performed, revealing a mass lesion in the right breast measuring 2cm. The core biopsy result was suggestive of invasive ductal adenocarcinoma. Right modified radical mastectomy with removal of the level 2 axillary lymph nodes was performed. The result of the histopathological investigation of the right hemicolectomy specimen was reported as moderately differentiated adenocarcinoma, while that of the mastectomy material was invasive ductal adenocarcinoma. Synchronous colorectal cancer is recognized as an important clinical entity, its clinical and pathological properties as well as prognosis are still undetermined. A family history of cancer might be a significant factor in synchronous cancers. Many of the theories about the etiology of multiple primary malignant neoplasia suggest the role of genetic, hormonal, environmental and immunological factors as well as iatrogenic causes. Especially for patients whose treatment begins in the emergency settings, meticulous systemic physical examination is recommended to initiate treatment of a possible synchronous tumor at an earlier stage. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates.

PubMed

McManus, I C; Keeling, A; Paice, E

2004-08-18

The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

Equatorial Annual Oscillation with QBO-driven 5-year Modulation in NCEP Data

NASA Technical Reports Server (NTRS)

Mayr, H. G.; Mengel, J. G.; Huang, F. T.; Nash, E. R.

2007-01-01

An analysis is presented of the zonal wind and temperature variations supplied by the National Center for Environmental Prediction (NCEP), which have been assimilated in the Reanalysis and the Climate Prediction Center (CCP) data sets. The derived zonal-mean variations are employed. Stimulated by modeling studies, the data are separated into the hemispherically symmetric and anti-symmetric components, and spectral analysis is applied to study the annual 12-month oscillation and Quasi-biennial Oscillation (QBO). For data samples that cover as much as 40 years, the results reveal a pronounced 5-year modulation of the symmetric AO in the lower stratosphere, which is confined to equatorial latitudes. This modulation is also inferred for the temperature variations but extends to high latitudes, qualitatively consistent with published model results. A comparison between different data samples indicates that the signature of the 5-year oscillation is larger when the QBO of 30 months is more pronounced. Thus there is circumstantial evidence that this periodicity of the QBO is involved in generating the oscillation. The spectral analysis shows that there is a weak anti-symmetric 5-year oscillation in the zonal winds, which could interact with the large antisymmetric A0 to produce the modulation of the symmetric AO as was shown in earlier modeling studies. According to these studies, the 30-month QBO tends to be synchronized by the equatorial Semi-annual Oscillation (SAO), and this would explain why the inferred 5-year modulation is observed to persist and is phase locked over several cycles.

Average and Bright Adults with Parents with Mild Cognitive Difficulties: The Huck Finn Syndrome 20 Years Later

ERIC Educational Resources Information Center

O'Neill, Audrey Myerson

2011-01-01

Background: This longitudinal study of 20 average and bright adults with parents with cognitive difficulties follows a study 20 years earlier of their childhood adaptation to their parents. Method: Semistructured interviews about life situation and changes and perception of family-of-origin. Results: The participants' socioeconomic status changed…

Secular changes in personality: study on 75-year-olds examined in 1976-1977 and 2005-2006.

PubMed

Billstedt, E; Waern, M; Duberstein, P; Marlow, T; Hellström, T; Ostling, S; Skoog, I

2013-03-01

In order to study secular changes in personality factors neuroticism and extroversion, representative population samples of non-demented 75-year-olds underwent psychiatric examinations in 1976-1977 (total n = 223, 138 women, 85 men) and 2005-2006 (total n = 556, 322 women and 234 men). Eysenck Personality Inventory was used at both occasions. Demographic factors (educational level, marital status, having children) were registered. Seventy-five-year-olds examined in 2005-2006 had higher values on extroversion and lower values on the Lie scale compared with those examined in 1976-1977. Neuroticism did not differ between the two birth cohorts. Neuroticism scores were higher in women than in men both in 1976-1977 and 2005-2006, and Lie score was higher in women than in men in 2005-2006. Our findings suggest that present cohorts of 75-year-olds are more extroverted and less prone to respond in a socially desirable manner than those born three decades earlier. Neuroticism levels remained unchanged, suggesting this trait may be less influenced by environmental factors than the other traits studied. Copyright © 2012 John Wiley & Sons, Ltd.

Finnish psychiatry--past and present.

PubMed

Pylkkänen, Kari

2012-03-01

The history of Finnish psychiatry has been characterized by polarizations: priority in hospitals vs. outpatient care, centralized vs. decentralized organization, independent vs. integrated administration, biological vs. psychological treatments, private vs. public production, special psychiatric policies vs. general health policies. The independent psychiatric organizations on District level lasted from the 1920s until 1990. Since then, the formerly independent psychiatry was subordinated to General Hospital administration and the centralized system of state planning and financing of healthcare was gradually decentralized and run down. During the heavy Finnish economic recession of the early 1990 s, the cuts of the public sector were unfortunately focused most heavily on psychiatric services. The main focus of research and teaching has shifted from earlier emphasis on psychoanalytical approach to biological psychiatry since the late 1980s. The administrative position of psychiatry has been repeatedly changing and unstable during the last 20 years. At the level of the contents of the services, however, there have been many very positive and promising developments. Psychiatry has come closer to other specialties from its formerly isolated position, when the separate administrations have been integrated. Provision of outpatient services has increased remarkably, while the number of hospital beds has decreased radically. Interest and resources in research have increased remarkably, and numerous new and good quality psychiatric research reports are being published.

National Study of Student Support Services. Third-Year Longitudinal Study Results and Program Implementation Study Update.

ERIC Educational Resources Information Center

Chaney, Bradford; Muraskin, Lana; Cahalan, Margaret; Rak, Rebecca

This follow-up study, part of the National Study of Student Support Services compared the status of 2,900 disadvantaged students receiving student support services (SSS) since entering college 3 years earlier and 2,900 nonparticipating comparable students. Services offered varied among institutions but were all intended to help students stay in…

Unusual Presentation of Duodenal Ulcer Presenting with Duodenal Intussusception.

PubMed

Lingala, Shilpa; Moore, Andrew; Kadire, Siri; Shankar, Sridhar; Das, Kanak; Howden, Colin W

2018-01-01

We present a unique case of duodeno-duodenal intussusception from a duodenal bulb ulcer. A 38-year-old man presented with nausea, vomiting, and abdominal pain. Computed tomography showed duodenal intussusception. Esophagogastroduodenoscopy (EGD) showed a linear gastric ulcer and a duodenal bulb ulcer with an overlying blood clot. Helicobacter pylori status was positive. Intussusception resolved spontaneously without intervention. He completed treatment for H. pylori infection, and repeat EGD showed ulcer healing. Duodenal intussusception is rarely reported; intussusception from an edematous duodenal ulcer with an overlying blood clot mimicking a mass lesion acting as lead point has never been reported to our knowledge.

Unusual presentation of sunburn.

PubMed

Verma, Gopalkrishna G; Dave, Dhaval; Byrne, Eileen

2008-10-01

We present three cases of sunburn to the head, presenting with oedema of the face in children aged 6, 9 and 13 years. Oedema was predominantly on the forehead and temporal region; a direct effect of gravity was associated with erythema of the scalp. Sunburn healed without any complications.

Cannabis use and first-episode psychosis: relationship with manic and psychotic symptoms, and with age at presentation.

PubMed

Stone, J M; Fisher, H L; Major, B; Chisholm, B; Woolley, J; Lawrence, J; Rahaman, N; Joyce, J; Hinton, M; Johnson, S; Young, A H

2014-02-01

Cannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we investigated the relationship between cannabis use, age of presentation to services, daily functioning, and positive, negative and manic symptoms. Clinical data on 502 patients with first-episode psychosis were collected using the MiData audit database from seven London-based Early Intervention in psychosis teams. Individuals were assessed at two time points--at entry to the service and after 1 year. On each occasion, the Positive and Negative Syndrome Scale, Young Mania Rating Scale and Global Assessment of Functioning Scale disability subscale were rated. At both time points, the use of cannabis and other drugs of abuse in the 6 months preceding each assessment was recorded. Level of cannabis use was associated with a younger age at presentation, and manic symptoms and conceptual disorganization, but not with delusions, hallucinations, negative symptoms or daily functioning. Cannabis users who reduced or stopped their use following contact with services had the greatest improvement in symptoms at 1 year compared with continued users and non-users. Continued users remained more symptomatic than non-users at follow-up. Effective interventions for reducing cannabis use may yield significant health benefits for patients with first-episode psychosis.

The effect of verbal reminders on memory reactivation in 2-, 3-, and 4-year-old children.

PubMed

Imuta, Kana; Scarf, Damian; Hayne, Harlene

2013-06-01

For adults, verbal reminders provide a powerful key to unlock our memories. For example, a simple question, such as "Do you remember your wedding day?" can reactivate rich memories of the past, allowing us to recall experiences that may have occurred days, weeks, and even decades earlier. The ability to use another person's language to access our memory of a prior experience is considered to be one of the hallmarks in human memory development, but surprisingly, little is known about the ontogeny of this fundamental ability. Prior research has shown that by 4 years of age, children can use a simple verbal reminder (e.g., "Do you remember coming here before?") to reactivate an otherwise inaccessible memory of a unique visual stimulus. Given that language comprehension precedes production, it has been hypothesized that the ability to use verbal reminders may emerge well before 4 years of age. In the present experiment, we tested this hypothesis by examining whether a verbal reminder reactivated memory in 2-, 3-, and 4-year-old children who were tested using the visual-paired comparison (VPC) paradigm. Our findings showed that the ability to exploit a simple verbal reminder emerges by at least 2 years of age. PsycINFO Database Record (c) 2013 APA, all rights reserved

Fiscal year 1981 scientific and technical reports, articles, papers, and presentations

NASA Technical Reports Server (NTRS)

Thacker, S. S. (Compiler)

1981-01-01

This bibliography lists approximately 503 formal NASA technical reports, papers published in technical journals, and presentations by MSFC personnel in FY-1981. It also includes papers of MSFC contractors. Citations announced in the NASA scientific and technical information system are noted.

Direct Federal Financial Interventions and Subsidies in Energy in Fiscal Year 2013

EIA Publications

2015-01-01

This report responds to a September 2014 request to the U.S. Energy Information Administration (EIA) from U.S. Representative Fred Upton, Chairman of the House Committee on Energy and Commerce, and U.S. Representative Ed Whitfield, Chairman of its Subcommittee on Energy and Power, for an update reflecting Fiscal Year (FY) 2013 data of two earlier EIA reports on direct federal financial interventions and subsidies in energy markets covering FY 2007 and FY 2010.

Bilateral lateral ventricular subependymoma with extensive multiplicity presenting with hemorrhage.

PubMed

Moinuddin, F M; Ikbar Khairunnisa, Novita; Hirano, Hirofumi; Hanada, Tomoko; Hiraki, Tsubasa; Kirishima, Mari; Kamimura, Kiyohisa; Arita, Kazunori

2018-02-01

This 48-year-old-man who had undergone right thyroid lobectomy for undifferentiated thyroid carcinoma nine years earlier developed generalized seizures. His cerebrospinal fluid was xanthochromic with elevation of total protein. Computed tomography (CT) showed mixed-density bilateral ventricular masses. Magnetic resonance imaging (MRI) revealed multiple nodules in both lateral ventricles; they were heterogeneously enhanced by gadolinium. Diffuse hyperintensity in the right medial temporal lobe and bilateral subependymal area was noted on fluid-attenuated inversion recovery images. Susceptibility-weighted imaging showed low intensity in the masses and cerebellar sulci suggesting hemorrhage and hemosiderin deposition. The preoperative diagnosis was disseminated malignant tumor with recurring hemorrhage. Histological examination of biopsy specimens showed clusters of cells with small uniform nuclei embedded in a dense fibrillary matrix of glial cells and microcystic degeneration. Pseudo-rosettes indicating ependymoma were absent. Microhemorrhages and hemosiderin deposits were noted. Immunohistochemically, the background fibrillary matrix and neoplastic cells were positive for glial fibrillary acidic protein. Mutated isocitrate dehydrogenase-1 was negative. The MIB-1 index was 1.5%. The tumor was pathologically diagnosed as subependymoma containing microhemorrhages and hemosiderin deposits. The extensive multiplicity and hemorrhage encountered in this case have rarely been reported in patients with subependymoma.

Planning steps forward in development: in girls earlier than in boys.

PubMed

Unterrainer, Josef M; Ruh, Nina; Loosli, Sandra V; Heinze, Katharina; Rahm, Benjamin; Kaller, Christoph P

2013-01-01

The development of planning ability in children initially aged four and five was examined longitudinally with a retest-interval of 12 months using the Tower of London task. As expected, problems to solve straightforward without mental look-ahead were mastered by most, even the youngest children. Problems demanding look-ahead were more difficult and accuracy improved significantly with age and over time. This development was strongly moderated by sex: In contrast to coeval boys, four year old girls showed an impressive performance enhancement at age five, reaching the performance of six year olds, whereas four year old boys lagged behind and caught up with girls at the age of six, the typical age of school enrollment. This sex-specific development of planning was clearly separated from overall intelligence: young boys showed a steeper increase in raw intelligence scores than girls, whereas in the older groups scores developed similarly. The observed sex differences in planning development are evident even within a narrow time window of twelve months and may relate to differences in maturational trajectories for girls and boys in dorsolateral prefrontal cortex.

Deformation strain is the main physical driver for skeletal precursors to undergo osteogenesis in earlier stages of osteogenic cell maturation.

PubMed

Ramani-Mohan, Ram-Kumar; Schwedhelm, Ivo; Finne-Wistrand, Anna; Krug, Melanie; Schwarz, Thomas; Jakob, Franz; Walles, Heike; Hansmann, Jan

2018-03-01

Mesenchymal stem cells play a major role during bone remodelling and are thus of high interest for tissue engineering and regenerative medicine applications. Mechanical stimuli, that is, deformation strain and interstitial fluid-flow-induced shear stress, promote osteogenic lineage commitment. However, the predominant physical stimulus that drives early osteogenic cell maturation is not clearly identified. The evaluation of each stimulus is challenging, as deformation and fluid-flow-induced shear stress interdepend. In this study, we developed a bioreactor that was used to culture mesenchymal stem cells harbouring a strain-responsive AP-1 luciferase reporter construct, on porous scaffolds. In addition to the reporter, mineralization and vitality of the cells was investigated by alizarin red staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Quantification of the expression of genes associated to bone regeneration and bone remodelling was used to confirm alizarin red measurements. Controlled perfusion and deformation of the 3-dimensional scaffold facilitated the alteration of the expression of osteogenic markers, luciferase activity, and calcification. To isolate the specific impact of scaffold deformation, a computational model was developed to derive a perfusion flow profile that results in dynamic shear stress conditions present in periodically loaded scaffolds. In comparison to actually deformed scaffolds, a lower expression of all measured readout parameters indicated that deformation strain is the predominant stimulus for skeletal precursors to undergo osteogenesis in earlier stages of osteogenic cell maturation. Copyright © 2017 John Wiley & Sons, Ltd.

Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review

PubMed Central

Qureshi, Nafees A; Hallissey, Michael T; Fielding, John W

2007-01-01

Background Patients with malignant tumours of the upper gastrointestinal tract tumours exhibit important alarm symptoms such as dysphagia that warrant clinical investigations. An endoscopic examination of the upper gastrointestinal tract will be required in most cases. This study evaluates the diagnostic potential of index endoscopy in a random population of patients with dysphagia. Methods This is a retrospective analysis of prospectively collected data over 10 years. Patients with previous endoscopic evaluation or upper gastrointestinal pathology were excluded from the study. Data was analysed to see the number and frequency of abnormal findings in upper gastrointestinal tract, and their significance in relation to the presenting symptoms. Results Total number of index endoscopies was 13, 881. 913 patients were included in the study including 465 males (age range: 17–92 years, median: 55 years) and 448 females (age range: 18–100, median: 59 years), with male to female ratio of 1.04: 1. Oesophagus was abnormal in 678 cases (74%) and biopsies were taken in 428 patients (47%). Superficial oesophagitis, Barrett's oesophagus, oesophageal cancer, and oesophageal ulcer were main histological findings. Age more than 50 years and weight loss were significant predictors of oesophageal cancer (p < 0.0001). Male gender, heartburn, epigastric pain, weight loss and vomiting were significantly related to Barrett's oesophagus. A total of 486 gastric and 56 duodenal biopsies were also taken. There were 20 cases of gastric adenocarcinoma. Conclusion OGD is an effective initial investigation to assess patients with dysphagia, especially males above the age of 50 years. Patients may be started on treatment or referred for further investigations, for example, a barium meal in the absence of any anatomical abnormality. PMID:18034883

When Introverts Ceased to Be More Religious: A Study among 12- to 16-Year-Old Pupils

ERIC Educational Resources Information Center

Williams, Emyr; Robbins, Mandy; Francis, Leslie J.

2005-01-01

A sample of 279 12- to 16-year-old pupils completed the Francis Scale of Attitude toward Christianity and the short-form Junior Eysenck Personality Questionnaire Revised. Contrary to the findings of research using earlier junior versions of the Eysenck scales, the data demonstrate that introverts have ceased to be more religious. (Contains 1…