Argentine references for the assessment of body proportions from birth to 17 years of age.

PubMed

Del Pino, Mariana; Orden, Alicia B; Arenas, María A; Fano, Virginia

2017-06-01

Abnormal body proportions may indicate skeletal disorders; therefore, their detection has great clinical significance. To estimate centiles for head circumference/height (HC/H) and sitting height/height (SH/H) ratios, and assess their diagnostic usefulness among a group of children with skeletal dysplasia. Centiles 3, 10, 25, 50, 75, 90 and 97 for HC/H and SH/H ratios were estimated with the LMS method using Box-Cox transformation to normalize data distribution for each age. Q-Q plot tests were applied to evaluate normality of residuals and the Q test to calculate goodness-of-fit. The sample included 4818 girls and4803 boys, all healthy, between 0-17 years old. The median of the SH/H ratio for each age decreased from 0.67 at birth to 0.57 at age 4. At 12 years of age, values reached 0.52 and 0.53 for males and females, respectively, remaining unchanged until age 17. The median of the HC/H ratio decreased from 0.45 at 6 years old to 0.34 at 17 years old for both sexes. Z-scores for SH/H among 20 children diagnosed with hypochondroplasia were better at showing abnormal proportions than the SH/H ratio not adjusted by age. Estimated centiles for HC/H and SH/H ratios show that the most dramatic changes in body proportions occur in the prepubertal period. These references allow an earlier detection of abnormal body proportions in children with skeletal dysplasia.

Median barrier crash severity: some new insights.

PubMed

Hu, Wen; Donnell, Eric T

2010-11-01

Median barrier is used to prevent cross-median crashes on divided highways. Although it is well documented that crash frequencies increase after installing median barrier, little is known about median barrier crash severity outcomes. The present study estimated a nested logit model of median barrier crash severity using 5 years of data from rural divided highways in North Carolina. Vehicle, driver, roadway, and median cross-section design data were factors considered in the model. A unique aspect of the data used to estimate the model was the availability of median barrier placement and median cross-slope data, two elements not commonly included in roadway inventory data files. The estimation results indicate that collisions with a cable median barrier increase the probability of less-severe crash outcomes relative to collisions with a concrete or guardrail median barrier. Increasing the median barrier offset was associated with a lower probability of severe crash outcomes. The presence of a cable median barrier installed on foreslopes that were between 6H:1V and 10H:1V were associated with an increase in severe crash probabilities when compared to cable median barrier installations on foreslopes that were 10H:1V or flatter. 2010 Elsevier Ltd. All rights reserved.

Multiples of Median-Transformed, Normalized Reference Ranges of Steroid Profiling Data Independent of Age, Sex, and Units.

PubMed

Zalas, Dominika; Reinehr, Thomas; Niedziela, Marek; Borzikowsky, Christoph; Flader, Maciej; Simic-Schleicher, Gunter; Akkurt, Halit Ilker; Heger, Sabine; Hornig, Nadine; Holterhus, Paul-Martin; Kulle, Alexandra E

2018-01-01

The high complexity of pediatric reference ranges across age, sex, and units impairs clinical application and comparability of steroid hormone data, e.g., in congenital adrenal hyperplasia (CAH). We developed a multiples-of-median (MoM) normalization tool to overcome this major drawback in pediatric endocrinology. Liquid chromatography tandem mass spectrometry data comprising 10 steroid hormones representing 905 controls (555 males, 350 females, 0 to > 16 years) from 2 previous datasets were MoM transformed across age and sex. Twenty-three genetically proven CAH patients were included (21-hydroxylase deficiency [21OHD], n = 19; 11β-hydroxylase deficiency [11OHD], n = 4). MoM cutoffs for single steroids predicting 21OHD and 11OHD were computed and validated through new, independent patients (21OHD, n = 8; adrenal cortical carcinoma, n = 6; obesity, n = 40). 21OHD and 11OHD patients showed disease-typical, easily recognizable MoM patterns independent of age, sex, and concentration units. Two single-steroid cutoffs indicated 21OHD: 3.87 MoM for 17-hydroxyprogesterone (100% sensitivity and 98.83% specificity) and 12.28 MoM for 21-deoxycortisol (94.74% sensitivity and 100% specificity). A cutoff of 13.18 MoM for 11-deoxycortisol indicated 11OHD (100% sensitivity and 100% specificity). Age- and sex-independent MoMs are straightforward for a clinically relevant display of multi-steroid patterns. In addition, defined single-steroid MoMs can serve alone as predictors of 21OHD and 11OHD. Finally, MoM transformation offers substantial enhancement of routine and scientific steroid hormone data exchange due to improved comparability. © 2018 S. Karger AG, Basel.

[Urinary iodine levels and its influencing factors among residents over age of 15 years in Shenzhen City].

PubMed

Luo, Yiqi; Xu, Jian; He, Shan; Wang, Jun; Fang, Xiaoheng

2014-11-01

To understand the status of iodine nutrition and the affective factors of urinary iodine concentration among residents over age of 15 years in Shenzhen City. Totally 8152 residents from 73 communities were selected with stratified cluster random sampling. The morning urinary iodine was determined and the dietary assessment of iodine using a food frequency questionnaire were carried out. The range of urinary iodine was 9. 65 - 4039.09 μg/L and the median of urinary iodine was 194.59 μg/L among the residents. The percentages of the residents with urinary iodine < 50,50 - 100,100 - 199, 200 - 300, and ≥ 300 μg/L were 2.49%, 12.12%, 40.16%, 26.94% and 20.78%, respectively. There was significant difference in the medians of iodine between different gender (P = 0.0001), the medians of urinary iodine of men (201.32 μg/L) was slightly higher. There was no significant difference in urinary iodine levels (186.59 - 197.44 μg/L) among all age groups, the medians of urinary iodine of all age groups were within the recommended adequate intake. Along with the increase in age, the medians of urinary iodine of all age groups was gradually decreased. Sex, alcohol consumption and daily dietary iodine intake was significant in the final regression model. The iodine nutrition of residents in Shenzhen City was in good condition, populations with low or high iodine still exist. The monitoring is needed and the influencing factors of the urine iodine levels need much exploration.

Age at spermarche: 15-year trend and its association with body mass index in Chinese school-aged boys.

PubMed

Song, Y; Ma, J; Wang, H-J; Wang, Z; Lau, P W C; Agardh, A

2016-10-01

Little is known about the secular trends in age at spermarche among boys, and the association between body mass index (BMI) and male puberty is controversial. This study aimed to estimate the trend in age at spermarche in China and explore the association of spermarche with BMI. We used four cross-sectional Chinese National Surveys on Students' Constitution and Health (CNSSCH; 1995, 2000, 2005 and 2010). Median age at spermarche was determined using probit analysis. Logistic regression was used to assess the association of spermarche with BMI. Age at spermarche among Chinese boys dropped from 14.57 to 14.03 years from 1995 to 2010 with a decrease of 4.3 months per decade. Boys with BMI-for-age z-score lower than -2 had the latest age at spermarche. A higher BMI or BMI-for-age z-score was associated with an increased likelihood of having reached spermarche, and this association was consistently observed at all survey points. This study provides important evidence of a secular trend of earlier age at spermarche over the past 15 years in China, and this decrease was accompanied by a simultaneous increase in BMI. Strategies and interventions focusing on thinness may promote both their nutritional status and puberty development among Chinese boys. © 2015 World Obesity.

Malnutrition at Age 3 Years and Lower Cognitive Ability at Age 11 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Dalais, Cyril; Mednick, Sarnoff A.

2014-01-01

Background Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. Objective To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. Design A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. Setting and Participants A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Main Outcome Measures Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Results Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Conclusions Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits. PMID:12796242

14-year median follow-up using the press-fit condylar sigma design for total knee arthroplasty.

PubMed

Patil, Shantanu S; Branovacki, George; Martin, Mersadies R; Pulido, Pamela A; Levy, Yadin D; Colwell, Clifford W

2013-09-01

Median 14-year follow-up (mean 11.8 years) of a cemented primary posterior cruciate-retaining total knee arthroplasty (TKA) utilizing the Press-Fit Condylar (PFC) Sigma design was evaluated in 77 patients (79 TKA). Follow-up assessment included implant survivorship, x-rays, Knee Society rating system, and clinical evaluation. Radiographic analysis demonstrated minor non-progressive osteolysis in 40% (10/25) knees. Two revisions, one for instability at 4 years and one for polyethylene wear at 10 years were performed. Survivorship of the PFC Sigma knee implant was 97% using revision for any reason and 100% using aseptic loosening as endpoints. The PFC Sigma had excellent survivorship at 14 years, the longest clinical follow-up reported. Copyright © 2013 Elsevier Inc. All rights reserved.

Differences in age at death according to smoking and age at menopause.

PubMed

Bellavia, Andrea; Wolk, Alicja; Orsini, Nicola

2016-01-01

Younger age at menopause is associated with overall mortality, and cigarette smoking is the only lifestyle factor influencing this association. However, the combined effects of age at menopause and smoking have never been quantified in terms of survival time. Our aim was to evaluate, in a large cohort of Swedish women, differences in age at death according to age at menopause and smoking status. Age at menopause and smoking were assessed, using a self-administered questionnaire, in a population-based cohort of 25,474 women aged 48 to 83 years. Laplace regression was used to calculate differences in median age at death (50th percentile difference [PD]) according to smoking and age at menopause. Across 16 years of follow-up, 5,942 participants died. The difference in median age at death between women with menopause at 40 years and women with menopause at 60 years was 1.3 years (50th PD, 1.3; 95% CI, 0.3-2.2). Compared with current smokers, former smokers and never smokers had older median age at death-2.5 years (50th PD, 2.5; 95% CI, 1.9-3.1) and 3.6 years (50th PD, 3.6; 95% CI, 3.1-4.1), respectively. When analysis was restricted to current smokers, the difference in age at death between women with menopause at 40 years and women with menopause at 60 years increased to 2.6 years (50th PD, 2.6; 95% CI, 0.8-4.5). No association among never smokers was observed. Younger age at menopause is linearly associated with shorter survival. This association tends to be stronger among current smokers.

Endoscopic Third Ventriculostomy Instead of Shunt Revision in Children Younger Than 3 Years of Age.

PubMed

Zhao, Rui; Shi, Wei; Yang, Haowei; Li, Hao

2016-04-01

Endoscopic third ventriculostomy (ETV) is a valuable option in the treatment of shunt failure, but no clinical data exist for young children. The aim of this study was to elucidate the role of ETV in patients younger than 3 years of age with shunt malfunction. A cohort of 37 patients younger than 3 years of age with shunt malfunction underwent ETV instead of shunt revision. Patients' preoperative condition and medical history were studied to determine the impact of a number of variables on outcome. The Fisher exact test was used to assess differences among groups. Median age at ETV was 21.6 months (8-36 months). Diagnosis was obstructive hydrocephalus in 24 patients and communicating hydrocephalus in 13. Median age at initial shunt placement was 3.2 months (10 days to 30 months). The etiology of shunt malfunction was obstruction (n = 27) or infection (n = 10). Overall ETV failure rate was 40.5% (15/37). Patients whose age at initial shunt placement was <6 months and/or who had a preterm birth history had higher relative rates of ETV failure. Other variables, including type of hydrocephalus, interval between initial shunt placement and ETV, history of intraventricular bleeding and/or infection, and etiology of shunt malfunction, did not significantly affect the final outcome. Patients younger than 3 years with obstructive or communicating hydrocephalus may benefit from ETV in the event of shunt malfunction and have about a 60% probability of becoming shunt free. Copyright © 2016 Elsevier Inc. All rights reserved.

Reptile-associated salmonellosis in children aged under 5 years in South West England.

PubMed

Murphy, Dan; Oshin, Femi

2015-04-01

To determine the proportion of Salmonella cases in children aged <5 years that were reptile-associated salmonellosis (RAS) and to compare the severity of illness. To analyse all cases of salmonellosis reported to public health authorities in children aged under 5 years in the South West of the UK from January 2010 to December 2013 for reptile exposure, age, serotype, hospitalisation and invasive disease. 48 of 175 (27%) Salmonella cases had exposure to reptiles. The median age of RAS cases was significantly lower than non-RAS cases (0.5 vs 1.0 year). RAS cases were 2.5 times more likely to be hospitalised (23/48) compared with non-RAS cases (25/127; p=0.0002). This trend continued in cases aged under 12 months, with significantly more RAS cases hospitalised (19/38) than non-RAS cases (8/42; p=0.003). Significantly more RAS cases had invasive disease (8/48: 5 bacteraemia, 2 meningitis, 1 colitis) than non-RAS cases (4/127: 3 bacteraemia, 1 meningitis). Reptile exposure was found in over a quarter of all reported Salmonella cases in children under 5 years of age. RAS is associated with young age, hospitalisation and invasive disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Suicide rates in five-year age-bands after the age of 60 years: the international landscape.

PubMed

Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia; DeLeo, Diego; Erlangsen, Annette

2016-01-01

There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60-79 years) and the oldest old (80+ years) age groups. Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000 were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations website. In men, suicide rates continued to increase for each of the seven five-year age-bands from 60-64 years to 90-94 years age-band, and then declined slightly for the 95-99 year age-band. In women, suicide rates continued to increase for each of the six five-year age-bands from 60-64 years to 85-89 years age-bands, and then declined slightly for the 90-94 years and 95-99 years age-bands. The overall global suicide rates for each of the eight five-year age-bands are sufficiently large for them to constitute a public health concern. This is especially important given the ongoing rise in the elderly population size and the paucity of data on risk and protective factors for suicide in the five-year age-bands after the age of 60 years.

Effect of age on immunological response in the first year of antiretroviral therapy in HIV-1-infected adults in West Africa.

PubMed

Balestre, Eric; Eholié, Serge P; Lokossue, Amani; Sow, Papa Salif; Charurat, Man; Minga, Albert; Drabo, Joseph; Dabis, François; Ekouevi, Didier K; Thiébaut, Rodolphe

2012-05-15

To assess the effect of aging on the immunological response to antiretroviral therapy (ART) in the West African context. The change in CD4 T-cell count was analysed according to age at the time of ART initiation among HIV-infected patients enrolled in the International epidemiological Database to Evaluate AIDS (IeDEA) Collaboration in the West African region. CD4 gain over 12 months of ART was estimated using linear mixed models. Models were adjusted for baseline CD4 cell count, sex, baseline clinical stage, calendar period and ART regimen. The total number of patients included was 24,107, contributing for 50,893 measures of CD4 cell count in the first year of ART. The baseline median CD4 cell count was 144 cells/μl [interquartile range (IQR) 61-235]; median CD4 cell count reached 310 cells/μl (IQR 204-443) after 1 year of ART. The median age at treatment initiation was 36.3 years (10th-90th percentiles = 26.5-50.1). In adjusted analysis, the mean CD4 gain was significantly higher in younger patients (P < 0.0001). At 12 months, patients below 30 years recovered an additional 22 cells/μl on average [95% confidence interval (CI) 2-43] compared to patients at least 50 years. Among HIV-infected adults in West Africa, the immunological response after 12 months of ART was significantly poorer in elderly patients. As the population of treated patients is likely to get older, the impact of this age effect on immunological response to ART may increase over time.

Congenital Median Upper Lip Fistula

PubMed Central

al Aithan, Bandar

2012-01-01

Congenital median upper lip fistula (MULF) is an extremely rare condition resulting from abnormal fusion of embryologic structures. We present a new case of congenital medial upper lip fistula located in the midline of the philtrum of a 6 year old girl. PMID:22953305

Stage I nonsmall cell lung cancer in patients aged > or =75 years: outcomes after stereotactic radiotherapy.

PubMed

Haasbeek, Cornelis J A; Lagerwaard, Frank J; Antonisse, Marilisa E; Slotman, Ben J; Senan, Suresh

2010-01-15

The number of patients aged > or =75 years who present with a stage I nonsmall cell lung cancer (NSCLC) is increasing. Elderly patients often have significant comorbidity and may be unfit for surgery. Furthermore, surgery in the elderly is associated with increased mortality and morbidity. In this study, the authors evaluated the outcomes of stereotactic radiotherapy (SRT) in elderly patients. Since 2003, 203 tumors in 193 patients aged > or =75 years were treated using SRT (118 T1 tumors, 85 T2 tumors). The median patient age was 79 years, 80% of patients were considered medically inoperable, and 20% of patients declined surgery. The median Charlson comorbidity score was 4, and severe chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease Class III or greater) was present in 25% of patients. Risk-adapted SRT schemes were used with the same total dose of 60 grays in 3 fractions (33%), 5 fractions (50%), or 8 fractions (17% of patients), depending on the patient's risk for toxicity. SRT was well tolerated, and all but 1 patient completed treatment. Survival rates at 1 year and 3 years were 86% and 45%, respectively. Survival was correlated with performance score (P = .001) and pre-SRT lung function (P = .04). The actuarial local control rate at 3 years was 89%. Acute toxicity was uncommon, and late Radiation Therapy Oncology Group grade > or =3 toxicity was observed in <10% of patients. SRT achieved high local control rates with minimal toxicity in patients aged > or =75 years despite their significant medical comorbidities. These results indicated that more active diagnostic and therapeutic approaches are justified in elderly patients and that SRT should be considered and discussed as a curative treatment alternative.

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.

Effects of grip force on median nerve deformation at different wrist angles

PubMed Central

Nakashima, Hiroki; Muraki, Satoshi

2016-01-01

The present study investigated the effects of grip on changes in the median nerve cross-sectional area (MNCSA) and median nerve diameter in the radial-ulnar direction (D1) and dorsal-palmar direction (D2) at three wrist angles. Twenty-nine healthy participants (19 men [mean age, 24.2 ± 1.6 years]; 10 women [mean age, 24.0 ± 1.6 years]) were recruited. The median nerve was examined at the proximal carpal tunnel region in three grip conditions, namely finger relaxation, unclenched fist, and clenched fist. Ultrasound examinations were performed in the neutral wrist position (0°), at 30°wrist flexion, and at 30°wrist extension for both wrists. The grip condition and wrist angle showed significant main effects (p < 0.01) on the changes in the MNCSA, D1, and D2. Furthermore, significant interactions (p < 0.01) were found between the grip condition and wrist angle for the MNCSA, D1, and D2. In the neutral wrist position (0°), significant reductions in the MNCSA, D1, and D2 were observed when finger relaxation changed to unclenched fist and clenched fist conditions. Clenched fist condition caused the highest deformations in the median nerve measurements (MNCSA, approximately −25%; D1, −13%; D2, −12%). The MNCSA was significantly lower at 30°wrist flexion and 30°wrist extension than in the neutral wrist position (0°) at unclenched fist and clenched fist conditions. Notably, clenched fist condition at 30°wrist flexion showed the highest reduction of the MNCSA (−29%). In addition, 30°wrist flexion resulted in a lower D1 at clenched fist condition. In contrast, 30°wrist extension resulted in a lower D2 at both unclenched fist and clenched fist conditions. Our results suggest that unclenched fist and clenched fist conditions cause reductions in the MNCSA, D1, and D2. More importantly, unclenched fist and clenched fist conditions at 30°wrist flexion and 30°wrist extension can lead to further deformation of the median nerve. PMID:27688983

Handwriting in healthy people aged 65 years and over.

PubMed

van Drempt, Nadege; McCluskey, Annie; Lannin, Natasha A

2011-08-01

Handwriting is an important activity that is commonly affected by neurological and orthopaedic conditions. Handwriting research has predominantly involved children. Little is known about handwriting behaviour in healthy older adults. This study aims to describe the handwriting practices of 30 unimpaired adults aged 65 years and over. In this cross-sectional observational study, data were collected from 30 older adults using a self-report questionnaire, digital pen recordings over three days and a handwriting log. Data were analysed using descriptive statistics. The mean age of participants was 75.1 years (standard deviation=6.9). Variations in handwriting were evident in letter size, slant and spacing. Participants wrote very little--a median of 18 words per occasion (interquartile range=10.5-26.9 words). Most handwriting involved self-generated text (85%), not copied or transcribed text. Participants stood while writing for 17% of handwriting occasions. The most common reasons for handwriting were note taking (23%) and puzzles (22%). Legibility may not depend exclusively on the handwriting script that a beginning writer is taught, but may be a result of other factors as the person ages. A comprehensive adult handwriting assessment and retraining programme should be relevant to older adults, including common handwriting activities, involving self-generated text and few words. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

Host age and Plasmodium falciparum multiclonality are associated with gametocyte prevalence: a 1-year prospective cohort study.

PubMed

Adomako-Ankomah, Yaw; Chenoweth, Matthew S; Tocker, Aaron M; Doumbia, Saibou; Konate, Drissa; Doumbouya, Mory; Keita, Abdoul S; Anderson, Jennifer M; Fairhurst, Rick M; Diakite, Mahamadou; Miura, Kazutoyo; Long, Carole A

2017-11-21

Since Plasmodium falciparum transmission relies exclusively on sexual-stage parasites, several malaria control strategies aim to disrupt this step of the life cycle. Thus, a better understanding of which individuals constitute the primary gametocyte reservoir within an endemic population, and the temporal dynamics of gametocyte carriage, especially in seasonal transmission settings, will not only support the effective implementation of current transmission control programmes, but also inform the design of more targeted strategies. A 1-year prospective cohort study was initiated in June 2013 with the goal of assessing the longitudinal dynamics of P. falciparum gametocyte carriage in a village in Mali with intense seasonal malaria transmission. A cohort of 500 individuals aged 1-65 years was recruited for this study. Gametocyte prevalence was measured monthly using Pfs25-specific RT-PCR, and analysed for the effects of host age and gender, seasonality, and multiclonality of P. falciparum infection over 1 year. Most P. falciparum infections (51-89%) in this population were accompanied by gametocytaemia throughout the 1-year period. Gametocyte prevalence among P. falciparum-positive individuals (proportion of gametocyte positive infections) was associated with age (p = 0.003) but not with seasonality (wet vs. dry) or gender. The proportion of gametocyte positive infections were similarly high in children aged 1-17 years (74-82% on median among 5 age groups), while older individuals had relatively lower proportion, and those aged > 35 years (median of 43%) had significantly lower than those aged 1-17 years (p < 0.05). Plasmodium falciparum-positive individuals with gametocytaemia were found to have significantly higher P. falciparum multiclonality than those without gametocytaemia (p < 0.033 in two different analyses). Taken together, these results suggest that a substantial proportion of Pf-positive individuals carries gametocytes throughout the year, and

Performance evaluation of cable median barrier systems in Texas.

DOT National Transportation Integrated Search

2009-08-01

Since 2003, the Texas Department of Transportation (TxDOT) has embarked on an aggressive campaign to install : median barriers to prevent cross-median crashes on freeway facilities statewide. In the few years prior to 2003, : virtually all fatalities...

Papillary Carcinoma in Median Aberrant Thyroid (Ectopic) - Case Report

PubMed Central

K, Shashidhar; Deshmane, Vijaya Laxmi; Kumar, Veerendra; Arjunan, Ravi

2014-01-01

Median ectopic thyroid may be encountered anywhere from the foramen caecum to the diaphragm. Non lingual median aberrant thyroid (incomplete descent) usually found in the infrahyoid region and malignant transformation in this ectopic thyroid tissue is very rare. We report an extremely rare case of papillary carcinoma in non lingual median aberrant thyroid in a 25-year-old female. The differentiation between a carcinoma arising in the median ectopic thyroid tissue and a metastatic papillary carcinoma from an occult primary in the main thyroid gland is also discussed. PMID:25121039

Papillary carcinoma in median aberrant thyroid (ectopic) - case report.

PubMed

Hebbar K, Ashwin; K, Shashidhar; Deshmane, Vijaya Laxmi; Kumar, Veerendra; Arjunan, Ravi

2014-06-01

Median ectopic thyroid may be encountered anywhere from the foramen caecum to the diaphragm. Non lingual median aberrant thyroid (incomplete descent) usually found in the infrahyoid region and malignant transformation in this ectopic thyroid tissue is very rare. We report an extremely rare case of papillary carcinoma in non lingual median aberrant thyroid in a 25-year-old female. The differentiation between a carcinoma arising in the median ectopic thyroid tissue and a metastatic papillary carcinoma from an occult primary in the main thyroid gland is also discussed.

Probabilistic population aging

PubMed Central

2017-01-01

We merge two methodologies, prospective measures of population aging and probabilistic population forecasts. We compare the speed of change and variability in forecasts of the old age dependency ratio and the prospective old age dependency ratio as well as the same comparison for the median age and the prospective median age. While conventional measures of population aging are computed on the basis of the number of years people have already lived, prospective measures are computed also taking account of the expected number of years they have left to live. Those remaining life expectancies change over time and differ from place to place. We compare the probabilistic distributions of the conventional and prospective measures using examples from China, Germany, Iran, and the United States. The changes over time and the variability of the prospective indicators are smaller than those that are observed in the conventional ones. A wide variety of new results emerge from the combination of methodologies. For example, for Germany, Iran, and the United States the likelihood that the prospective median age of the population in 2098 will be lower than it is today is close to 100 percent. PMID:28636675

Social Security: a financial appraisal for the median voter.

PubMed

Galasso, V

Several explanations have been proposed for why voters continue to support unfunded social security systems. Browning (1975) suggests that the extremely large unfunded pension systems of most democracies depend on the existence of a voting majority composed of middle-aged and older people who fail to fully internalize the cost of financing the system. In fact, when voting, economically rational workers consider only their current and future contributions to the system and their expected pension benefits--not their past contributions, which they regard as sunk costs. If, for a majority of voters, the expected continuation return from social security exceeds the return from alternative assets, an unfunded social security system is politically sustainable. This article explores the validity of Browning's proposition by quantifying the returns that U.S. voters in presidential elections from 1964 to 1996 have obtained, or expect to obtain, from Social Security. Did "investments" in Social Security outperform alternative forms of investment, such as mutual funds or pension funds, for a majority of the voters? What can be expected for the future? The U.S. Social Security system redistributes income within age cohorts on the basis of sex, income, and marital status. To account for some of these features, the median voter is represented by a family unit whose members--a husband who accounts for 70 percent of household earnings and a wife who accounts for 30 percent--make joint economic and voting decisions. Thus, retirement and survival benefits paid out to the spouse of an insured worker can be included in the calculation of Social Security returns. Interval estimates of voters' family incomes from the U.S. Census Bureau were used to obtain the median voter's household earnings. The median voter's age is derived from the ages of those who voted in presidential elections, not from the ages of the entire electorate. The median voter's contributions to Social Security are the

Sustained impact of rotavirus vaccine introduction on rotavirus gastroenteritis hospitalizations in children <5 years of age, Ghana, 2009-2016.

PubMed

Enweronu-Laryea, Christabel C; Armah, George; Sagoe, Kwamena W; Ansong, Daniel; Addo-Yobo, Emmanuel; Diamenu, Stanley K; Mwenda, Jason M; Parashar, Umesh D; Tate, Jacqueline E

2018-05-08

Ghana introduced monovalent rotavirus vaccine in April 2012. We sought to determine the long-term impact of routine rotavirus vaccination on rotavirus gastroenteritis hospitalizations in Ghana during the first 4 years following rotavirus vaccine introduction. Active sentinel surveillance for acute gastroenteritis hospitalizations among children <5 years of age was conducted at two sites from July 2009 through June 2016. Stool specimens were collected from enrolled children and tested by enzyme immunoassay. Changes in the proportion of all-cause gastroenteritis hospitalizations due to rotavirus pre- (July 2009-June 2012) and post-vaccine introduction (July 2012-June 2016) were compared using chi-square test. The proportion of acute gastroenteritis hospitalizations due to rotavirus among children <5 years of age significantly declined by 42% from a pre-vaccine median of 50% (343/684) to a post-vaccine median of 29% (118/396) (p < 0.001). The age distribution of rotavirus hospitalizations shifted toward older ages with 64% (759/1197) of rotavirus hospitalizations occurring in children <12 months of age pre-vaccine introduction to 47% (212/453) occurring in children <12 months of age post-vaccine introduction (p < 0.001). The decline in rotavirus hospitalizations following rotavirus vaccine introduction have been sustained over the first 4 years of the vaccination program in Ghana. Continued vaccination against rotavirus will ensure that this burden remains low. Copyright © 2018. Published by Elsevier Ltd.

The national trend of blood lead levels among Chinese children aged 0-18 years old, 1990-2012.

PubMed

Li, Min-ming; Cao, Jia; Xu, Jian; Cai, Shi-zhong; Shen, Xiao-ming; Yan, Chong-huai

2014-10-01

We analyzed the epidemiological data during 1990-2012 that investigated the blood lead level (BLL) in the population aged 0-18 years old in China mainland and provided evidence of the benefits of implementing policies to prevent lead pollution based on the dynamic changes of BLL. Data were collected through databases including China Knowledge Resource Integrated Database (CNKI), CBM disc, Wanfang Data, Pubmed and Medline. The inclusion criteria were: 1. Epidemiological study in healthy population not included studies limited to specific patient; 2. Study subject was not the specific lead exposure population; 3. Sample size should be no less than 100 (for neonatal, no less than 50); 4. BLL detection was under strict quality control; and 5. Results should be presented as BLL (arithmetic mean level or geometric mean level). 62 articles were included in this study. All the surveys in these articles contained 189,352 subjects in 19 provinces, autonomous regions and municipalities. Linear regression analysis showed a significant decrease between 1990 and 2012 with an estimated regression coefficient of 3.05/year (SE=0.01, p<0.001). BLL gradually declined since early 21st century. Median levels of BLL among the three economic zones were 51.4 μg/L in the eastern zone, 52.72 μg/L in the central zone and 46.2 μg/L in the western zone respectively. Median BLLs in male and female population aged 0-18 years old of China were 48.8 μg/L and 46.1μg/L. Median levels of BLL among the different age ranges were 74.9 μg/L in newborn, 46.4 μg/L in 0 to 3 years old, 57.6 μg/L in 3 to 7 years old and 55.6 μg/L in above 7 years old respectively. In conclusion, the BLL in the Chinese population of 0-18 years old has gradually dropped in the past 10 years. The decline in temporal trend still remains under potential impacts of several factors such as economical level, gender and age difference. Although, China has made significant achievements in the control prevention of lead

White Matter Lesions: Prevalence and Clinical Phenotype in Asymptomatic Individuals Aged ≥50 Years.

PubMed

David, Jean-Philippe; Ferrat, Emilie; Parisot, Juliette; Naga, Henri; Lakroun, Samia; Menasria, Feriel; Saddedine, Sofiane; Natella, Pierre-André; Paillaud, Elena; Fromentin, Isabelle; Bastuji-Garin, Sylvie

2016-01-01

To assess the prevalence of early confluent/confluent white matter lesions (ec/cWMLs) in asymptomatic individuals aged ≥50 years and to identify associated clinical phenotypes. Cross-sectional analysis of 141 asymptomatic individuals aged ≥50 years assessed at an outpatient department in France. Brain magnetic resonance imaging was rated using the Fazekas scale. Age-adjusted odds ratios (ORs) and 95% confidence intervals were estimated using logistic models to investigate factors associated with ec/cWMLs; independent risk factors were identified by multivariate analysis. Median age was 63 years; 53.9% were women, 32.6% had hypertension, and 76.6% had ≥1 cardiovascular risk factors. The prevalence of ec/cWMLs was 26.2%. Apart from age, independent risk factors were family history of cardiovascular event (OR = 5.55; 1.13-27.32) and hypertension (2.47; 1.05-5.81). Patients with ec/cWMLs had lower cognitive dual-task walking speed (1.15; 0.98-1.40), MMSE (1.41; 1.06-1.89), and FAB scores (5.21; 1.49-19.84). The Scheltens score was independently associated with the WML severity score. ec/cWMLs are common in asymptomatic community-dwelling individuals aged ≥50 years. They are associated with cardiovascular risk factors, impairments in global and executive cognitive function, and Scheltens score elevation. © 2016 S. Karger AG, Basel.

Clinical Outcomes following median to radial nerve transfers

PubMed Central

Ray, Wilson Z.; Mackinnon, Susan E.

2010-01-01

Purpose In this study the authors evaluate the clinical outcomes in patients with radial nerve palsy who underwent nerve transfers utilizing redundant fascicles of median nerve (innervating the flexor digitorum superficialis and flexor carpi radialis muscles) to the posterior interosseous nerve and the nerve to the extensor carpi radialis brevis. Methods A retrospective review of the clinical records of 19 patients with radial nerve injuries who underwent nerve transfer procedures using the median nerve as a donor nerve were included. All patients were evaluated using the Medical Research Council (MRC) grading system. Results The mean age of patients was 41 years (range 17 – 78 years). All patients received at least 12 months of follow-up (20.3 ± 5.8 months). Surgery was performed at a mean of 5.7 ± 1.9 months post-injury. Post-operative functional evaluation was graded according to the following scale: grades MRC 0/5 - MRC 2/5 were considered poor outcomes, while MRC of 3/5 was a fair result, MRC grade 4/5 was a good result, and grade 4+/5 was considered an excellent outcome. Seventeen patients (89%) had a complete radial nerve palsy while two patients (11%) had intact wrist extension but no finger or thumb extension. Post-operatively all patients except one had good to excellent recovery of wrist extension. Twelve patients recovered good to excellent finger and thumb extension, two patients had fair recovery, five patients had a poor recovery. Conclusions The radial nerve is a commonly injured nerve, causing significant morbidity in affected patients. The median nerve provides a reliable source of donor nerve fascicles for radial nerve reinnervation. This transfer was first performed in 1999 and evolved over the subsequent decade. The important nuances of both surgical technique and motor re-education critical for to the success of this transfer have been identified and are discussed. PMID:21168979

Development of guidelines for cable median barrier systems in Texas.

DOT National Transportation Integrated Search

2009-12-01

Since 2003, the Texas Department of Transportation (TxDOT) has embarked on an aggressive campaign to install : median barriers to prevent cross-median crashes on freeway facilities statewide. In the few years prior to 2003, : virtually all fatalities...

Central nervous system medications and falls risk in men aged 60-75 years: the Study on Male Osteoporosis and Aging (SOMA).

PubMed

Masud, Tahir; Frost, Morten; Ryg, Jesper; Matzen, Lars; Ibsen, Marlene; Abrahamsen, Bo; Brixen, Kim

2013-01-01

drugs acting on the central nervous system (CNS) increase falls risk. Most data on CNS drugs and falls are in women/mixed-sex populations. This study assessed the relationship between CNS drugs and falls in men aged 60-75 years. a questionnaire was sent to randomly selected Danish men aged 60-75 years. Cross-sectional data on CNS drugs and falls in the previous year were available for 4,696 men. Logistic regression investigated the relationship between falls and CNS drugs. the median age was 66.3 (IQR = 63.1-70.0) years; 21.7% were fallers. The following were associated with fallers (OR; 95% CI): opiates (2.4; 1.5-3.7), other analgesics (1.7; 1.4-2.1), antiepileptics (2.8; 1.5-5.1), antidepressants (2.8; 1.9-4.1) and anxiolytics/hypnotics (1.5; 0.9-2.6). Effects of opiates interacted strongly and significantly with age, with a marked association with falls in the older half of the subjects only. No significant associations were found between antipsychotics and fallers. Selective serotonin reuptake inhibitors and tricyclics were significantly associated with fallers (3.1; 2.0-5.0 and 2.2; 1.0-4.7, respectively). several CNS drug classes are associated with an approximately 2-3-fold increase risk of falls in men aged 60-75 years randomly selected from the population. Further longitudinal data are now required to confirm and further investigate the role of CNS drugs in falls causation in men.

Median barrier placement on six-lane, 46-foot median divided freeways

DOT National Transportation Integrated Search

2010-11-01

This report summarizes the research efforts of using finite element modeling and simulations to evaluate the : performance of W-beam guardrails and cable median barriers on six-lane, 46-foot median divided freeways. A : literature review is included ...

Effects of Thai Dancing on Median Neurodynamic Response During 4-Hour Computer Use.

PubMed

Mekhora, Keerin; Septham, Chatdao; Jalayondeja, Wattana

2015-06-01

To investigate the effects of Thai dancing on median neurodynamic response during 4-hour computer use. Twenty-four healthy participants aged 20-30 years performed 5 minutes of Thai dancing including Prom See Na, Yoong Fon Hang, Sod Soy Mala, Lor Keaw and Cha Nee Rai Mai during a 10-minute break of 4-hour computer use. All participants were assessed for nerve tension by elbow range of motion ofupper limb neurodynamic test 1 (ULNT1) and components of quick test. The discomfort was measured by visual analogue discomfort scale (VADS). These measurements were assessed before and after computer work. The statistical analyses employed paired t-test for continuous outcome and Friedman's test. The median nerve tension (indicated by elbow range of motion) was significantly reduced at before and after work, when 5 minutes of Thai dancing was introduced during the break. While components of the quick test emphasized that Thai dance immediately helped reduce the median nerve tension. The VADS in eight body areas increased over the period of 4 hours, but decreased after performing Thai dancing (p<0.05). Thai dancing helped relieve median nerve tension and body discomfort. It may be recommended as an exercise during break for computer users who continuously work to prevent WMSDs.

Malnutrition at Age 3 Years and Externalizing Behavior Problems at Ages 8, 11, and 17 Years

PubMed Central

Liu, Jianghong; Raine, Adrian; Venables, Peter H.; Mednick, Sarnoff A.

2006-01-01

Objective Poor nutrition is thought to predispose to externalizing behavior problems, but to date there appear to have been no prospective longitudinal studies testing this hypothesis. This study assessed whether 1) poor nutrition at age 3 years predisposes to antisocial behavior at ages 8, 11, and 17 years, 2) such relationships are independent of psychosocial adversity, and 3) IQ mediates the relationship between nutrition and externalizing behavior problems. Method The participants were drawn from a birth cohort (N=1,795) in whom signs of malnutrition were assessed at age 3 years, cognitive measures were assessed at ages 3 and 11 years, and antisocial, aggressive, and hyperactive behavior was assessed at ages 8, 11, and 17 years. Results In relation to comparison subjects (N=1,206), the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. The results were independent of psychosocial adversity and were not moderated by gender. There was a dose-response relationship between degree of malnutrition and degree of externalizing behavior at ages 8 and 17. Low IQ mediated the link between malnutrition and externalizing behavior at ages 8 and 11. Conclusions These results indicate that malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior. PMID:15514400

Experience of silicone gel sheets for patients with keloid scars after median sternotomy.

PubMed

Sakuraba, Motoki; Takahashi, Nobumasa; Akahoshi, Taku; Miyasaka, Yoshikazu; Suzuki, Kenji

2010-09-01

It is often difficult to control hypertrophic scars and keloids with drug therapy, steroid injection, surgery, radiation therapy, laser, or wound pressing. Use of silicone gel to treat hypertrophic burn scars and fresh incisions has yielded encouraging results. We report our experience of silicone gel sheets for patients with keloids following median sternotomy. Nine patients underwent a median sternotomy and received other therapies before participating in this treatment. A silicone gel sheet was placed directly on the keloid scar and maintained at all times. Sheets were replaced every 4 weeks for a total treatment duration of 24 weeks. The scar area was measured, and subjective symptoms were determined prior to therapy and after completion of therapy. There were three men and six women, with a mean age of 45.2 years (range 22-69 years). Progression of protuberance and rub was seen in one patient. Scar redness and cramping were either diminished or unchanged in all patients. Itching progressed in two patients. After 6 months, the area of the scar relative to its initial area was 0.98 (range 0.78-1.27). Harmful events did not occur. A silicone gel sheet is effective for treating keloid scars following median sternotomy. Silicone gel sheets are safe and easy to use and do not aggravate any subjective symptoms.

Medians

DOT National Transportation Integrated Search

1996-02-01

This discussion paper summarizes the literature relating to the use of medians on major roadways. The primary focus is on safety due to the sizable amount of literature in this area and the very limited number of studies relating to such topics as th...

Repair of symptomatic paraesophageal hernias in elderly (>70 years) patients results in sustained quality of life at 5 years and beyond.

PubMed

Merzlikin, Oleg V; Louie, Brian E; Farivar, Alexander S; Shultz, Dale; Aye, Ralph W

2017-10-01

Paraesophageal hernias (PEHs) involve herniation of stomach and/or other viscera into the mediastinum. These commonly occur in the elderly and can severely limit quality of life. Short term outcomes of repaired PEH demonstrated low morbidity and significant improvement in quality of life, but long-term data for all patients, especially the elderly, are lacking. Retrospective chart review of a prospectively collected database of patients aged 70 or greater with a symptomatic PEH repaired 5+ years ago. Quality of life data were assessed preoperatively, at 12-24 months, and at 5+ years using QOLRAD, GERD-HRQL, and DSS. We identified 137 patients who met the age criteria, with 69 patients undergoing surgery 5+ years ago. With ten patients were lost to follow-up, 59 patients were analyzed, including 24 males and 35 females. Median age at repair was 77 years. There were two 90-day mortalities, with one occurring within 30 days of surgery. Patients alive at evaluation had a median age of 74 years and were followed a median 7.4 years. From baseline, QOLRAD improved from 4 to 6.5, GERD-HRQL improved from 11 to 5, and swallowing improved from 11 to 38. During follow-up, 21 patients died. Deceased patients lived a median of 4 years after repair, with a median age at repair of 80 years. At a median time follow-up of 2 years, this group's QOLRAD improved from 5.1 to 7, GERD-HRQL improved from 16 to 4, and swallowing improved from 14.5 to 35. In elderly patients with symptomatic PEH undergoing surgical repair more than 5 years ago, there was sustained improvement in quality of life. This justifies surgical repair of symptomatic PEH in elderly patients.

Meningococcal carriage prevalence in university students, 1824 years of age in Santiago, Chile.

PubMed

Rodriguez, P; Alvarez, I; Torres, M T; Diaz, J; Bertoglia, M P; Carcamo, M; Seoane, M; Araya, P; Russo, M; Santolaya, M E

2014-09-29

Neisseria meningitidis invasive disease is a major public health problem. Pharyngeal carriage is considered a prerequisite for invasive infection. Prevalence reaches 10% in general population and up to 30% in the 20-24 years age group. The aim of this study was to asses pharyngeal carriage prevalence in healthy subjects aged 18-24 years, and as secondary endpoints evaluate known risk factors, to identify serogroups and sequence in the isolated strains. Cross-sectional study in 500 healthy subjects; students from Universidad de Chile aged 18-24 years, Santiago, Chile, October 2012. Each subject underwent a risk factor survey prior to throat culture sampling. Samples were processed in one central Microbiology Laboratory of Hospital Luis Calvo Mackenna and serogrouping and sequencing was performed at Instituto de Salud Pública de Chile. We obtained throat samples from 500 healthy subjects, 20 (4%) positive for N. meningitidis. Of positive strains 20% were serogroup B, 15% W and the rest non groupable. The median age was 20 years, 50% were men. Of the risk factors evaluated, 24% were current smokers, 16% shared a room, 72% had kissed someone during the last month, 64% had gone to pub and 76% had consumed alcohol in the same period of time. Literatures meningococcal carriage prevalence reaches up to 30% in people aged 18-24 years. Prevalence in our study was 4%. Different interpretations could be given; one could be the absence of overcrowding in our students because of the lack of dorms in our scholar system and also the characteristics of our enrolled group. Our results suggest the necessity to extend the study to other age groups and to other cities, to better understand the Chilean reality, as well as others regions of America, considering that these results cannot be extrapolated to another countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

OPEC/OJEC for stage 4 neuroblastoma in children over 1 year of age.

PubMed

Tweddle, D A; Pinkerton, C R; Lewis, I J; Ellershaw, C; Cole, M; Pearson, A D

2001-01-01

This paper reports the toxicity of OPEC/OJEC chemotherapy in stage 4 neuroblastoma patients over 1 year of age. Ninety-five patients with stage 4 neuroblastoma received alternating courses of OPEC/OJEC--vincristine 1.5 mg/m2 (O), cisplatin 80 mg/m2 (P), etoposide 200 mg/m2 (E), cyclophosphamide 600 mg/m2 (C), and carboplatin 500 mg/m2 (J), every 21 days if there was haematological recovery. Seventy out of ninety-five (74%) patients completed seven or more courses and were evaluable for toxicity. Of these 70 patients, 33% had more than three episodes of fever and sepsis, 35% required more than five blood or platelet transfusions, 36% had grade 2 or more gastrointestinal toxicity and 9% had neurotoxicity. There was a median reduction in GFR of 32 ml/min/1.73 m2 (-46 to 134) and there was one toxic death. OPEC/OJEC is a well-tolerated therapy for stage 4 neuroblastoma over 1 year of age.

Malnutrition at age 3 years and lower cognitive ability at age 11 years: independence from psychosocial adversity.

PubMed

Liu, Jianghong; Raine, Adrian; Venables, Peter H; Dalais, Cyril; Mednick, Sarnoff A

2003-06-01

Early malnutrition is linked to poor cognition, but long-term effects have not been extensively examined and psychosocial confounds have not always been controlled. To test the hypothesis that malnutrition at age 3 years will be associated with poorer cognitive ability at age 11 years independent of psychosocial confounds. A prospective, longitudinal study of a birth cohort of 1559 children originally assessed at age 3 years for malnutrition (low hemoglobin level, angular stomatitis, kwashiorkor, and sparse, thin hair) and followed up to age 11 years. A community sample of 1559 children (51.4% boys and 48.6% girls) born between September 1, 1969, and August 31, 1970, in 2 towns in the island of Mauritius, with 68.7% Indians and 25.7% Creoles (African origin). Verbal and spatial ability measured at ages 3 and 11 years and reading, scholastic ability, and neuropsychologic performance measured at age 11 years. Malnourished children had poorer cognition at both ages. Deficits were stable across time, applied to all sex and ethnic groups, and remained after controlling for multiple measures of psychosocial adversity. Children with 3 indicators of malnutrition had a 15.3-point deficit in IQ at age 11 years. Malnutrition at age 3 years is associated with poor cognition at age 11 years independent of psychosocial adversity. Promoting early childhood nutrition could enhance long-term cognitive development and school performance, especially in children with multiple nutritional deficits.

Age- and gender-specific estimates of cumulative CT dose over 5 years using real radiation dose tracking data in children.

PubMed

Lee, Eunsol; Goo, Hyun Woo; Lee, Jae-Yeong

2015-08-01

It is necessary to develop a mechanism to estimate and analyze cumulative radiation risks from multiple CT exams in various clinical scenarios in children. To identify major contributors to high cumulative CT dose estimates using actual dose-length product values collected for 5 years in children. Between August 2006 and July 2011 we reviewed 26,937 CT exams in 13,803 children. Among them, we included 931 children (median age 3.5 years, age range 0 days-15 years; M:F = 533:398) who had 5,339 CT exams. Each child underwent at least three CT scans and had accessible radiation dose reports. Dose-length product values were automatically extracted from DICOM files and we used recently updated conversion factors for age, gender, anatomical region and tube voltage to estimate CT radiation dose. We tracked the calculated CT dose estimates to obtain a 5-year cumulative value for each child. The study population was divided into three groups according to the cumulative CT dose estimates: high, ≥30 mSv; moderate, 10-30 mSv; and low, <10 mSv. We reviewed clinical data and CT protocols to identify major contributors to high and moderate cumulative CT dose estimates. Median cumulative CT dose estimate was 5.4 mSv (range 0.5-71.1 mSv), and median number of CT scans was 4 (range 3-36). High cumulative CT dose estimates were most common in children with malignant tumors (57.9%, 11/19). High frequency of CT scans was attributed to high cumulative CT dose estimates in children with ventriculoperitoneal shunt (35 in 1 child) and malignant tumors (range 18-49). Moreover, high-dose CT protocols, such as multiphase abdomen CT (median 4.7 mSv) contributed to high cumulative CT dose estimates even in children with a low number of CT scans. Disease group, number of CT scans, and high-dose CT protocols are major contributors to higher cumulative CT dose estimates in children.

Suprasegmental Characteristics of Spontaneous Speech Produced in Good and Challenging Communicative Conditions by Talkers Aged 9-14 Years.

PubMed

Hazan, Valerie; Tuomainen, Outi; Pettinato, Michèle

2016-12-01

This study investigated the acoustic characteristics of spontaneous speech by talkers aged 9-14 years and their ability to adapt these characteristics to maintain effective communication when intelligibility was artificially degraded for their interlocutor. Recordings were made for 96 children (50 female participants, 46 male participants) engaged in a problem-solving task with a same-sex friend; recordings for 20 adults were used as reference. The task was carried out in good listening conditions (normal transmission) and in degraded transmission conditions. Articulation rate, median fundamental frequency (f0), f0 range, and relative energy in the 1- to 3-kHz range were analyzed. With increasing age, children significantly reduced their median f0 and f0 range, became faster talkers, and reduced their mid-frequency energy in spontaneous speech. Children produced similar clear speech adaptations (in degraded transmission conditions) as adults, but only children aged 11-14 years increased their f0 range, an unhelpful strategy not transmitted via the vocoder. Changes made by children were consistent with a general increase in vocal effort. Further developments in speech production take place during later childhood. Children use clear speech strategies to benefit an interlocutor facing intelligibility problems but may not be able to attune these strategies to the same degree as adults.

Improved survival of infants less than 1 year of age with acute lymphoblastic leukemia treated with intensive multiagent chemotherapy.

PubMed

Reaman, G H; Steinherz, P G; Gaynon, P S; Bleyer, W A; Finklestein, J Z; Evans, R; Miller, D R; Sather, H N; Hammond, G D

1987-11-01

Infants with acute lymphoblastic leukemia (ALL) have a poor prognosis. Early disease recurrence, rather than excessive toxicity and complications resulting in limitation of therapy is the major factor responsible for this disappointing outcome. The CCG-192P trial was a groupwide pilot study of the Childrens Cancer Study Group for the treatment of ALL in patients at high risk for relapse, which was defined by wbc count greater than 50 X 10(3)/microliters at diagnosis. Because of the recognized poor prognosis, all infants less than 1 year of age were entered in this study regardless of wbc count at diagnosis. Therapy included intensive induction and consolidation followed by a cyclic, sequential maintenance program. The CNS prophylaxis consisted of intrathecal chemotherapy and cranial irradiation, which was deferred until patients were greater than 1 year of age. During the period January 1982 to January 1984, 27 infants ranging in age from 2 days to 11 months who had ALL were entered in this study; 71% had wbc counts greater than 50 X 10(3)/microliters, and 23% presented with CNS leukemia. Complete remission was achieved in 93% of the patients. The median duration of remission is 17 months. With a median follow-up of 43 months, the life-table estimate of event-free survival (EFS) is 36% at 4 years. A recently reported historical control group of infants with ALL who were treated with previous Childrens Cancer Study Group protocols demonstrated a median remission duration of 8 months and an estimated EFS of only 21% at 4 years. Toxicity and therapy-related complications were not observed more frequently in infants than in older patients treated with this protocol. However, EFS of infants was significantly worse than that of patients greater than 1 year of age (P = less than 0.001). All four CNS relapses occurred in patients who had received cranial irradiation. A wbc count less than 50 X 10(3)/microliters at diagnosis demonstrated significance (P = 0.03) as a

Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients

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

Nasr, Layla A.; Faraj, Walid G.; Al-Kutoubi, Aghiad

BackgroundMedian arcuate ligament syndrome (MALS) is a rare entity that occurs when the median arcuate ligament of the diaphragm is low-lying, causing a compression to the underlying celiac trunk. We reviewed the vascular changes associated with MALS in an effort to emphasize the seriousness of this disease and the complications that may result.MethodsThis is a retrospective descriptive analysis of 23 consecutive patients diagnosed with MALS between January 1, 2012 and December 31, 2015 at a tertiary medical center. Computed tomographic (CT) scans, medical records, and patient follow-up were reviewed.ResultsThe number of patients included herein was 23. The median age wasmore » 56 years (17–83). Sixteen patients (69.6%) had a significant arterial collateral circulation. Eleven patients (47.8%) were found to have visceral artery aneurysms; 4 patients (36.4%) bled secondary to aneurysm rupture. All ruptured aneurysms were treated with endovascular approach. The severity of the hemodynamic changes appears to be greater with complete occlusion,ConclusionsMALS causes pathological hemodynamic changes within the abdominal vasculature. Follow-up is advised for patients who develop a collateral circulation. Resulting aneurysms should preferably be treated when the size ratio approaches three. Treatment of these aneurysms can be done via an endovascular approach coupled with possible celiac artery decompression to restore physiologic blood flow.« less

A hospital-based surveillance of rotavirus gastroenteritis in children <5 years of age in Singapore.

PubMed

Phua, Kong Boo; Tee, Nancy; Tan, Nancy; Ramakrishnan, Gunasekaran; Teoh, Yee-Leong; Bock, Hans; Liu, Yanfang

2013-12-01

In Singapore, 2 rotavirus vaccines were licensed in October 2005 and July 2007, respectively, for vaccinating infants aged ≥ 6 weeks against rotavirus gastroenteritis. These vaccines are optional and are not included in the National Childhood Immunization Program. This study aimed to determine the incidence of rotavirus gastroenteritis-associated hospitalizations among children <5 years of age. Children <5 years, who were hospitalized for acute gastro enteritis, were enrolled between September 2005 and April 2008. Stool samples were tested for the presence and serotyping of rotavirus. Incidence and proportion of gastroenteritis and rotavirus gastroenteritis cases were calculated with 95% confidence intervals. Among 1976 children included in the according-to-protocol cohort, 781 were rotavirus positive with a median age of 24 months (range: 0-59 months). The overall incidence of rotavirus gastroenteritis hospitalizations during the entire study period in children <5 years of age was 4.6 (95% confidence interval: 4.3-4.9) per 1000 person-years with the highest number of cases observed in children 13-24 months of age (26.5%). G1P[8] (18.3%) and G9P[8] (9.9%) were the most common rotavirus types. Rotavirus gastroenteritis hospitalizations peaked between January and March. Rotavirus infection was the primary cause of acute gastro enteritis hospitalizations among children <5 years of age, constituting nearly one-third of gastroenteritis hospitalizations in Singapore. The predominant strain observed in Singapore was G1P[8]. Results of this study suggest the need for implementation of rotavirus vaccination into National Childhood Immunization Program in Singapore.

Age-specific and sex-specific prevalence of cerebral β-amyloidosis, tauopathy, and neurodegeneration in cognitively unimpaired individuals aged 50-95 years: a cross-sectional study.

PubMed

Jack, Clifford R; Wiste, Heather J; Weigand, Stephen D; Therneau, Terry M; Knopman, David S; Lowe, Val; Vemuri, Prashanthi; Mielke, Michelle M; Roberts, Rosebud O; Machulda, Mary M; Senjem, Matthew L; Gunter, Jeffrey L; Rocca, Walter A; Petersen, Ronald C

2017-06-01

A new classification for biomarkers in Alzheimer's disease and cognitive ageing research is based on grouping the markers into three categories: amyloid deposition (A), tauopathy (T), and neurodegeneration or neuronal injury (N). Dichotomising these biomarkers as normal or abnormal results in eight possible profiles. We determined the clinical characteristics and prevalence of each ATN profile in cognitively unimpaired individuals aged 50 years and older. All participants were in the Mayo Clinic Study of Aging, a population-based study that uses a medical records linkage system to enumerate all individuals aged 50-89 years in Olmsted County, MN, USA. Potential participants are randomly selected, stratified by age and sex, and invited to participate in cognitive assessments; individuals without medical contraindications are invited to participate in brain imaging studies. Participants who were judged clinically as having no cognitive impairment and underwent multimodality imaging between Oct 11, 2006, and Oct 5, 2016, were included in the current study. Participants were classified as having normal (A-) or abnormal (A+) amyloid using amyloid PET, normal (T-) or abnormal (T+) tau using tau PET, and normal (N-) or abnormal (N+) neurodegeneration or neuronal injury using cortical thickness assessed by MRI. We used the cutoff points of standard uptake value ratio (SUVR) 1·42 (centiloid 19) for amyloid PET, 1·23 SUVR for tau PET, and 2·67 mm for MRI cortical thickness. Age-specific and sex-specific prevalences of the eight groups were determined using multinomial models combining data from 435 individuals with amyloid PET, tau PET, and MRI assessments, and 1113 individuals who underwent amyloid PET and MRI, but not tau PET imaging. The numbers of participants in each profile group were 165 A-T-N-, 35 A-T+N-, 63 A-T-N+, 19 A-T+N+, 44 A+T-N-, 25 A+T+N-, 35 A+T-N+, and 49 A+T+N+. Age differed by ATN group (p<0·0001), ranging from a median 58 years (IQR 55-64) in A

Age at first marriage in Nepal: differentials and determinants.

PubMed

Aryal, Tika Ram

2007-09-01

The aim of this paper is to investigate the differentials and determinants of female age at first marriage in rural Nepal. The life table technique was employed to calculate median age at marriage. The proportional hazard model was used to study the effect of various socioeconomic variables, and to identify the magnitude and significance of their effects on the timing of first marriage. The data were taken from a sample survey of Palpa and Rupandehi districts in rural Nepal. Both married and unmarried females of marriageable age were included in the survey. Median age at marriage was about 17 years for data from only married females, whereas it was about 18 years for data from married as well as unmarried females of marriageable age. Median age at marriage was about 16 years for uneducated females and 19 years for females educated up to intermediate or higher level. The analysis underestimates the median age at marriage for married females, probably due to right censoring. The risk of getting married early decreased gradually with increasing year-of-birth cohort. The risk of early marriage was higher among females of high socioeconomic status compared with those of low socioeconomic status. Females engaged in service married earlier than those engaged in household work. High socioeconomic status families are motivated, for religious and prestige reasons, to get their daughters married at an early age, preferably before menarche. Thus, education, occupation and age at menarche are the most powerful factors in deciding the timing of first marriage in Nepal.

Differences in BMI z-Scores between Offspring of Smoking and Nonsmoking Mothers: A Longitudinal Study of German Children from Birth through 14 Years of Age

PubMed Central

Fenske, Nora; Müller, Manfred J.; Plachta-Danielzik, Sandra; Keil, Thomas; Grabenhenrich, Linus; von Kries, Rüdiger

2014-01-01

Background: Children of mothers who smoked during pregnancy have a lower birth weight but have a higher chance to become overweight during childhood. Objectives: We followed children longitudinally to assess the age when higher body mass index (BMI) z-scores became evident in the children of mothers who smoked during pregnancy, and to evaluate the trajectory of changes until adolescence. Methods: We pooled data from two German cohort studies that included repeated anthropometric measurements until 14 years of age and information on smoking during pregnancy and other risk factors for overweight. We used longitudinal quantile regression to estimate age- and sex-specific associations between maternal smoking and the 10th, 25th, 50th, 75th, and 90th quantiles of the BMI z-score distribution in study participants from birth through 14 years of age, adjusted for potential confounders. We used additive mixed models to estimate associations with mean BMI z-scores. Results: Mean and median (50th quantile) BMI z-scores at birth were smaller in the children of mothers who smoked during pregnancy compared with children of nonsmoking mothers, but BMI z-scores were significantly associated with maternal smoking beginning at the age of 4–5 years, and differences increased over time. For example, the difference in the median BMI z-score between the daughters of smokers versus nonsmokers was 0.12 (95% CI: 0.01, 0.21) at 5 years, and 0.30 (95% CI: 0.08, 0.39) at 14 years of age. For lower BMI z-score quantiles, the association with smoking was more pronounced in girls, whereas in boys the association was more pronounced for higher BMI z-score quantiles. Conclusions: A clear difference in BMI z-score (mean and median) between children of smoking and nonsmoking mothers emerged at 4–5 years of age. The shape and size of age-specific effect estimates for maternal smoking during pregnancy varied by age and sex across the BMI z-score distribution. Citation: Riedel C, Fenske N, M�

Prenatal and childhood perfluoroalkyl substances exposures and children's reading skills at ages 5 and 8years.

PubMed

Zhang, Hongmei; Yolton, Kimberly; Webster, Glenys M; Ye, Xiaoyun; Calafat, Antonia M; Dietrich, Kim N; Xu, Yingying; Xie, Changchun; Braun, Joseph M; Lanphear, Bruce P; Chen, Aimin

2018-02-01

Exposure to perfluoroalkyl substances (PFASs) may impact children's neurodevelopment. To examine the association of prenatal and early childhood serum PFAS concentrations with children's reading skills at ages 5 and 8years. We used data from 167 mother-child pairs recruited during pregnancy (2003-2006) in Cincinnati, OH, quantified prenatal serum PFAS concentrations at 16±3weeks of gestation and childhood sera at ages 3 and 8years. We assessed children's reading skills using Woodcock-Johnson Tests of Achievement III at age 5years and Wide Range Achievement Test-4 at age 8years. We used general linear regression to quantify the covariate-adjusted associations between natural log-transformed PFAS concentrations and reading skills, and used multiple informant model to identify the potential windows of susceptibility. Median serum PFASs concentrations were PFOS>PFOA>PFHxS>PFNA in prenatal, 3-year, and 8-year children. The covariate-adjusted general linear regression identified positive associations between serum PFOA, PFOS and PFNA concentrations and children's reading scores at ages 5 and 8years, but no association between any PFHxS concentration and reading skills. The multiple informant model showed: a) Prenatal PFOA was positively associated with higher children's scores in Reading Composite (β: 4.0, 95% CI: 0.6, 7.4 per a natural log unit increase in exposure) and Sentence Comprehension (β: 4.2, 95% CI: 0.5, 8.0) at age 8years; b) 3-year PFOA was positively associated with higher children's scores in Brief Reading (β: 7.3, 95% CI: 0.9, 13.8), Letter Word Identification (β: 6.6, 95% CI: 1.1, 12.0), and Passage Comprehension (β: 5.9, 95% CI: 1.5, 10.2) at age 5years; c) 8-year PFOA was positively associated with higher children's Word Reading scores (β: 5.8, 95% CI: 0.8, 10.7) at age 8years. Prenatal PFOS and PFNA were positively associated with children's reading abilities at age 5years, but not at age 8years; 3-year PFOS and PFNA were positively associated

Age-specific serum anti-Müllerian hormone values for 17,120 women presenting to fertility centers within the United States.

PubMed

Seifer, David B; Baker, Valerie L; Leader, Benjamin

2011-02-01

To determine age-specific serum anti-Müllerian hormone (AMH) values for women presenting to U.S. fertility clinics. Retrospective study. Single clinical reference laboratory. A total of 17,120 women of reproductive age ranging from 24 to 50 years old. None. Determination of single-year median and mean AMH values with SDs. Single-year-specific median, mean, and SD values are summarized in Table 1. Both median and mean AMH values decreased steadily in a manner highly correlated with advancing age. The average yearly decrease in the median serum AMH value was 0.2 ng/mL/year through age 35 and then diminished to 0.1 ng/mL/year after age 35. The rate of decline in mean AMH values was 0.2 ng/mL/year through age 40 and then diminished to 0.1 ng/mL/year thereafter. Median and mean AMH levels decreased steadily with increasing age from 24 to 50 years of age. Such data may be of value to physicians and their patients who are considering reproductive options. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Iodine status and thyroid function among Spanish schoolchildren aged 6-7 years: the Tirokid study.

PubMed

Vila, L; Donnay, S; Arena, J; Arrizabalaga, J J; Pineda, J; Garcia-Fuentes, E; García-Rey, C; Marín, J L; Serra-Prat, M; Velasco, I; López-Guzmán, A; Luengo, L M; Villar, A; Muñoz, Z; Bandrés, O; Guerrero, E; Muñoz, J A; Moll, G; Vich, F; Menéndez, E; Riestra, M; Torres, Y; Beato-Víbora, P; Aguirre, M; Santiago, P; Aranda, J; Gutiérrez-Repiso, C

2016-05-01

I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6-7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 μg/l, and 17·9 % of children showed UI<100 μg/l. The median UI was higher in males (180·8 v. 153·6 μg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.

Recipient age and time spent hospitalized in the year before and after kidney transplantation1

PubMed Central

Grams, Morgan E.; McAdams DeMarco, Mara A.; Kucirka, Lauren M.; Segev, Dorry L.

2012-01-01

BACKGROUND Kidney transplantation (KT) is a life-prolonging therapy in certain older end-stage renal disease (ESRD) patients, but concerns regarding peri-transplant morbidity remain. We estimate the relative increase in time spent hospitalized in the year post-KT for older versus younger ESRD patients. METHODS This was a retrospective analysis of 27,247 Medicare-primary KT recipients from 2000–2005 using United States Renal Data System and Organ Procurement and Transplantation Network data. Time spent hospitalized was enumerated in the year pre- and post-KT from Medicare Part A claims. Excess inpatient days were the difference in an individual’s post-KT and pre-KT hospital and skilled nursing facility days, standardized by time spent alive in the year post-KT. RESULTS Median excess inpatient days were similar by age group (9 in recipients ≥65 years vs. 7 in recipients < 65 years); however, the distribution was skewed, such that many more older adults had large increases in inpatient time (8.6% totaled > 120 excess inpatient days vs. 4.2% in younger recipients). Among older recipients, risk factors for poor outcomes included recipient age, donor age, longer dialysis vintage, diabetic nephropathy, and congestive heart failure. Reasons for post-transplant hospitalization were similar by age with the exception of rehabilitation, which was common only in the 65+ age group. Mean inpatient costs were equivalent pre-transplant by age but significantly higher post-transplant among older KT recipients. CONCLUSIONS Post-transplant morbidity may not be so different in the majority of older individuals selected for KT; however, a minority fares much worse. PMID:22932116

Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome.

PubMed

Araújo, Rogério Gayer Machado de; Kouyoumdjian, João Aris

2007-09-01

Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32 degrees C, and after wrist/hand cooling to <27 degrees C in ice water. After cooling, there was a significantly greater increase in PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

Survival and Late Effects after Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancy at Less than Three Years of Age.

PubMed

Vrooman, Lynda M; Millard, Heather R; Brazauskas, Ruta; Majhail, Navneet S; Battiwalla, Minoo; Flowers, Mary E; Savani, Bipin N; Akpek, Görgün; Aljurf, Mahmoud; Bajwa, Rajinder; Baker, K Scott; Beitinjaneh, Amer; Bitan, Menachem; Buchbinder, David; Chow, Eric; Dandoy, Christopher; Dietz, Andrew C; Diller, Lisa; Gale, Robert Peter; Hashmi, Shahrukh K; Hayashi, Robert J; Hematti, Peiman; Kamble, Rammurti T; Kasow, Kimberly A; Kletzel, Morris; Lazarus, Hillard M; Malone, Adriana K; Marks, David I; O'Brien, Tracey A; Olsson, Richard F; Ringden, Olle; Seo, Sachiko; Steinberg, Amir; Yu, Lolie C; Warwick, Anne; Shaw, Bronwen; Duncan, Christine

2017-08-01

Very young children undergoing hematopoietic cell transplantation (HCT) are a unique and vulnerable population. We analyzed outcomes of 717 patients from 117 centers who survived relapse free for ≥1 year after allogeneic myeloablative HCT for hematologic malignancy at <3 years of age, between 1987 and 2012. The median follow-up was 8.3 years (range, 1.0 to 26.4 years); median age at follow-up was 9 years (range, 2 to 29 years). Ten-year overall and relapse-free survival were 87% (95% confidence interval [CI], 85% to 90%) and 84% (95% CI, 81% to 87%). Ten-year cumulative incidence of relapse was 11% (95% CI, 9% to 13%). Of 84 deaths, relapse was the leading cause (43%). Chronic graft-versus-host-disease 1 year after HCT was associated with increased risk of mortality (hazard ratio [HR], 2.1; 95% CI, 1.3 to 3.3; P = .0018). Thirty percent of patients experienced ≥1 organ toxicity/late effect >1 year after HCT. The most frequent late effects included growth hormone deficiency/growth disturbance (10-year cumulative incidence, 23%; 95% CI, 19% to 28%), cataracts (18%; 95% CI, 15% to 22%), hypothyroidism (13%; 95% CI, 10% to 16%), gonadal dysfunction/infertility requiring hormone replacement (3%; 95% CI, 2% to 5%), and stroke/seizure (3%; 95% CI, 2% to 5%). Subsequent malignancy was reported in 3.6%. In multivariable analysis, total body irradiation (TBI) was predictive of increased risk of cataracts (HR, 17.2; 95% CI, 7.4 to 39.8; P < .001), growth deficiency (HR, 3.5; 95% CI, 2.2 to 5.5; P < .001), and hypothyroidism (HR, 5.3; 95% CI, 3.0 to 9.4; P < .001). In summary, those who survived relapse free ≥1 year after HCT for hematologic malignancy at <3 years of age had favorable overall survival. Chronic graft-versus-host-disease and TBI were associated with adverse outcomes. Future efforts should focus on reducing the risk of relapse and late effects after HCT at early age. Copyright © 2017 The American Society for Blood and Marrow Transplantation

Current Tobacco Smoking and Desire to Quit Smoking Among Students Aged 13-15 Years - Global Youth Tobacco Survey, 61 Countries, 2012-2015.

PubMed

Arrazola, René A; Ahluwalia, Indu B; Pun, Eugene; Garcia de Quevedo, Isabel; Babb, Stephen; Armour, Brian S

2017-05-26

Tobacco use is the world's leading cause of preventable morbidity and mortality, resulting in nearly 6 million deaths each year (1). Smoked tobacco products, such as cigarettes and cigars, are the most common form of tobacco consumed worldwide (2), and most tobacco smokers begin smoking during adolescence (3). The health benefits of quitting are greater for persons who stop smoking at earlier ages; however, quitting smoking at any age has health benefits (4). CDC used the Global Youth Tobacco Survey (GYTS) data from 61 countries across the six World Health Organization (WHO) regions from 2012 to 2015 to examine the prevalence of current tobacco smoking and desire to quit smoking among students aged 13-15 years. Across all 61 countries, the median current tobacco smoking prevalence among students aged 13-15 years was 10.7% (range = 1.7%, Sri Lanka to 35.0%, Timor-Leste). By sex, the median current tobacco smoking prevalence was 14.6% among males (range = 2.9%, Tajikistan to 61.4%, Timor-Leste) and 7.5% among females (range = 1.6%, Tajikistan to 29.0%, Bulgaria). In the majority of countries assessed, the proportion of current tobacco smokers who desired to quit smoking exceeded 50%. These findings could be used by country level tobacco control programs to inform strategies to prevent and reduce youth tobacco use (1,4).

Kinetics of human aging: I. Rates of senescence between ages 30 and 70 years in healthy people.

PubMed

Sehl, M E; Yates, F E

2001-05-01

A calculation of loss rates is reported for human structural and functional variables from a substantially larger data set than has been previously studied. Data were collected for healthy, nonsmoking human subjects of both sexes from a literature search of cross-sectional, longitudinal, and cross-sequential studies. The number of studies analyzed was 469, and the total number of subjects was 54,274. A linear model provided a fit of the data, for each variable, that was not significantly different from the best polynomial fit. Therefore, linear loss rates (as a percent decline per year from the reference value at age 30) were calculated for 445 variables from 13 organ systems, and additionally for 24 variables even more integrative, such as maximum oxygen consumption and exercise performance, that express effects of multiple contributing variables and systems. The frequency distribution of the 13 individual system linear loss rates (as percent loss per year) for a very healthy population has roughly a unimodal, right-skewed shape, with mean 0.65, median 0.5, and variance 0.32. (The actual underlying distribution could be a truncated Gaussian, an exponential, Poisson, gamma or some other). The linear estimates of loss rates were clustered between 0% and 2% per year for variables from most organ systems, with exceptions being the endocrine, thermoregulatory, and gastrointestinal systems, for which wider ranges (up to approximately 3% per year) of loss rates were found. We suggest that this set of linear losses over time, observed in healthy individuals between ages (approximately) 30 to 70 years, exposes the underlying kinetics of human senescence, independent of effects of substantial disease.

A multi-country study of intussusception in children under 2 years of age in Latin America: analysis of prospective surveillance data.

PubMed

Sáez-Llorens, Xavier; Velázquez, F Raúl; Lopez, Pio; Espinoza, Felix; Linhares, Alexandre C; Abate, Hector; Nuñez, Ernesto; Venegas, Guillermo; Vergara, Rodrigo; Jimenez, Ana L; Rivera, Maribel; Aranza, Carlos; Richardson, Vesta; Macias-Parra, Mercedes; Palacios, Guillermo Ruiz; Rivera, Luis; Ortega-Barria, Eduardo; Cervantes, Yolanda; Rüttimann, Ricardo; Rubio, Pilar; Acosta, Camilo J; Newbern, Claire; Verstraeten, Thomas; Breuer, Thomas

2013-05-27

Intussusception (IS) is a form of acute intestinal obstruction that occurs mainly in infants and is usually of unknown cause. An association between IS and the first licensed rotavirus vaccine, a reassortant-tetravalent, rhesus-based rotavirus vaccine (RRV-TV), led to the withdrawal of the vaccine. New rotavirus vaccines have now been developed and extensively studied for their potential association with IS. This study aimed to describe the epidemiology and to estimate the incidence of IS in Latin American infants prior to new vaccine introduction. Children under 2 years of age representing potential IS cases were enrolled in 16 centers in 11 Latin American countries from January 2003 to May 2005. IS cases were classified as definite, probable, possible or suspected as stated on the Brighton Collaboration Working Group guidelines. From 517 potential cases identified, 476 (92%) cases were classified as definite, 21 probable, 10 possible and 10 suspected for intussusception. Among the 476 definite IS cases, the median age at presentation was 6.4 months with 89% of cases aged <1 year. The male to female ratio was 1.5:1. The incidence of definite IS per 100,000 subject-years ranged from 1.9 in Brazil to 62.4 in Argentina for children <2 years of age, and from 3.8 in Brazil to 105.3 in Argentina for children aged <1 year. Median hospital stay was 4 days with a high prevalence of surgery as the primary treatment (65%). Most cases (88%) made a complete recovery, but 13 (3%) died. No clear seasonal pattern of IS cases emerged. This study describes the epidemiology and estimates the incidence of IS in Latin American infants prior to the introduction of new rotavirus vaccines. The incidence of IS was found to vary between different countries, as observed in previous studies. Clinical study identifier 999910/204 (SERO-EPI-IS-204).

Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

PubMed

Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

2016-11-15

Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

Difference in normal values of median nerve cross-sectional area between Dutch and Indian subjects.

PubMed

Burg, Ellen Walhout-van; Bathala, Lokesh; Visser, Leo H

2014-07-01

Ultrasound (US) measurement of the median nerve cross-sectional area (CSA) at the wrist is a useful diagnostic test for carpal tunnel syndrome (CTS). We compared median nerve normal values between samples of Indian and Dutch populations. The median nerve was examined by US at the wrist in 100 healthy volunteers in India and 137 volunteers in The Netherlands using the same protocol. Median nerve CSA at the wrist (7.0 ± 1.1 mm(2)) in the Indian cohort was lower in comparison to the Dutch cohort (8.3 ± 1.9 mm(2) ; P < 0.05). This difference was still present after controlling for age, height, and weight (P = 0.001). CSA normal values for the median nerve were different between the examined population samples even after correcting for age, height, and weight. This enforces the idea that laboratories around the world should obtain their own normative data. Copyright © 2013 Wiley Periodicals, Inc.

Epidermal growth factor receptor-tyrosine kinase inhibitors for non-small-cell lung cancer patients aged 80 years or older: A retrospective analysis

PubMed Central

NAKAO, MAKOTO; MURAMATSU, HIDEKI; SONE, KAZUKI; AOKI, SACHIKO; AKIKO, HARATA; KAGAWA, YUSUKE; SATO, HIDEFUMI; KUNIEDA, TAKEFUMI

2015-01-01

The efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in elderly patients with non-small-cell lung cancer (NSCLC) remains uncertain. This retrospective study aimed to evaluate the efficacy and feasibility of EGFR-TKIs for NSCLC patients aged ≥ 80 years. We analyzed data from 21 NSCLC patients aged ≥ 80 years who were administered gefitinib and/or erlotinib between January, 2009 and December, 2014. The clinical characteristics, smoking status, type of EFGR mutation and the efficacy and toxicity of EGFR-TKIs were evaluated in these patients. In total, 14 (66.7%), 5 (23.8%) and 2 patients (9.5%) displayed partial response, stable disease and progressive disease, respectively. The median progression-free survival was 182 days, whereas the median overall survival was 371 days. Adverse events ≥ grade 2 were as follows: skin toxicities, 12 patients; liver function test abnormalities, 7 patients; anorexia, 3 patients; and diarrhea, 2 patients. Dose reduction of EGFR-TKIs due to adverse events was required in 15 patients (71.4%). Although gefitinib and erlotinib therapy may be beneficial in patients aged ≥ 80 years, EGFR-TKI dose modification may be necessary according to the overall medical condition of elderly patients. Further studies are required to evaluate our findings. PMID:25798276

Measuring trends in age at first sex and age at marriage in Manicaland, Zimbabwe.

PubMed

Cremin, I; Mushati, P; Hallett, T; Mupambireyi, Z; Nyamukapa, C; Garnett, G P; Gregson, S

2009-04-01

To identify reporting biases and to determine the influence of inconsistent reporting on observed trends in the timing of age at first sex and age at marriage. Longitudinal data from three rounds of a population-based cohort in eastern Zimbabwe were analysed. Reports of age at first sex and age at marriage from 6837 individuals attending multiple rounds were classified according to consistency. Survival analysis was used to identify trends in the timing of first sex and marriage. In this population, women initiate sex and enter marriage at younger ages than men but spend much less time between first sex and marriage. Among those surveyed between 1998 and 2005, median ages at first sex and first marriage were 18.5 years and 21.4 years for men and 18.2 years and 18.5 years, respectively, for women aged 15-54 years. High levels of reports of both age at first sex and age at marriage among those attending multiple surveys were found to be unreliable. Excluding reports identified as unreliable from these analyses did not alter the observed trends in either age at first sex or age at marriage. Tracing birth cohorts as they aged revealed reporting biases, particularly among the youngest cohorts. Comparisons by birth cohorts, which span a period of >40 years, indicate that median age at first sex has remained constant over time for women but has declined gradually for men. Although many reports of age at first sex and age at marriage were found to be unreliable, inclusion of such reports did not result in artificial generation or suppression of trends.

Cable median barriers : a cost-effective means to save lives : research spotlight.

DOT National Transportation Integrated Search

2014-10-01

Median-crossover crashes are among the most hazardous events that : can occur on freeways, often leading to serious injury or death. In recent : years, high-tension cable median barriers have emerged as a cost-effective alternative to conventional ba...

College Students' Perceptions about Older People and Aging

ERIC Educational Resources Information Center

Kimuna, Sitawa R.; Knox, David; Zusman, Marty

2005-01-01

This study assessed the perceptions of college students at a large southeastern university about aging and older people. Participants were 441 students from age 17 to 49 years with a median age of 19 years. There were 118 males (26.8%) and 323 females (73.2%). The results indicated that students believed a person is "old" at the age of 60 years.…

Baseline PSA in a Spanish male population aged 40-49 years anticipates detection of prostate cancer.

PubMed

Angulo, J C; Viñas, M A; Gimbernat, H; Fata, F Ramón de; Granados, R; Luján, M

2015-12-01

We researched the usefulness of optimizing prostate cancer (PC) screening in our community using baseline PSA readings in men between 40-49 years of age. A retrospective study was performed that analyzed baseline PSA in the fifth decade of life and its ability to predict the development of PC in a population of Madrid (Spain). An ROC curve was created and a cutoff was proposed. We compared the evolution of PSA from baseline in patients with consecutive readings using the Friedman test. We established baseline PSA ranges with different risks of developing cancer and assessed the diagnostic utility of the annual PSA velocity (PSAV) in this population. Some 4,304 men aged 40-49 years underwent opportunistic screening over the course of 17 years, with at least one serum PSA reading (6,001 readings) and a mean follow-up of 57.1±36.8 months. Of these, 768 underwent biopsy of some organ, and 104 underwent prostate biopsy. Fourteen patients (.33%) were diagnosed with prostate cancer. The median baseline PSA was .74 (.01-58.5) ng/mL for patients without PC and 4.21 (.76-47.4) ng/mL for those with PC. The median time from the reading to diagnosis was 26.8 (1.5-143.8) months. The optimal cutoff for detecting PC was 1.9ng/mL (sensitivity, 92.86%; specificity, 92.54%; PPV, 3.9%; NPV, 99.97%), and the area under the curve was 92.8%. In terms of the repeated reading, the evolution of the PSA showed no statistically significant differences between the patients without cancer (p=.56) and those with cancer (P=.64). However, a PSAV value >.3ng/mL/year revealed high specificity for detecting cancer in this population. A baseline PSA level ≥1.9ng/mL in Spanish men aged 40-49 years predicted the development of PC. This value could therefore be of use for opportunistic screening at an early age. An appropriate follow-up adapted to the risk of this population needs to be defined, but an annual PSAV ≥.3ng/mL/year appears of use for reaching an early diagnosis. Copyright © 2015 AEU

The Impact of Diabetes on the Labour Force Participation, Savings and Retirement Income of Workers Aged 45-64 Years in Australia

PubMed Central

Schofield, Deborah; Cunich, Michelle; Kelly, Simon; Passey, Megan E.; Shrestha, Rupendra; Callander, Emily; Tanton, Robert; Veerman, Lennert

2015-01-01

Background Diabetes is a debilitating and costly condition. The costs of reduced labour force participation due to diabetes can have severe economic impacts on individuals by reducing their living standards during working and retirement years. Methods A purpose-built microsimulation model of Australians aged 45-64 years in 2010, Health&WealthMOD2030, was used to estimate the lost savings at age 65 due to premature exit from the labour force because of diabetes. Regression models were used to examine the differences between the projected savings and retirement incomes of people at age 65 for those currently working full or part time with no chronic health condition, full or part time with diabetes, and people not in the labour force due to diabetes. Results All Australians aged 45-65 years who are employed full time in 2010 will have accumulated some savings at age 65; whereas only 90.5% of those who are out of the labour force due to diabetes will have done so. By the time they reach age 65, those who retire from the labour force early due to diabetes have a median projected savings of less than $35,000. This is far lower than the median value of total savings for those who remained in the labour force full time with no chronic condition, projected to have $638,000 at age 65. Conclusions Not only does premature retirement due to diabetes limit the immediate income available to individuals with this condition, but it also reduces their long-term financial capacity by reducing their accumulated savings and the income these savings could generate in retirement. Policies designed to support the labour force participation of those with diabetes, or interventions to prevent the onset of the disease itself, should be a priority to preserve living standards comparable with others who do not suffer from this condition. PMID:25706941

High-Dose-Rate Brachytherapy as Monotherapy for Intermediate- and High-Risk Prostate Cancer: Clinical Results for a Median 8-Year Follow-Up

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

Yoshioka, Yasuo, E-mail: yoshioka@radonc.med.osaka-u.ac.jp; Suzuki, Osamu; Isohashi, Fumiaki

2016-03-15

Purpose: To present mature results of high-dose-rate brachytherapy (HDR-BT) as monotherapy for intermediate- and high-risk prostate cancer. Methods and Materials: From 1995 through 2012, 190 patients, 79 with intermediate-risk and 111 with high-risk prostate cancer, were treated with HDR-BT alone using 48 Gy/8 fractions, 54 Gy/9 fractions, or 45.5 Gy/7 fractions over 4 to 5 days. Neoadjuvant with or without adjuvant androgen deprivation therapy was administered to 139 patients, 35 intermediate- and 104 high-risk. Results: Median follow-up time was 92 months (range, 10-227 months), with a minimum of 2 years for surviving patients. Respective rates of cause-specific survival, overall survival, metastasis-free survival, and biochemical no evidence ofmore » disease for the intermediate-risk patients were 100%, 100%, 96%, and 93% at 5 years, and 100%, 96%, 91%, and 91% at 8 years. Corresponding rates for the high-risk patients were 97%, 93%, 84%, and 81% at 5 years, and 93%, 81%, 74%, and 77% at 8 years. The cumulative incidence of late grade 2 to 3 genitourinary toxicity was 5% at 5 years and 10% at 8 years, and that of late grade 3 was 0 at 5 years and 1% at 8 years. The cumulative incidence of late grade 2-3 gastrointestinal toxicity was 4% at 5 years and 6% at 8 years, and that of late grade 3 was 0 at 5 years and 2% at 8 years. No grade 4 or 5 toxicity was detected. Conclusions: Our single-institution study with a median 8-year follow-up showed that HDR-BT as monotherapy was safe and effective for patients with intermediate- and high-risk prostate cancer.« less

Ultrahigh-frequency ultrasound of fascicles in the median nerve at the wrist.

PubMed

Cartwright, Michael S; Baute, Vanessa; Caress, James B; Walker, Francis O

2017-10-01

An ultrahigh-frequency (70 MHZ) ultrasound device has recently been approved for human use. This study seeks to determine whether this device facilitates counting of fascicles within the median nerve at the wrist. Twenty healthy volunteers underwent imaging of the median nerve at the wrist bilaterally. The number of fascicles in each nerve was counted by two independent raters. The mean fascicle number was 22.68. Correlation was strong between the two raters (r = 0.68, P < 0.001). Age, sex, body mass index, and nerve area did not predict fascicle number. Those with bifid median nerves and persistent median arteries had lower fascicle density than those without anatomic anomalies (1.79 vs. 2.29; P = 0.01). Fascicles within the median nerve at the wrist can be readily imaged. Ultrahigh-frequency ultrasound technology may be informative in a variety of disorders affecting the peripheral nervous system. Muscle Nerve 56: 819-822, 2017. © 2017 Wiley Periodicals, Inc.

Median and ulnar muscle and sensory evoked potentials.

PubMed

Felsenthal, G

1978-08-01

The medical literature was reviewed to find suggested clinical applications of the study of the amplitude of evoked muscle action potentials (MAP) and sensory action potentials (SAP). In addition, the literature was reviewed to ascertain the normal amplitude and duration of the evoked MAP and SAP as well as the factors affecting the amplitude: age, sex, temperature, ischemia. The present study determined the normal amplitude and duration of the median and ulnar MAP and SAP in fifty normal subjects. The amplitude of evoked muscle or sensory action potentials depends on multiple factors. Increased skin resistance, capacitance, and impedance at the surface of the recording electrode diminishes the amplitude. Similarly, increased distance from the source of the action potential diminishes its amplitude. Increased interelectrode distance increases the amplitude of the bipolarly recorded sensory action potential until a certain interelectrode distance is exceeded and the diphasic response becomes tri- or tetraphasic. Artifact or poor technique may reduce the potential difference between the recording electrodes or obscure the late positive phase of the action potential and thus diminish the peak to peak amplitude measurement. Intraindividual comparison indicated a marked difference of amplitude in opposite hands. The range of the MAP of the abductor pollicis brevis in one hand was 40.0--100% of the response in the opposite hand. For the abductor digiti minimi, the MAP was 58.5--100% of the response of the opposite hand. The median and ulnar SAP was between 50--100% of the opposite SAP. Consequent to these findings the effect of hand dominance on the amplitude of median and ulnar evoked muscle and sensory action potentials was studied in 41 right handed volunteers. The amplitudes of the median muscle action potential (p less than 0.02) and the median and ulnar sensory action potentials (p less than 0.001) were significantly less in the dominant hand. There was no

Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010

PubMed Central

Bhuiyan, Mejbah Uddin; Luby, Stephen P; Alamgir, Nadia Ishrat; Homaira, Nusrat; Sturm–Ramirez, Katharine; Gurley, Emily S.; Abedin, Jaynal; Zaman, Rashid Uz; Alamgir, ASM; Rahman, Mahmudur; Ortega–Sanchez, Ismael R.; Azziz–Baumgartner, Eduardo

2017-01-01

Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged <5 years with laboratory–confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case–patients’ homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non–medical costs (costs for food, lodging and transportation); indirect costs (caregivers’ productivity loss), and coping strategies used by families to pay for treatment. We used WHO–Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost–per–episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43–101), indirect cost was US$ 19 (IQR = 11–29) and total cost was US$ 94 (IQR = 67–127). The median out–of–pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV–associated hospitalization in children

Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010.

PubMed

Bhuiyan, Mejbah Uddin; Luby, Stephen P; Alamgir, Nadia Ishrat; Homaira, Nusrat; Sturm-Ramirez, Katharine; Gurley, Emily S; Abedin, Jaynal; Zaman, Rashid Uz; Alamgir, Asm; Rahman, Mahmudur; Ortega-Sanchez, Ismael R; Azziz-Baumgartner, Eduardo

2017-06-01

Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. From May through October 2010, children aged <5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non-medical costs (costs for food, lodging and transportation); indirect costs (caregivers' productivity loss), and coping strategies used by families to pay for treatment. We used WHO-Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost-per-episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43-101), indirect cost was US$ 19 (IQR = 11-29) and total cost was US$ 94 (IQR = 67-127). The median out-of-pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV-associated hospitalization in children aged <5 years in Bangladesh was US$ 10 million (IQR: US

50 Years of Cognitive Aging Theory.

PubMed

Anderson, Nicole D; Craik, Fergus I M

2017-01-01

The objectives of this Introduction to the Journal of Gerontology: Psychological Sciences special issue on "50 Years of Cognitive Aging Theory" are to provide a brief overview of cognitive aging research prior to 1965 and to highlight significant developments in cognitive aging theory over the last 50 years. Historical and recent theories of cognitive aging were reviewed, with a particular focus on those not directly covered by the articles included in this special issue. Prior to 1965, cognitive aging research was predominantly descriptive, identifying what aspects of intellectual functioning are affected in older compared with younger adults. Since the mid-1960s, there has been an increasing interest in how and why specific components of cognitive domains are differentially affected in aging and a growing focus on cognitive aging neuroscience. Significant advances have taken place in our theoretical understanding of how and why certain components of cognitive functioning are or are not affected by aging. We also know much more now than we did 50 years ago about the underlying neural mechanisms of these changes. The next 50 years undoubtedly will bring new theories, as well as new tools (e.g., neuroimaging advances, neuromodulation, and technology), that will further our understanding of cognitive aging. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A short-term epidemiological study of median nerve dysfunction in practicing dental hygienists.

PubMed

Conrad, J C; Conrad, K J; Osborn, J B

1992-02-01

The purpose of this study was to assess over time changes in median nerve function in a group of 20 students who entered the University of Minnesota dental hygiene program in 1986. This is a follow-up report on 16 of the 20 students who were evaluated two years postgraduation in 1990. Comparisons were made with prior evaluations of the subjects completed at graduation in 1988, and one year postgraduation in 1989. Digital vibrometry was used to evaluate median nerve sensibility threshold at each of the time periods studied. Analysis revealed that after one year of clinical practice, there was a mean sensibility threshold shift of 11.04% in the left median nerve and 8.42% in the right median nerve as measured by digital vibrometry. Results at two years postgraduation indicated that the threshold shift observed in an earlier study had been arrested. The reasons appeared to be twofold: (1) a period of work hardening with a concept of neuromuscular ligamentous tissue hypertrophy or adaptation to the rigors of dental hygiene practice, and/or (2) the practicing dental hygienist had learned to become more efficient in the provision of hygiene procedures. There were no reported symptoms of median nerve dysfunction and none of the subjects had been diagnosed as having CTS at any time during the two years since graduation. Continued evaluations will be necessary to determine whether the observations noted during the second year postgraduation evaluation indicated temporary or permanent slowing of the conditions necessary for the development of CTS.

Gonorrhoea positivity among women aged 15-24 years in the USA, 2005-2007.

PubMed

Gorgos, Linda; Newman, Lori; Satterwhite, Catherine; Berman, Stuart; Weinstock, Hillard

2011-04-01

To examine the epidemiology of young women screened for gonorrhoea in the USA. Data on tests for gonorrhoea among women aged 15-24 years attending family planning clinics from 2005 to 2007 were obtained through the infertility prevention project. Clinics testing 90% or more of women for gonorrhoea and sending 50 or more gonorrhoea tests per year were included. Gonorrhoea positivity on a state and county level was calculated and compared by age and race/ethnicity. A total of 1,119,394 tests from 948 clinics was eligible for inclusion. Median state-specific gonorrhoea positivity was 1.3% (IQR 0.7-2.0%). Positivity was higher among women aged 15-19 years (1.4%, IQR 0.9-2.6%) than among those aged 20-24 years (1.1%, IQR 0.6-1.4%, p=0.03) and among non-Hispanic black women (3.8%, IQR 3.2-4.6%) than non-Hispanic white women (0.6%, IQR 0.4-0.8%, p<0.0001). Half of all gonorrhoea cases in these women originated from 57 of 753 counties. Among non-Hispanic white women, positivity was 2.0% or greater in 4% of counties, while 83% of counties had gonorrhoea positivity of less than 1.0%. Gonorrhoea positivity among non-Hispanic black women was 2.0% or greater in 58% of counties, and less than 1.0% in only one-third of counties. These disparities were present diffusely across the geographical areas included in this analysis. Gonorrhea positivity was consistently high for young non-Hispanic black women attending family planning clinics across multiple geographical regions. A large proportion of gonorrhoea morbidity was concentrated in a relatively small number of counties in the USA among this population of young women.

Contemporary Labor Patterns and Maternal Age

PubMed Central

ZAKI, Mary N.; HIBBARD, Judith U.; KOMINIAREK, Michelle A.

2013-01-01

Objective To evaluate labor progress and length according to maternal age. Methods Data were abstracted from the Consortium on Safe Labor, a multicenter retrospective study from 19 hospitals in the United States. We studied 120,442 laboring gravid women with singleton, term, cephalic fetuses with normal outcomes and without a prior cesarean delivery from 2002 to 2008. Maternal age categories were less than 20 years old, greater than or equal to 20 to less than 30, greater than or equal to 30 to less than 40 and greater than or 40 years old, with the reference being less than 20 years. Interval-censored regression analysis was used to determine median traverse times (progression cm by cm) with 95th percentiles, adjusting for covariates (race, admission body mass index, diabetes, gestational age, induction, augmentation, epidural use and birth weight). A repeated-measures analysis with an eighth-degree polynomial model was used to construct mean labor curves for each maternal age category, stratified by parity. Results Traverse times for nulliparous women demonstrated the time to progress from 4 to 10 cm decreased as age increased up to age 40 (median 8.5 hrs vs. 7.8 hrs in those greater than or equal to 20 to less than 30 year old group and 7.4 hrs in the greater than or equal to 30 to less than 40 year old group, p<0.001); the length of the second stage with and without epidural increased with age (p<0.001). For multiparous women, time to progress from 4 to 10 cm decreased as age increased (median 8.8 hrs, 7.5, 6.7 and 6.5 from the youngest to oldest maternal age groups, p<0.001). Labor progressed faster with increasing maternal age in both nulliparous and multiparous women in the labor curves analysis. Conclusion The first stage of labor progressed more quickly with increasing age for nulliparous up to age 40 and all multiparous women. Contemporary labor management should account for maternal age. PMID:24104787

Tympanogram findings in patients with cleft palates aged six months to seven years

NASA Astrophysics Data System (ADS)

Yanti, A.; Widiarni, D.; Alviandi, W.; Tamin, S.; Mansyur, M.

2017-08-01

Cleft palate is one of the most common congenital craniofacial deformities. Otitis media with effusion (OME) is a middle ear disease having a prevalence of almost 90% in patients with cleft palates. Tympanometry is a fast, safe, non-invasive, and easy tool for diagnosing middle ear disease qualitatively and quantitatively. Studies have been conducted using tympanometry to detect middle ear conditions in patients with cleft palates, but no research has studied tympanogram findings in patients with cleft palates in Indonesia. The aim of this study is to determine the tympanogram findings in Indonesian children aged six months to seven years with cleft palates. This is a cross-sectional study of 30 patients (17 males and 13 females) with Veau classification of palatal clefts aged six months to seven years (median 26.5 months) who underwent tympanometry examinations using a 226 Hztympanometer. Tympanograms were classified using the Jerger/Liden classification. Examinations of 58 ears found that type B tympanograms occurred most frequently (70.7%). The quantitative values of tympanometry analyzed included SAA (0.1-0.2 cm3), TPP value (-197.2-(-146.8 daPa)), Vec value (0.5-0.6 cm3), and gradient value (0.03-0.07 cm3). Using the Fisher test, a significant relationship was found between age and type of tympanogram (p = 0.0039) with the risk of type B and C tympanograms in infants (6-60 months) as high as 4.8 times that of children without cleft palates. The type B tympanogram was most frequently seen in patients with cleft palates aged six months to seven years old with the quantitative values of tympanometry lower than the normal values. Therefore, there was a significant difference in the type of tympanogram seen with age.

Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

PubMed

Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

2012-04-01

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). Evidence from the review was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from extensive on-line consultations with input from >900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged <1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

Stereotactic radiosurgery for brain metastases: a case-matched study comparing treatment results for patients 80 years of age or older versus patients 65-79 years of age.

PubMed

Watanabe, Shinya; Yamamoto, Masaaki; Sato, Yasunori; Kawabe, Takuya; Higuchi, Yoshinori; Kasuya, Hidetoshi; Yamamoto, Tetsuya; Matsumura, Akira; Barfod, Bierta E

2014-11-01

Recently, an increasing number of patients with brain metastases, even patients over 80 years of age, have been treated with stereotactic radiosurgery (SRS). However, there is little information on SRS treatment results for patients with brain metastases 80 years of age and older. The authors undertook this study to reappraise whether SRS treatment results for patients 80 years of age or older differ from those of patients who are 65-79 years old. This was an institutional review board-approved, retrospective cohort study. Among 2552 consecutive brain metastasis patients who underwent SRS during the 1998-2011 period, we studied 165 who were 80 years of age or older (Group A) and 1181 who were age 65-79 years old (Group B). Because of the remarkable disproportion in patient numbers between the 2 groups and considerable differences in pre-SRS clinical factors, the authors conducted a case-matched study using the propensity score matching method. Ultimately, 330 patients (165 from each group, A and B) were selected. For time-to-event outcomes, the Kaplan-Meier method was used to estimate overall survival and competing risk analysis was used to estimate other study end points, as appropriate. Although the case-matched study showed that post-SRS median survival time (MST, months) was shorter in Group A patients (5.3 months, 95% CI 3.9-7.0 months) than in Group B patients (6.9 months, 95% CI 5.0-8.1 months), this difference was not statistically significant (HR 1.147, 95% CI 0.921-1.429, p = 0.22). Incidences of neurological death and deterioration were slightly lower in Group A than in Group B patients (6.3% vs 11.8% and 8.5% vs 13.9%), but these differences did not reach statistical significance (p = 0.11 and p = 0.16). Furthermore, competing risk analyses showed that the 2 groups did not differ significantly in cumulative incidence of local recurrence (HR 0.830, 95% CI 0.268-2.573, p = 0.75), rates of repeat SRS (HR 0.738, 95% CI 0.438-1.242, p = 0.25), or incidence

[Chronic malnutrition among children under five years of age in the northern part of Côte d'Ivoire].

PubMed

Aké-Tano, Odile; Tiembré, Issaka; Konan, Yao Eugène; Donnen, Philippe; Dagnan, Simplice N'cho; Dramaix, Michelle; Koffi, Kouamé; Diarra-Nama, Alimata Jeanne

2010-01-01

The malnutrition of children under five years of age constitutes a major public health problem in most developing countries. A cross-section study was carried in 2003 in the northern part of Côte d'Ivoire to determine the prevalence of chronic malnutrition and to identify risk factors among children under five years of age living in urban and rural areas of the northern part of Côte d'Ivoire. A total of 292 and 268 children under five years of age residing respectively in urban and rural areas were included in the study. Their median age was 24 months. Chronic malnutrition was more frequent in children from rural areas (39.9%) than in those living in urban areas (16.7%). Malnutrition was significantly associated with the type of food consumed by children under two years of age in urban areas, and it was strongly linked to emaciation of the mother and presence of childhood fever in rural areas. In light of these results, we advocate a healthy diet and adequate health status for the mother and child to improve the nutritional status of children. Moreover, these results need to be completed and complemented by further studies for more detailed information to contribute to a better definition of actions to fight efficiently against malnutrition among children of the northern part of Côte d'Ivoire.

A comparison of freeway median crash frequency, severity, and barrier strike outcomes by median barrier type.

PubMed

Russo, Brendan J; Savolainen, Peter T

2018-08-01

Median-crossover crashes are among the most hazardous events that can occur on freeways, often resulting in severe or fatal injuries. The primary countermeasure to reduce the occurrence of such crashes is the installation of a median barrier. When installation of a median barrier is warranted, transportation agencies are faced with the decision among various alternatives including concrete barriers, beam guardrail, or high-tension cable barriers. Each barrier type differs in terms of its deflection characteristics upon impact, the required installation and maintenance costs, and the roadway characteristics (e.g., median width) where installation would be feasible. This study involved an investigation of barrier performance through an in-depth analysis of crash frequency and severity data from freeway segments where high-tension cable, thrie-beam, and concrete median barriers were installed. A comprehensive manual review of crash reports was conducted to identify crashes in which a vehicle left the roadway and encroached into the median. This review also involved an examination of crash outcomes when a barrier strike occurred, which included vehicle containment, penetration, or re-direction onto the travel lanes. The manual review of crash reports provided critical supplementary information through narratives and diagrams not normally available through standard fields on police crash report forms. Statistical models were estimated to identify factors that affect the frequency, severity, and outcomes of median-related crashes, with particular emphases on differences between segments with varying median barrier types. Several roadway-, traffic-, and environmental-related characteristics were found to affect these metrics, with results varying across the different barrier types. The results of this study provide transportation agencies with important guidance as to the in-service performance of various types of median barrier. Copyright © 2018 Elsevier Ltd. All rights

Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation.

PubMed

Lu, Chun-Wei; Wu, Mei-Hwan; Chen, Hui-Chi; Kao, Feng-Yu; Huang, San-Kuei

2014-07-01

The prevalence of Wolff-Parkinson-White (WPW) syndrome varies between 0.68 and 1.7/1000. The epidemiological profile may be modified after the introduction of transcatheter interventions. The aim of this study is to investigate the epidemiological trends of the WPW syndrome in a general population during a period with available and reimbursed transcatheter ablation. Data of WPW patients <50 years old were retrieved from our national database (2000-2010). We identified 6086 (61% male) patients, accounting for an overall prevalence of 0.36/1000 with a peak of 0.61/1000 in ages 20-24 years. The risk of death and sudden death was 0.071% and 0.02% per patient-year, respectively. The 42 deaths occurred at a median age of 29 years. Associated congenial heart disease was noted in 158 (2.6%) patients, including 42 with Ebstein's anomaly that increased the mortality risk (P=0.001, OR=8.5). In those without congenital heart disease, myocardial dysfunction occurred in 115 (1.9%) patients and increased the risk of death (P<0.001, OR=10.6) and sudden death. Radiofrequency catheter ablation was performed in 2527 patients at a median age of 25.7 years (4.54% per patient-year, discharge mortality 0.16%); 11 (0.4%) before the age of 5, and 2231 (88%) after the age of 15. Whereas repeated ablation procedures accounted for 6.0% of the procedures, those in Ebstein's patients were 25%. Radiofrequency catheter ablation is already a common treatment for WPW patients, particularly during young adulthood, which accounts for a lower prevalence. Myocardial dysfunction and associated congenital heart disease remain as risks of mortality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years.

PubMed

Lambert, Scott R; Lynn, Michael J; Hartmann, E Eugenie; DuBois, Lindreth; Drews-Botsch, Carolyn; Freedman, Sharon F; Plager, David A; Buckley, Edward G; Wilson, M Edward

2014-06-01

The efficacy and safety of primary intraocular lens (IOL) implantation during early infancy is unknown. To compare the visual outcomes of patients optically corrected with contact lenses vs IOLs following unilateral cataract surgery during early infancy. The Infant Aphakia Treatment Study is a randomized clinical trial with 5 years of follow-up that involved 114 infants with unilateral congenital cataracts at 12 sites. A traveling examiner assessed visual acuity at age 4.5 years. Cataract surgery with or without primary IOL implantation. Contact lenses were used to correct aphakia in patients who did not receive IOLs. Treatment was determined through random assignment. HOTV optotype visual acuity at 4.5 years of age. The median logMAR visual acuity was not significantly different between the treated eyes in the 2 treatment groups (both, 0.90 [20/159]; P = .54). About 50% of treated eyes in both groups had visual acuity less than or equal to 20/200. Significantly more patients in the IOL group had at least 1 adverse event after cataract surgery (contact lens, 56%; IOL, 81%; P = .02). The most common adverse events in the IOL group were lens reproliferation into the visual axis, pupillary membranes, and corectopia. Glaucoma/glaucoma suspect occurred in 35% of treated eyes in the contact lens group vs 28% of eyes in the IOL group (P = .55). Since the initial cataract surgery, significantly more patients in the IOL group have had at least 1 additional intraocular surgery (contact lens, 21%; IOL, 72%; P < .001). There was no significant difference between the median visual acuity of operated eyes in children who underwent primary IOL implantation and those left aphakic. However, there were significantly more adverse events and additional intraoperative procedures in the IOL group. When operating on an infant younger than 7 months of age with a unilateral cataract, we recommend leaving the eye aphakic and focusing the eye with a contact lens. Primary IOL

One-Year Outcomes of Aflibercept in Recurrent or Persistent Neovascular Age-Related Macular Degeneration

PubMed Central

Arcinue, Cheryl A.; Ma, Feiyan; Barteselli, Giulio; Sharpsten, Lucie; Gomez, Maria Laura; Freeman, William R.

2014-01-01

Purpose To evaluate 6-month and 1-year outcomes of every 8 weeks (Q8W) aflibercept in patients with resistant neovascular age-related macular degeneration (AMD). Design Retrospective, interventional, consecutive case series. Methods Retrospective review of patients with resistance (multiple recurrences or persistent exudation) to every 4 weeks (Q4W) ranibizumab or bevacizumab that were switched to Q8W aflibercept. Results Sixty-three eyes of 58 patients had a median of 13 (interquartile range (IQR), 7-22) previous anti Vascular Endothelial Growth Factor (anti-VEGF) injections. At 6-months after changing to aflibercept, 60.3% of eyes were completely dry, which was maintained up to one-year. The median maximum retinal thickness improved from 355 microns to 269 microns at 6 months (p<0.0001) and 248 microns at one year (p<0.0001). There was no significant improvement in ETDRS visual acuity at 6 months (p=0.2559) and one-year follow-up (p=0.1081) compared with baseline. The mean difference in ETDRS visual acuity compared to baseline at 6 months was −0.05 logMAR (+2.5 letters) and 0.04 logMAR at 1 year (−2 letters). Conclusion Sixty percent of eyes with resistant AMD while on Q4W ranibizumab or bevacizumab were completely dry after changing to Q8W aflibercept at the 6-month and 1-year follow-ups, but visual acuity did not significantly improve. Only a third of eyes needed to be switched from Q8W to Q4W aflibercept due to persistence of fluid; Q8W dosing of aflibercept without the initial 3 monthly loading doses may be a good alternative in a select group of patients who may have developed ranibizumab or bevacizumab resistance. PMID:25461263

[Xp11.2 translocation renal carcinoma in adults over 50 years of age: about four cases].

PubMed

Arnoux, V; Long, J-A; Fiard, G; Pasquier, D; Bensaadi, L; Terrier, N; Rambeaud, J-J; Descotes, J-L

2012-11-01

To describe demographic, therapeutic and follow-up data of four cases of renal cell carcinoma with Xp11.2 translocation in adults older than 50 years of age. Between January 2008 and December 2011, 170 patients underwent surgery for renal cell carcinoma in our center. Systematic histopathologic analysis of specimen removed was performed. Complementary immunohistochemical analysis was performed only in cases with uncertain diagnosis or in patients younger than 40 years of age. Among these 170 patients with a median age of 59years old (21-89), immunohistochemistry helped find a TFE3 translocation in four cases (2.4%). There were three women and one man of 53, 71, 75 and 86years old respectively. One patient was metastatic at diagnosis. Radical nephrectomy was first performed in all cases. TNM staging was T3aN2R0, T3bN0R0, T2N2R0 and T3aN2R2, with a Furhman grade of 4. Two patients progressed with metastasis 5 and 7months after surgery, and two with lymphatic invasion 2 and 9months after nephrectomy. One patient died during follow-up. Xp11.2 translocation renal cell carcinoma was uncommon after 50years of age in our series, but probably under estimated. It seemed to be associated with a poor prognosis. Larger studies must be performed to optimize its specific treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Outcomes of surgery in patients aged ≥90 years in the general surgical setting.

PubMed

Sudlow, A; Tuffaha, H; Stearns, A T; Shaikh, I A

2018-03-01

Introduction An increasing proportion of the population is living into their nineties and beyond. These high risk patients are now presenting more frequently to both elective and emergency surgical services. There is limited research looking at outcomes of general surgical procedures in nonagenarians and centenarians to guide surgeons assessing these cases. Methods A retrospective analysis was conducted of all patients aged ≥90 years undergoing elective and emergency general surgical procedures at a tertiary care facility between 2009 and 2015. Vascular, breast and endocrine procedures were excluded. Patient demographics and characteristics were collated. Primary outcomes were 30-day and 90-day mortality rates. The impact of ASA (American Society of Anesthesiologists) grade, operation severity and emergency presentation was assessed using multivariate analysis. Results Overall, 161 patients (58 elective, 103 emergency) were identified for inclusion in the study. The mean patient age was 92.8 years (range: 90-106 years). The 90-day mortality rates were 5.2% and 19.4% for elective and emergency procedures respectively (p=0.013). The median survival was 29 and 19 months respectively (p=0.001). Emergency and major gastrointestinal operations were associated with a significant increase in mortality. Patients undergoing emergency major colonic or upper gastrointestinal surgery had a 90-day mortality rate of 53.8%. Conclusions The risk for patients aged over 90 years having an elective procedure differs significantly in the short term from those having emergency surgery. In selected cases, elective surgery carries an acceptable mortality risk. Emergency surgery is associated with a significantly increased risk of death, particularly after major gastrointestinal resections.

GPU Accelerated Vector Median Filter

NASA Technical Reports Server (NTRS)

Aras, Rifat; Shen, Yuzhong

2011-01-01

Noise reduction is an important step for most image processing tasks. For three channel color images, a widely used technique is vector median filter in which color values of pixels are treated as 3-component vectors. Vector median filters are computationally expensive; for a window size of n x n, each of the n(sup 2) vectors has to be compared with other n(sup 2) - 1 vectors in distances. General purpose computation on graphics processing units (GPUs) is the paradigm of utilizing high-performance many-core GPU architectures for computation tasks that are normally handled by CPUs. In this work. NVIDIA's Compute Unified Device Architecture (CUDA) paradigm is used to accelerate vector median filtering. which has to the best of our knowledge never been done before. The performance of GPU accelerated vector median filter is compared to that of the CPU and MPI-based versions for different image and window sizes, Initial findings of the study showed 100x improvement of performance of vector median filter implementation on GPUs over CPU implementations and further speed-up is expected after more extensive optimizations of the GPU algorithm .

Carpal tunnel syndrome assessment with ultrasonography: value of inlet-to-outlet median nerve area ratio in patients versus healthy volunteers.

PubMed

Fu, Tengfei; Cao, Manlin; Liu, Fang; Zhu, Jiaan; Ye, Dongmei; Feng, Xianxuan; Xu, Yiming; Wang, Gang; Bai, Yuehong

2015-01-01

To evaluate the diagnostic value of the Inlet-to-outlet median nerve area ratio (IOR) in patients with clinically and electrophysiologically confirmed carpal tunnel syndrome (CTS). Forty-six wrists in 46 consecutive patients with clinical and electrodiagnostic evidence of CTS and forty-four wrists in 44 healthy volunteers were examined with ultrasonography. The cross-sectional area (CSA) of the median nerve was measured at the carpal tunnel inlet (the level of scaphoid-pisiform) and outlet (the level of the hook of the hamate), and the IOR was calculated for each wrist. Ultrasonography and electrodiagnostic tests were performed under blinded conditions. Electrodiagnostic testing combined with clinical symptoms were considered to be the gold standard test. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value between the inlet CSA and IOR. The study population included 16 men and 30 women (mean age, 45.3 years; range, 18-83 years). The control population included 18 men and 26 women (mean age, 50.4 years; range, 18-79 years). The mean inlet CSA was 8.7 mm2 in healthy controls and 14.6mm2 in CTS group (P<0.001). The mean IOR in healthy volunteers (1.0) was smaller than that in patients (1.6, P<0.001). Receiver operating characteristic analysis revealed a diagnostic advantage to using the IOR rather than the inlet CSA (P<0.01). An IOR cutoff value of ≥ 1.3 would yield 93% specificity and 91% sensitivity in the diagnosis of CTS. The IOR of median nerve area promises to be an effective means in the diagnosis of CTS. A large-scale, randomized controlled trial is required to determine how and when this parameter will be used.

[Safety of repeat median sternotomy in the palliative treatment of patients with a univentricular heart].

PubMed

Díliz-Nava, Héctor; Meléndez-Sagaón, Isis; Tamaríz-Cruz, Orlando; García-Benítez, Luis; Araujo-Martínez, Aric; Palacios-Macedo, Alexis

To establish the morbidity and mortality of patients with univentricular hearts who underwent a repeat median sternotomy at the Instituto Nacional de Pediatría. A retrospective review was performed on the clinical charts of all patients who underwent a repeat median sternotomy from 2001 to 2016. Sixty-five patients underwent 76 surgeries by repeat median sternotomy. Fifty-nine patients had a first repeat median sternotomy, with a mean age of 36 months (range: 4-176 months) and a mean weight of 12.2 kg (range: 3.2-21.5 kg). Forty patients had a Glenn procedure, and 19 patients had a Fontan procedure. There were 17 patients with a second repeat median sternotomy, with a mean age of 89 months (range 48-156 months), and a mean weight of 22.7 kg (14.4-41 kg). A Fontan procedure was performed on all these 17 patients. A section of the right coronary artery with electrocardiographic changes and a right atrium tear that caused hypotension occurred during first repeat sternotomy. An aortic tear occurred during a second repeat sternotomy with massive bleeding and subsequent death. This represents 3.9% of re-entry injuries. It is concluded that repeat median sternotomy is a safe procedure. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Switching non-local median filter

NASA Astrophysics Data System (ADS)

Matsuoka, Jyohei; Koga, Takanori; Suetake, Noriaki; Uchino, Eiji

2015-06-01

This paper describes a novel image filtering method for removal of random-valued impulse noise superimposed on grayscale images. Generally, it is well known that switching-type median filters are effective for impulse noise removal. In this paper, we propose a more sophisticated switching-type impulse noise removal method in terms of detail-preserving performance. Specifically, the noise detector of the proposed method finds out noise-corrupted pixels by focusing attention on the difference between the value of a pixel of interest (POI) and the median of its neighboring pixel values, and on the POI's isolation tendency from the surrounding pixels. Furthermore, the removal of the detected noise is performed by the newly proposed median filter based on non-local processing, which has superior detail-preservation capability compared to the conventional median filter. The effectiveness and the validity of the proposed method are verified by some experiments using natural grayscale images.

August median streamflow on ungaged streams in Eastern Coastal Maine

USGS Publications Warehouse

Lombard, Pamela J.

2004-01-01

Methods for estimating August median streamflow were developed for ungaged, unregulated streams in eastern coastal Maine. The methods apply to streams with drainage areas ranging in size from 0.04 to 73.2 square miles and fraction of basin underlain by a sand and gravel aquifer ranging from 0 to 71 percent. The equations were developed with data from three long-term (greater than or equal to 10 years of record) continuous-record streamflow-gaging stations, 23 partial-record streamflow- gaging stations, and 5 short-term (less than 10 years of record) continuous-record streamflow-gaging stations. A mathematical technique for estimating a standard low-flow statistic, August median streamflow, at partial-record streamflow-gaging stations and short-term continuous-record streamflow-gaging stations was applied by relating base-flow measurements at these stations to concurrent daily streamflows at nearby long-term continuous-record streamflow-gaging stations (index stations). Generalized least-squares regression analysis (GLS) was used to relate estimates of August median streamflow at streamflow-gaging stations to basin characteristics at these same stations to develop equations that can be applied to estimate August median streamflow on ungaged streams. GLS accounts for different periods of record at the gaging stations and the cross correlation of concurrent streamflows among gaging stations. Thirty-one stations were used for the final regression equations. Two basin characteristics?drainage area and fraction of basin underlain by a sand and gravel aquifer?are used in the calculated regression equation to estimate August median streamflow for ungaged streams. The equation has an average standard error of prediction from -27 to 38 percent. A one-variable equation uses only drainage area to estimate August median streamflow when less accuracy is acceptable. This equation has an average standard error of prediction from -30 to 43 percent. Model error is larger than

The age and symptomatology of natural menopause among United Arab Emirates women.

PubMed

Rizk, D E; Bener, A; Ezimokhai, M; Hassan, M Y; Micallef, R

1998-06-17

To determine the median age of natural menopause in United Arab Emirates women, the factors affecting that age and the prevalence of climacteric symptoms amongst those women. A population-based survey was conducted on a community sample of United Arab Emirates women who had had natural menopause defined as cessation of menstruation for at least 6 months at the end of reproductive years. A total of 742 women aged 40 years and above were recruited from both urban and rural areas of the country using the multi-stage stratified cluster sampling technique. Data were collected using a structured questionnaire and face to face interviews and included a number of familial, reproductive and life-style variables. The median age of the menopause in the United Arab Emirates is 48 years (mean = 47.3 +/- 3.29, range 40-59). This is significantly lower than the median age reported from the West (50.3 years). The subject median age of the menopause was significantly related to that of the mother (P < 0.001), older sister (P < 0.001), parity (P < 0.0001) and the previous use of oral contraceptive pills for more than 1 year (P < 0.001). Hot flushes were the commonest feature of the menopause occurring in 45% of women. The age of natural menopause in United Arab Emirates women, as in other developing countries, is less than in Western women and may be influenced by genetic factors, parity and previous use of oral contraceptives. Climacteric symptomatology, however, is similar in the different patient groups.

Personality Stability From Age 14 to Age 77 Years

PubMed Central

2016-01-01

There is evidence for differential stability in personality trait differences, even over decades. The authors used data from a sample of the Scottish Mental Survey, 1947 to study personality stability from childhood to older age. The 6-Day Sample (N = 1,208) were rated on six personality characteristics by their teachers at around age 14. In 2012, the authors traced as many of these participants as possible and invited them to take part in a follow-up study. Those who agreed (N = 174) completed a questionnaire booklet at age 77 years, which included rating themselves and asking someone who knew them well to rate them on the same 6 characteristics on which they were rated in adolescence. Each set of 6 ratings was reduced to the same single underlying factor, denoted dependability, a trait comparable to conscientiousness. Participants’ and others’ older-age personality characteristic ratings were moderately correlated with each other, and with other measures of personality and wellbeing, but correlations suggested no significant stability of any of the 6 characteristics or their underlying factor, dependability, over the 63-year interval. However, a more complex model, controlling rater effects, indicated significant 63-year stability of 1 personality characteristic, Stability of Moods, and near-significant stability of another, Conscientiousness. Results suggest that lifelong differential stability of personality is generally quite low, but that some aspects of personality in older age may relate to personality in childhood. PMID:27929341

Pathways Linking Perceived Athletic Competence and Parental Support at Age 9 Years to Girls' Physical Activity at Age 11 Years

ERIC Educational Resources Information Center

Davison, Kirsten Krahnstoever; Downs, Danielle Symons; Birch, Leann L.

2006-01-01

Girls' perceived athletic competence and parental support of physical activity across the ages of 9 to 11 years were examined as predictors of girls' physical activity at age 11 years. Participants were 174 girls and their mothers and fathers who completed questionnaires when the girls were ages 9 and 11 years. Two alternative temporal pathways…

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis

PubMed Central

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N’Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2017-01-01

Background There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions. Methods ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. Results About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes. Conclusions Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%. PMID:26479876

The need for triple assessment and predictors for diagnosis of breast cancer in patients <40 years of age.

PubMed

Mazari, F A K; Sharma, N; Reid, D; Horgan, K

2018-05-03

To assess the safety of selective use of triple assessment with omission of radiological assessment proposed in patients <40-years old. Data were collected retrospectively for all patients seen in the one-stop breast clinic between January 2014 and August 2015. Demographics, symptoms, diagnostics, and treatment details were recorded. Subgroup and logistic regression analysis was performed to identify predictors for breast cancer. Of the 3,305 patients included, 95.6% (n=3,161) were first-time referrals. 57.6% (n=1,903) had a breast lump, and 4% (n=133) had a high-risk family history; 75.6% (n=2,499) underwent imaging and 16.7% (n=552) underwent a biopsy. The median age was 29 years (interquartile range [IQR]=25-34). Breast cancer was diagnosed in 29 cases (0.88%) and 3.2% (n=105) had surgery. Median referral-to-diagnosis time was 13 days (IQR=9-14) and referral-to-surgery time was 44 days (IQR=34-95). Patients with breast cancer were significantly older (33 versus 28 years, p=0.016). All patients were first-time referrals. Most patients had a breast lump with low suspicion on clinical examination and breast cancer identified on imaging. Time-to-diagnosis (12 versus 14 days, p=0.017) and time-to-surgery (37 versus 67 days, p=0.012) was significantly shorter in the breast cancer group. Comparative older age (odds ratio [OR]=1.08, 95% confidence interval [CI]: 1.01-1.15) and breast lump (OR=11.43,95% CI: 2.72-48.07) were the only significant predictors of cancer on uni/multivariate regression. Triple assessment is also the best practice for all patients in the younger age group. This cohort should not be treated any differently regarding one-stop clinic infrastructure as the cancers detected were not clinically malignant. Missed cancers in this age group would have significant personal, clinical, and legal consequences. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

A multi-country study of intussusception in children under 2 years of age in Latin America: analysis of prospective surveillance data

PubMed Central

2013-01-01

Background Intussusception (IS) is a form of acute intestinal obstruction that occurs mainly in infants and is usually of unknown cause. An association between IS and the first licensed rotavirus vaccine, a reassortant-tetravalent, rhesus-based rotavirus vaccine (RRV-TV), led to the withdrawal of the vaccine. New rotavirus vaccines have now been developed and extensively studied for their potential association with IS. This study aimed to describe the epidemiology and to estimate the incidence of IS in Latin American infants prior to new vaccine introduction. Methods Children under 2 years of age representing potential IS cases were enrolled in 16 centers in 11 Latin American countries from January 2003 to May 2005. IS cases were classified as definite, probable, possible or suspected as stated on the Brighton Collaboration Working Group guidelines. Results From 517 potential cases identified, 476 (92%) cases were classified as definite, 21 probable, 10 possible and 10 suspected for intussusception. Among the 476 definite IS cases, the median age at presentation was 6.4 months with 89% of cases aged <1 year. The male to female ratio was 1.5:1. The incidence of definite IS per 100,000 subject-years ranged from 1.9 in Brazil to 62.4 in Argentina for children <2 years of age, and from 3.8 in Brazil to 105.3 in Argentina for children aged <1 year. Median hospital stay was 4 days with a high prevalence of surgery as the primary treatment (65%). Most cases (88%) made a complete recovery, but 13 (3%) died. No clear seasonal pattern of IS cases emerged. Conclusions This study describes the epidemiology and estimates the incidence of IS in Latin American infants prior to the introduction of new rotavirus vaccines. The incidence of IS was found to vary between different countries, as observed in previous studies. Trial registration Clinical study identifier 999910/204 (SERO-EPI-IS-204) PMID:23710610

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes among Community-Dwelling Japanese Aged 40 to 79 Years.

PubMed

Otsuka, R; Nishita, Y; Tange, C; Tomida, M; Kato, Y; Imai, T; Ando, F; Shimokata, H

2018-01-01

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially. Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave. Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit

Efficacy of non-nucleoside reverse transcriptase inhibitor-based highly active antiretroviral therapy in Thai HIV-infected children aged two years or less.

PubMed

Puthanakit, Thanyawee; Aurpibul, Linda; Sirisanthana, Thira; Sirisanthana, Virat

2009-03-01

Twenty-six Thai HIV-infected children, aged 2 years or less were prospectively enrolled to receive non-nucleoside reverse transcription inhibitor-based highly active antiretroviral therapy (HAART). Twenty-two children (85%) had World Health Organization clinical stage 3 or 4. The median baseline CD4 cell percentage and plasma HIV RNA were 17% and 5.9 log 10 copies/mL, respectively. The median age at HAART initiation was 9.8 months (range, 1.5-24.0). One child died. The mean CD4 cell percentages at 24, 48, and 96 weeks of treatment were 26%, 31%, and 37%, respectively. The proportions of children with virologic suppression (<400 copies/mL) at week 24 and 48 were 14/26 (54%) and 19/26 (73%), respectively. Non-nucleoside reverse transcription inhibitor-based HAART is safe and effective in HIV-infected young children in a resource-limited setting.

Stature-for-Age and Weight-for-Age Percentiles: Boys, 2 to 20 Years

MedlinePlus

2 to 20 years: Boys NAME Stature-for-age and Weight-for-age percentiles RECORD # Mother’s Stature Date Age in cm 160 62 S 155 60 T 150 ... 14 15 16 17 18 19 20 BMI* AGE (YEARS) cm 95 190 90 185 75 180 ...

[Median nerve constrictive operation combined with tendon transfer to treat brain paralysis convulsive deformity of hand].

PubMed

Ma, Shanjun; Zhou, Tianjian

2014-05-01

To evaluate the effectiveness of the median nerve constrictive operation combined with tendon transfer to treat the brain paralysis convulsive deformity of the hand. The clinical data from 21 cases with brain paralysis convulsive deformity of the hand were analyzed retrospectively between August 2009 and April 2012. Of them, there were 13 males and 8 females with an average age of 15 years (range, 10-29 years). The causes of the convulsive cerebral palsy included preterm deliveries in 11 cases, hypoxia asphyxia in 7, traumatic brain injury in 2, and encephalitis sequela in 1. The disease duration was 2-26 years (mean, 10.6 years). All the 21 patients had cock waists, crooking fingers, and contracture of adductors pollicis, 12 had the forearm pronation deformity. According to Ashworth criteria, there were 2 cases at level I, 5 cases at level II, 8 cases at level III, 4 cases at level IV, and 2 cases at level V. All patients had no intelligence disturbances. The forearm X-ray film showed no bone architectural changes before operation. The contraction of muscle and innervation was analyzed before operation. The median nerve constrictive operation combined with tendon transfer was performed. The functional activities and deformity improvement were evaluated during follow-up. After operation, all the patients' incision healed by first intension, without muscle atrophy and ischemic spasm. All the 21 cases were followed up 1.5-4.5 years (mean, 2.3 years). No superficial sensory loss occurred. The effectiveness was excellent in 13 cases, good in 6 cases, and poor in 2 cases, with an excellent and good rate of 90.4% at last follow-up. The median nerve constrictive operation combined with tendon transfer to treat brain paralysis convulsive deformity of the hand can remove and prevent the recurrence of spasm, achieve the orthopedic goals, to assure the restoration of motor function and the improvement of the life quality.

Age of diagnosis of congenital hearing loss: Private v. public healthcare sector.

PubMed

Butler, I R T; Ceronio, D; Swart, T; Joubert, G

2015-11-01

The age of diagnosis of congenital hearing loss is one of the most important determinants of communication outcome. A previous study by the lead author had evaluated the performance of the public health services in Bloemfontein, South Africa (SA), in this regard. This study aimed to examine whether the private health services in the same city were any better. To determine whether the age of diagnosis of congenital hearing loss (CHL) in children seen in the private healthcare sector in Bloemfontein, Free State Province, SA, was lower than that in the public healthcare system in the same city. A comparative study design was utilised and a retrospective database review conducted. Data obtained from this study in the private healthcare sector were compared with data from a previous study in the public healthcare sector using the same study design. Forty-eight children aged <6 years with disabling hearing impairment (DHI) were identified in the private healthcare sector during the study period; 33/47 (70.2%) did not undergo hearing screening at birth. The median age of diagnosis of DHI in the private healthcare sector was 2.24 years, and this was statistically significantly lower than the median age of diagnosis of 3.71 years in the public healthcare sector (p<0.0001; 95% confidence interval (CI) 0.99-2.0). The median age of diagnosis of congenital hearing loss (CHL) in the private healthcare sector was 3.01 years in children who were not screened at birth, and 1.25 years in those who were screened at birth. This difference was statistically significant (p<0.01; 95% CI 0.72-2.47). We also compared the median age of diagnosis of CHL in children from the private healthcare sector who were not screened at birth (median 3.01 years) with that in children in the public healthcare sector (median 3.71 years). This difference was statistically significant (p<0.01; 95% CI 0.41-1.56). Children in the Free State are diagnosed with CHL at a younger age in the private healthcare

Fat Imaging via Magnetic Resonance Imaging (MRI) in Young Children (Ages 1-4 Years) without Sedation

PubMed Central

Shearrer, Grace E.; House, Benjamin T.; Gallas, Michelle C.; Luci, Jeffrey J.; Davis, Jaimie N.

2016-01-01

Introduction This pilot study developed techniques to perform Magnetic Resonance Imaging (MRI) of specific fat deposition in 18 children (age 18 months to 4 years). Methods The children engaged in a series of practice tests to become acclimated to the scanner noises, reduce claustrophobia, and rehearse holding still for a set time. The practice tests assessed if the child could remain still for two minutes while watching a video, first while lying on a blanket, second, on the blanket with headphones, and third, in the mock scanner. The children who passed the three practice tests were then scanned with a 3T Siemens Skyra magnet. Abdominal fat distribution (region of interest (ROI) from the top of the ileac crest to the bottom of the ribcage) volume was measured using 2-point DIXON technique. This region was chosen to give an indication of the body composition around the liver. Results Twelve out of eighteen participants successfully completed the actual MRI scan. Chi-squared test showed no significant difference between male and female pass-fail rates. The median age of completed scans was 36 months, whereas the median age for children unable to complete a scan was 28 months. The average total trunk fat was 240.9±85.2mL and the average total VAT was 37.7±25.9mLand liver fat was not quantifiable due to physiological motion. Several strategies (modeling, videos, and incentives) were identified to improve pediatric imaging in different age ranges. Conclusion Using an age-specific and tailored protocol, we were able to successfully use MRI for fat imaging in a majority of young children. Development of such protocols enables researchers to better understand the etiology of fat deposition in young children, which can be used to aid in the prevention and treatment of adiposity. PMID:26901881

Fat Imaging via Magnetic Resonance Imaging (MRI) in Young Children (Ages 1-4 Years) without Sedation.

PubMed

Shearrer, Grace E; House, Benjamin T; Gallas, Michelle C; Luci, Jeffrey J; Davis, Jaimie N

2016-01-01

This pilot study developed techniques to perform Magnetic Resonance Imaging (MRI) of specific fat deposition in 18 children (age 18 months to 4 years). The children engaged in a series of practice tests to become acclimated to the scanner noises, reduce claustrophobia, and rehearse holding still for a set time. The practice tests assessed if the child could remain still for two minutes while watching a video, first while lying on a blanket, second, on the blanket with headphones, and third, in the mock scanner. The children who passed the three practice tests were then scanned with a 3T Siemens Skyra magnet. Abdominal fat distribution (region of interest (ROI) from the top of the ileac crest to the bottom of the ribcage) volume was measured using 2-point DIXON technique. This region was chosen to give an indication of the body composition around the liver. Twelve out of eighteen participants successfully completed the actual MRI scan. Chi-squared test showed no significant difference between male and female pass-fail rates. The median age of completed scans was 36 months, whereas the median age for children unable to complete a scan was 28 months. The average total trunk fat was 240.9±85.2mL and the average total VAT was 37.7±25.9mLand liver fat was not quantifiable due to physiological motion. Several strategies (modeling, videos, and incentives) were identified to improve pediatric imaging in different age ranges. Using an age-specific and tailored protocol, we were able to successfully use MRI for fat imaging in a majority of young children. Development of such protocols enables researchers to better understand the etiology of fat deposition in young children, which can be used to aid in the prevention and treatment of adiposity.

Safety performance evaluation of cable median barriers on freeways in Florida.

PubMed

Alluri, Priyanka; Haleem, Kirolos; Gan, Albert; Mauthner, John

2016-07-03

This article aims to evaluate the safety performance of cable median barriers on freeways in Florida. The safety performance evaluation was based on the percentages of barrier and median crossovers by vehicle type, crash severity, and cable median barrier type (Trinity Cable Safety System [CASS] and Gibraltar system). Twenty-three locations with cable median barriers totaling about 101 miles were identified. Police reports of 6,524 crashes from years 2005-2010 at these locations were reviewed to verify and obtain detailed crash information. A total of 549 crashes were determined to be barrier related (i.e., crashes involving vehicles hitting the cable median barrier) and were reviewed in further detail to identify crossover crashes and the manner in which the vehicles crossed the barriers; that is, by either overriding, underriding, or penetrating the barriers. Overall, 2.6% of vehicles that hit the cable median barrier crossed the median and traversed into the opposite travel lane. Overall, 98.1% of cars and 95.5% of light trucks that hit the barrier were prevented from crossing the median. In other words, 1.9% of cars and 4.5% of light trucks that hit the barrier had crossed the median and encroached on the opposite travel lanes. There is no significant difference in the performance of cable median barrier for cars versus light trucks in terms of crossover crashes. In terms of severity, overrides were more severe compared to underrides and penetrations. The statistics showed that the CASS and Gibraltar systems performed similarly in terms of crossover crashes. However, the Gibraltar system experienced a higher proportion of penetrations compared to the CASS system. The CASS system resulted in a slightly higher percentage of moderate and minor injury crashes compared to the Gibraltar system. Cable median barriers are successful in preventing median crossover crashes; 97.4% of the cable median barrier crashes were prevented from crossing over the median. Of all of

Heuristics for the inversion median problem

PubMed Central

2010-01-01

Background The study of genome rearrangements has become a mainstay of phylogenetics and comparative genomics. Fundamental in such a study is the median problem: given three genomes find a fourth that minimizes the sum of the evolutionary distances between itself and the given three. Many exact algorithms and heuristics have been developed for the inversion median problem, of which the best known is MGR. Results We present a unifying framework for median heuristics, which enables us to clarify existing strategies and to place them in a partial ordering. Analysis of this framework leads to a new insight: the best strategies continue to refer to the input data rather than reducing the problem to smaller instances. Using this insight, we develop a new heuristic for inversion medians that uses input data to the end of its computation and leverages our previous work with DCJ medians. Finally, we present the results of extensive experimentation showing that our new heuristic outperforms all others in accuracy and, especially, in running time: the heuristic typically returns solutions within 1% of optimal and runs in seconds to minutes even on genomes with 25'000 genes--in contrast, MGR can take days on instances of 200 genes and cannot be used beyond 1'000 genes. Conclusion Finding good rearrangement medians, in particular inversion medians, had long been regarded as the computational bottleneck in whole-genome studies. Our new heuristic for inversion medians, ASM, which dominates all others in our framework, puts that issue to rest by providing near-optimal solutions within seconds to minutes on even the largest genomes. PMID:20122203

Polypharmacy in the oldest old (≥80 years of age) patients in China: a cross-sectional study.

PubMed

Lai, Xiaoxing; Zhu, Hongwei; Huo, Xiaopeng; Li, Zheng

2018-03-02

The oldest old generally have worse health and more comorbidities than the general population of older adults, and they are more likely to be exposed to polypharmacy. Reliable investigation of polypharmacy among the oldest old (≥80 years of age) in China are lacking. So this study aims to describe the polypharmacy status of oldest old patients ≥80 years of age and to assess the factors influencing medication compliance. This was a cross-sectional study of 258 oldest old patients ≥ 80 years of age and hospitalized at a tertiary hospital in Beijing between December 1, 2014 and June 30, 2015. They completed three validated questionnaires to assess their pre-admission status (general demographics, medication knowledge, and medication adherence). Potentially inappropriate medications (PIM) use was evaluated by physicians. The majority of the patients (55.4%) took < 10 types of drugs. The numbers of drugs taken ranged from 8 to 60 drugs (median of 22.9). Patients taking 11-20 drugs accounted for 46.1% of the patients. Subjects with a history of adverse drug reactions accounted for 40.3%. The proportion of PIMs was 27.1%. Compliance was only 32.6% among the oldest old patients with polypharmacy. Age and medication classes were independently negatively associated with compliance, and medication knowledge was independently positively associated with compliance. Oldest old patients (≥ 80 years of age) had a poor medication knowledge. Age, medication classes, and medication knowledge were independently associated with medication compliance.

Blood Lead Levels in Children Aged 0–6 Years Old in Hunan Province, China from 2009–2013

PubMed Central

Qiu, Jun; Wang, Kewei; Wu, Xiaoli; Xiao, Zhenghui; Lu, Xiulan; Zhu, Yimin; Zuo, Chao; Yang, Yongjia; Wang, Youjie

2015-01-01

Objectives The aim of this study is to describe blood lead levels (BLLs) and the prevalence of elevated blood lead levels (EBLLs) in children aged 0–6 years old and to analyze the BLL trend in children from 2009 to 2013 in China. Methods A total of 124,376 children aged 0–6 years old were recruited for this study from January 1st 2009 to December 31st 2013. Their blood lead levels were analyzed using atomic absorption spectrometry. Results The median BLL was 64.3 μg/L (IQR: 49.6–81.0), and the range was 4.3–799.0 μg/L. Blood lead levels were significantly higher in boys (66.0 μg/L) than in girls (61.9 μg/L) (P<0.001). The overall prevalence of BLLs≥100 μg/L was 10.54% in children aged 0–6 years in Hunan Province. Between 2009 and 2013, the prevalence of EBLLs (≥100 μg/L) decreased from 18.31% to 4.26% in children aged 0–6 years and increased with age. The prevalence of EBLLs has dramatically decreased in two stages (2009–2010 and 2012–2013), with a slight fluctuation in 2010 and 2011. Conclusions Both BLLs and the prevalence of EBLLs in children aged 0–6 years old declined substantially from 2009 to 2013 in Hunan Province; however, both remain at unacceptably high levels compared to developed countries. Comprehensive strategies are required to further reduce blood lead levels in children. PMID:25830596

Estimated Glomerular Filtration Rate, Cardiovascular Events and Mortality Across Age Groups Among Individuals Older Than 60 Years in Southern Europe.

PubMed

Salvador-González, Betlem; Gil-Terrón, Neus; Cerain-Herrero, M Jesús; Subirana, Isaac; Güell-Miró, Roser; Rodríguez-Latre, Luisa M; Cunillera-Puértolas, Oriol; Elosua, Roberto; Grau, Maria; Vila, Joan; Pascual-Benito, Luisa; Mestre-Ferrer, Jordi; Ramos, Rafel; Baena-Díez, José Miguel; Soler-Vila, Maria; Alonso-Bes, Eva; Ruipérez-Guijarro, Laura; Álvarez-Funes, Virtudes; Freixes-Villaró, Esther; Rodríguez-Pascual, Mercedes; Martínez-Castelao, Alberto

2018-06-01

Individuals with a decreased estimated glomerular filtration rate (eGFR) are at increased risk of all-cause (ACM) and cardiovascular mortality; there is ongoing debate about whether older individuals with eGFR 45 to 59mL/min/1.73 m 2 are also at increased risk. We evaluated the association between eGFR and ACM and cardiovascular events (CVE) in people aged 60 to 74 and ≥ 75 years in a population with a low coronary disease incidence. We conducted a retrospective cohort study by using primary care and hospital electronic records. We included 130 233 individuals aged ≥ 60 years with creatinine measurement between January 1, 2010 and December 31, 2011; eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. The independent association between eGFR and the risk of ACM and hospital admission due to CVE were determined with Cox and Fine-Gray regressions, respectively. The median was age 70 years, and 56.1% were women; 13.5% had eGFR < 60 (69.7% eGFR 45-59). During a median follow-up of 38.2 months, 6474 participants died and 3746 had a CVE. For ACM and CVE, the HR in older individuals became significant at eGFR < 60. Fully adjusted HR for ACM in the eGFR 45 to 59 category were 1.61; 95%CI, 1.37-1.89 and 1.19; 95%CI, 1.10-1.28 in 60- to 74-year-olds and ≥ 75-year-olds, respectively; for CVE HR were 1.28; 95%CI, 1.08-1.51 and 1.12; 95%CI, 0.99-1.26. In a region with low coronary disease incidence, the risk of death and CVE increased with decreasing eGFR. In ≥ 75-year-olds, the eGFR 45 to 59 category, which had borderline risk for CVE, included many individuals without significant additional risk. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

The management of small area burns and unexpected illness after burn in children under five years of age - A costing study in the English healthcare setting.

PubMed

Kandiyali, R; Sarginson, J H; Hollén, L I; Spickett-Jones, F; Young, A E R

2018-02-01

The objective of this economic study was to evaluate the resource use and cost associated with the management of small area burns, including the additional costs associated with unexpected illness after burn in children of less than five years of age. This study was conducted as a secondary analysis of a multi-centre prospective observational cohort study investigating the physiological response to burns in children. 452 children were included in the economic analysis (median age=1.60years, 61.3% boys, median total burn surface area [TBSA]=1.00%) with a mean length of stay of 0.69 days. Of these children, 21.5% re-presented to medical care with an unexpected illness within fourteen days of injury. The cost of managing a burn of less than 10% TBSA in a child less than five years of age was £785. The additional cost associated with the management of illness after burn was £1381. A generalised linear regression model was used to determine the association between an unexpected illness after burn, presenting child characteristics and NHS cost. Our findings may be of value to those planning economic evaluations of novel technologies in burn care. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

PubMed Central

Dobie, Robert A; Wojcik, Nancy C

2015-01-01

Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999–2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Methods Regression analysis was used to derive new age-correction values using audiometric data from the 1999–2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20–75 years. Results The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20–75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61–75 years. Conclusions Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by

Outcomes of liver transplant with donors over 70 years of age.

PubMed

Mils, Kristel; Lladó, Laura; Fabregat, Juan; Baliellas, Carme; Ramos, Emilio; Secanella, Lluís; Busquets, Juli; Pelaez, Núria

2015-10-01

Organ shortage has forced transplant teams to progressively expand the acceptance of marginal donors. We performed a comparative analysis of the post-transplant evolution depending on donor age (group I: less than 70 years old (n=474) vs. group II: 70 or more years old [n=105]) over a 10 year period (2002-2011). Donors over 70 years old were similar to donors less than 70 years old in terms of ICU stay, gender, weight, laboratory results, and use of vasoactive drugs. However, the younger donor group presented with cardiac arrest more often (GI: 14 vs. GII: 3%, P=.005). There were no differences in initial poor function (GI: 6% vs. GII: 7,7%; P=.71), ICU stay (GI: 2.7±2 vs. GII: 3.3±3.8, P=.46), hospital stay (GI: 13.5±10 vs. GII: 15.5±11, P=.1), or hospital mortality (GI: 5.3 vs. GII: 5.8%, P=.66) between receptors of more or less than 70 year old grafts. After a median follow up of 32 months, no differences were found in the incidence of biliary tract complications (GI: 17 vs. GII: 20%, P=.4) or vascular complications (GI: 11 vs. GII: 9%, P=.69). The actuarial 5 year survival was similar for both study groups (GI: 70 vs. GII: 76%, P=.54). In our experience, the use of grafts from donors older than 70 years, when other risk factors are avoided (cold ischemia, steatosis, sodium levels), does not worsen the results of liver transplantation on the short or long term. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Applicability of Greulich and Pyle method for age assessment in forensic practice on an Italian sample.

PubMed

Tisè, Marco; Mazzarini, Laura; Fabrizzi, Giancarlo; Ferrante, Luigi; Giorgetti, Raffaele; Tagliabracci, Adriano

2011-05-01

The main importance in age estimation lies in the assessment of criminal liability and protection of unaccompanied minor immigrants, when their age is unknown. Under Italian law, persons are not criminally responsible before they reach the age of 14. The age of 18 is important when deciding whether juvenile or adult law must be applied. In the case of unaccompanied minors, it is important to assess age in order to establish special protective measures, and correct age estimation may prevent a person over 18 from benefiting from measures reserved for minors. Since the Greulich and Pyle method is one of the most frequently used in age estimation, the aim of this study was to assess the reproducibility and accuracy of the method on a large Italian sample of teenagers, to ascertain the applicability of the Atlas at the critical age thresholds of 14 and 18 years. This retrospective study examined posteroanterior X-ray projections of hand and wrist from 484 Italian-Caucasian young people (125 females, 359 males) between 11 and 19 years old. All radiographic images were taken from trauma patients hospitalized in the Azienda Ospedaliero Universitaria Ospedali Riuniti of Ancona (Italy) between 2006 and 2007. Two physicians analyzed all radiographic images separately. The blind method was used. In the case of an estimated age of 14 years old, the true age ranged from 12.2 to 15.9 years (median, 14.3 years, interquartile range, 1.0 years) for males, and 12.6 to 15.7 years (median, 14.2 years, interquartile range, 1.7 years) for females. In the case of an estimated age of 18 years, the true age ranged from 15.6 to 19.7 years (median, 17.7 years, interquartile range, 1.4 years) for males, and from 16.2 to 20.0 years (median, 18.7 years, interquartile range, 1.8 years) for females. Our study shows that although the GPM is a reproducible and repeatable method, there is a wide margin of error in the estimation of chronological age, mainly in the critical estimated

Disease Burden Due to Herpes Zoster among Population Aged ≥50 Years Old in China: A Community Based Retrospective Survey.

PubMed

Li, Yan; An, Zhijie; Yin, Dapeng; Liu, Yanmin; Huang, Zhuoying; Xu, Jianfang; Ma, Yujie; Tu, Qiufeng; Li, Qi; Wang, Huaqing

2016-01-01

To understand the disease burden due to Herpes Zoster (HZ) among people aged ≥50 years old in China and provide baseline data for future similar studies, and provide evidence for development of herpes zoster vaccination strategy. Retrospective cohort study was conducted in 4 townships and one community. A questionnaire was used to collect information on incidence and cost of HZ among people aged ≥ 50 years old. The cumulative incidence rate was 22.6/1,000 among people aged ≥ 50 years old. The average annual incidence rate of HZ was 3.43/1,000 among people aged ≥ 50 years old in 2010-2012. Cumulative incidence and average annual incidence rate increased with age: the cumulative incidence of HZ among people aged ≥ 80 years old was 3.34 times of that among 50-years old (52.3/1000 vs 15.7/1,000); average annual incidence rate rises from 2.66/1,000 among 50-years old to 8.55/1,000 among 80-year old. Cumulative incidence and average annual incidence rate for females were higher than that for males (cumulative incidence, 26.5/1000 vs 18.7/1,000; annual incidence rate, 3.95/1000 vs 2.89/1,000). Cumulative incidence and average annual incidence rate in urban were higher than in rural (cumulative incidence, 39.5/1000 vs 17.2/1,000; annual incidence rate, 7.65/1000 vs 2.06/1,000). The hospitalization rate of HZ was 4.53%. And with the increase of age, the rate has an increasing trend. HZ costs 945,709.5 RMB in total, corresponding to 840.6 RMB per patient with a median cost of 385 RMB (interquartile range 171.7-795.6). Factors associated with cost included the first onset year, area, whether hospitalized and whether sequelae left. Incidence rate, complications, hospitalization rate and average cost of HZ increase with age. We recommend that the HZ vaccinations should target people aged ≥50 years old if Zoster vaccine is licensed in China.

ERICA: age at menarche and its association with nutritional status.

PubMed

Barros, Bruna de Siqueira; Kuschnir, Maria Cristina Maria Caetano; Bloch, Katia Vergetti; Silva, Thiago Luiz Nogueira da

2018-01-18

To estimate the mean age at menarche and its association with nutritional status in Brazilian adolescents. The study sample included female adolescents aged 12-17 who participated in a multicenter, school-based, country-wide, cross-sectional study entitled The Study of Cardiovascular Risk in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes [ERICA]). Mean and median ages at menarche in Brazil were estimated. The association of age at menarche with sociodemographic data and nutritional status were described as means and their respective 95% confidence intervals. Survival analysis was used to assess the age at menarche according to nutritional status categories and the log-rank test was used to compare the medians. Bivariate and multivariate analyses were performed using Cox regression to verify the association between menarche and other variables. A total of 73,624 students were evaluated, comprising 40,803 girls, of whom 37,390 reported menarche at a mean age of 11.71 years and a median of 12.41 years. Median age at menarche was lower in overweight and obese girls (p<0.001). The multivariate analysis showed that excess weight (HR=1.28; 95% CI 1.21-1.36; p<0.001) and studying in a private school (HR=1.06; 95% CI 1.02-1.10; p=0.003) were associated with menarche. This is a pioneering study in Brazil with national and regional representativeness to estimate the mean and the median age of occurrence of menarche. Adolescents with excess weight had an earlier menarche than their peers, even after adjustment for confounding factors. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Reference values of whole-blood fatty acids by age and sex from European children aged 3-8 years.

PubMed

Wolters, M; Schlenz, H; Foraita, R; Galli, C; Risé, P; Moreno, L A; Molnár, D; Russo, P; Veidebaum, T; Tornaritis, M; Vyncke, K; Eiben, G; Iacoviello, L; Ahrens, W

2014-09-01

To establish reference values for fatty acids (FA) especially for n-3 and n-6 long-chain polyunsaturated FAs (LC PUFA) in whole-blood samples from apparently healthy 3-8-year-old European children. The whole-blood FA composition was analysed and the age- and sex-specific distribution of FA was determined. Blood samples for FA analysis were taken from 2661 children of the IDEFICS (identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study cohort. Children with obesity (n=454) and other diseases that are known to alter the FA composition (n=450) were excluded leaving 1653 participants in the reference population. The FA composition of whole blood was analysed from blood drops by a rapid, validated gas chromatographic method. Pearson correlation coefficients showed an age-dependent increase of C18:2n-6 and a decrease of C18:1n-9 in a subsample of normal weight boys and girls. Other significant correlations with age were weak and only seen either in boys or in girls, whereas most of the FA did not show any age dependence. For age-dependent n-3 and n-6 PUFA as well as for other FA that are correlated with age (16:0, C18:0 and C18:1n-9) percentiles analysed with the general additive model for location scale and shape are presented. A higher median in boys than in girls was observed for C20:3n-6, C20:4n-6 and C22:4n-6. Given the reported associations between FA status and health-related outcome, the provision of FA reference ranges may be useful for the interpretation of the FA status of children in epidemiological and clinical studies.

Current Cigarette Smoking, Access, and Purchases from Retail Outlets Among Students Aged 13-15 Years - Global Youth Tobacco Survey, 45 Countries, 2013 and 2014.

PubMed

D'Angelo, Denise; Ahluwalia, Indu B; Pun, Eugene; Yin, Shaoman; Palipudi, Krishna; Mbulo, Lazarous

2016-09-02

Tobacco use is a leading preventable cause of morbidity and mortality, with nearly 6 million deaths caused by tobacco use worldwide every year (1). Cigarette smoking is the most common form of tobacco use in most countries, and the majority of adult smokers initiate smoking before age 18 years (2,3). Limiting access to cigarettes among youths is an effective strategy to curb the tobacco epidemic by preventing smoking initiation and reducing the number of new smokers (3,4). CDC used the Global Youth Tobacco Survey (GYTS) data from 45 countries to examine the prevalence of current cigarette smoking, purchase of cigarettes from retail outlets, and type of cigarette purchases made among school students aged 13-15 years. The results are presented by the six World Health Organization (WHO) regions: African Region (AFR); Eastern Mediterranean Region (EMR); European Region (EUR); Region of the Americas (AMR); South-East Asian Region (SEAR); and Western Pacific Region (WPR). Across all 45 countries, the median overall current cigarette smoking prevalence among students aged 13-15 years was 6.8% (range = 1.7% [Kazakhstan]-28.9% [Timor-Leste]); the median prevalence among boys was 9.7% (2.0% [Kazakhstan]-53.5% [Timor-Leste]), and among girls was 3.5% (0.0% [Bangladesh]-26.3% [Italy]). The proportion of current cigarette smokers aged 13-15 years who reported purchasing cigarettes from a retail outlet such as a store, street vendor, or kiosk during the past 30 days ranged from 14.9% [Latvia] to 95.1% [Montenegro], and in approximately half the countries, exceeded 50%. In the majority of countries assessed in AFR and SEAR, approximately 40% of cigarette smokers aged 13-15 years reported purchasing individual cigarettes. Approximately half of smokers in all but one country assessed in EUR reported purchasing cigarettes in packs. These findings could be used by countries to inform tobacco control strategies in the retail environment to reduce and prevent marketing and sales of

Fecal overflow often affects children with chronic constipation that appears after the age of 2 years.

PubMed

Kammacher Guerreiro, Mélissa; Bettinville, Aurore; Herzog, Denise

2014-08-01

Chronic functional constipation with or without encopresis is a common problem in the pediatric population, and the prevalence of encopresis may be underestimated. The aim of this study was to assess the prevalence and risk factors for overflow incontinence in patients with chronic constipation seen at a pediatric gastroenterology consultation. A retrospective study of 270 files of patients seen between 1997 and 2012 was conducted, and a classification according to Rome III criteria was done. Among 145 (53.7%) boys and 125 (46.2%) girls, 117 had overflow incontinence (43.3%) - 41 (35%) girls and 76 (65%) boys. The first symptoms of chronic constipation appeared at a median age of 30 and 33 months in encopretic and 16 and 12 months in nonencopretic girls and boys, respectively. The first specialized consultation took place after a median disease duration of 26.5 and 24 months in encopretic and 16 and 9 months in nonencopretic girls and boys, respectively. A history of stool retention and the presence of scybala at examination, but not of pain at defecation or anal fissure, were associated with encopresis. The onset of chronic constipation after the age of 2 years, a longer disease duration, male gender, and a history of stool retention were seen as risk factors for the development of encopresis in patients with chronic functional constipation. © The Author(s) 2014.

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.

Abnormal sensory reactivity in preterm infants during the first year correlates with adverse neurodevelopmental outcomes at 2 years of age.

PubMed

Chorna, Olena; Solomon, Jessica E; Slaughter, James C; Stark, Ann R; Maitre, Nathalie L

2014-11-01

Sensory experience is the basis for learning in infancy. In older children, abnormal sensory reactivity is associated with behavioural and developmental disorders. We hypothesised that in preterm infants, abnormal sensory reactivity during infancy would be associated with perinatal characteristics and correlate with 2-year neurodevelopmental outcomes. We conducted a prospective observational study of infants with birth weight ≤1500 g using the Test of Sensory Function in Infants (TSFI) in the first year. Infants with gestational age ≤30 weeks were tested with the Bayley Scales of Infant and Toddler Development III (BSID III) at 24 months. Of the 72 participants evaluated at 4-12 months corrected age (median 8 months), 59 (82%) had a least one TSFI score concerning for abnormal sensory reactivity. Lower gestational age was associated with abnormal reactivity to deep pressure and vestibular stimulation (p<0.001). Poor ocular-motor control predicted worse cognitive and motor scores in early childhood (OR 16.7; p=0.004), but was tightly correlated to the presence of severe white matter injury. Poor adaptive motor function in response to tactile stimuli predicted worse BSID III motor (p=0.01) and language scores (p=0.04) at 2 years, even after adjusting for confounders. Abnormal sensory reactivity is common in preterm infants; is associated with immaturity at birth, severe white matter injury and lower primary caregiver education; and predicts neurodevelopmental delays. Early identification of abnormal sensory reactivity of very preterm infants may promote parental support and education and may facilitate improved neurodevelopment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Motor and executive function at 6 years of age after extremely preterm birth.

PubMed

Marlow, Neil; Hennessy, Enid M; Bracewell, Melanie A; Wolke, Dieter

2007-10-01

Studies of very preterm infants have demonstrated impairments in multiple neurocognitive domains. We hypothesized that neuromotor and executive-function deficits may independently contribute to school failure. We studied children who were born at < or = 25 completed weeks' gestation in the United Kingdom and Ireland in 1995 at early school age. Children underwent standardized cognitive and neuromotor assessments, including the Kaufman Assessment Battery for Children and NEPSY, and a teacher-based assessment of academic achievement. Of 308 surviving children, 241 (78%) were assessed at a median age of 6 years 4 months. Compared with 160 term classmates, 180 extremely preterm children without cerebral palsy and attending mainstream school performed less well on 3 simple motor tasks: posting coins, heel walking, and 1-leg standing. They more frequently had non-right-hand preferences (28% vs 10%) and more associated/overflow movements during motor tasks. Standardized scores for visuospatial and sensorimotor function performance differed from classmates by 1.6 and 1.1 SDs of the classmates' scores, respectively. These differences attenuated but remained significant after controlling for overall cognitive scores. Cognitive, visuospatial scores, and motor scores explained 54% of the variance in teachers' ratings of performance in the whole set; in the extremely preterm group, additional variance was explained by attention-executive tasks and gender. Impairment of motor, visuospatial, and sensorimotor function, including planning, self-regulation, inhibition, and motor persistence, contributes excess morbidity over cognitive impairment in extremely preterm children and contributes independently to poor classroom performance at 6 years of age.

Adaptive marginal median filter for colour images.

PubMed

Morillas, Samuel; Gregori, Valentín; Sapena, Almanzor

2011-01-01

This paper describes a new filter for impulse noise reduction in colour images which is aimed at improving the noise reduction capability of the classical vector median filter. The filter is inspired by the application of a vector marginal median filtering process over a selected group of pixels in each filtering window. This selection, which is based on the vector median, along with the application of the marginal median operation constitutes an adaptive process that leads to a more robust filter design. Also, the proposed method is able to process colour images without introducing colour artifacts. Experimental results show that the images filtered with the proposed method contain less noisy pixels than those obtained through the vector median filter.

Decline of Neurologic Varicella Complications in Children During the First Seven Years After Introduction of Universal Varicella Vaccination in Germany, 2005-2011.

PubMed

Streng, Andrea; Grote, Veit; Rack-Hoch, Anita; Liese, Johannes G

2017-01-01

Universal varicella vaccination for 1-year-old children was introduced in Germany in 2004. We investigated changes in the incidence and type of varicella-associated neurologic complications in children during the first 7 years after universal vaccination recommendation. A surveillance study was conducted based on patients <17 years of age with an International Classification of Diseases (10th Revision) discharge diagnosis of varicella, annually reported by 22-29 pediatric hospitals in Bavaria, Germany, 2005 to 2011. Annual incidences were estimated and linear trend across years was assessed by Poisson regression models. Of a total of 1263 varicella-associated pediatric hospitalizations, 228 children (18.1%) had neurologic complications (median age 4 years, interquartile range 2-7; 56% male). The most frequent neurologic complications were febrile convulsion (32.0% of 228 children, median age 3.0 years), varicella encephalitis or meningitis (28.9%; median age 4.5 years), syncope (13.2%; median age 7.0 years) and cerebral convulsion (11.0%; median age 4.0 years). Other complications included ataxia (3.1%), facial nerve palsy (2.6%) and cerebral vasculitis/infarction (1.8%). Neurologic complications showed a continuous decrease between 2005 and 2011, from an incidence of 2.8 (95% confidence interval: 2.1-3.6) per 100,000 children <17 years of age to 1.2 (95% confidence interval: 0.7-2.1; P < 0.001). In particular, a marked decline was observed among children up to 7 years of age, mainly because of a decrease in the number of febrile convulsions and encephalitis or meningitis. The incidence of varicella-associated neurologic complications in children decreased approximately by 60% during the first 7 years following the recommendation for universal vaccination.

Comparison of intensive, pediatric-inspired therapy with non-intensive therapy in older adults aged 55-65 years with Philadelphia chromosome-negative acute lymphoblastic leukemia.

PubMed

Ribera, Josep-Maria; García, Olga; Gil, Cristina; Mercadal, Santiago; García-Cadenas, Irene; Montesinos, Pau; Barba, Pere; Vives, Susana; González-Campos, José; Tormo, Mar; Esteve, Jordi; López, Aurelio; Moreno, María José; Ribera, Jordi; Alonso, Natalia; Bermúdez, Arancha; Amigo, María Luz; Genescà, Eulàlia; García, Daniel; Vall-Llovera, Ferran; Bergua, Juan Miguel; Guàrdia, Ramon; Monteserín, María Carmen; Bernal, Teresa; Calbacho, María; Martínez, María Pilar; Feliu, Evarist

2018-05-01

The standardization of treatment of older adults with Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) is challenging, especially in the age range of 55-65 years. This study aimed to compare intensive, pediatric-inspired therapy with non-intensive therapy in this population of patients. The outcomes of 67 patients prospectively included in two consecutive pediatric-inspired intensive protocols (ALL-HR03 and ALL-HR11) from the Spanish PETHEMA Group were compared with those from 44 patients included in a contemporary semi-intensive protocol (ALL-OLD07). Baseline patient and ALL characteristics were similar in both groups, except for a younger median age in the intensive group (medians: 58 vs. 62 years). Patients treated intensively had a higher complete remission rate (85% vs. 64%, p = 0.005), a lower cumulative incidence of relapse (39% [95%CI, 25% to 52%] vs. 60% [95%CI, 38% to 77%], p = .003), a similar cumulative incidence of treatment-related mortality (28% [95% CI, 18%, 40%] vs. 21% [95% CI, 10%, 34%]) and superior event-free survival at 2 years (37% [95%CI, 25%-49%) vs. 21% [8%-34%], p = 0.002). On multivariable analysis the type of protocol was the only variable with independent significance for event-free survival (HR [95% CI]: 2 [1.3, 3], p = .002). Compared with less intensive chemotherapy, pediatric-inspired intensive chemotherapy significantly improves the outcome of older adults with Ph-negative ALL in the age range of 55-65 years. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Comparison of Ultrasound and MRI Measurements of the Cross-Sectional Area of the Median Nerve at the Wrist.

PubMed

Hersh, Beverly; D'Auria, Jennifer; Scott, Michael; Fowler, John R

2018-05-01

Ultrasound (US) measurement of cross-sectional area (CSA) of the median nerve has emerged as a viable alternative to electromyography/nerve conduction studies (EMG/NCS) for diagnosis of carpal tunnel syndrome (CTS). The purpose of this study is to compare CSA of the median nerve between US and MRI using current MRI and US technology. The null hypothesis is there is no difference between US and MRI CSA measurements. The study design was an observational cohort, enrolling patients presenting to clinic with MRI of the wrist. Participants with clinical signs and symptoms of CTS were excluded. The CSA measurements of the median nerve on MRI T1-weighted axial images were performed by a hand fellow blinded to results of US measurements, and US measurement of median nerve CSA was performed by a hand fellowship trained surgeon blinded to results of the MRI measurements. Results were analyzed via percent error, Pearson correlation, and t tests. Twenty participants were enrolled with mean age of 29.4 years. Four left wrists and 16 right wrists were measured. The US mean CSA of the median nerve was 6.8 mm 2 (±2.330 mm 2 ). The MRI mean CSA of the median nerve was 6.8 mm 2 (±2.153 mm 2 ), P = .442. Pearson correlation between modalities was 0.93, suggesting near-perfect correlation. Mean percent error was 8.8%. Results of this study suggest that US is an accurate method to measure CSA of the median nerve at the carpal tunnel inlet. The mean difference between US and MRI was unlikely to be clinically significant.

Iterative dip-steering median filter

NASA Astrophysics Data System (ADS)

Huo, Shoudong; Zhu, Weihong; Shi, Taikun

2017-09-01

Seismic data are always contaminated with high noise components, which present processing challenges especially for signal preservation and its true amplitude response. This paper deals with an extension of the conventional median filter, which is widely used in random noise attenuation. It is known that the standard median filter works well with laterally aligned coherent events but cannot handle steep events, especially events with conflicting dips. In this paper, an iterative dip-steering median filter is proposed for the attenuation of random noise in the presence of multiple dips. The filter first identifies the dominant dips inside an optimized processing window by a Fourier-radial transform in the frequency-wavenumber domain. The optimum size of the processing window depends on the intensity of random noise that needs to be attenuated and the amount of signal to be preserved. It then applies median filter along the dominant dip and retains the signals. Iterations are adopted to process the residual signals along the remaining dominant dips in a descending sequence, until all signals have been retained. The method is tested by both synthetic and field data gathers and also compared with the commonly used f-k least squares de-noising and f-x deconvolution.

Carotid disease at age 73 and cognitive change from age 70 to 76 years: A longitudinal cohort study

PubMed Central

Allerhand, Michael; Eadie, Elizabeth; Thomas, Avril; Corley, Janey; Pattie, Alison; Taylor, Adele; Shenkin, Susan D; Cox, Simon; Gow, Alan; Starr, John M; Deary, Ian J

2016-01-01

Cognitive decline and carotid artery atheroma are common at older ages. In community-dwelling subjects, we assessed cognition at ages 70, 73 and 76 and carotid Doppler ultrasound at age 73, to determine whether carotid stenosis was related to cognitive decline. We used latent growth curve models to examine associations between four carotid measures (internal carotid artery stenosis, velocity, pulsatility and resistivity indices) and four cognitive ability domains (memory, visuospatial function, crystallised intelligence, processing speed) adjusted for cognitive ability at age 11, current age, gender and vascular risk factors. Amongst 866 participants, carotid stenosis (median 12.96%) was not associated with cognitive abilities at age 70 or cognitive decline from age 70 to 76. Increased ICA pulsatility and resistivity indices were associated with slower processing speed (both P < 0.001) and worse visuospatial function (P = 0.036, 0.031, respectively) at age 70, and declining crystallised intelligence from ages 70 to 76 (P = 0.008, 0.006, respectively). The findings suggest that vascular stiffening, rather than carotid luminal narrowing, adversely influences cognitive ageing and provides a potential target for ameliorating age-related cognitive decline. PMID:28155579

Carotid disease at age 73 and cognitive change from age 70 to 76 years: A longitudinal cohort study.

PubMed

Wardlaw, Joanna M; Allerhand, Michael; Eadie, Elizabeth; Thomas, Avril; Corley, Janey; Pattie, Alison; Taylor, Adele; Shenkin, Susan D; Cox, Simon; Gow, Alan; Starr, John M; Deary, Ian J

2017-08-01

Cognitive decline and carotid artery atheroma are common at older ages. In community-dwelling subjects, we assessed cognition at ages 70, 73 and 76 and carotid Doppler ultrasound at age 73, to determine whether carotid stenosis was related to cognitive decline. We used latent growth curve models to examine associations between four carotid measures (internal carotid artery stenosis, velocity, pulsatility and resistivity indices) and four cognitive ability domains (memory, visuospatial function, crystallised intelligence, processing speed) adjusted for cognitive ability at age 11, current age, gender and vascular risk factors. Amongst 866 participants, carotid stenosis (median 12.96%) was not associated with cognitive abilities at age 70 or cognitive decline from age 70 to 76. Increased ICA pulsatility and resistivity indices were associated with slower processing speed (both P < 0.001) and worse visuospatial function ( P = 0.036, 0.031, respectively) at age 70, and declining crystallised intelligence from ages 70 to 76 ( P = 0.008, 0.006, respectively). The findings suggest that vascular stiffening, rather than carotid luminal narrowing, adversely influences cognitive ageing and provides a potential target for ameliorating age-related cognitive decline.

Vertical Jump and Leg Power Normative Data for Colombian Schoolchildren Aged 9-17.9 Years: The FUPRECOL Study.

PubMed

Ramírez-Vélez, Robinson; Correa-Bautista, Jorge E; Lobelo, Felipe; Cadore, Eduardo L; Alonso-Martinez, Alicia M; Izquierdo, Mikel

2017-04-01

Ramírez-Vélez, R, Correa-Bautista, JE, Lobelo, F, Cadore, EL, Alonso-Martinez, AM, and Izquierdo, M. Vertical jump and leg power normative data for Colombian schoolchildren aged 9-17.9 years: the FUPRECOL study. J Strength Cond Res 31(4): 990-998, 2017-The aims of the present study were to generate normative vertical jump height and predicted peak power (Ppeak) data for 9- to 17.9-year-olds and to investigate between-sex and age group differences in these measures. This was a cross-sectional study of 7,614 healthy schoolchildren (boys n = 3,258 and girls n = 4,356, mean [SD] age 12.8 [2.3] years). Each participant performed 2 countermovement jumps; jump height was calculated using a Takei 5414 Jump-DF Digital Vertical (Takei Scientific Instruments Co., Ltd.). The highest jump was used for analysis and in the calculation of predicted Ppeak. Centile smoothed curves, percentiles, and tables for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were calculated using Cole's LMS (L [curve Box-Cox], M [curve median], and S [curve coefficient of variation]) method. The 2-way analysis of variance tests showed that maximum jump height (in centimeters) and predicted Ppeak (in watts) were higher in boys than in girls (p < 0.01). Post hoc analyses within sexes showed yearly increases in jump height and Ppeak in all ages. In boys, the maximum jump height and predicted Ppeak 50th percentile ranged from 24.0 to 38.0 cm and from 845.5 to 3061.6 W, respectively. In girls, the 50th percentile for jump height ranged from 22.3 to 27.0 cm, and the predicted Ppeak was 710.1-2036.4 W. For girls, jump height increased yearly from 9 to 17.9 years old. Our results provide, for the first time, sex- and age-specific vertical jump height and predicted Ppeak reference standards for Colombian schoolchildren aged 9-17.9 years.

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

PubMed

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

2010-12-01

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

Switching non-local vector median filter

NASA Astrophysics Data System (ADS)

Matsuoka, Jyohei; Koga, Takanori; Suetake, Noriaki; Uchino, Eiji

2016-04-01

This paper describes a novel image filtering method that removes random-valued impulse noise superimposed on a natural color image. In impulse noise removal, it is essential to employ a switching-type filtering method, as used in the well-known switching median filter, to preserve the detail of an original image with good quality. In color image filtering, it is generally preferable to deal with the red (R), green (G), and blue (B) components of each pixel of a color image as elements of a vectorized signal, as in the well-known vector median filter, rather than as component-wise signals to prevent a color shift after filtering. By taking these fundamentals into consideration, we propose a switching-type vector median filter with non-local processing that mainly consists of a noise detector and a noise removal filter. Concretely, we propose a noise detector that proactively detects noise-corrupted pixels by focusing attention on the isolation tendencies of pixels of interest not in an input image but in difference images between RGB components. Furthermore, as the noise removal filter, we propose an extended version of the non-local median filter, we proposed previously for grayscale image processing, named the non-local vector median filter, which is designed for color image processing. The proposed method realizes a superior balance between the preservation of detail and impulse noise removal by proactive noise detection and non-local switching vector median filtering, respectively. The effectiveness and validity of the proposed method are verified in a series of experiments using natural color images.

Fractionated gemtuzumab ozogamicin and standard dose cytarabine produced prolonged second remissions in patients over the age of 55 years with acute myeloid leukemia in late first relapse.

PubMed

Pilorge, Sylvain; Rigaudeau, Sophie; Rabian, Florence; Sarkozy, Clémentine; Taksin, Anne L; Farhat, Hassan; Merabet, Fathia; Ghez, Stéphanie; Raggueneau, Victoria; Terré, Christine; Garcia, Isabelle; Renneville, Aline; Preudhomme, Claude; Castaigne, Sylvie; Rousselot, Philippe

2014-04-01

Gemtuzumab ozogamicin (fGO), a humanized anti-CD33 monoclonal antibody linked to calicheamicin in combination with intensive chemotherapy gives high response rates in adult acute myeloid leukemia (AML) patients in relapse. However, reduced intensity chemotherapy in combination with fractionated GO has not been tested in aged relapsing patients. Patients from our institution with CD33+ AML aged 55 years or more in first late relapse (≥ 6 months) were proposed participation in a GO compassionate use program. Induction therapy consisted in fractionated GO (fGO; 3 mg/m², days 1, 4, 7) with standard-dose cytarabine (200 mg/m² /day, 7 days). Patients were consolidated with two courses of GO and intermediate dose cytarabine. Twenty-four patients (median age 68 years) received fGO with cytarabine. Median follow-up was 42 months. The response rate was 75%, including complete remission (CR) in 16 patients and CR with incomplete platelet recovery (CRp) in two patients. Two-year overall survival (OS) was 51% (95% CI: 28-69) and 2 years relapse-free survival (RFS) was 51% (95%CI: 25-72). Duration of second CR (CR2) was longer than first CR (CR1) in 9 out of 18 patients. Minimal residual disease (MRD) was negative in evaluable patients in CR2, particularly in NPM1 mutated cases. Toxicity was in line with that of the same fractionated single agent GO schedule. Fractionated GO with low intensity chemotherapy produced high response rates and prolonged CR2 in aged AML patients in first late relapse. Copyright © 2013 Wiley Periodicals, Inc.

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

PubMed

Dobie, Robert A; Wojcik, Nancy C

2015-07-13

The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to

Wavelet median denoising of ultrasound images

NASA Astrophysics Data System (ADS)

Macey, Katherine E.; Page, Wyatt H.

2002-05-01

Ultrasound images are contaminated with both additive and multiplicative noise, which is modeled by Gaussian and speckle noise respectively. Distinguishing small features such as fallopian tubes in the female genital tract in the noisy environment is problematic. A new method for noise reduction, Wavelet Median Denoising, is presented. Wavelet Median Denoising consists of performing a standard noise reduction technique, median filtering, in the wavelet domain. The new method is tested on 126 images, comprised of 9 original images each with 14 levels of Gaussian or speckle noise. Results for both separable and non-separable wavelets are evaluated, relative to soft-thresholding in the wavelet domain, using the signal-to-noise ratio and subjective assessment. The performance of Wavelet Median Denoising is comparable to that of soft-thresholding. Both methods are more successful in removing Gaussian noise than speckle noise. Wavelet Median Denoising outperforms soft-thresholding for a larger number of cases of speckle noise reduction than of Gaussian noise reduction. Noise reduction is more successful using non-separable wavelets than separable wavelets. When both methods are applied to ultrasound images obtained from a phantom of the female genital tract a small improvement is seen; however, a substantial improvement is required prior to clinical use.

Effect of family disintegration on age at menarche.

PubMed

Toromanović, Alma; Tahirović, Husref

2015-01-01

The aim of this study was to determine the effect of psychosocial factors on the age at menarche of girls in Federation of Bosnia and Herzegovina (FBH). A cross-sectional study was conducted from September 2002 to May 2003 in all Cantons of the FBH. The random stratified sample included 19.803 girls aged 9.0 to 17.5 years. Data were collected using the status quo method. Probit analysis was used to estimate median age at menarche and 95% confidence intervals. The present study shows that menarche occurred significantly earlier (p<0.05) in girls from dysfunctional families (median: 12.99 years, 95% confidence interval: 12.93-13.05) than in girls who grew up in intact families (median: 13.04 years, 95% confidence interval: 13.01-13.07). Analyzing separately the impact of each of family stressors on age at menarche, we found that menarcheal age was significantly lower in girls from single-mother families, whose parents are divorced, whose one parent is died and where alcoholism in family is present than in girls from intact families. Maturation was found to be earlier in girls from dysfunctional families then in those from intact families after the influence of place of residence and sibship size was eliminated. From our research we can conclude that the girls from dysfunctional families reached earlier age at menarche than their peers who grew up in normal families, and that this effect did not disappear after controlling for socioeconomic variables. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

The effectiveness of nasal mask vs face mask ventilation in anesthetized, apneic pediatric subjects over 2 years of age: a randomized controlled trial.

PubMed

Itagaki, Taiga; Gubin, Tatyana A; Sayal, Puneet; Jiang, Yandong; Kacmarek, Robert M; Anderson, Thomas Anthony

2016-02-01

We hypothesized that anesthetized, apneic children could be ventilated equivalently or more efficiently by nasal mask ventilation (NMV) than face mask ventilation (FMV). The aim of this randomized controlled study was to test this hypothesis by comparing the expiratory tidal volume (Vte) between NMV and FMV. After the induction of anesthesia, 41 subjects, 3-17 years of age without anticipated difficult mask ventilation, were randomly assigned to receive either NMV or FMV with neck extension. Both groups were ventilated with pressure control ventilation (PCV) at 20 cmH2 O of peak inspiratory pressure (PIP) with positive end-expiratory pressure (PEEP) levels of 0, 5, and 10 cmH2 O. An additional mouth closing maneuver (MCM) was applied for the NMV group. The Vte was higher in the FMV group compared with the NMV group (median difference [95% CI]: 8.4 [5.5-11.6] ml·kg(-1) ; P < 0.001) when MCM was not applied. NMV achieved less PEEP than FMV (median difference [95% CI]: 5.0 [4.3-5.3] cmH2 O at 10 cmH2 O; P < 0.001) though both groups achieved the set PIP level. In the NMV group, MCM markedly increased Vte (median increase [95% CI]: 5.9 [2.5-9.0] ml·kg(-1) ; P < 0.005) and PEEP (median increase [95% CI]: 5.0 [0.6-8.6] cmH2 O at 10 cmH2 O; P < 0.005); however, PEEP was highly variable and lower than that of FMV (median difference [95% CI]: 2.5 [0.8-8.5] cmH2 O at 10 cmH2 O; P < 0.05). In anesthetized, apneic children greater than 2 years of age ventilated with an anesthesia ventilator and neck extension, FMV established a greater Vte than NMV regardless of mouth status. NMV could not maintain the set PEEP level due to an air leak from the mouth. The MCM increased the Vte and PEEP. © 2016 John Wiley & Sons Ltd.

Evaluation of median barrier safety issues.

DOT National Transportation Integrated Search

2008-01-01

The objective of this study was to evaluate the effectiveness of the Brifen TL-4 and Trinity CASS median cable barrier systems in preventing cross-median collisions on sections of I-64, I-71, and I-265 (Brifen system) and I-265 (Trinity system) in Je...

Establishing International Blood Pressure References Among Nonoverweight Children and Adolescents Aged 6 to 17 Years.

PubMed

Xi, Bo; Zong, Xin'nan; Kelishadi, Roya; Hong, Young Mi; Khadilkar, Anuradha; Steffen, Lyn M; Nawarycz, Tadeusz; Krzywińska-Wiewiorowska, Małgorzata; Aounallah-Skhiri, Hajer; Bovet, Pascal; Chiolero, Arnaud; Pan, Haiyan; Litwin, Mieczysław; Poh, Bee Koon; Sung, Rita Y T; So, Hung-Kwan; Schwandt, Peter; Haas, Gerda-Maria; Neuhauser, Hannelore K; Marinov, Lachezar; Galcheva, Sonya V; Motlagh, Mohammad Esmaeil; Kim, Hae Soon; Khadilkar, Vaman; Krzyżaniak, Alicja; Romdhane, Habiba Ben; Heshmat, Ramin; Chiplonkar, Shashi; Stawińska-Witoszyńska, Barbara; El Ati, Jalila; Qorbani, Mostafa; Kajale, Neha; Traissac, Pierre; Ostrowska-Nawarycz, Lidia; Ardalan, Gelayol; Parthasarathy, Lavanya; Zhao, Min; Zhang, Tao

2016-01-26

Several distributions of country-specific blood pressure (BP) percentiles by sex, age, and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limits international comparisons of the prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents by using 7 nationally representative data sets (China, India, Iran, Korea, Poland, Tunisia, and the United States). Data on BP for 52 636 nonoverweight children and adolescents aged 6 to 19 years were obtained from 7 large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. BP values were obtained with certified mercury sphygmomanometers in all 7 countries by using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th, and 99th) by age and height were estimated by using the Generalized Additive Model for Location Scale and Shape model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. In comparison with the BP levels of the 90th and 95th percentiles of the US Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower, whereas diastolic BP was similar. These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help to identify hypertensive youths in diverse populations. © 2015 American Heart Association, Inc.

Landscaping of highway medians and roadway safety at unsignalized intersections.

PubMed

Chen, Hongyun; Fabregas, Aldo; Lin, Pei-Sung

2016-05-01

Well-planted and maintained landscaping can help reduce driving stress, provide better visual quality, and decrease over speeding, thus improving roadway safety. Florida Department of Transportation (FDOT) Standard Index (SI-546) is one of the more demanding standards in the U.S. for landscaping design criteria at highway medians near intersections. The purposes of this study were to (1) empirically evaluate the safety results of SI-546 at unsignalized intersections and (2) quantify the impacts of geometrics, traffic, and landscaping design features on total crashes and injury plus fatal crashes. The studied unsignalized intersections were divided into (1) those without median trees near intersections, (2) those with median trees near intersections that were compliant with SI-546, and (3) those with median trees near intersections that were non-compliant with SI-546. A total of 72 intersections were selected, for which five-year crash data from 2006-2010 were collected. The sites that were compliant with SI-546 showed the best safety performance in terms of the lowest crash counts and crash rates. Four crash predictive models-two for total crashes and two for injury crashes-were developed. The results indicated that improperly planted and maintained median trees near highway intersections can increase the total number of crashes and injury plus fatal crashes at a 90% confidence level; no significant difference could be found in crash rates between sites that were compliant with SI-546 and sites without trees. All other conditions remaining the same, an intersection with trees that was not compliant with SI-546 had 63% more crashes and almost doubled injury plus fatal crashes than those at intersections without trees. The study indicates that appropriate landscaping in highway medians near intersections can be an engineering technology that not only improves roadway environmental quality but also maintains intersection safety. Copyright © 2016. Published by

REGRESSION ON MEDIANS OF PROBABILITY DISTRIBUTIONS

EPA Science Inventory

The median is a fundamental parameter in the area of lifetime and survival statistics. n toxicodynamics the LD50, lethal dose that results in 50% mortality, is frequently used. he median is also used to describe the incidence of cancer and other disease states. Factors such as nu...

Sports engagement and age at first myocardial infarction in men under 55 years of age.

PubMed

Janggen, Christoph; Gräni, Christoph; Brunner, Jonas; Trachsel, Lukas D; Windecker, Stephan; Eser, Prisca; Räber, Lorenz; Wilhelm, Matthias

2017-01-01

Low levels of physical activity in childhood are associated with clustering of cardiovascular risk factors (CVRF) as predisposition for atherosclerosis. We assessed the association between sports engagement and age at first myocardial infarction (MI) in a cohort of men under 55 years of age. The Bern percutaneous coronary intervention Registry (NCT 02241291) was analyzed from March 2009 until January 2012. Male patients with first MI, age 18 to 54 years and body mass index ≤25kg/m2 were included. Patients were stratified into two groups based on their starting age with organized sports ≥1 h/week outside school (EARLY: <18, CONTROL: ≥18 years or never). We assessed age at time of first MI, CVRF, and volume of sports training. Of 4,394 consecutive patients, 123 fulfilled the inclusion criteria (EARLY n = 81, CONTROL n = 42). Age at the time of first MI was 3 years younger in the EARLY compared to the CONTROL group (46.8±6.0 vs. 49.8±4.6 years, p = 0.006). Total lifetime training hours, and average yearly training hours, both, before and after age 18, were significantly greater in the EARLY group. Years of training <18 years were weakly inversely correlated with age at first MI (r2 = 0.075, p = 0.002). The proportion of sports-related MI was not different between EARLY and CONTROL (13.6% vs. 11.9%). Patients in the EARLY group had fewer CVRF (2 vs. 3; p = 0.001). Prevalence of smoking was equally high in both groups (63.0% and 64.3%). In our patients aged 54 and younger, the first MI occurred 3 years earlier in those who started regular sports activity before age 18, despite a more active lifestyle and favorable CVRF profile.

Separate patient serum sodium medians from males and females provide independent information on analytical bias.

PubMed

Hansen, Steen Ingemann; Petersen, Per Hyltoft; Lund, Flemming; Fraser, Callum G; Sölétormos, György

2017-10-26

During monitoring of monthly medians of results from patients undertaken to assess analytical stability in routine laboratory performance, the medians for serum sodium for male and female patients were found to be significantly related. Daily, weekly and monthly patient medians of serum sodium for both male and female patients were calculated from results obtained on samples from the population >18 years on three analysers in the hospital laboratory. The half-range of medians was applied as an estimate of the maximum bias. Further, the ratios between the two medians were calculated. The medians of both genders demonstrated dispersions over time, but they were closely connected in like patterns, which were confirmed by the half-range of the ratios of medians for males and females that varied from 0.36% for daily, 0.14% for weekly and 0.036% for monthly ratios over all instruments. The tight relationship between the gender medians for serum sodium is only possible when raw laboratory data are used for calculation. The two patient medians can be used to confirm both and are useful as independent estimates of analytical bias during constant calibration periods. In contrast to the gender combined median, the estimate of analytical bias can be confirmed further by calculation of the ratios of medians for males and females.

Treatment strategies and outcomes in diffuse large B-cell lymphoma among 1011 patients aged 75 years or older: A Danish population-based cohort study.

PubMed

Juul, Maja Bech; Jensen, Pernille Hammershoej; Engberg, Henriette; Wehberg, Sonja; Dessau-Arp, Andriette; Haziri, Donika; Kristensen, Helene Bjoerg; Baech, Joachim; Schurmann, Lene; Clausen, Michael Roost; Valentin, Rebecca; Knudsen, Lene Meldgaard; Munksgaard, Lars; El-Galaly, Tarec Christoffer; Frederiksen, Henrik; Larsen, Thomas Stauffer

2018-06-20

Optimal treatment strategy for the oldest patients with diffuse large B-cell lymphoma (DLBCL) remains controversial, as this group often is precluded from clinical trials, and population-based studies are limited. All Danish DLBCL-patients ≥75 years diagnosed from 2003 to 2012 were identified, using the Danish National Lymphoma Registry (LYFO). Information regarding baseline characteristics, treatment, comorbidities and outcomes was retrieved from LYFO, the Danish National health registries and medical records. Patients were stratified by age (75-79; 80-84 and 85 + years), comorbidity score and treatment modality (standard treatment [R-CHOP/CHOP-like], less intensive regimens or palliative treatment). A total of 1011 patients were included. Standard treatment was initiated in 64%, ranging from 83% among patients aged 75-79 years to 32% among patient aged 85 + years. With standard treatment, median overall survival (OS) estimates were 4·6, 2·6, and 1·9 years for the age groups 75-79, 80-84 and 85+ years. Among patient aged 75-79 and 80-84 years, OS was superior with standard treatment, although high comorbidity scores attenuated this association. Among patients aged 85+ years, survival was not influenced by treatment intensity. Patients ≥80 years had similar OS regardless of intended (R-)CHOP dosing, whereas patients of 75-79 years scheduled for full dose had higher OS. Standard treatment was not associated with increased hospitalisation. Standard treatment is feasible with good outcomes in a large proportion of elderly DLBCL-patients. Planned dose reduction in patients aged ≥80 years had no negative impact on OS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Age as a Risk Factor in Abdominoplasty.

PubMed

Couto, Rafael A; Lamaris, Gregory A; Baker, Todd A; Hashem, Ahmed M; Tadisina, Kashyap; Durand, Paul; Rueda, Steven; Orra, Susan; Zins, James E

2017-05-01

Recent studies reviewing large patient databases suggested that age may be an independent risk factor for abdominoplasty. However, these investigations by design considered only short-term major complications. The purpose of this investigation was: (1) to compare the safety of abdominoplasty in an elderly and younger patient population; (2) to determine the complication rates across all spectrums: major, minor, local, and systemic; and (3) to evaluate complications occurring both short and long term. Abdominoplasty procedures performed from 2010 to 2015 were retrospectively reviewed. Subjects were divided into two groups: ≤59 years old and ≥60 years old. Major, minor, local, and systemic complications were analyzed. Patient demographics, comorbidities, perioperative details, adjunctive procedures were also assessed. A total of 129 patients were included in the study: 43 in the older and 86 in the younger age group. The median age of The elderly and young groups was 65.0 and 41.5 years, respectively (P < .001). No statistically significant differences in major, minor, local, or systemic complications were found when both age groups were compared. Major local, major systemic, minor local, and minor systemic in the elderly were 6.9%, 2.3%, 18.6%, and 2.3%, while in the younger patients were 9.3%, 4.7%, 10.5%, and 0.0%, respectively (P > .05). Median follow-up time of the elderly (4.0 months) was no different than the younger (5.0 months) patients (P > .07). Median procedure time in the elderly (4.5 hours) was no different than the younger group (5.0 hours) (P = .4). The elderly exhibited a greater American Society of Anesthesiologist score, median body mass index (28.7 vs 25.1 kg/m2), and number of comorbidities (2.7 vs 0.9) (P < .001). There was no significant difference in either major or minor complications between the two groups. This suggests that with proper patient selection, abdominoplasty can be safely performed in the older age patient population. 2. �

Age of onset of pubertal maturation of Thai boys.

PubMed

Jaruratanasirikul, Somchit; Yuenyongwiwat, Sakdawut; Kreetapirom, Piyavut; Sriplung, Hutcha

2014-03-01

Data regarding sexual maturation in Thai boys are limited to only one 1999 study done in Bangkok which found that the ages of onset of Tanner 2 testicular enlargement and pubic hair were 10.8 and 12.4 years, respectively. To determine the age of onset of pubertal maturation and the physical growth of Thai boys at Hat Yai municipality, southern Thailand, in the year 2012. A cross-sectional study was conducted in 1320 healthy boys, aged 6-19 years, during June 2011 to March 2012. Testicular volume and pubic hair development were assessed according to the Tanner staging method. Probit analysis was used to calculate the median age of different stages of testicular enlargement and pubic hair development. The median ages of boys having Tanner 2 testicular enlargement and Tanner 2 pubic hair were 10.6 [95% confidence interval (CI), 10.4-10.7] and 12.0 (95% CI, 11.8-12.2) years, respectively. The youngest ages of boys who had Tanner 2 testicular enlargement and Tanner 2 pubic hair were 8.2 and 9.7 years, respectively. The final height was attained at age 18 years at 170.3 cm, 3.3 cm greater than the 167.0 cm final height of Hat Yai boys studied in 1994. The age of onset of puberty in Hat Yai schoolboys in 2012 was 0.2 years earlier than that of Bangkok schoolboys in 1999. The final adult height of Thai boys increased 3 cm during the two decades.

Recommendations for placement of cable median barriers on 6:1 and 4:1 sloped medians with horizontal curvatures.

DOT National Transportation Integrated Search

2012-09-01

This report summarizes the research efforts of using finite element modeling and simulations to evaluate the performance of generic lowtension : cable median barriers (CMBs) on four-lane and six-lane freeways with a 46-foot median, horizontal curvatu...

Post-recurrence survival of elderly patients 75 years of age or older with surgically resected non-small cell lung cancer.

PubMed

Takenaka, Tomoyoshi; Inamasu, Eiko; Yoshida, Tsukihisa; Toyokawa, Gouji; Nosaki, Kaname; Hirai, Fumihiko; Yamaguchi, Masafumi; Seto, Takashi; Takenoyama, Mitsuhiro; Ichinose, Yukito

2016-04-01

The purpose of this study was to evaluate the outcomes of elderly patients 75 years of age or older with recurrent non-small cell lung cancer (NSCLC). A total of 1237 consecutive patients with NSCLC underwent pulmonary resection at our institution. Of these patients, 280 experienced postoperative recurrence. The rate of the post-recurrence survival and predictors were analyzed independently in a group of younger patients (<75 years) and a group of elderly patients (≥75 years). There were 215 younger patients (<75 years) and 65 elderly (≥75 years) patients at the time of diagnosis of recurrence. The median post-recurrence survival time and the five-year survival rate of all cases were 25 months and 20.8%, respectively. There were no significant survival differences between the younger and elderly groups (p = 0.20). A univariate analysis determined that gender, Eastern Cooperative Oncology Group performance status, smoking status, histological type and epithelial growth factor receptor (EGFR) mutation status were factors influencing the post-recurrence survival among the elderly patients. In addition, a multivariate analysis determined the EGFR mutation status to be an independent prognostic factor for the post-recurrence survival. Elderly patients 75 years of age or older in this study achieved satisfactory long-term outcomes.

Aging in Prader-Willi syndrome: twelve persons over the age of 50 years.

PubMed

Sinnema, Margje; Schrander-Stumpel, Constance T R M; Maaskant, Marian A; Boer, Harm; Curfs, Leopold M G

2012-06-01

The life expectancy of persons with Prader-Willi syndrome (PWS) has increased in recent years. Because of the paucity of reports on older persons with PWS, the natural history, the onset, and type of age-related problems are poorly understood. Twelve persons with a genetically confirmed diagnosis of PWS aged over 50 years are described (4 deletion; 8 mUPD). Data on physical, behavioral, psychiatric, and aging characteristics were collected through semi-structured interviews with the individuals with PWS and their main carers. Cardiovascular diseases, diabetes, dermatological, and orthopedic problems were common physical complaints in older people with PWS. Functioning in activities of daily living, psychological functioning, physical functions, and care dependence were substantially worse in the older age group (50+) compared to the control group (18-49 years). Seven out of eight persons with mUPD had a history of psychiatric illness. Behavioral problems were observed in the older age group. Given the combination of age-related physical morbidity, physical appearance, behavioral and psychiatric problems, and functional decline in our cohort, we hypothesize that premature aging occurs in PWS. The care for older people with PWS requires a lifespan approach that recognizes the presence, progression, and consequences of specific morbidity. Special medical surveillance of people with PWS from 40 years onwards would ensure that intervention and support is offered with respect to specific areas of decline at the earliest possible time. Copyright © 2012 Wiley Periodicals, Inc.

Age-independent anti-Müllerian hormone (AMH) standard deviation scores to estimate ovarian function.

PubMed

Helden, Josef van; Weiskirchen, Ralf

2017-06-01

To determine single year age-specific anti-Müllerian hormone (AMH) standard deviation scores (SDS) for women associated to normal ovarian function and different ovarian disorders resulting in sub- or infertility. Determination of particular year median and mean AMH values with standard deviations (SD), calculation of age-independent cut off SDS for the discrimination between normal ovarian function and ovarian disorders. Single-year-specific median, mean, and SD values have been evaluated for the Beckman Access AMH immunoassay. While the decrease of both median and mean AMH values is strongly correlated with increasing age, calculated SDS values have been shown to be age independent with the differentiation between normal ovarian function measured as occurred ovulation with sufficient luteal activity compared with hyperandrogenemic cycle disorders or anovulation associated with high AMH values and reduced ovarian activity or insufficiency associated with low AMH, respectively. These results will be helpful for the treatment of patients and the ventilation of the different reproductive options. Copyright © 2017 Elsevier B.V. All rights reserved.

Methodology for determining economic impacts of raised medians : data collection for additional case studies

DOT National Transportation Integrated Search

1998-10-01

The objective of this four-year resaerch effort is to develop and test a methodology to estimate the economic impact of median design. This report summarizes the work performed in the second year. The secnd year of this study included collecting data...

Efficacy and safety of BH4 before the age of 4 years in patients with mild phenylketonuria.

PubMed

Leuret, Oriane; Barth, Magalie; Kuster, Alice; Eyer, Didier; de Parscau, Loïc; Odent, Sylvie; Gilbert-Dussardier, Brigitte; Feillet, François; Labarthe, François

2012-11-01

Sapropterin dihydrochloride, an EMEA-approved synthetic formulation of BH4, has been available in Europe since 2009 for PKU patients older than 4 years, but its use with younger children is allowed in France based on an expert recommendation. We report the cases of 15 patients treated under the age of 4 years and demonstrate the safety and efficacy of this treatment for patients in this age group. We report the use of BH4 in 15 PKU patients treated before the age of 4 years. Fifteen patients were enrolled in this retrospective study. Mean phenylalaninemia at diagnosis was 542 ± 164 μM and all patients had mild PKU (maximal phenylalaninemia: 600-1200 μM). BH4 responsiveness was assessed using a 24-hour BH4 loading test (20 mg/kg), performed during the neonatal period (n = 11) or before 18 months of age (n = 4). During the test, these patients exhibited an 80 ± 12% decrease in phenylalaninemia. Long-term BH4 therapy was initiated during the neonatal period (n = 7) or at the age of 13 ± 12 months (n = 8). The median duration of treatment was 23 months [min 7; max 80]. BH4 therapy drastically improved dietary phenylalanine tolerance (456 ± 181 vs 1683 ± 627 mg/day, p < 0.0001) and allowed a phenylalanine-free amino acid mixture to be discontinued or not introduced in 14 patients. Additionally, in the eight patients treated after a few months of diet therapy, BH4 treatment significantly decreased mean phenylalaninemia (352 ± 85 vs 254 ± 64 μM, p < 0.05), raised the percentage of phenylalaninemia tests within therapeutic targets [120-300 μM] (35 ± 25 vs 64 ± 16%, p < 0.05), and reduced phenylalaninemia variance (130 ± 21 vs 93 ± 27 μM, p < 0.05). No side effects were reported. BH4-therapy is efficient and safe before the age of 4 years in mild PKU, BH4-responsive patients.

Successful amblyopia therapy initiated after age 7 years: compliance cures.

PubMed

Mintz-Hittner, H A; Fernandez, K M

2000-11-01

To report successful therapy for anisometropic and strabismic amblyopia initiated after age 7 years. A consecutive series of 36 compliant children older than 7 years (range, 7.0 to 10.3 years; mean, 8.2 years) at initiation of amblyopia therapy for anisometropic (19 patients; mean age, 8.3 years), strabismic (9 patients; mean age, 8.0 years), or anisometropic and strabismic (8 patients; mean age, 8.0 years) amblyopia was studied. Initial (worst) visual acuities were between 20/50 and 20/400 (log geometric mean, -0.83 [antilog, 20/134] for all patients; -0.88 [antilog, 20/151] for anisometropic patients; -0.70 [antilog, 20/100] for strabismic patients; and -0.88 [antilog, 20/151] for anisometropic and strabismic patients). Initial (worst) binocularity was absent or reduced in all cases. Therapy consisted of (1) full-time standard occlusion (21 patients; mean age, 8.0 years), (2) total penalization (7 patients; mean age, 7.8 years), or (3) full-time occlusive contact lenses (8 patients; mean age, 8.8 years). Final (best) visual acuities were between 20/20 and 20/30 for all 36 patients. Final (best) binocularity was maintained or improved for 22 (61%) of 36 patients, including 16 anisometropic patients (84%), 2 strabismic patients (22%), and 4 anisometropic and strabismic patients (50%). Given compliance, therapy for anisometropic and strabismic amblyopia can be successful even if initiated after age 7 years. Arch Ophthalmol. 2000;118:1535-1541

Distal median nerve dysfunction

MedlinePlus

... Distal median nerve dysfunction is a form of peripheral neuropathy that affects the movement of or sensation in ... and the A.D.A.M. Editorial team. Peripheral Nerve Disorders Read more NIH MedlinePlus Magazine Read more Health ...

The effect of symptoms of carpal tunnel syndrome on ultrasonographic median nerve measures before and after wheelchair propulsion.

PubMed

Impink, Bradley G; Collinger, Jennifer L; Boninger, Michael L

2011-09-01

To quantify median nerve characteristics before and after strenuous wheelchair propulsion and relate them to symptoms of carpal tunnel syndrome (CTS). We hypothesized that persons with and without symptoms of CTS would have significantly different nerve characteristics at baseline and after propulsion. A repeated-measures design was used to obtain ultrasound images of the median nerve at 3 levels of the wrist (radius, pisiform, and hamate) before and after wheelchair propulsion. Investigators were blinded to subject history related to CTS. The 2007 and 2008 National Veterans Wheelchair Games and the Human Engineering Research Laboratories. Fifty-four participants between the ages of 18 and 65 years with a nonprogressive disability who used a manual wheelchair as their primary means of mobility completed this study. Participants completed questionnaires regarding demographics and the presence and severity of symptoms of CTS. Ultrasound images of the median nerve were obtained before and after a 15-minute strenuous wheelchair-propulsion task. Baseline values and post-propulsion changes were determined for median nerve cross-sectional area, flattening ratio, and swelling ratio. Differences in median nerve variables between symptomatic and asymptomatic groups were assessed. No significant differences between symptom groups were identified at baseline; however, persons with symptoms of CTS showed a significantly different percent change from baseline compared with the asymptomatic participants for cross-sectional area at pisiform (P = .014) and flattening ratio at hamate (P = .022), and they showed a strong trend toward a difference in swelling ratio (P = .0502). For each of these variables, the change in the symptomatic group was in the opposite direction of the change in the asymptomatic group. We found several median nerve responses to wheelchair propulsion associated with symptoms of CTS. These responses occurred even though no baseline ultrasound difference was

Flexible parametric survival models built on age-specific antimüllerian hormone percentiles are better predictors of menopause.

PubMed

Ramezani Tehrani, Fahimeh; Mansournia, Mohammad Ali; Solaymani-Dodaran, Masoud; Steyerberg, Ewout; Azizi, Fereidoun

2016-06-01

This study aimed to improve existing prediction models for age at menopause. We identified all reproductive aged women with regular menstrual cycles who met our eligibility criteria (n = 1,015) in the Tehran Lipid and Glucose Study-an ongoing population-based cohort study initiated in 1998. Participants were examined every 3 years and their reproductive histories were recorded. Blood levels of antimüllerian hormone (AMH) were measured at the time of recruitment. Age at menopause was estimated based on serum concentrations of AMH using flexible parametric survival models. The optimum model was selected according to Akaike Information Criteria and the realness of the range of predicted median menopause age. We followed study participants for a median of 9.8 years during which 277 women reached menopause and found that a spline-based proportional odds model including age-specific AMH percentiles as the covariate performed well in terms of statistical criteria and provided the most clinically relevant and realistic predictions. The range of predicted median age at menopause for this model was 47.1 to 55.9 years. For those who reached menopause, the median of the absolute mean difference between actual and predicted age at menopause was 1.9 years (interquartile range 2.9). The model including the age-specific AMH percentiles as the covariate and using proportional odds as its covariate metrics meets all the statistical criteria for the best model and provides the most clinically relevant and realistic predictions for age at menopause for reproductive-aged women.

YEAR-TO-YEAR CHANGES IN LUNG FUNCTION IN INDIVIDUALS WITH CYSTIC FIBROSIS

PubMed Central

Liou, Theodore G.; Elkin, Eric P.; Pasta, David J.; Jacobs, Joan R.; Konstan, Michael W.; Morgan, Wayne J.; Wagener, Jeffrey S.

2014-01-01

Background We examined the year-to-year change in FEV1 for individuals and the overall cystic fibrosis population to better understand how individual trends may differ from population trends. Methods We calculated individual yearly changes using the largest annual FEV1 percent predicted (FEV1%) measurement in 20,644 patients (6–45 years old) included in the Epidemiologic Study of Cystic Fibrosis. We calculated yearly population changes using age-specific medians. Results FEV1% predicted decreased 1–3 points per year for individuals, with maximal decreases in 14–15 year olds. Population changes agreed with individual changes up to age 15; however after age 30, yearly population change approximated zero while individual FEV1% predicted decreases were 1–2 points per year. Conclusions Adolescents have the greatest FEV1% predicted decreases; however. loss of FEV1 is a persistent risk in 6–45 year old CF patients. Recognizing individual year-to-year changes may improve patient-specific care and may suggest new methods for measuring program quality. PMID:20471331

Pregnancy Outcome of Multiparous Women Aged over 40 Years

PubMed Central

Ates, Seda; Batmaz, Gonca; Sevket, Osman; Molla, Taner; Dane, Cem; Dane, Banu

2013-01-01

Objective. The aim of this study was to evaluate the effect of maternal age on prenatal and obstetric outcome in multiparaous women. Materials and Methods. A retrospective case control study was conducted, including women aged 40 years and over (study group, n = 97) who delivered at 20 week's gestation or beyond and women aged 20–29 years (control group, n = 97). Results. The mean age of women in the study group was 41.2 ± 1.7 years versus 25.4 ± 2.3 years in the control group. Advanced maternal age was associated with a significantly higher rate of hypertension, diabetes mellitus, fetal complication, and 5-minute Apgar scores <7 (P < 0.05). Caeserean section rate, incidence of placental abruption, preterm delivery, and neonatal intensive care unit admission were more common in the older group, but the differences were not statistically significant. Conclusions. Advanced maternal age is related to maternal and neonatal complications. PMID:25954770

Subcutaneous Immunoglobulin Replacement Therapy with Hizentra® is Safe and Effective in Children Less Than 5 Years of Age.

PubMed

Patel, Niraj C; Gallagher, Joel L; Ochs, Hans D; Prescott Atkinson, Thomas; Wahlstrom, Justin; Dorsey, Morna; Bonilla, Francisco A; Heimall, Jennifer; Kobrynski, Lisa; Morris, David; Haddad, Elie

2015-08-01

Hizentra® (IGSC 20%) is a 20% liquid IgG product approved for subcutaneous administration in adults and children 2 years of age and older who have primary immunodeficiency disease (PIDD). There is limited information about the use of IGSC 20 % in very young children including those less than 5 years of age. A retrospective chart review involved 88 PIDD infants and children less than 5 years of age who received Hizentra®. The mean age at the start of Hizentra® was 34 months (range 2 to 59 months). IGSC 20 % was administered weekly to 86 infants (two additional infants received twice weekly and three times weekly infusions, respectively) and included an average of 63 infusions (range 6-182) for an observation period up to 45.5 months. Infusion by manual delivery occurred in 15 patients. The mean dose was 674 mg/kg/4 weeks. The mean IgG level was 942 mg/dL while on IGSC 20 %, compared to a mean trough IgG level of 794 mg/dL (p < 0.0001) during intravenous or subcutaneous IgG administration prior to IGSC 20 %. Average infusion time was 47 (range 5-120) minutes, and the median number of infusion sites was 2 (range 1-4). Local reactions were mostly mild and observed in 36/88 (41%) children. No serious adverse events were reported. A significant increase in weight percentile (7 % ± 19.2, p = 0.0012) among subjects was observed during IGSC 20% administration. The rate of serious bacterial infections was 0.067 per patient-year while receiving IGSC 20%, similar to previously reported efficacy studies. Hizentra® is effective in preventing infections, and is well tolerated in children less than age 5 years.

Age distribution and age-related outcomes of olfactory neuroblastoma: a population-based analysis.

PubMed

Yin, Zhenzhen; Wang, Youyou; Wu, Yuemei; Zhang, Ximei; Wang, Fengming; Wang, Peiguo; Tao, Zhen; Yuan, Zhiyong

2018-01-01

The objective of the study was to describe the age distribution and to evaluate the role of prognostic value of age on survival in patients diagnosed with olfactory neuroblastoma (ONB). A population-based retrospective analysis was conducted. The population-based study of patients in the Surveillance, Epidemiology, and End Results (SEER) tumor registry, who were diagnosed with ONB from 1973 to 2014, were retrospectively analyzed. The cohort included 876 patients with a median age of 54 years. There was a unimodal distribution of age and ONBs most frequently occurred in the fifth to sixth decades of life. Kaplan-Meier analysis demonstrated overall survival (OS) and cancer-specific survival (CSS) rates of 69% and 78% at 5 years. Multivariable Cox regression analysis showed that age, SEER stage, and surgery were independent prognostic factors for CSS. The risk of overall death and cancer-specific death increased 3.1% and 1.6% per year, respectively. Patients aged >60 years presented significantly poor OS and CSS compared with patients aged ≤60 years, even in patients with loco-regional disease or in those treated with surgery. This study highlights the growing evidence that there is a unimodal age distribution of ONB and that age is an important adverse prognostic factor.

BMI at Age 17 Years and Diabetes Mortality in Midlife: A Nationwide Cohort of 2.3 Million Adolescents.

PubMed

Twig, Gilad; Tirosh, Amir; Leiba, Adi; Levine, Hagai; Ben-Ami Shor, Dana; Derazne, Estela; Haklai, Ziona; Goldberger, Nehama; Kasher-Meron, Michal; Yifrach, Dror; Gerstein, Hertzel C; Kark, Jeremy D

2016-11-01

The sequelae of increasing childhood obesity are of major concern. We assessed the association of BMI in late adolescence with diabetes mortality in midlife. The BMI values of 2,294,139 Israeli adolescents (age 17.4 ± 0.3 years), measured between 1967 and 2010, were grouped by U.S. Centers for Disease Control and Prevention age/sex percentiles and by ordinary BMI values. The outcome, obtained by linkage with official national records, was death attributed to diabetes mellitus (DM) as the underlying cause. Cox proportional hazards models were applied. During 42,297,007 person-years of follow-up (median, 18.4 years; range <1-44 years) there were 481 deaths from DM (mean age at death, 50.6 ± 6.6 years). There was a graded increase in DM mortality evident from the 25th to the 49th BMI percentile group onward and from a BMI of 20.0-22.4 kg/m 2 onward. Overweight (85th to 94th percentiles) and obesity (the 95th percentile or higher), compared with the 5th to 24th percentiles, were associated with hazard ratios (HRs) of 8.0 (95% CI 5.7-11.3) and 17.2 (11.9-24.8) for DM mortality, respectively, after adjusting for sex, age, birth year, height, and sociodemographic variables. The HR for the 50th through 74th percentiles was 1.6 (95% CI 1.1-2.3). Findings persisted in a series of sensitivity analyses. The estimated population-attributable fraction for DM mortality, 31.2% (95% CI 26.6-36.1%) for the 1967-1977 prevalence of overweight and obesity at age 17, rose to a projected 52.1% (95% CI 46.4-57.4%) for the 2012-2014 prevalence. Adolescent BMI, including values within the currently accepted "normal" range, strongly predicts DM mortality up to the seventh decade. The increasing prevalence of childhood and adolescent overweight and obesity points to a substantially increased future adult DM burden. © 2016 by the American Diabetes Association.

Use of levetiracetam in a population of patients aged 65 years and older: a subset analysis of the KEEPER trial.

PubMed

Ferrendelli, J A; French, J; Leppik, I; Morrell, M J; Herbeuval, A; Han, J; Magnus, L

2003-12-01

Levetiracetam (Keppra) was evaluated in a subset of patients aged >/=65 years (n=78) enrolled in a large (n=1030) open-label, phase IV trial (the KEEPER trial). A 4-week dose adjustment was followed by a 12-week evaluation period. An overall median reduction in partial seizures of 80.1% (n=65) was observed. Overall, 76.9% of patients were >/=50% responders, 56.9% were >/=75% responders, and 40.0% were 100% responders. Levetiracetam was well tolerated, with 42.3% of patients reporting one or more adverse events. A total of 15 patients (19.2%) experienced an adverse event that led to discontinuation. Somnolence (n=13,16.7%) and dizziness (n=7,9.0%) were the most commonly reported adverse events. Despite the limitations of the open-label study design, these data provide information regarding the use of levetiracetam as add-on therapy for the treatment of partial-onset seizures in patients >/=65 years of age, including those requiring concomitant medications.

Breast cancer screening initiation after turning 40 years of age within the PROSPR consortium.

PubMed

Beaber, Elisabeth F; Tosteson, Anna N A; Haas, Jennifer S; Onega, Tracy; Sprague, Brian L; Weaver, Donald L; McCarthy, Anne Marie; Doubeni, Chyke A; Quinn, Virginia P; Skinner, Celette Sugg; Zauber, Ann G; Barlow, William E

2016-11-01

Although United States clinical guidelines differ, the earliest recommended age for average risk breast cancer screening is 40 years. Little is known about factors influencing screening initiation. We conducted a cohort study within the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. We identified 3413 women on their 40th birthday in primary care networks at Geisel School of Medicine at Dartmouth (DH) and Brigham and Women's Hospital (BWH) during 2011-2013 with no prior breast imaging or breast cancer. Cumulative incidence curves and Cox modeling were used to determine time from the 40th birthday to first breast cancer screening, cohort exit, or 42nd birthday. We calculated hazards ratios and 95 % confidence intervals from multivariable Cox proportional hazards models. Breast cancer screening cumulative incidence by the 42nd birthday was 62.9 % (BWH) and 39.8 % (DH). Factors associated with screening initiation were: a primary care visit within a year (HR 4.99, 95 % CI 4.23-5.89), an increasing number of primary care visits within a year (p for trend <0.0001), ZIP code of residence annual median household income ≤$52,000 (HR 0.79, 95 % CI 0.68-0.92), and health insurance type (Medicaid HR 0.72, 95 % CI 0.58-0.88; Medicare HR 0.55, 95 % CI 0.39-0.77; uninsured HR 0.37, 95 % CI 0.25-0.57). Breast cancer screening uptake after the 40th birthday varies by health system, primary care visits, median household income, and health insurance type, suggesting the need for further exploration. Future research should evaluate screening performance metrics after initiation and consider cumulative benefits and risks associated with breast cancer screening over time.

Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England: Evidence From a 12-Year Follow-up in the English Longitudinal Study of Ageing.

PubMed

Cadar, Dorina; Lassale, Camille; Davies, Hilary; Llewellyn, David J; Batty, G David; Steptoe, Andrew

2018-05-16

Lower educational attainment is associated with a higher risk of dementia. However, less clear is the extent to which other socioeconomic markers contribute to dementia risk. To examine the relationship of education, wealth, and area-based deprivation with the incidence of dementia over the last decade in England and investigate differences between people born in different periods. Data from the English Longitudinal Study of Ageing, a prospective cohort study that is representative of the English population, were used to investigate the associations between markers of socioeconomic status (wealth quintiles and the index of multiple deprivation) and dementia incidence. To investigate outcomes associated with age cohorts, 2 independent groups were derived using a median split (born between 1902-1925 and 1926-1943) . Dementia as determined by physician diagnosis and the Informant Questionnaire on Cognitive Decline in the Elderly. A total of 6220 individuals aged 65 years and older enrolled in the study (median [interquartile range] age at baseline, 73.2 [68.1-78.3] years; 3410 [54.8%] female). Of these, 463 individuals (7.4%) had new cases of dementia ascertained in the 12 years between 2002-2003 and 2014-2015. The hazard of developing dementia was 1.68 times higher (hazard ratio [HR] = 1.68 [95% CI, 1.05-2.86]) for those in the lowest wealth quintile compared with those in the highest quintile, independent of education, index of multiple deprivation, and health indicators. Higher hazards were also observed for those in the second-highest quintile of index of multiple deprivation (HR = 1.62 [95% CI, 1.06-2.46]) compared with those in the lowest (least deprived) quintile. In an English nationally representative sample, the incidence of dementia appeared to be socioeconomically patterned primarily by the level of wealth. This association was somewhat stronger for participants born in later years.

Establishing International Blood Pressure References Among Non-Overweight Children and Adolescents Aged 6–17 Years

PubMed Central

Xi, Bo; Zong, Xin’nan; Kelishadi, Roya; Hong, Young Mi; Khadilkar, Anuradha; Steffen, Lyn M.; Nawarycz, Tadeusz; Krzywińska-Wiewiorowska, Małgorzata; Aounallah-Skhiri, Hajer; Bovet, Pascal; Chiolero, Arnaud; Pan, Haiyan; Litwin, Mieczysław; Poh, Bee Koon; Sung, Rita Y.T.; So, Hung-Kwan; Schwandt, Peter; Haas, Gerda-Maria; Neuhauser, Hannelore K.; Marinov, Lachezar; Galcheva, Sonya V; Motlagh, Mohammad Esmaeil; Kim, Hae Soon; Khadilkar, Vaman; Krzyżaniak, Alicja; Ben Romdhane, Habiba; Heshmat, Ramin; Chiplonkar, Shashi; Stawińska-Witoszyńska, Barbara; Ati, Jalila El; Qorbani, Mostafa; Kajale, Neha; Traissac, Pierre; Ostrowska-Nawarycz, Lidia; Ardalan, Gelayol; Parthasarathy, Lavanya; Zhao, Min; Zhang, Tao

2015-01-01

Background Several distributions of country-specific blood pressure (BP) percentiles by sex, age and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limit international comparisons of prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents using seven nationally representative data (China, India, Iran, Korea, Poland, Tunisia and USA). Methods and Results Data on BP for 52,636 non-overweight children and adolescents aged 6–19 years were obtained from seven large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and USA. BP values were obtained with certified mercury sphygmomanometers in all seven countries, using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th and 99th) by age and height were estimated using the Generalized Additive Model for Location Scale and Shape (GAMLSS) model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. Compared to BP level of the 90th and 95th percentiles of the U.S. Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower while diastolic BP was similar. Conclusions These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help identify hypertensive youths in diverse populations. PMID:26671979

A 3-year surveillance on causes of death or reasons for euthanasia of domesticated dogs in Taiwan.

PubMed

Huang, Wei-Hsiang; Liao, Albert Taiching; Chu, Pei-Yi; Zhai, Shao-Hua; Yen, I-Feng; Liu, Chen-Hsuan

2017-11-01

Over the last 2 decades, there has been growing interest in research on the mortality of domesticated pets. These studies relied on an effective data-collecting system. During 2012-2014, a real-time reporting system was designed for mortality data in owned dogs and cats. The present retrospective study aimed to report on the causes of death (CODs) or reasons for euthanasia (RFEs) in domesticated dogs in Taiwan, and to investigate CODs/RFEs segregated by demographic variables. Data from 2306 domesticated dogs were acquired during the 3-year period in the present study. The median age at death of the study population was 10.2 years (median interquartile range 7.0-14.0; range 0.0-25.0). Crossbred, female, and neutered dogs showed greater ages at death than other groups. The most common COD/RFE was neoplasia, followed by multiple organ involvement (MOI) and cardiovascular diseases. Segregated by cut-off ages, the most common COD/RFE was infection among dogs younger than 3 years or 1year, and neoplasia among dogs at or older than 3 years or 1year of age; the most common COD/RFE was neoplasia among dogs younger than median age, and MOI among dogs at or older than median age. Segregated by geographic variables, the ranking and frequency of CODs/RFEs displayed different patterns between the capital city/non-capital areas, and among areas stratified by human population densities. The study provides various insights into age at death and CODs/RFEs in owned-dog population in Taiwan, and provides new directions for future research. Copyright © 2017 Elsevier B.V. All rights reserved.

Epidemiological Profile and Treatment Outcomes in Young Adults (19-29 Years of Age) Treated for Cancer in a Tertiary Hospital in São Paulo, Brazil.

PubMed

de Jesus, Victor Hugo Fonseca; Ribeiro, Taynan Nunes; Chinen, Ludmilla T Domingos; Alves, Vanessa; Curado, Maria Paula; Fanelli, Marcello Ferretti

2017-06-01

Worldwide, the incidence of cancer in young adults (20-39 years) is increasing, and represents an important cause of mortality in this age group. A retrospective study was undertaken to provide information that may lead to improved treatment outcomes. Epidemiological, clinicopathological, treatment, and survival information were retrieved from the electronic database registry of a tertiary referral hospital in São Paulo, Brazil for patients 19-29 years of age diagnosed with cancer between January 2007 and December 2012. There were 960 patients with a median age at diagnosis of 26 years; female patients comprised 59.2%. A previous diagnosis of malignancy was present in 2.3%; 0.4% had malignant tumors that were radiation-associated; regular alcohol use was present in 10.4%; 9% of patients reported tobacco use; a family history of cancer was present in 41.7%. Malignant tumors included carcinomas (45.7%), germ cell and trophoblastic neoplasms (12.3%), and lymphomas (12.1%). Median follow-up was 47.7 months (range: 0.62-100.9 months) during which time 111 patients (13.5%) died. Carcinomas (n = 43, 38.7%), soft tissue sarcomas (n = 18, 16.2%), and leukemias (n = 10, 9.0%) were the most common causes of death. This study has shown that carcinomas represent the most common malignancy in adolescents and young adults referred to a tertiary cancer center in Brazil and are the most common cause of mortality. Because clinical outcome may be affected by multiple factors in this patient population, further global studies are needed to characterize this population and improve clinical care.

Children with a History of Premature Adrenarche Have Good Health-Related Quality of Life at the Age of 12 Years.

PubMed

Liimatta, Jani; Sintonen, Harri; Utriainen, Pauliina; Voutilainen, Raimo; Jääskeläinen, Jarmo

2018-01-01

Children with premature adrenarche (PA) are taller and more overweight than their healthy peers, and PA girls have a slightly accelerated pubertal development. There is some evidence that early exposure to androgens may have an influence on psychosocial development. The aim of this cross-sectional case-control study was to evaluate health-related quality of life (HRQoL) in PA children at the age of 12 years. The HRQoL was assessed for 43 PA (36 girls) and 63 control children (52 girls) at the median age of 12.0 years using the standardized 16D instrument, and the scores of the PA children were compared to those of the control children and reference population. The mean overall HRQoL scores did not differ between PA and control girls, PA and control boys, or all PA and control children or the reference population. Independently of PA, overweight girls had a lower mean overall HRQoL score than lean girls, and both overweight girls and boys were on average worse off on the dimension of appearance than their lean peers. PA children have as good self-rated HRQoL as their peers at the age of 12 years. Overweight is associated with a worse HRQoL profile independently of PA. © 2018 S. Karger AG, Basel.

Factors Affecting Age at ASD Diagnosis in UK: No Evidence That Diagnosis Age Has Decreased between 2004 and 2014

ERIC Educational Resources Information Center

Brett, Denise; Warnell, Frances; McConachie, Helen; Parr, Jeremy R.

2016-01-01

Clinical initiatives have aimed to reduce the age at ASD diagnosis in the UK. This study investigated whether the median age at diagnosis in childhood has reduced in recent years, and identified the factors associated with earlier diagnosis in the UK. Data on 2,134 children with ASD came from two large family databases. Results showed that the age…

Poor postdischarge head growth is related to a 10% lower intelligence quotient in very preterm infants at the chronological age of five years.

PubMed

Neubauer, Vera; Fuchs, Teresa; Griesmaier, Elke; Kager, Katrin; Pupp-Peglow, Ulrike; Kiechl-Kohlendorfer, Ursula

2016-05-01

This study examined the relationship between head growth and cognitive outcome at the age of five years in preterm infants born at less than 32 weeks of gestation from 2003 to 2009, as previous research has mostly focused on outcomes in toddlers. The head circumference of 273 very preterm infants born in Tyrol, Austria, was measured at birth, discharge, the corrected ages of three, 12 and 24 months and the chronological age of five years. Suboptimal head size was defined as a head circumference of more than one standard deviation below the mean. Full-scale intelligence quotient (IQ) at five years was determined using Wechsler Preschool and Primary Scales of Intelligence, third edition. Infants with a suboptimal head size at the age of three months had a significantly lower median IQ than those with a normal head size (90 [20-122] versus 98 [20-138], p = 0.001) and from three months onwards they were more likely to exhibit cognitive delay. A suboptimal head size from the age of three months was consistently related to a 10% lower IQ, and this study adds further evidence that head growth failure, especially during the early postdischarge period, is related to impaired cognitive abilities. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

[Testis volume, pubic hair development and spermarcheal age in urban Chinese boys].

PubMed

Hua-mei, M A

2010-06-01

There is a trend that puberty is starting earlier in the 21st century, which is primarily based on studies of girls. The assessment of pubertal stages in the individual child is useful only if recent and reliable reference data from the same population are available for comparison. However, nationally representative pubertal data for Chinese boys in China are lacking. The aim of this study was to investigate the current pubertal development in healthy urban Chinese boys. A cross-sectional study of the pubertal development of a sample of 19,054 urban Chinese boys aged 3 - 19.83 years was conducted between 2003 and 2005. Testicular volume was determined with a Prader orchidometer. Pubic hair development was assessed according to the Tanner method. Data on spermarche were collected by the status quo method. Probit analysis was used to calculate the median age and 95% CI for onset of testicular and pubic hair development and spermarche. A testicular volume greater than or equal to 4 ml was taken as a definite sign of the onset of puberty. Mean ages for sexual development in boys were compared with other published series, while the spermarcheal age was compared to those in the similar population of the five National Surveys on Students Constitution and Health undertaken since 1979 in China. At the age of 9 years, 12.99% of the boys had a testicular volume 4 ml or more. The median age of onset of puberty as indicated by a testicular volume of 4 ml or more was 10.55 (95% CI 10.27 - 10.79) years. The median age for onset of pubic hair development (PH(2)) and spermarche was 12.78 (95% CI 12.67 - 12.89) years and 14.05 (95%CI 13.80 - 14.32) years, respectively. There was a highly significant downward secular trend for spermarcheal age of Chinese boys since 1979. Pubertal onset as indicated by testicular development in urban Chinese boys is earlier than currently used norms. Age of testicular development is among the earliest medians recorded in the world population, while

Influence of paternal age on perinatal outcomes.

PubMed

Hurley, Emily G; DeFranco, Emily A

2017-11-01

There is an increasing trend to delay childbearing to advanced parental age. Increased risks of advanced maternal age and assisted reproductive technologies are widely accepted. There are limited data regarding advanced paternal age. To adequately counsel patients on risk, more research regarding advanced paternal age is necessary. We sought to determine the influence of paternal age on perinatal outcomes, and to assess whether this influence differs between pregnancies achieved spontaneously and those achieved with assisted reproductive technology. A population-based retrospective cohort study of all live births in Ohio from 2006 through 2012 was completed. Data were evaluated to determine if advanced paternal age is associated with an increased risk of adverse outcomes in pregnancies. The analysis was stratified by status of utilization of assisted reproductive technology. Generalized linear regression models assessed the association of paternal age on pregnancy complications in assisted reproductive technology and spontaneously conceived pregnancies, after adjusting for maternal age, race, multifetal gestation, and Medicaid status, using Stata software (Stata, Release 12; StataCorp, College Station, TX). Paternal age was documented in 82.2% of 1,034,552 live births in Ohio during the 7-year study period. Paternal age ranged from 12-87 years, with a median of 30 (interquartile range, 26-35) years. Maternal age ranged from 11-62 years, with a median of 27 (interquartile range, 22-31) years. The use of assisted reproductive technology in live births increased as paternal age increased: 0.1% <30 years vs 2.5% >60 years, P < .001. After accounting for maternal age and other confounding risk factors, increased paternal age was not associated with a significant increase in the rate of preeclampsia, preterm birth, fetal growth restriction, congenital anomaly, genetic disorder, or neonatal intensive care unit admission. The influence of paternal age on pregnancy outcomes

Relationship between age and elite marathon race time in world single age records from 5 to 93 years

PubMed Central

2014-01-01

Background The aims of the study were (i) to investigate the relationship between elite marathon race times and age in 1-year intervals by using the world single age records in marathon running from 5 to 93 years and (ii) to evaluate the sex difference in elite marathon running performance with advancing age. Methods World single age records in marathon running in 1-year intervals for women and men were analysed regarding changes across age for both men and women using linear and non-linear regression analyses for each age for women and men. Results The relationship between elite marathon race time and age was non-linear (i.e. polynomial regression 4th degree) for women and men. The curve was U-shaped where performance improved from 5 to ~20 years. From 5 years to ~15 years, boys and girls performed very similar. Between ~20 and ~35 years, performance was quite linear, but started to decrease at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference increased non-linearly (i.e. polynomial regression 7th degree) from 5 to ~20 years, remained unchanged at ~20 min from ~20 to ~50 years and increased thereafter. The sex difference was lowest (7.5%, 10.5 min) at the age of 49 years. Conclusion Elite marathon race times improved from 5 to ~20 years, remained linear between ~20 and ~35 years, and started to increase at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference in elite marathon race time increased non-linearly and was lowest at the age of ~49 years. PMID:25120915

Reliability of the nerve conduction monitor in repeated measures of median and ulnar nerve latencies

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

Washington, I A

According to the Bureau of Labor Statistics, carpal tunnel syndrome (CTS), one of the most rapidly growing work-related injuries, cost American businesses up to $10 billion dollars in medical costs each year (1992). Because conservative therapy can be implemented and CTS is more reversible in it early stages, early detection will not only save industry unnecessary health care costs, but also prevent employees from experiencing debilitating pain and unnecessary surgery. In response to the growing number of cases of CTS, many companies have introduced screening tools to detect early stages of carpal tunnel syndrome. Neurotron Medical (New Jersey) has designedmore » a portable nerve conduction monitor (Nervepace S-200) which measures motor and sensory nerve latencies. The slowing of these latencies is one diagnostic indicator of carpal tunnel syndrome. In this study, we determined the reliability of the Nervepace Monitor in measure ulnar and median nerve latencies during repeated testing. The testing was performed on 28 normal subjects between the ages of 20 and 35 who had no prior symptoms of CTS. They were tested at the same time each day for three consecutive days. Nerve latencies between different ethnic groups and genders were compared. Results show that there was no significant daily variation of the median motor and lunar sensory latencies or the median sensory latencies. No significant differences of latencies was observed among ethnic groups; however, a significant difference of latencies between male and female subjects was observed (p<0.05).« less

The Second Antithyroid Drug Treatment Is Effective in Relapsed Graves' Disease Patients: A Median 11-Year Follow-Up Study.

PubMed

Kim, Ye An; Cho, Sun Wook; Choi, Hoon Sung; Moon, Shinje; Moon, Jae Hoon; Kim, Kyung Won; Park, Do Joon; Yi, Ka Hee; Park, Young Joo; Cho, Bo Youn

2017-04-01

Antithyroid drug (ATD) is a widely used treatment for Graves' disease (GD). However, its long-term efficiency remains unclear. This study investigated the long-term disease prognosis and predictive factors for relapse in ATD-treated GD patients. Newly diagnosed, ATD-treated GD patients with at least four years of follow-up were recruited (n = 187). Remission was defined as maintaining a euthyroid status for more than one year after ATD withdrawal. During 11.1 years (range 4.0-23.7 years) of median follow-up, overall, 51.9% of the newly diagnosed ATD-treated GD patients achieved remission, 32.1% continued ATD treatment, and 13.4% underwent other ablation treatments. The 10-year remission rates were higher in the first (34.2%) and second (25.5%) ATD courses than in any of the other subsequent ATD courses, and decreased as ATD treatments were repeated. The 10-year relapse rate was the highest after the third ATD treatment (71.4%) compared with that after the first (60.5%) and second (58.3%) courses. Longer duration of ATD treatment (odds ratio [OR] = 1.4 [confidence interval (CI) 1.2-1.7], p < 0.001), higher number of relapses (OR = 4.7 [CI 2.3-9.8], p < 0.001), and moderate to severe Graves' ophthalmopathy (OR = 4.1 [CI 1.1-15.2], p = 0.032) were associated with persistent disease status. A second course of ATD can be considered for GD patients after the first relapse because the chance of remission and the relapse rate are similar to the one after the first ATD treatment course. For GD patients with more than two relapses, or with an ATD treatment duration of more than four to five years, low-dose maintenance of ATD or ablative treatment needs to be considered.

Cable median barrier failure analysis and prevention.

DOT National Transportation Integrated Search

2012-12-01

Cross-median crashes have been identified as one of the highest injury or fatality risk crash types. Although crossmedian : crashes account for only 2% to 5% of all median crash events, they are disproportionately represented in the number : and freq...

Age-specific Mycoplasma pneumoniae pneumonia-associated myocardial damage in children.

PubMed

Li, Cheng-Mei; Gu, Li; Yin, Shao-Jun; Yang, Rong; Xie, Yuan; Guo, Xiao-Zhi; Fu, Yu-Xuan; Cheng, Dan

2013-10-01

To measure Mycoplasma pneumoniae pneumonia (MPP)-associated myocardial damage in different age groups of children with pneumonia. Children aged 0-14 years with pneumonia and myocardial damage (serum creatine kinase isoenzyme-MB [CK-MB] concentration >25 U/l) were enrolled in the study. The children were classified as Mycoplasma pneumoniae immunoglobulin M positive (M. pneumoniae IgM+) or negative (M. pneumoniae IgM-) based on a serological test. Children were stratified into four age groups in order to analyse age-specific MPP-associated myocardial damage. The incidence of fever was significantly higher in children who were M. pneumoniae IgM+ compared with M. pneumoniae IgM- children. The median serum CK-MB concentration was significantly higher in children who were M. pneumoniae IgM+ compared with those who were M. pneumoniae IgM-. Children who were M. pneumoniae IgM+ in the 13-36 months and 72 months-14 years age groups had significantly higher median serum CK-MB concentrations than those who were M. pneumoniae IgM- in the same age group. M. pneumoniae infection was associated with greater myocardial damage in children aged 13-36 months and 72 months-14 years. This suggests age-specific immune responses to M. pneumoniae.

Median raphe cysts of the perineum in children.

PubMed

Krauel, Lucas; Tarrado, Xavier; Garcia-Aparicio, Luis; Lerena, Javier; Suñol, Mariona; Rodó, Joan; Ribó, Josep Maria

2008-05-01

Median raphe cysts of the perineum are uncommon congenital lesions of the male genitalia. They can be found all the way from the distal penis and scrotum toward the perineum in a midline position. They are considered as congenital alterations in embryologic development. A case of a 6 year-old boy is presented. Review of the literature relevant to children was made regarding the embryologic, diagnostic, and treatment aspects. We believe it is important that adult and pediatric urologists recognize these lesions and their management to provide the appropriate information to the parents.

The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references.

PubMed

Kulaga, Zbigniew; Litwin, Mieczysław; Tkaczyk, Marcin; Rózdzyńska, Agnieszka; Barwicka, Katarzyna; Grajda, Aneta; Swiader, Anna; Gurzkowska, Beata; Napieralska, Ewelina; Pan, Huiqi

2010-03-04

The growth of children is an indicator of health and society's wellbeing. Growth references are useful in monitoring a child's growth, which is a very important part of child care. Poland's growth references are not updated regularly. Although several growth reference ranges have been developed in Poland over recent years, sampling was restricted to urban populations of major cities. The aim of this study was to assess how well Polish children match with, or diverge from, regional charts and to compare them with international growth references. Four Polish and two international (WHO 2007 and USCDC2000) growth references were used to calculate the height, weight and BMI z-scores in a recent, large, population-representative sample of school-aged children and adolescents in Poland. The distributions of z-scores were analysed with descriptive and inferential statistical methods. Mean height z-scores calculated with the use of the WHO 2007 and USCDC2000 references were positive and significantly different from zero over the entire age range. The mean height z-score was closest to zero in the Poznan reference for boys (0.05) and Warszawa reference for girls (0.01). Median weight z-scores were positive under all weight references over the entire age range with only the exception of 18-year-old girls' weight z-score calculated relative to USCDC2000. Median BMI z-scores were positive in males in early childhood, decreasing with age. In the case of girls, the median BMI z-score calculated using WHO 2007 and USCDC2000 was close to zero in early childhood, decreased in adolescents and reached minimum values at age 18 years. Median BMI z-scores calculated with the use of the Lodz reference fluctuated between 0.05 and 0.2 over the studied age range. In this contemporary sample of Polish school-aged children, distributions of height, weight and BMI differed from those of children from the international growth references. These differences should be considered when using the

The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references

PubMed Central

2010-01-01

Background The growth of children is an indicator of health and society's wellbeing. Growth references are useful in monitoring a child's growth, which is a very important part of child care. Poland's growth references are not updated regularly. Although several growth reference ranges have been developed in Poland over recent years, sampling was restricted to urban populations of major cities. The aim of this study was to assess how well Polish children match with, or diverge from, regional charts and to compare them with international growth references. Methods Four Polish and two international (WHO 2007 and USCDC2000) growth references were used to calculate the height, weight and BMI z-scores in a recent, large, population-representative sample of school-aged children and adolescents in Poland. The distributions of z-scores were analysed with descriptive and inferential statistical methods. Results Mean height z-scores calculated with the use of the WHO 2007 and USCDC2000 references were positive and significantly different from zero over the entire age range. The mean height z-score was closest to zero in the Poznan reference for boys (0.05) and Warszawa reference for girls (0.01). Median weight z-scores were positive under all weight references over the entire age range with only the exception of 18-year-old girls' weight z-score calculated relative to USCDC2000. Median BMI z-scores were positive in males in early childhood, decreasing with age. In the case of girls, the median BMI z-score calculated using WHO 2007 and USCDC2000 was close to zero in early childhood, decreased in adolescents and reached minimum values at age 18 years. Median BMI z-scores calculated with the use of the Lodz reference fluctuated between 0.05 and 0.2 over the studied age range. Conclusions In this contemporary sample of Polish school-aged children, distributions of height, weight and BMI differed from those of children from the international growth references. These differences

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

PubMed

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

2014-09-01

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

Comprehensive Analysis of Large Sets of Age-Related Physiological Indicators Reveals Rapid Aging around the Age of 55 Years.

PubMed

Lixie, Erin; Edgeworth, Jameson; Shamir, Lior

2015-01-01

While many studies show a correlation between chronological age and physiological indicators, the nature of this correlation is not fully understood. To perform a comprehensive analysis of the correlation between chronological age and age-related physiological indicators. Physiological aging scores were deduced using principal component analysis from a large dataset of 1,227 variables measured in a cohort of 4,796 human subjects, and the correlation between the physiological aging scores and chronological age was assessed. Physiological age does not progress linearly or exponentially with chronological age: a more rapid physiological change is observed around the age of 55 years, followed by a mild decline until around the age of 70 years. These findings provide evidence that the progression of physiological age is not linear with that of chronological age, and that periods of mild change in physiological age are separated by periods of more rapid aging. © 2015 S. Karger AG, Basel.

Design of cable-to-post attachments for use in a non-proprietary, high-tension, cable median barrier.

DOT National Transportation Integrated Search

2013-08-01

Cable median barriers are widely used across the country to prevent cross-median crashes. Several years ago, the Midwest States Pooled Fund Program contracted with the Midwest Roadside Safety Facility (MwRSF) to develop a new, non-proprietary, high-t...

Psychology and Aging: The First 20 Years

PubMed Central

Zacks, Rose T.; Blanchard-Fields, Fredda; Haley, William E.

2006-01-01

This article provides a review of the first 20 years of Psychology and Aging, the American Psychological Association’s first and only scholarly journal devoted to the topic of aging. The authors briefly summarize its history, its contributions to the study of aging, and its broader status as a scholarly publication. One theme highlighted in our review is the diversity of content in the journal throughout its history. Another is the strong impact that articles published in the journal have had on both basic and applied topics in aging. Efforts to encompass the breadth of topics and methodologies in aging research while retaining excellent quality remain the exciting but essential challenge for Psychology and Aging. PMID:16594786

Age-Dependent Human Hepatic Carboxylesterase 1 (Ces1) ...

EPA Pesticide Factsheets

Human hepatic carboxylesterase 1 and 2 (CES1 and CES2) are important for ester- and amide- bond containing pharmaceutical and environmental chemical disposition. Despite concern regarding juvenile sensitivity to such compounds, CES1 and CES2 ontogeny has not been well characterized. To define human hepatic microsomal and cytosolic CES1 and CES2 expression during early postnatal life, microsomal and cytosolic fractions were prepared using liver samples from subjects without liver disease [N=165, 1d-18 yrs]. Proteins were fractionated, detected and quantitated by western blotting. Median microsomal CES1 was lower among samples from subjects < 3 weeks of age (N=36) compared to the rest of the population (N=126; 6.27 vs 17.5 pmoles/mg microsomal protein, respectively; p<0.001; Kruskal Wallis test). Cytosolic CES1 increased sequentially with expression being lowest among samples from individuals between birth and 3 weeks of age (N=36), markedly greater among those from ages 3 weeks to 6 years (N=90), and then modestly greater still among those over 6 years of age (N=36; median values = 4.7, 15.8, and 16.6 pmoles/mg cytosolic protein, respectively; p values <0.001 and 0.05, respectively, Kruskal Wallis test). Microsomal CES2 also increased sequentially across the same three age groups with median values of 1.8, 2.9, and 4.2 pmoles/mg microsomal protein, respectively (p<0.001, both), whereas for cytosolic CES2, only the youngest age group differed from the two older g

HIV Diagnoses Among Persons Aged 13-29 Years - United States, 2010-2014.

PubMed

Ocfemia, M Cheryl Bañez; Dunville, Richard; Zhang, Tianchi; Barrios, Lisa C; Oster, Alexandra M

2018-02-23

In 2014, persons aged 13-29 years represented 23% of the U.S. population, yet accounted for 40% of diagnoses of human immunodeficiency virus (HIV) infection during the same year (1). During 2010-2014, the rates of diagnosis of HIV infection decreased among persons aged 15-19 years, were stable among persons aged 20-24 years, and increased among persons aged 25-29 years (1). However, these 5-year age groups encompass multiple developmental stages and potentially mask trends associated with the rapid psychosocial changes during adolescence through young adulthood. To better understand HIV infection among adolescents aged 13-17 years and young adults aged 18-29 years in the United States and identify ideal ages to target primary HIV prevention efforts, CDC analyzed data from the National HIV Surveillance System (NHSS)* using narrow age groups. During 2010-2014, rates of diagnosis of HIV infection per 100,000 population varied substantially among persons aged 13-15 years (0.7), 16-17 years (4.5), 18-19 years (16.5), and 20-21 years (28.6), and were higher, but less variable, among persons aged 22-23 years (34.0), 24-25 years (33.8), 26-27 years (31.3), and 28-29 years (28.7). In light of the remarkable increase in rates between ages 16-17, 18-19, and 20-21 years, and a recent study revealing that infection precedes diagnosis for young persons by an average of 2.7 years (2), these findings demonstrate the importance of targeting primary prevention efforts to persons aged <18 years and continuing through the period of elevated risk in their mid-twenties.

Age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: the Hilo Women's Health Study.

PubMed

Sievert, Lynnette Leidy; Murphy, Lorna; Morrison, Lynn A; Reza, Angela M; Brown, Daniel E

2013-12-01

A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii. Participants aged 40-60 years (n=898) were drawn from a larger, randomly generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause. History of hysterectomy, age at menopause. Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause. Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Multiligament Knee Injuries in Older Adolescents: A 2-Year Minimum Follow-up Study

PubMed Central

Godin, Jonathan A.; Cinque, Mark E.; Pogorzelski, Jonas; Moatshe, Gilbert; Chahla, Jorge; LaPrade, Robert F.

2017-01-01

Background: Multiligament knee injuries cause significant functional impairment. Adults undergoing anatomic reconstruction of multiligament knee injuries have excellent outcomes postoperatively. However, less is known about the outcomes in adolescent patients following multiligament reconstruction. Purpose/Hypothesis: We aimed to assess patient outcomes and failure rates following unstaged multiligament reconstruction in an adolescent population at a minimum 2-year follow-up. We hypothesized that outcomes of multiligament reconstruction in these patients would be comparable to previously reported outcomes in the adult population. Study Design: Case series; Level of evidence, 4. Methods: The study included patients who had undergone multiligament knee reconstruction at 19 years of age or younger and had at least 2 years of follow-up. All procedures were performed by the same surgeon. Exclusion criteria included patient age 14 years or younger at the time of surgery, open physes, prior ipsilateral meniscal or knee ligament surgery, or a tibial plateau fracture at the time of injury. Multiligament reconstruction was defined as a reconstruction of at least 1 cruciate ligament and at least 1 component of the posterolateral corner or the medial knee. Patients were evaluated according to Lysholm score, Tegner score, Short Form–12 physical component summary (SF-12 PCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and postoperative patient satisfaction. Results: Twenty patients (mean age, 17.7 years; mean follow-up, 37.1 months) were included in this study. No patient required additional ligament surgery after the index surgery because of graft failure. The median preoperative Lysholm score was 49.5 (range, 18-90), and the median postoperative Lysholm score was 86 (range, 44-100) (P < .001). The median preoperative Tegner activity score was 2 (range, 0-9), and the median postoperative Tegner activity score was 6 (range, 2-10) (P = .012

Risk factors for eating disorder symptoms at 12 years of age: A 6-year longitudinal cohort study.

PubMed

Evans, Elizabeth H; Adamson, Ashley J; Basterfield, Laura; Le Couteur, Ann; Reilly, Jessica K; Reilly, John J; Parkinson, Kathryn N

2017-01-01

Eating disorders pose risks to health and wellbeing in young adolescents, but prospective studies of risk factors are scarce and this has impeded prevention efforts. This longitudinal study aimed to examine risk factors for eating disorder symptoms in a population-based birth cohort of young adolescents at 12 years. Participants from the Gateshead Millennium Study birth cohort (n = 516; 262 girls and 254 boys) completed self-report questionnaire measures of eating disorder symptoms and putative risk factors at age 7 years, 9 years and 12 years, including dietary restraint, depressive symptoms and body dissatisfaction. Body mass index (BMI) was also measured at each age. Within-time correlates of eating disorder symptoms at 12 years of age were greater body dissatisfaction for both sexes and, for girls only, higher depressive symptoms. For both sexes, higher eating disorder symptoms at 9 years old significantly predicted higher eating disorder symptoms at 12 years old. Dietary restraint at 7 years old predicted boys' eating disorder symptoms at age 12, but not girls'. Factors that did not predict eating disorder symptoms at 12 years of age were BMI (any age), girls' dietary restraint at 7 years and body dissatisfaction at 7 and 9 years of age for both sexes. In this population-based study, different patterns of predictors and correlates of eating disorder symptoms were found for girls and boys. Body dissatisfaction, a purported risk factor for eating disorder symptoms in young adolescents, developed concurrently with eating disorder symptoms rather than preceding them. However, restraint at age 7 and eating disorder symptoms at age 9 years did predict 12-year eating disorder symptoms. Overall, our findings suggest that efforts to prevent disordered eating might beneficially focus on preadolescent populations. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Median and common peroneal neuropathy in coir workers of Alappuzha district, Kerala.

PubMed

Chandra, Sadanandavalli Retnaswami; Anand, Biji; Issac, Thomas Gregor

2017-01-01

Coir work, in a large number of people involves mechanically rolling the coconut fibers into coir which is later subjected to various processes. The primary work is done as a cottage industry specially by women in the sitting posture for several hours. This study reports evidence of median and common peroneal neuropathy electrophysiologically in people who had been engaged in this job for several years. This study was initiated to establish the possible relationship between coir work and symptomatic neuropathies which was seen in that region with all investigations " for other causes not " contributing to the etiological diagnosis. One hundred and forty-two upper limbs and 142 lower limbs in patients engaged in long years of coir work but having no symptoms were evaluated electrophysiologically with informed consent and financial compensation, appropriate inclusion and exclusion criteria were followed as described in the text. There is electrophysiological evidence for median and common peroneal neuropathy in persons engaged in long years of coir work. Coir workers neuropathy appears to be a new occupational neuropathy which can be prevented by following simple preventive measures.

Association of Bullying Behavior at 8 Years of Age and Use of Specialized Services for Psychiatric Disorders by 29 Years of Age.

PubMed

Sourander, Andre; Gyllenberg, David; Brunstein Klomek, Anat; Sillanmäki, Lauri; Ilola, Anna-Marja; Kumpulainen, Kirsti

2016-02-01

Bullying and being exposed to bullying among children is prevalent, especially among children with psychiatric symptoms, and constitutes a major concern worldwide. Whether childhood bullying or exposure to bullying in the absence of childhood psychiatric symptoms is associated with psychiatric outcomes in adulthood remains unclear. To study the associations between bullying behavior at 8 years of age and adult psychiatric outcomes by 29 years of age. Nationwide birth cohort study of 5034 Finnish children with complete information about childhood bullying behavior was followed up from 8 to 29 years of age. Follow-up was completed on December 31, 2009, and data were analyzed from January 15, 2013, to February 15, 2015. Information about bullying, exposure to bullying, and psychiatric symptoms were obtained from parents, teachers, and child self-reports when children were 8 years of age. Use of specialized services for psychiatric disorders from 16 to 29 years of age was obtained from a nationwide hospital register, including outpatient and inpatient treatment. Among the 5034 study participants, 4540 (90.2%) did not engage in bullying behavior; of these, 520 (11.5%) had received a psychiatric diagnosis at follow-up; 33 of 166 (19.9%) who engaged in frequent bullying, 58 of 251 (23.1%) frequently exposed to bullying, and 24 of 77 (31.2%) who both frequently engaged in and were frequently exposed to bullying had received psychiatric diagnoses at follow-up. When analyses were adjusted by sex, family factors, and child psychiatric symptoms at 8 years of age, we found independent associations of treatment of any psychiatric disorder with frequent exposure to bullying (hazard ratio [HR], 1.9; 95% CI, 1.4-2.5) and being a bully and exposed to bullying (HR, 2.1; 95% CI, 1.3-3.4). Exposure to bullying was specifically associated with depression (HR, 1.9; 95% CI, 1.2-2.9). Bullying was associated with psychiatric outcomes only in the presence of psychiatric problems at 8 years

June and August median streamflows estimated for ungaged streams in southern Maine

USGS Publications Warehouse

Lombard, Pamela J.

2010-01-01

Methods for estimating June and August median streamflows were developed for ungaged, unregulated streams in southern Maine. The methods apply to streams with drainage areas ranging in size from 0.4 to 74 square miles, with percentage of basin underlain by a sand and gravel aquifer ranging from 0 to 84 percent, and with distance from the centroid of the basin to a Gulf of Maine line paralleling the coast ranging from 14 to 94 miles. Equations were developed with data from 4 long-term continuous-record streamgage stations and 27 partial-record streamgage stations. Estimates of median streamflows at the continuous-record and partial-record stations are presented. A mathematical technique for estimating standard low-flow statistics, such as June and August median streamflows, at partial-record streamgage stations was applied by relating base-flow measurements at these stations to concurrent daily streamflows at nearby long-term (at least 10 years of record) continuous-record streamgage stations (index stations). Weighted least-squares regression analysis (WLS) was used to relate estimates of June and August median streamflows at streamgage stations to basin characteristics at these same stations to develop equations that can be used to estimate June and August median streamflows on ungaged streams. WLS accounts for different periods of record at the gaging stations. Three basin characteristics-drainage area, percentage of basin underlain by a sand and gravel aquifer, and distance from the centroid of the basin to a Gulf of Maine line paralleling the coast-are used in the final regression equation to estimate June and August median streamflows for ungaged streams. The three-variable equation to estimate June median streamflow has an average standard error of prediction from -35 to 54 percent. The three-variable equation to estimate August median streamflow has an average standard error of prediction from -45 to 83 percent. Simpler one-variable equations that use only

Dynamic Risk Stratification in Stage I Papillary Thyroid Cancer Patients Younger Than 45 Years of Age.

PubMed

Sung, Tae-Yon; Cho, Jae Won; Lee, Yu-Mi; Lee, Yi Ho; Kwon, Hyemi; Jeon, Min Ji; Kim, Won Gu; Choi, Young Jun; Song, Dong Eun; Chung, Ki-Wook; Yoon, Jong Ho; Hong, Suck Joon

2017-11-01

This study validated the dynamic risk stratification (DRS) system with regard to its association with structural recurrence and risk factors associated with non-excellent responses in patients <45 years with stage I classical papillary thyroid cancer (PTC). This historical cohort study included 598 patients with stage I classical PTC <45 years of age treated with total thyroidectomy followed by radioactive iodine remnant ablation (n = 440), total thyroidectomy without radioactive iodine remnant ablation (n = 23), and thyroid lobectomy alone (n = 135). The median follow-up period was 123 months. Structural recurrence occurred in 4.2% (n = 18/432) of the patients with an excellent response, 17.1% (18/105) of patients with an indeterminate response, 44.7% (17/38) of patients with a biochemically incomplete response, and 82.6% (19/23) of patients with a structurally incomplete response (p < 0.001) during the follow-up. The disease-free survival curves of each response showed significant differences (p < 0.001). Extensive extrathyroidal extension and extranodal extension were the independent risk factors associated with non-excellent response (p < 0.05). DRS may reduce unnecessary additional treatments by reclassifying initial risk estimates of structural recurrence. Furthermore, applying the risk factors associated with non-excellent response to initial therapy may be a more useful and viable surrogate of the risk for structural recurrence in stage I PTC patients <45 years of age.

Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age

PubMed Central

Barnevik Olsson, Martina; Holm, Anette; Westerlund, Joakim; Lundholm Hedvall, Åsa; Gillberg, Christopher; Fernell, Elisabeth

2017-01-01

Background Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as “high-functioning”, that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70–84) is limited. Methods From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5–6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36). Results Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84. Conclusion None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support. PMID:29042781

CABLE MEDIAN BARRIER FAILURE ANALYSIS AND REMEDIATION, PHASE II

DOT National Transportation Integrated Search

2013-06-20

On divided roadways, cross-median fatalities are disproportionately overrepresented in fatal and serious injury crashes. Many state DOTs sought to mitigate cross-median crash risk by installing cable median barriers. Despite increased crash rates, st...

[Body mass index charts of Algerian children and adolescents (6-18 years)].

PubMed

Bahchachi, N; Dahel-Mekhancha, C-C; Rolland-Cachera, M-F; Roelants, M; Hauspie, R; Nezzal, L

2017-12-01

The body mass index (BMI) is widely accepted as a measure of overweight and obesity in children. There are no BMI reference charts for Algerian children and adolescents. The purpose of this study was to construct BMI percentile curves appropriate for children aged 6-18 years in Algeria. The weight and height of 7772 (54.9% girls) healthy schoolchildren from Constantine (eastern Algeria) were measured in 2008/2009. Weight and height for age curves based on the same sample were published previously. The BMI for age percentile curves were estimated in girls and boys separately using the LMS smoothing method. In both sexes, the median BMI increased with age. Girls had lower BMI values than boys before the age of 10 years but they were higher after this age until 18 years of age. Within the study population, the prevalence of overweight (including obesity) and obesity in girls and boys together was 13.7% and 3.0%, respectively, according to the International Obesity Task Force (IOTF) and 16.9% and 4.9% according to the World Health Organization (WHO) (2007). The median BMI curves of Algerian girls and boys were generally lower than those observed in other Arab countries. Compared with other references, the median BMI values of girls were lower than those of a Belgian Flemish population and WHO 2007 until 14 years of age and higher than the French reference between 7 and 18 years of age. The BMI values of Algerian boys were close to the Belgian (Flemish population), French and WHO 2007 references between 6 and 9 years of age and generally lower thereafter. These BMI curves are complementary to the height and weight charts published previously for the assessment of growth in children and adolescents. They were developed according to international guidelines and could serve as a national reference. They could be used as a complement to the 0- to 5-year-old WHO 2006 standards. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Age differences in health care spending, fiscal year 1977.

PubMed

Gibson, R M; Fisher, C R

1979-01-01

This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65.

Age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: The Hilo Women’s Health Study

PubMed Central

Sievert, Lynnette Leidy; Murphy, Lorna; Morrison, Lynn; Reza, Angela; Brown, Daniel E.

2013-01-01

Objectives A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii. Study design Participants aged 40–60 years (n=898) were drawn from a larger, randomly-generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause. Main outcome measures History of hysterectomy, Age at menopause Results Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause. Conclusions Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause. PMID:24054435

Development of a MASH TL-3 median barrier gate.

DOT National Transportation Integrated Search

2011-06-01

Median barriers are commonly used to separate opposing lanes of traffic on divided highways and to : separate managed lanes from general purpose lanes. Concrete median barriers (CMBs) are often preferred : on urban freeways with narrow medians due to...

MEDIAN-BASED INCREMENTAL COST-EFFECTIVENESS RATIOS WITH CENSORED DATA

PubMed Central

Bang, Heejung; Zhao, Hongwei

2016-01-01

Cost-effectiveness is an essential part of treatment evaluation, in addition to effectiveness. In the cost-effectiveness analysis, a measure called the incremental cost-effectiveness ratio (ICER) is widely utilized, and the mean cost and the mean (quality-adjusted) life years have served as norms to summarize cost and effectiveness for a study population. Recently, the median-based ICER was proposed for complementary or sensitivity analysis purposes. In this paper, we extend this method when some data are censored. PMID:26010599

Age-related injury patterns in Spanish trauma ICU patients. Results from the RETRAUCI.

PubMed

Llompart-Pou, Juan Antonio; Chico-Fernández, Mario; Sánchez-Casado, Marcelino; Alberdi-Odriozola, Fermín; Guerrero-López, Francisco; Mayor-García, María Dolores; González-Robledo, Javier; Ballesteros-Sanz, María Ángeles; Herrán-Monge, Rubén; León-López, Rafael; López-Amor, Lucía; Bueno-González, Ana

2016-09-01

Injury patterns may differ in trauma patients when age is considered. This information is relevant in the management of trauma patients and for planning preventive measures. We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23 rd , 2012 to July 31 st , 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly). Quantitative data were reported as median (Interquartile Range (IQR) 25-75) and categorical data as number and percentage. Comparison between groups of age with quantitative variables was performed using the analysis of variance (ANOVA) test. Differences between groups with categorical variables were compared using the chi-square test. A value of p<0.05 was considered significant. We included 2700 patients (78.9% male). Median age was 46 (31-62) years. Blunt trauma was present in 93.7% of the patients. Median RTS was 7.55 (5.97-7.84). Median ISS was 20 (13-26). High-energy trauma secondary to motor-vehicle accident with rhabdomyolysis and drugs abuse showed an inverse linear association with ageing, whilst pedestrian falls with isolated brain injury, being run-over and pre-injury antiplatelets or anticoagulant treatment increased with age (in all cases p<0.001). Multiple injuries were more common in young adults (p<0.001). Acute kidney injury prevalence was higher in elderly and very elderly patients (p<0.001). ICU Mortality increased with age in spite of similar severity scores in all groups (p<0.001). The main cause of death in all groups was intracranial hypertension. Different injury patterns exist in relation with ageing in trauma ICU patients. Adult patients were more likely to present high-energy trauma with significant injuries in different areas whilst elderly

Free and protein-bound cobalamin absorption in healthy middle-aged and older subjects.

PubMed

van Asselt, D Z; van den Broek, W J; Lamers, C B; Corstens, F H; Hoefnagels, W H

1996-08-01

To study free- and protein-bound cobalamin absorption and the correlation with atrophic gastritis in healthy middle-aged and older subjects. A cross-sectional study. Fifty-two healthy subjects, aged 26 to 87 years, apparently free from conditions known to influence the cobalamin status. Middle-aged subjects were defined as those younger than 65 years of age (median age 57 years) and older subjects as those 65 years and older (median age 75 years). Protein-bound cobalamin absorption was assessed by 48-hour urinary excretion method following oral administration of scrambled egg yolk, labeled in vivo with 57 Co-cobalamin by injecting a hen with 57 Co-cyanocobalamin. The percentage of 57 Co-cobalamin bound to protein was 65%. Free cobalamin absorption was assessed by 48-hour urinary excretion method following oral administration of crystalline 57 Co-cyanocobalamin. Plasma cobalamin, folate and fasting plasma gastrin, and pepsinogen A and C concentrations were determined. The median urinary excretion of egg yolk 57 Co-cobalamin in middle-aged subjects was 12.3% (25th and 75th percentiles 10.5%-14.5%) compared with 11.7% (25th and 75th percentiles 9.8%-13.6%) in older subjects (P = .283). The median urinary excretion after administration of free 57 Co-cobalamin in middle-aged subjects was 25.7% (25th and 75th percentiles 20.6%-30.7%) compared with 27.9% (25th and 75th percentiles 21.4%-34.5%) in older subjects (P = .694). Neither egg yolk nor free 57 Co-cobalamin excretion correlated with age. A ratio of pepsinogen A to pepsinogen C less than 1.6, indicating atrophic gastritis, was found in 13 subjects. Within the atrophic gastritis group, 11 subjects had a pepsinogen A concentration greater than or equal to 17 micrograms/L, indicating mild to moderate atrophic gastritis, and two subjects had a pepsinogen A concentration less than 17 micrograms/L, indicating severe atrophic gastritis or gastric atrophy. All subjects had normal fasting plasma gastrin concentrations. Free

Alcohol consumption at age 11-12 years and traumatic dental injuries at age 15-16 years in school children from East London.

PubMed

Baig Enver, Muneera; Marcenes, Wagner; Stansfeld, Stephen A; Bernabé, Eduardo

2016-10-01

To explore the association between alcohol consumption at age 11-12 years and traumatic dental injuries (TDI) at age 15-16 years. Data of 635 adolescents who participated in phases I and III of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal school-based survey of a representative sample of adolescents from East London, were used for this study. Information on socio-demographic characteristics and alcohol consumption was obtained from questionnaires in phase I when adolescents were 11-12 years of age. Data on TDI and clinical characteristics (incisor overjet and lip coverage) were taken from clinical examination in phase III when adolescents were 15-16 years of age. The association between (lifetime and last month) alcohol consumption and TDI was assessed in crude and adjusted logistic regression models. Overall, 14.5% of adolescents had ever consumed alcohol and 3.5% had consumed alcohol the month before the baseline survey, whereas 17% of adolescents had experienced TDI by age 15-16 years. No significant association of alcohol consumption with TDI was seen in these adolescents for either lifetime (adjusted odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.45-1.67) or last month consumption of alcohol (adjusted OR: 0.86; 95% CI: 0.28-2.69). This study did not support the association between alcohol use and TDI in adolescents. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

Signs on concrete median barriers.

DOT National Transportation Integrated Search

2013-04-01

Concrete median barriers have been used throughout the state as permanent and temporary barriers for providing separation of traffic. Typically, these barriers are tested and considered crashworthy through crash testing according to National Cooperat...

The Association Of Median Width and Highway Accident Rate

DOT National Transportation Integrated Search

1993-08-01

Medians on divided highways may be used as recovery areas by out-of-control vehicles. In some regions, the median widths of new highways are being minimized to control the amount of right-of-way required, and in others, existing highway medians are b...

Retail impact of raising tobacco sales age to 21 years.

PubMed

Winickoff, Jonathan P; Hartman, Lester; Chen, Minghua L; Gottlieb, Mark; Nabi-Burza, Emara; DiFranza, Joseph R

2014-11-01

The majority of tobacco use emerges in individuals before they reach 21 years of age, and many adult distributors of tobacco to youths are young adults aged between 18 and 20 years. Raising the tobacco sales minimum age to 21 years across the United States would decrease tobacco retailer and industry sales by approximately 2% but could contribute to a substantial reduction in the prevalence of youths' tobacco use and dependency by limiting access.

Assessment of self-esteem in mid-aged women.

PubMed

Chedraui, Peter; Pérez-López, Faustino R; Mendoza, Marcela; Leimberg, María L; Martinez, María A; Vallarino, Varinia; Hidalgo, Luis

2010-05-01

To assess self-esteem and affecting factors in a middle-aged Ecuadorian female population using the Rosenberg Self-Esteem Scale (RSES). This was a cross-sectional study in which 149 women (40-59 years) were requested to fill out the RSES and a general socio-demographic form containing personal and partner data. Mean age of sample was 47.6+/-5.5 years, a 67.8% had less than 12 years of schooling and 33.6% were postmenopausal. At the moment of the survey 2.7% were on hormone therapy, and 2% were taking psychotropic drugs. Mean total RSES score was 26.6+/-3.1 (median 26, range 17-35). A 35.6% and 18.1% of women respectively presented total RSES scores below 26 (median) and 25 (25th percentile) suggesting lower self-esteem. Total scores did not differ when comparing older age, menopausal phases or time since the menopause. Logistic regression analysis determined that women with lower parity and an unhealthy partner were related to lower total RSES scores (below the 25th percentile) suggesting lower self-esteem. In this mid-aged series lower self-esteem was not related to the aging process per se yet to socio-demographic female/male aspects. More research is needed in this regard that incorporates other sociological aspects. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Efficient Scalable Median Filtering Using Histogram-Based Operations.

PubMed

Green, Oded

2018-05-01

Median filtering is a smoothing technique for noise removal in images. While there are various implementations of median filtering for a single-core CPU, there are few implementations for accelerators and multi-core systems. Many parallel implementations of median filtering use a sorting algorithm for rearranging the values within a filtering window and taking the median of the sorted value. While using sorting algorithms allows for simple parallel implementations, the cost of the sorting becomes prohibitive as the filtering windows grow. This makes such algorithms, sequential and parallel alike, inefficient. In this work, we introduce the first software parallel median filtering that is non-sorting-based. The new algorithm uses efficient histogram-based operations. These reduce the computational requirements of the new algorithm while also accessing the image fewer times. We show an implementation of our algorithm for both the CPU and NVIDIA's CUDA supported graphics processing unit (GPU). The new algorithm is compared with several other leading CPU and GPU implementations. The CPU implementation has near perfect linear scaling with a speedup on a quad-core system. The GPU implementation is several orders of magnitude faster than the other GPU implementations for mid-size median filters. For small kernels, and , comparison-based approaches are preferable as fewer operations are required. Lastly, the new algorithm is open-source and can be found in the OpenCV library.

Intravitreal aflibercept for neovascular age-related macular degeneration in patients aged 90 years or older: 2-year visual acuity outcomes.

PubMed

Chatziralli, Irini; Regan, Shane O; Mohamed, Ryian; Talks, James; Sivaprasad, Sobha

2018-06-04

The purpose of this study was to investigate the efficacy of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) in very elderly patients aged 90 years or older at 2 years after treatment initiation. In this multicentre retrospective data analysis from electronic medical record, consecutive treatment-naive patients with nAMD treated with aflibercept with at least 2 years follow-up were stratified into those aged < 90 years (Group I) and an older cohort aged 90 and over (Group II). We compared the visual acuity (EDTRS letters) outcomes at 4 weekly intervals between the two groups over a 2-year period. The mean visual acuity of Group I at presentation was 56.3 ETDRS letters versus 52.8 letters in Group II. Maximal visual acuity was achieved in both the groups by 6 months after initiating treatment (4.7 vs. 4.0 letters gain). By 2 years, the mean visual acuity of the older cohort fell marginally below their baseline visual acuity (0.8 letter loss), while Group I presented +2.1 letters gain. The number of injections given and the retention rate of the older cohort were no different to the rest of the patients. Very old patients with nAMD benefited from aflibercept, but not to the same degree as the younger patients. The study showed that, on an average, the very elderly patients were able to adhere to the intensive anti-VEGF treatment regimens.

The Heterogeneous P-Median Problem for Categorization Based Clustering

ERIC Educational Resources Information Center

Blanchard, Simon J.; Aloise, Daniel; DeSarbo, Wayne S.

2012-01-01

The p-median offers an alternative to centroid-based clustering algorithms for identifying unobserved categories. However, existing p-median formulations typically require data aggregation into a single proximity matrix, resulting in masked respondent heterogeneity. A proposed three-way formulation of the p-median problem explicitly considers…

Beverage Consumption Patterns at Age 13 to 17 Years Are Associated with Weight, Height, and Body Mass Index at Age 17 Years.

PubMed

Marshall, Teresa A; Van Buren, John M; Warren, John J; Cavanaugh, Joseph E; Levy, Steven M

2017-05-01

Sugar-sweetened beverages (SSBs) have been associated with obesity in children and adults; however, associations between beverage patterns and obesity are not understood. Our aim was to describe beverage patterns during adolescence and associations between adolescent beverage patterns and anthropometric measures at age 17 years. We conducted a cross-sectional analyses of longitudinally collected data. Data from participants in the longitudinal Iowa Fluoride Study having at least one beverage questionnaire completed between ages 13.0 and 14.0 years, having a second questionnaire completed between 16.0 and 17.0 years, and attending clinic examination for weight and height measurements at age 17 years (n=369) were included. Beverages were collapsed into four categories (ie, 100% juice, milk, water and other sugar-free beverages, and SSBs) for the purpose of clustering. Five beverage clusters were identified from standardized age 13 to 17 years mean daily beverage intakes and named by the authors for the dominant beverage: juice, milk, water/sugar-free beverages, neutral, and SSB. Weight, height, and body mass index (BMI; calculated as kg/m 2 ) at age 17 years were analyzed. We used Ward's method for clustering of beverage variables, one-way analysis of variance and χ 2 tests for bivariable associations, and γ-regression for associations of weight or BMI (outcomes) with beverage clusters and demographic variables. Linear regression was used for associations of height (outcome) with beverage clusters and demographic variables. Participants with family incomes <$60,000 trended shorter (1.5±0.8 cm; P=0.070) and were heavier (2.0±0.7 BMI units; P=0.002) than participants with family incomes ≥$60,000/year. Adjusted mean weight, height, and BMI estimates differed by beverage cluster membership. For example, on average, male and female members of the neutral cluster were 4.5 cm (P=0.010) and 4.2 cm (P=0.034) shorter, respectively, than members of the milk cluster. For

On the rank-distance median of 3 permutations.

PubMed

Chindelevitch, Leonid; Pereira Zanetti, João Paulo; Meidanis, João

2018-05-08

Recently, Pereira Zanetti, Biller and Meidanis have proposed a new definition of a rearrangement distance between genomes. In this formulation, each genome is represented as a matrix, and the distance d is the rank distance between these matrices. Although defined in terms of matrices, the rank distance is equal to the minimum total weight of a series of weighted operations that leads from one genome to the other, including inversions, translocations, transpositions, and others. The computational complexity of the median-of-three problem according to this distance is currently unknown. The genome matrices are a special kind of permutation matrices, which we study in this paper. In their paper, the authors provide an [Formula: see text] algorithm for determining three candidate medians, prove the tight approximation ratio [Formula: see text], and provide a sufficient condition for their candidates to be true medians. They also conduct some experiments that suggest that their method is accurate on simulated and real data. In this paper, we extend their results and provide the following: Three invariants characterizing the problem of finding the median of 3 matrices A sufficient condition for uniqueness of medians that can be checked in O(n) A faster, [Formula: see text] algorithm for determining the median under this condition A new heuristic algorithm for this problem based on compressed sensing A [Formula: see text] algorithm that exactly solves the problem when the inputs are orthogonal matrices, a class that includes both permutations and genomes as special cases. Our work provides the first proof that, with respect to the rank distance, the problem of finding the median of 3 genomes, as well as the median of 3 permutations, is exactly solvable in polynomial time, a result which should be contrasted with its NP-hardness for the DCJ (double cut-and-join) distance and most other families of genome rearrangement operations. This result, backed by our experimental

Portfolio optimization using median-variance approach

NASA Astrophysics Data System (ADS)

Wan Mohd, Wan Rosanisah; Mohamad, Daud; Mohamed, Zulkifli

2013-04-01

Optimization models have been applied in many decision-making problems particularly in portfolio selection. Since the introduction of Markowitz's theory of portfolio selection, various approaches based on mathematical programming have been introduced such as mean-variance, mean-absolute deviation, mean-variance-skewness and conditional value-at-risk (CVaR) mainly to maximize return and minimize risk. However most of the approaches assume that the distribution of data is normal and this is not generally true. As an alternative, in this paper, we employ the median-variance approach to improve the portfolio optimization. This approach has successfully catered both types of normal and non-normal distribution of data. With this actual representation, we analyze and compare the rate of return and risk between the mean-variance and the median-variance based portfolio which consist of 30 stocks from Bursa Malaysia. The results in this study show that the median-variance approach is capable to produce a lower risk for each return earning as compared to the mean-variance approach.

Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

MedlinePlus

... Share Compartir Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily ... 2010, the age-adjusted percentage of adults aged 18 years or older with diagnosed diabetes performing daily ...

Age-related annual decline of lung function in patients with COPD.

PubMed

Kim, Soo Jung; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Yoon, Ho Il; Lee, Sang-Min; Yim, Jae-Joon; Kim, Young Whan; Han, Sung Koo; Yoo, Chul-Gyu

2016-01-01

According to the Fletcher-Peto curve, rate of decline in forced expiratory volume in 1-second (FEV1) accelerates as age increases. However, recent studies have not demonstrated that the rate of FEV1 decline accelerates with age among COPD patients. The objective of the study is to evaluate annual rate of FEV1 decline as age increases among COPD patients. In this retrospective cohort study, we enrolled COPD patients who were followed up at two tertiary care university hospitals from January 2000 to August 2013. COPD was defined as post-bronchodilator (BD) FEV1/forced vital capacity (FVC) of <0.7. All participants had more than two spirometries, including BD response. Age groups were categorized as follows: below versus above median age or four quartiles. A total of 518 participants (94.2% male; median age, 67 years; range, 42-90 years) were included. Mean absolute and predictive values of post-BD FEV1 were 1.57±0.62 L and 52.53%±18.29%, respectively. Distribution of Global initiative for Chronic Obstructive Lung Disease groups did not show statistical differences between age groups categorized by two different criteria. After grouping the population by age quartiles, the rate of FEV1 decline was faster among older patients than younger ones whether expressed as absolute value (-10.60±5.57 mL/year, -15.84±6.01 mL/year, -18.63±5.53 mL/year, 32.94±6.01 mL/year, respectively; P=0.048) or predicted value (-0.34%±0.19%/year, -0.53%±0.21%/year, -0.62%±0.19%/year, -1.26%±0.21%/year, respectively, P=0.010). As suggested conceptually by the Fletcher-Peto curve, annual FEV1 decline among COPD patients is accelerated among older patients than younger ones.

Patterns of sugar-sweetened beverage consumption amongst young people aged 13-15 years during the school day in Scotland.

PubMed

Hamilton, Laura Kate; Wills, Wendy J

2017-09-01

There is currently little research regarding sugar-sweetened beverage (SSB) consumption patterns of young people though adolescents are thought to be frequent consumers of these drinks. There is no research regarding the other foods and drinks consumed alongside SSBs by young people. The aim of this paper is to explore the patterns of SSB purchase and consumption amongst young people aged 13-15 years. A purchasing recall questionnaire (PRQ) was administered online in seven case study schools with 535 young people aged 13-15 years. Nutrient composition (kilocalories, fat, saturated fat, sodium and sugar) was also calculated for food/drink purchases. Chi-Square and Wilcoxon-Mann Whitney tests were conducted to examine patterns of SSB consumption and sugar/kilocalories consumption for SSB consumers and non-consumers. SSB consumers were significantly more likely to consume a drink at mid-morning break. Fewer consumed food at mid-morning break, ate food before school or ate food at lunchtime, but this was not statistically significant. A higher percentage of SSB consumers consumed 'unhealthy' food and drinks in comparison to young people who did not consume a SSB. Both median lunchtime sugar consumption (40.7 g vs 10.2 g) and median sugar as a percentage of Kcals (39% vs 14%) were significantly higher for SSB purchasers in comparison to non-purchasers. The analysis highlights that SSB purchasers consume significantly more sugar at lunchtime than non-purchasers. However, both purchasers and non-purchasers exceeded WHO (2015) recommendations that sugar consumption be halved to form no more than 5% of daily energy intake. This study provides new insights for public health stakeholders and schools. Multifaceted and inventive strategies relevant to young people will be required to achieve the new WHO recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Aging in Mexico: Population Trends and Emerging Issues

PubMed Central

Vega, William; López-Ortega, Mariana

2017-01-01

Abstract Although all nations in the America’s face a common demographic reality of longevity, declining fertility rates and changes in family roles a growing body of research points to a dramatic demographic transformation in Mexico. Although Mexico’s population is relatively young, with a median age of 27.9 in 2015, it will age rapidly in coming years, increasing to 42 years by 2050. The rapid median age in the nation also reflects the growing proportion of people 65 or older, and is expected to triple to 20.2% by 2050. This article examines how the age and gender structure of Mexico offers important insights about current and future political and social stability, as well as economic development. Mexico is the world’s eleventh largest country in terms of population size and the “demographic dividend” of a large youthful population is giving way to a growing older population that will inevitably place demands on health care and social security. The shift in age structure will result in increased dependency of retirees on the working-age population in the next 20 years. Mexico does not provide universal coverage of social security benefits and less than half of the labor force is covered by any pension or retirement plan. As a result, elderly Mexicans often continue working into old age. The high total poverty rate in the country, especially among the older population magnifies the problem of the potential dependency burden. The article ends with a discussion of key public policy issues related to aging in Mexico. PMID:27927730

Median and common peroneal neuropathy in coir workers of Alappuzha district, Kerala

PubMed Central

Chandra, Sadanandavalli Retnaswami; Anand, Biji; Issac, Thomas Gregor

2017-01-01

Introduction: Coir work, in a large number of people involves mechanically rolling the coconut fibers into coir which is later subjected to various processes. The primary work is done as a cottage industry specially by women in the sitting posture for several hours. This study reports evidence of median and common peroneal neuropathy electrophysiologically in people who had been engaged in this job for several years. This study was initiated to establish the possible relationship between coir work and symptomatic neuropathies which was seen in that region with all investigations “for other causes not” contributing to the etiological diagnosis. Subjects and Methods: One hundred and forty-two upper limbs and 142 lower limbs in patients engaged in long years of coir work but having no symptoms were evaluated electrophysiologically with informed consent and financial compensation, appropriate inclusion and exclusion criteria were followed as described in the text. Results: There is electrophysiological evidence for median and common peroneal neuropathy in persons engaged in long years of coir work. Conclusions: Coir workers neuropathy appears to be a new occupational neuropathy which can be prevented by following simple preventive measures. PMID:28298838

Dietary practices in glutaric aciduria type 1 over 16 years.

PubMed

Gokmen-Ozel, H; MacDonald, A; Daly, A; Ashmore, C; Preece, M A; Hendriksz, C; Vijay, S; Chakrapani, A

2012-12-01

In glutaric aciduria type 1 (GA1), dietary treatment with emergency management (EM) is essential to prevent encephalopathic crisis (EC). In the present study, dietary practices were examined in a single UK centre without access to newborn screening. Twenty GA1 patients (11 males, median age: 10.2 years, range 2.2-24.1 years) were evaluated. Nine presented without EC (median diagnosis age: 1.1 years, range 4 days to 8 years) and 11 with EC (median diagnosis age 10 months, range 6 months to 1.7 years). Dietary treatment, neurological outcome, anthropometry and biochemical/haematological markers were assessed. Diet treatment varied according to age of diagnosis and symptom severity. Four of six pre-encephalopathic children diagnosed before 2 years of age were treated with carnitine, protein restriction (medium l.2 g kg day(-1)) and lysine-free/low tryptophan protein substitute (PS) (medium dose: 1.6 g kg day(-1)). EM consisted of natural protein cessation and glucose polymer with PS delivered via an enteral feeding tube. Older children (>3 years) without EC were given carnitine and protein restriction, and seven of nine EC patients had PS via an enteral feeding tube. Clinical deterioration occurred in two patients without EC; one taking PS and protein restriction (with a second untreatable pathology) and one after protein restriction only. In patients presenting with EC, four died and one had some improvement in movement, with the rest remaining stable but with severe disability. Patients taking PS had better nutritional markers [serum vitamin B(12) (P < 0.001), albumin (P < 0.001), haemoglobin (P < 0.001) and essential plasma amino acids]. Early diagnosis of GA1 before EC is essential because PS and protein restriction with meticulous EM prevents EC. PS also improves nutritional status irrespective of clinical condition. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

A methodology for determining economic impacts of raised medians : data analysis on additional case studies

DOT National Transportation Integrated Search

1999-10-01

The objective of this four-year research effort is to develop and test a methodology to estimate the economic impacts of median design. This report summarizes the activities performed in the third year of this project. The primary task in the third y...

Dual pathology proximal median nerve compression of the forearm.

PubMed

Murphy, Siun M; Browne, Katherine; Tuite, David J; O'Shaughnessy, Michael

2013-12-01

We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

PubMed

Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

2015-02-01

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (�

Determining median urinary iodine concentration that indicates adequate iodine intake at population level.

PubMed Central

Delange, François; de Benoist, Bruno; Burgi, Hans

2002-01-01

OBJECTIVE: Urinary iodine concentration is the prime indicator of nutritional iodine status and is used to evaluate population-based iodine supplementation. In 1994, WHO, UNICEF and ICCIDD recommended median urinary iodine concentrations for populations of 100- 200 micro g/l, assuming the 100 micro g/l threshold would limit concentrations <50 micro g/l to median urinary iodine concentrations >100 micro g/l. The total population was 55 892, including 35 661 (64%) schoolchildren. Median urinary iodine concentrations were 111-540 (median 201) micro g/l for all populations, 100-199 micro g/l in 23 (48%) populations and >/=200 micro g/l in 25 (52%). The frequencies of values <50 micro g/l were 0-20.8 (mean 4.8%) overall and 7.2% and 2.5% in populations with medians of 100-199 micro g/l and >200 micro g/l, respectively. The frequency reached 20% only in two places where iodine had been supplemented for <2 years. CONCLUSION: The frequency of urinary iodine concentrations <50 micro g/l in populations with median urinary iodine concentrations >/=100 micro g/l has been overestimated. The threshold of 100 micro g/l does not need to be increased. In populations, median urinary iodine concentrations of 100-200 micro g/l indicate adequate iodine intake and optimal iodine nutrition. PMID:12219154

Quantum image median filtering in the spatial domain

NASA Astrophysics Data System (ADS)

Li, Panchi; Liu, Xiande; Xiao, Hong

2018-03-01

Spatial filtering is one principal tool used in image processing for a broad spectrum of applications. Median filtering has become a prominent representation of spatial filtering because its performance in noise reduction is excellent. Although filtering of quantum images in the frequency domain has been described in the literature, and there is a one-to-one correspondence between linear spatial filters and filters in the frequency domain, median filtering is a nonlinear process that cannot be achieved in the frequency domain. We therefore investigated the spatial filtering of quantum image, focusing on the design method of the quantum median filter and applications in image de-noising. To this end, first, we presented the quantum circuits for three basic modules (i.e., Cycle Shift, Comparator, and Swap), and then, we design two composite modules (i.e., Sort and Median Calculation). We next constructed a complete quantum circuit that implements the median filtering task and present the results of several simulation experiments on some grayscale images with different noise patterns. Although experimental results show that the proposed scheme has almost the same noise suppression capacity as its classical counterpart, the complexity analysis shows that the proposed scheme can reduce the computational complexity of the classical median filter from the exponential function of image size n to the second-order polynomial function of image size n, so that the classical method can be speeded up.

Age-specific MRI brain and head templates for healthy adults from 20 through 89 years of age

PubMed Central

Fillmore, Paul T.; Phillips-Meek, Michelle C.; Richards, John E.

2015-01-01

This study created and tested a database of adult, age-specific MRI brain and head templates. The participants included healthy adults from 20 through 89 years of age. The templates were done in five-year, 10-year, and multi-year intervals from 20 through 89 years, and consist of average T1W for the head and brain, and segmenting priors for gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF). It was found that age-appropriate templates provided less biased tissue classification estimates than age-inappropriate reference data and reference data based on young adult templates. This database is available for use by other investigators and clinicians for their MRI studies, as well as other types of neuroimaging and electrophysiological research.1 PMID:25904864

Adding Spatially Correlated Noise to a Median Ionosphere

NASA Astrophysics Data System (ADS)

Holmes, J. M.; Egert, A. R.; Dao, E. V.; Colman, J. J.; Parris, R. T.

2017-12-01

We describe a process for adding spatially correlated noise to a background ionospheric model, in this case the International Reference Ionosphere (IRI). Monthly median models do a good job describing bulk features of the ionosphere in a median sense. It is well known that the ionosphere almost never actually looks like its median. For the purposes of constructing an Operational System Simulation Experiment, it may be desirable to construct an ionosphere more similar to a particular instant, hour, or day than to the monthly median. We will examine selected data from the Global Ionosphere Radio Observatory (GIRO) database and estimate the amount of variance captured by the IRI model. We will then examine spatial and temporal correlations within the residuals. This analysis will be used to construct a temporal-spatial gridded ionosphere that represents a particular instantiation of those statistics.

Geographic and income variations in age at diagnosis and incidence of chronic myeloid leukemia.

PubMed

Mendizabal, Adam M; Younes, Naji; Levine, Paul H

2016-01-01

Developing countries have a younger population of CML patients than developed countries. Patterns of age at diagnosis and incidence by geography and gross national income (GNI) are not well understood. A population-based descriptive study was conducted using data from the International Agency for Research on Cancer's population-based registry compilation. Geographical regions were classified according to the United Nations World Macro Regions and Components. Age-Standardized Incidence Rates (ASR) were adjusted to the World Standard Population. Poisson regression was used to assess age-specific interactions. 57.2% were male among 33,690 diagnoses. Median age at diagnosis was lowest in Africa and Asia (47 years) and highest in Oceania (72 years). ASR was lowest in African males (0.61 per 100,000) and Asian females (0.55 per 100,000) and highest in Oceania males and females (1.78 and 0.96 per 100,000, respectively). A significant interaction (p < 0.0001) between age (<50 years and >50 years) and region exists; no significant differences were seen by region in the <50 age-group while significant differences by region exist in the >50 age group. Population-based estimates suggest that the median age at diagnosis and incidence varies by region. Geographic and income heterogeneity suggest an important effect of environment that warrants further studies.

Adolescent vaccination: coverage achieved by ages 13-15 years, and vaccinations received as recommended during ages 11-12 years, National Health Interview Survey 1997-2003.

PubMed

McCauley, Mary Mason; Stokley, Shannon; Stevenson, John; Fishbein, Daniel B

2008-12-01

To present progress toward Healthy People 2010 vaccination objectives for adolescents aged 13-15 years, and to determine how much catch-up and routine vaccination was administered at the recommended ages of 11-12 years. Data from the 1997-2003 National Health Interview Survey were evaluated. In the first analysis, vaccination coverage levels for adolescents aged 13-15 years were determined for each survey year. Main outcome measures include the percent of adolescents who had received the three-dose hepatitis B vaccine (Hep B) series, the two-dose measles/mumps/rubella vaccine (MMR) series, the tetanus and diphtheria toxoids (Td) booster, and one dose of varicella vaccine. In the second analysis, data from all survey years were combined and vaccination dates were analyzed to determine the percentage of adolescents who were missing any vaccines at ages 11-12 and received them at that age. Data for varicella vaccine were sufficient only for the first analysis. Among the approximately 15%-20% of respondents who reported vaccination history from records in the home and who were reporting on a 13-15-year-old, coverage with three doses of Hep B increased significantly during 1997-2001, from 15.2% to 55.0%. Coverage with MMR and Td fluctuated, with no significant increase; highs were 76.7% for MMR in 2003 and 36.2% for Td in 2002. Examination of vaccination dates for all surveyed adolescents showed that among 11-12-year-olds who needed catch-up vaccine, 0.6%-31.3% were brought up to date for Hep B and 22.1%-31.8% were brought up to date for MMR. For Td, 2.6%-15.4% of 11-12-year-olds who had not previously received Td received the vaccine. Vaccination coverage among adolescents aged 13-15 years was below the Healthy People 2010 goals of 90%, but generally increased over the survey years. However, the suboptimal delivery of needed vaccines during ages 11 and 12 is concerning in light of recent vaccine recommendations targeted at this age. Continuing to focus on strategies to

Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study.

PubMed

Currie, Candace; Ahluwalia, Naman; Godeau, Emmanuelle; Nic Gabhainn, Saoirse; Due, Pernille; Currie, Dorothy B

2012-06-01

A unique standardized international data set from adolescent girls in 34 countries in Europe and North America participating in the Health Behaviour in School-aged Children Study (HBSC) is used to investigate the contribution of body mass index (BMI) at individual and country level to cross-national differences in age at menarche. Two independent nationally representative survey data sets from 15-year-olds (n = 27,878, in 34 countries, year = 2005/2006) and 11-year-olds (n = 18,101, in 29 countries, year = 2001/2002) were analyzed. The survey instrument is a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated using Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). "Country-level obesity" was measured by prevalence of overweight/obesity (%) in each country. Country-level median age at menarche ranged between 12 years and 5 months and 13 years and 5 months. Country-level prevalence of overweight among 15-year-old girls ranged from 4% to 28%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = -1.01; 95% CI, -1.09 to -.94) and country-level aggregate overweight at age 11 (unstandardized regression coefficient beta = -.25; 95% CI, -.43 to -.08). Individual- and country-level measures of BMI account for 40% of the country-level variance in age at menarche. The findings add to the evidence that obesity in childhood is a risk factor for early puberty in girls and accounts for much of the cross-national variation in age at menarche. Future HBSC surveys can track this relationship in the wake of the obesity "epidemic." Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Transplantation With Livers From Deceased Donors Older Than 75 Years.

PubMed

Thorsen, Trygve; Aandahl, Einar Martin; Bennet, William; Olausson, Michael; Ericzon, Bo-Göran; Nowak, Greg; Duraj, Frans; Isoniemi, Helena; Rasmussen, Allan; Karlsen, Tom H; Foss, Aksel

2015-12-01

The availability of donor organs limits the number of patients in need who are offered liver transplantation. Measures to expand the donor pool are crucial to prevent on-list mortality. The aim of this study was to evaluate the use of livers from deceased donors who were older than 75 years. Fifty-four patients who received a first liver transplant (D75 group) from 2001 to 2011 were included. Donor and recipient data were collected from the Nordic Liver Transplant Registry and medical records. The outcome was compared with a control group of 54 patients who received a liver graft from donors aged 20 to 49 years (D20-49 group). Median donor age was 77 years (range, 75-86 years) in the D75 group and 41 years (range, 20-49 years) in the D20-49 group. Median recipient age was 59 years (range, 31-73 years) in the D75 group and 58 years (range, 31-74 years) in the D20-49 group. The 1-, 3-, and 5-year patient/graft survival values were 87/87%, 81/81%, and 71/67% for the D75 group and 88/87%, 75/73%, and 75/73% for the D20-49 group, respectively. Patient (P = 0.89) and graft (P = 0.79) survival did not differ between groups. The frequency of biliary complications was higher in the D75 group (29.6/13%, P = 0.03). Selected livers from donors over age 75 years should not be excluded based on age, which does not compromise patient or graft survival despite a higher frequency of biliary complications.

Neurodevelopmental outcome at two years of age after general and awake-regional anaesthesia in infancy: a randomised controlled trial

PubMed Central

Davidson, Andrew J.; Disma, Nicola; de Graaff, Jurgen C.; Withington, Davinia E.; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C.; Schuster, Tibor; Arnup, Sarah J.; Hardy, Pollyanna; Hunt, Rodney W.; Takagi, Michael J.; Giribaldi, Gaia; Hartmann, Penelope L.; Salvo, Ida; Morton, Neil S.; von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J.; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R.; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; Ellen, Mary

2016-01-01

Summary Background There is pre-clinical evidence that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia may have an increased risk of poorer neurodevelopmental outcome. This trial aims to determine if GA in infancy has any impact on neurodevelopmental outcome. The primary outcome for the trial is neurodevelopmental outcome at 5 years of age. The secondary outcome is neurodevelopmental outcome at two years of age and is reported here. Methods We performed an international assessor-masked randomised controlled equivalence trial in infants less than 60 weeks post-menstrual age, born at greater than 26 weeks gestational age having inguinal herniorrhaphy. Infants were excluded if they had existing risk factors for neurologic injury. Infants were randomly assigned to awake-regional (RA) or sevoflurane-based general anaesthesia (GA). Web-based randomisation was performed in blocks of two or four and stratified by site and gestational age at birth. The outcome for analysis was the composite cognitive score of the Bayley Scales of Infant and Toddler Development, Third Edition. The analysis was as-per-protocol adjusted for gestational age at birth. A difference in means of five points (1/3 SD) was predefined as the clinical equivalence margin. The trial was registered at ANZCTR, ACTRN12606000441516 and ClinicalTrials.gov, NCT00756600. Findings Between February 2007, and January 2013, 363 infants were randomised to RA and 359 to GA. Outcome data were available for 238 in the RA and 294 in the GA arms. The median duration of anaesthesia in the GA arm was 54 minutes. For the cognitive composite score there was equivalence in means between arms (RA-GA: +0·169, 95% CI −2·30 to +2·64). Interpretation For this secondary outcome we found no evidence that just under an hour of sevoflurane anaesthesia in infancy increases the risk of adverse neurodevelopmental outcome at two years of age compared

Micronutrient status in middle childhood and age at menarche: results from the Bogotá School Children Cohort.

PubMed

Villamor, Eduardo; Marín, Constanza; Mora-Plazas, Mercedes; Oliveros, Henry

2017-12-01

Childhood intake of animal foods is associated with age at first menstrual period (menarche). It is unknown whether the micronutrients present in these foods could explain this association. Our objective was to investigate the associations of micronutrient status biomarkers in middle childhood with age at menarche. We quantified circulating Hb, ferritin, mean corpuscular volume, Zn, vitamin B12, erythrocyte folate and retinol in 1464 pre-menarcheal girls aged 5-12 years in Bogotá, Colombia, and followed them for a median 5·7 years for the occurrence and date of menarche. We estimated median age at menarche and hazard ratios (HR) with 95 % CI by levels of each biomarker with use of Kaplan-Meier survival probabilities and Cox regression, respectively. Median age at menarche was 12·4 years. Middle childhood Hb was inversely related to age at menarche whereas plasma ferritin was positively associated with this outcome in a linear manner. HR of menarche for every 1 sd of Hb (11 g/l) and ferritin (23·2 µg/l) were 1·11 (95 % CI 1·04, 1·18; P=0·001) and 0·94 (95 % CI 0·88, 0·99; P=0·02), respectively, after adjustment for baseline age, C-reactive protein concentration, maternal age at menarche and parity and socioeconomic status. The association with ferritin was stronger in girls aged 9-10 years at baseline. Additional adjustment for baseline height- and BMI-for-age did not change the results. We conclude that higher Fe status in middle childhood is related to later age at menarche whereas Hb concentrations are inversely associated with age at onset of menses.

Breast cancer in women aging 35 years old and younger: The Egyptian National Cancer Institute (NCI) experience.

PubMed

Darwish, A D; Helal, A M; Aly El-Din, N H; Solaiman, L L; Amin, A

2017-02-01

The aim is to identify the epidemiological and clinicopathological features associated with young breast cancer (BC) patients and to discuss factors affecting tumor recurrence and DFS. A retrospective analysis was conducted based on medical records from young females patients aged ≤35 years with pathologically confirmed primary breast cancer treated during 2008-2010 at NCI. Cases with non invasive cancer and non carcinoma histology are excluded. Of the 5408 cases diagnosed with breast cancer, 554 were young. Four hundred & fifty eight patients representing 9.2% were within our inclusion criteria. Almost half of the patients (45.9%) presented with stage III. Axillary nodes involvement was in 63.9%, 83.3% were grade 2. More than one quarter of tumors was hormone receptors negative (28.8%) & Her2 was over-expressed in 30%. Mastectomy was offered in 72% while conservative breast surgery in 26%, 69.2% received chemotherapy either adjuvant, neoadjuvant or both, 82.5% received adjuvant radiotherapy, 68.6% received hormonal therapy. Metastatic disease developed in 51.3%, with 31% having more than one site of metastases. After a median follow up period of 66 months, the median DFS of patients was 60 months. The median DFS was significantly shorter among patients with positive lymph nodes (P < 0.0001), ER negative disease (P = 0.045) and stage III disease (P < 0.0001). Breast cancer in young women is aggressive from the time of diagnosis. Our results provide baseline data of young BC in the Middle East & North Africa region; thus, contributing to future epidemiological and hospital-based researches. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Importance of age and other risk factors in NSAID-induced gastropathy].

PubMed

Lee, Hang Lak; Han, Dong Soo; Kim, Jin Bae; Kim, Jong Pyo; Jeon, Yong Chul; Sohn, Joo Hyun; Hahm, Joon Soo

2004-11-01

It is clinically important to analyze the risk factors of NSAID-induced gastropathy because there could be no symptoms. Age is the most important risk factor according to previous reports. The aim of this study was to find risk factors of NSAID-induced gastropathy and to confirm the association between NSAID-induced gastropathy and age. We retrospectively assessed 300 patients who conducted an upper gastroscopy during the course of chronic NSAID treatment. Median age of patients group is 51.4 +/- 12.2 years. In multivariate analysis, age and ulcer history are two significant risk factors. Median age is 46.7 +/- 10.7 years for the patients with nonspecific gastroscopic finding, 53.0 +/- 12.5 for those with erosion, 57.6 +/- 10.0 for those with ulcer, and 63.2 +/- 8.9 for those with hemorrhage. The proportion of ulcer patients is as follows: 6% in the patients of under 40 years old, 14.9% in patients of the 40s, 20% in patients of the 50s, 30.9% in patients of the 60s, 33.3% in patients over 70 years. The proportion of nonspecific findings is 62.2% in patients of the 40s, 37.8% in patients of the 50s, and 29% in patients over 60 years. Age is the most important risk factor of the NSAID-induced gastrointestinal mucosal injury. A larger randomized prospective control study will be required in the future for more conclusive results.

User Guide for the 2014-15 Teacher Median Student Growth Percentile Report

ERIC Educational Resources Information Center

New Jersey Department of Education, 2016

2016-01-01

On March 22, 2016, the New Jersey Department of Education ("the Department") published a broadcast memo sharing secure district access to 2014-15 median Student Growth Percentile (mSGP) data for all qualifying teachers. These data describe student growth from the last school year, and comprise 10% of qualifying teachers' 2014-15…

Factors influencing adherence to guidelines for screening mammography among women aged 40 years and older.

PubMed

Rahman, Saleh M M; Dignan, Mark B; Shelton, Brent J

2003-01-01

To explore patterns of adherence to guidelines for screening mammography among participants in the Colorado Mammography Project (CMAP) surveillance database. An algorithm was developed to assess factors associated with adherence to mammography screening guidelines. Of the 27,778 women ranging from 40-90 years of age included in the analysis, 41.4% were adherent with mammography screening guidelines. According to the model tested in this study, race/ethnicity (Black vs White, OR=0.76, 95% CI=0.64-0.91); educational attainment (high school vs median income by zip code of residence (15,000 dollars-24,999 dollars vs <15,000 dollars, OR=0.84, 95% CI=0.76-0.94, >55,000 dollars vs <15,000 dollars, OR 1.14, 95% CI=1.03-1.26) were statistically significant predictors of adherence to guidelines. A significant interaction between age and family history of breast cancer (BC) was also found. Younger females with a family history of BC were less likely to be adherent than their counterparts without a family history (OR=0.93, 95% CI=0.90-0.96). In general, elderly women were more likely to be adherent compared with the youngest group in this cohort (OR=1.21, 95% CI=1.11-1.33). Inclusion or exclusion of women aged 70 years and older did not change the outcome of the analysis. Adherence with screening mammography guidelines was found to be associated with women's personal characteristics including race/ethnicity, age, and family history of BC. In addition, socioeconomic status, as measured by educational level and community economic status, are important predictors of adherence. Efforts to increase adherence may need to be specific to race/ethnic group and age, but the effect of age is mediated by family history of BC and vice versa.

SCI Longitudinal Aging Study: 40 Years of Research.

PubMed

Krause, James S; Clark, Jillian M R; Saunders, Lee L

2015-01-01

The Spinal Cord Injury (SCI) Longitudinal Aging Study was initiated in 1973 and has conducted 8 assessments over the past 40 years. It was designed to help rehabilitation professionals understand the life situation of people with SCI, but it has developed into the most long-standing study of aging and SCI and has resulted in over 50 publications. Our purpose was to provide a detailed history of the study, response patterns, utilization of measures, and a summary of key findings reported in the literature. Five participant samples have been incorporated over the 40 years, with enrollment in 1973, 1984, 1993 (2 samples), and 2003. A total of 2,208 participants have completed 6,001 assessments, with a particularly large number of assessments among those who are more than 40 years post injury (n = 349). The overall results have indicated changing patterns of outcomes over time as persons with SCI age, with some notable declines in participation and health. There has been a survivor effect whereby persons who are more active, well-adjusted, and healthier live longer. This study has several important features that are required for longitudinal research including (a) consistency of follow-up, (b) consistency of measures over time, (c) addition of new participant samples to counteract attrition, and (d) inclusion of a large number of individuals who have reached aging milestones unparalleled in the literature. Data from this study can inform the literature on the natural course of aging with SCI.

The social network index and its relation to later-life depression among the elderly aged ≥80 years in Northern Thailand.

PubMed

Aung, Myo Nyein; Moolphate, Saiyud; Aung, Thin Nyein Nyein; Katonyoo, Chitima; Khamchai, Songyos; Wannakrairot, Pongsak

2016-01-01

Having a diverse social network is considered to be beneficial to a person's well-being. The significance, however, of social network diversity in the geriatric assessment of people aged ≥80 years has not been adequately investigated within the Southeast Asian context. This study explored the social networks belonging to the elderly aged ≥80 years and assessed the relation of social network and geriatric depression. This study was a community-based cross-sectional survey conducted in Chiang Mai Province, Northern Thailand. A representative sample of 435 community residents, aged ≥80 years, were included in a multistage sample. The participants' social network diversity was assessed by applying Cohen's social network index (SNI). The geriatric depression scale and activities of daily living measures were carried out during home visits. Descriptive analyses revealed the distribution of SNI, while the relationship between the SNI and the geriatric depression scale was examined by ordinal logistic regression models controlling possible covariants such as age, sex, and educational attainment. The median age of the sample was 83 years, with females comprising of 54.94% of the sample. The participants' children, their neighbors, and members of Buddhist temples were reported as the most frequent contacts of the study participants. Among the 435 participants, 25% were at risk of social isolation due to having a "limited" social network group (SNI 0-3), whereas 37% had a "medium" social network (SNI 4-5), and 38% had a "diverse" social network (SNI ≥6). The SNI was not different among the two sexes. Activities of daily living scores in the diverse social network group were significantly higher than those in the limited social network group. Multivariate ordinal logistic regression analysis models revealed a significant negative association between social network diversity and geriatric depression. Regular and frequent contact with various social contacts may

29 CFR 780.321 - Minors 16 years of age or under.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Minors 16 years of age or under. 780.321 Section 780.321... 13(a)(6) Statutory Provisions § 780.321 Minors 16 years of age or under. Section 13(a)(6)(D) by its very terms is available only to employees 16 years of age or under. Accordingly, even though all the...

29 CFR 780.321 - Minors 16 years of age or under.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Minors 16 years of age or under. 780.321 Section 780.321... 13(a)(6) Statutory Provisions § 780.321 Minors 16 years of age or under. Section 13(a)(6)(D) by its very terms is available only to employees 16 years of age or under. Accordingly, even though all the...

29 CFR 780.321 - Minors 16 years of age or under.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Minors 16 years of age or under. 780.321 Section 780.321... 13(a)(6) Statutory Provisions § 780.321 Minors 16 years of age or under. Section 13(a)(6)(D) by its very terms is available only to employees 16 years of age or under. Accordingly, even though all the...

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.

Lost productive life years caused by chronic conditions in Australians aged 45-64 years, 2010-2030.

PubMed

Schofield, Deborah J; Shrestha, Rupendra N; Cunich, Michelle; Tanton, Robert; Kelly, Simon; Passey, Megan E; Veerman, Lennert J

2015-09-21

To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45-64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period. A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45-64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury's GDP equation. Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease); the national impact of lost PLYs at the same time points (GDP loss caused by PLYs); the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point. Using Health&WealthMOD2030, we estimated a loss of 347,000 PLYs in 2010; this was projected to increase to 459,000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45-64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%). Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55-59 years and in women aged 60-64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.

Estimates of Median Flows for Streams on the 1999 Kansas Surface Water Register

USGS Publications Warehouse

Perry, Charles A.; Wolock, David M.; Artman, Joshua C.

2004-01-01

The Kansas State Legislature, by enacting Kansas Statute KSA 82a?2001 et. seq., mandated the criteria for determining which Kansas stream segments would be subject to classification by the State. One criterion for the selection as a classified stream segment is based on the statistic of median flow being equal to or greater than 1 cubic foot per second. As specified by KSA 82a?2001 et. seq., median flows were determined from U.S. Geological Survey streamflow-gaging-station data by using the most-recent 10 years of gaged data (KSA) for each streamflow-gaging station. Median flows also were determined by using gaged data from the entire period of record (all-available hydrology, AAH). Least-squares multiple regression techniques were used, along with Tobit analyses, to develop equations for estimating median flows for uncontrolled stream segments. The drainage area of the gaging stations on uncontrolled stream segments used in the regression analyses ranged from 2.06 to 12,004 square miles. A logarithmic transformation of the data was needed to develop the best linear relation for computing median flows. In the regression analyses, the significant climatic and basin characteristics, in order of importance, were drainage area, mean annual precipitation, mean basin permeability, and mean basin slope. Tobit analyses of KSA data yielded a model standard error of prediction of 0.285 logarithmic units, and the best equations using Tobit analyses of AAH data had a model standard error of prediction of 0.250 logarithmic units. These regression equations and an interpolation procedure were used to compute median flows for the uncontrolled stream segments on the 1999 Kansas Surface Water Register. Measured median flows from gaging stations were incorporated into the regression-estimated median flows along the stream segments where available. The segments that were uncontrolled were interpolated using gaged data weighted according to the drainage area and the bias between the

The impact of young age on locoregional recurrence after doxorubicin-based breast conservation therapy in patients 40 years old or younger: How young is 'young'?

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

Oh, Julia L.; Bonnen, Mark; Outlaw, Elesyia D.

2006-08-01

Purpose: The aim of this study was to investigate whether patients <35 years old have similar risk of locoregional recurrence after breast conservation therapy compared with patients 35 to 40 years old. Methods and materials: We retrospectively reviewed records of 196 consecutive patients {<=}40 years old who received breast conservation therapy (BCT) from 1987 to 2000 for breast cancer and compared outcomes between patients <35 years old with patients 35 to 40 years old. The majority of patients received neoadjuvant chemotherapy as part of their treatment. Multivariate analysis was performed to assess risk factors for locoregional recurrence. Results: After amore » median follow-up of 64 months, 22 locoregional recurrences (LRR) were observed. Twenty patients developed locoregional recurrence as their first site of relapse. Two patients had bone-only metastases before their locoregional recurrence. On multivariate analysis, age <35 years was associated with a statistically significant increased risk of locoregional recurrence. The 5-year rate of locoregional control was 87.9% in patients <35 years old compared with 91.7% in patients 35 to 40 years old (p = 0.042). Conclusions: Our finding supports an increased risk of locoregional recurrence as a function of younger age after breast conservation therapy, even among young patients 40 years old and younger.« less

Immune Responses to a Recombinant Glycoprotein E Herpes Zoster Vaccine in Adults Aged 50 Years or Older

PubMed Central

Cunningham, Anthony L; Heineman, Thomas C; Lal, Himal; Godeaux, Olivier; Chlibek, Roman; Hwang, Shinn-Jang; McElhaney, Janet E; Vesikari, Timo; Andrews, Charles; Choi, Won Suk; Esen, Meral; Ikematsu, Hideyuki; Choma, Martina Kovac; Pauksens, Karlis; Ravault, Stéphanie; Salaun, Bruno; Schwarz, Tino F; Smetana, Jan; Abeele, Carline Vanden; Van den Steen, Peter; Vastiau, Ilse; Weckx, Lily Yin; Levin, Myron J

2018-01-01

Abstract Background The herpes zoster subunit vaccine (HZ/su), consisting of varicella-zoster virus glycoprotein E (gE) and AS01B Adjuvant System, was highly efficacious in preventing herpes zoster in the ZOE-50 and ZOE-70 trials. We present immunogenicity results from those trials. Methods Participants (ZOE-50: ≥50; ZOE-70: ≥70 years of age) received 2 doses of HZ/su or placebo, 2 months apart. Serum anti-gE antibodies and CD4 T cells expressing ≥2 of 4 activation markers assessed (CD42+) after stimulation with gE-peptides were measured in subcohorts for humoral (n = 3293) and cell-mediated (n = 466) immunogenicity. Results After vaccination, 97.8% of HZ/su and 2.0% of placebo recipients showed a humoral response. Geometric mean anti-gE antibody concentrations increased 39.1-fold and 8.3-fold over baseline in HZ/su recipients at 1 and 36 months post-dose 2, respectively. A gE-specific CD42+ T-cell response was shown in 93.3% of HZ/su and 0% of placebo recipients. Median CD42+ T-cell frequencies increased 24.6-fold (1 month) and 7.9-fold (36 months) over baseline in HZ/su recipients and remained ≥5.6-fold above baseline in all age groups at 36 months. The proportion of CD4 T cells expressing all 4 activation markers increased over time in all age groups. Conclusions Most HZ/su recipients developed robust immune responses persisting for 3 years following vaccination. Clinical Trials Registration NCT01165177; NCT01165229. PMID:29529222

Preschool Gender-Typed Play Behavior at Age 3.5 Years Predicts Physical Aggression at Age 13 Years.

PubMed

Kung, Karson T F; Li, Gu; Golding, Jean; Hines, Melissa

2018-05-01

Gender differences in play behavior and physical aggression have been consistently reported. Theoretical perspectives concerning evolutionary, social, and social-cognitive mechanisms suggest that male-typical play behavior during childhood increases subsequent physical aggression. The evidence supporting these connections is limited, however. The present study investigated the association between gender-typed play behavior in early childhood and physical aggression in early adolescence using a sample drawn from a longitudinal, population study, the Avon Longitudinal Study of Parents and Children. Based on gender-typed play behavior as measured by the Pre-School Activities Inventory at age 3.5 years, samples of masculine (64 boys, 60 girls), feminine (80 boys, 66 girls), and randomly selected control children (55 boys, 67 girls) were recruited at age 13 years and administered the Reinisch Aggression Inventory. After controlling for a range of sociodemographic variables, maternal characteristics, and behavioral problems, including hyperactivity and conduct problems at age 3.5, significant group differences in physical aggression at age 13 were found among children classified as masculine, control, and feminine at age 3.5. Masculine children exhibited significantly more physical aggression than control children or feminine children, and control children exhibited significantly more physical aggression than feminine children. The association between gender-typed play behavior and physical aggression was not moderated by sex. These results suggest that the degree of childhood gender-typed play behavior independently predicts the degree of physical aggression at adolescence in boys and in girls.

Association between median episiotomy and severe perineal lacerations in primiparous women

PubMed Central

Labrecque, M; Baillargeon, L; Dallaire, M; Tremblay, A; Pinault, J J; Gingras, S

1997-01-01

OBJECTIVE: To evaluate the association between median episiotomy and severe (third- and fourth-degree) perineal lacerations in primiparous women. DESIGN: Retrospective cohort study. SETTING: University-affiliated hospital providing secondary obstetric care in Quebec City. PATIENTS: A total of 6522 primiparous women who gave birth vaginally to a single live baby in cephalic position between 1985 and 1993. OUTCOME MEASURE: Incidence of third- and fourth-degree perineal lacerations. RESULTS: Median episiotomy was performed in 4390 women (67.3%). A total of 1002 women (15.4%) had a third- or fourth-degree laceration. The frequency of severe perineal lacerations was 20.6% with episiotomy and 4.5% without episiotomy (relative risk [RR] 4.58, 95% confidence interval [CI] 3.74-5.62). This association persisted after adjustment by stratified analysis for type of delivery and birth weight (RR 3.03, 95% CI 2.52-3.63) and by logistic regression for type of delivery, birth weight, epidural analgesia, shoulder dystocia, baby's head circumference, experience of the physician and year of delivery (odds ratio 3.58, 95% CI 2.84-4.50). CONCLUSION: Median episiotomy is strongly associated with third- and fourth-degree perineal lacerations in primiparous women. Reducing the use of this procedure could decrease the occurrence of severe perineal tears. PMID:9084384

Comparison of early and late clinical outcomes in patients >= 80 versus <80 years of age after successful primary angioplasty for ST segment elevation myocardial infarction.

PubMed

Oduncu, Vecih; Erkol, Ayhan; Tanalp, Ali Cevat; Kırma, Cevat; Bulut, Mustafa; Bitigen, Atila; Pala, Selçuk; Tigen, Kürşat; Esen, Ali M

2013-06-01

We aimed to compare the efficacy of primary percutaneous coronary intervention (p-PCI) in patients >=80 versus <80 years of age with ST-segment elevation myocardial infarction (STEMI). We retrospectively enrolled 2213 patients with acute STEMI. The patients were prospectively followed up for a median of 42 months. Early and late clinical outcomes were compared according to age. One-hundred and seventy-nine (8.1%) of the 2213 patients were aged >=80 years. Post-procedural TIMI grade 3 flow was significantly less frequent in the age >=80 years patients (82.1% vs. 91.1%, p<0.001). Rates of mortality (14.5% vs. 3.4%, p<0.001), heart failure (20.7% vs. 10.5%, p<0.001), major hemorrhage (9.5% vs. 3.3%, p<0.001), secondary VT/VF (10.1% vs. 4.2%, p=0.002) and atrial fibrillation (12.8% vs. 4.3%, p<0.001) during the early hospitalization period were significantly higher in the age >=80 years patient group. Overall rates of mortality (40% vs. 9.7%, p<0.001) and total stroke (5.6% vs. 1.1%, p=0.005) at long-term follow-up were also higher in the age >=80 years patient group. However, there was no difference between the two groups with respect to the reinfarction/revascularization rates. Analysis, using the Cox proportional hazards model, revealed that age >=80 to was an independent predictor of long-term mortality (hazard ratio 2.17, 95% CI 1.23-4.17, p=0.02). Age is an independent predictor of mortality after p-PCI for STEMI. Although it seems to improve early outcomes, the efficacy of p-PCI at long-term follow-up is limited in elderly patients.

Effect of aging and long-term erectile function after iodine-125 prostate brachytherapy.

PubMed

Keyes, Mira; Pickles, Tom; Crook, Juanita; McKenzie, Michael; Cheung, Arthur; Spadinger, Ingrid; LaPointe, Vincent; Bachand, W Francois; Morris, James

2015-01-01

To evaluate long-term erectile function (EF) in men treated with iodine-125 prostate brachytherapy (PB) and to determine factors predictive for erectile dysfunction (ED), including natural decline because of aging. Two thousand nine hundred twenty-nine patients (implanted July 1989-June 2012) with baseline EF and greater than 10-month followup (FU) are included. About 78.9% had full and 7.9% had partial EF at baseline. EF was assessed on a physician-reported three-point scale. Poisson regression with generalized estimating equations was used to assess predictors of ED and Kaplan-Meier curves time to ED. The effect of aging was calculated from the declining rate of baseline EF seen in sequential 5-year age cohorts and from the Massachusetts Male Aging Study. The median age was 66 years and median FU 3.5 years (maximum 14 years). About 1142 patients had more than 5 years of FU, and 43% had received 6 months of androgen deprivation therapy (ADT). Significant drop in EF was seen at 6 weeks after PB, with gradual decline thereafter. EF preservation at 5 years for age younger than 55, 56-59, 60-64, 65-69, and 70 year and older was 82%, 73%, 58%, 39%, and 23%, respectively. Comparisons of the 5-year age-related and treatment-related EF decline show that 50% of the long-term EF decline is related to aging. On univariate and multivariate analyses, age at implant, length of FU, hypertension, diabetes, and use of ADT (all p < 0.01) were significant predictors of ED. More than 80% of young men have EF preserved 5 years after PB. Age, ADT, history of hypertension, and the natural decline in EF have negative impact on long-term EF after PB. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Does duration of caffeine therapy in preterm infants born ≤1250 g at birth influence neurodevelopmental (ND) outcomes at 3 years of age?

PubMed

Lodha, A; Rabi, Y; Soraisham, A; Dobry, J; Lodha, Arijit; Amin, H; Awad, E Al; Tang, S; Sahai, A; Bhandari, V

2018-05-08

To evaluate the effect of duration of caffeine use on long-term neurodevelopmental (ND) outcomes at 3 years corrected age (CA) in preterm infants with birthweights (BW) ≤ 1250 g. All surviving infants with BW ≤ 1250 g admitted to the Foothills Medical Center neonatal intensive care unit (NICU) from January 2002 to December 2009 who received the first dose of caffeine in the first week of life and were followed up at three years CA were included in the study. Demographics and follow-up outcomes were compared based on early cessation of caffeine ≤ 14 days (ECC), intermediate cessation of caffeine 15-30 days (ICC), and late cessation of caffeine >30 days (LCC). The primary outcome of ND impairment was present if a child had any one of the following: cerebral palsy, cognitive delay, visual impairment, or hearing impairment or deafness. Univariate and logistic regression analyses were performed. Of the 508 eligible infants, 448 (88%) were seen at 3 years CA at follow-up. ECC (n = 139), ICC (n = 122) and LCC (n = 187) groups had a median (range) BW of 979 (560-1250), 1010 (530-1250), and 980 (520-1250) g (p = 0.524) and median (range) gestational age (GA) of 27 (23-33), 28 (24-33), and 27 (24-32) weeks, respectively (p = 0.034). In logistic regression models adjusting for GA, maternal smoking, and each neonatal risk factor separately (IVH, NEC, sepsis, blood transfusions, BPD, postnatal dexamethasone, SNAP-II, and ventilator days), none of the models showed a statistically significant association between caffeine duration and ND impairment. The duration of caffeine use in premature infants in the NICU does not impact on long-term ND outcomes at 3 years CA.

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.

Change in HbA1c Levels between the Age of 8 Years and the Age of 12 Years in Dutch Children without Diabetes: The PIAMA Birth Cohort Study

PubMed Central

Jansen, Hanneke; Wijga, Alet H.; Scholtens, Salome; Koppelman, Gerard H.; Postma, Dirkje S.; Brunekreef, Bert; de Jongste, Johan C.; Smit, Henriëtte A.; Stolk, Ronald P.

2015-01-01

Objective HbA1c is associated with cardiovascular risk in persons without diabetes and cardiovascular risk accumulates over the life course. Therefore, insight in factors determining HbA1c from childhood onwards is important. We investigated (lifestyle) determinants of HbA1c at age 12 years and the effects of growth on change in HbA1c and the tracking of HbA1c between the age of 8 and 12 years. Study Design and Methods Anthropometric measurements were taken and HbA1c levels were assessed in 955 children without diabetes aged around 12 years participating in the PIAMA birth cohort study. In 363 of these children HbA1c was also measured at age 8 years. Data on parents and children were collected prospectively by questionnaires. Results We found no significant association between known risk factors for diabetes and HbA1c at age 12 years. Mean(SD) change in HbA1c between ages 8 and 12 years was 0.6(0.7) mmol/mol per year (or 0.1(0.1) %/yr). Anthropometric measures at age 8 and their change between age 8 and 12 years were not associated with the change in HbA1c. 68.9% of the children remained in the same quintile or had an HbA1c one quintile higher or lower at age 8 years compared to age 12 years. Conclusion The lack of association between known risk factors for diabetes and HbA1c suggest that HbA1c in children without diabetes is relatively unaffected by factors associated with glycaemia. HbA1c at age 8 years is by far the most important predictor of HbA1c at age 12. Therefore, the ranking of HbA1c levels appear to be fairly stable over time. PMID:25875773

Carpal tunnel and median nerve volume changes after tunnel release in patients with the carpal tunnel syndrome: a magnetic resonance imaging (MRI) study.

PubMed

Crnković, T; Trkulja, V; Bilić, R; Gašpar, D; Kolundžić, R

2016-05-01

Our aim was to study the dynamics of the post-surgical canal and nerve volumes and their relationships to objective [electromyoneurography (EMNG)] and subjective (pain) outcomes. Forty-seven patients with carpal tunnel syndrome (CTS) (median age 52, range 23-75 years) with a prominent narrowing of the median nerve within the canal (observed during carpal tunnel release) were evaluated clinically using EMNG and magnetic resonance imagining (MRI) before and at 90 and 180 days post-surgery. Canal and nerve volumes increased, EMNG findings improved and pain resolved during the follow-up. Increase in tunnel volume was independently associated with increased nerve volume. A greater post-surgical nerve volume was independently associated with a more prominent resolution of pain, but not with the extent of EMNG improvement, whereas EMNG improvement was not associated with pain resolution. Data confirm that MRI can detect even modest changes in the carpal tunnel and median nerve volume and that tunnel release results in tunnel and nerve-volume increases that are paralleled by EMNG and clinical improvements. Taken together, these observations suggest that MRI could be used to objectivise persistent post-surgical difficulties in CTS patients. Level of evidence 3 (follow-up study).

[Case report: acute carpal tunnel syndrome with prolapse of the median nerve].

PubMed

Kindler, C; Lukas, B

2013-10-01

We report a case of an 80-year-old woman with an acute carpal tunnel syndrome. This was based on an acute episode of chondrocalcinoses and accompagnied by a prolaps of the median nerve into a gap of the forearm fascia as result of a cut injury in childhood. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical features and resolution of food protein-induced enterocolitis syndrome: 10-year experience.

PubMed

Caubet, Jean Christoph; Ford, Lara Simone; Sickles, Laura; Järvinen, Kirsi M; Sicherer, Scott H; Sampson, Hugh A; Nowak-Węgrzyn, Anna

2014-08-01

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. FPIES diagnosis is frequently delayed because of the absence of classic allergic symptoms and lack of biomarkers. We sought to characterize the clinical features and resolution of FPIES in patients evaluated in our practice. Subjects 6 months to 45 years of age with FPIES were prospectively recruited for oral food challenges (OFCs). Medical records were searched to identify the subjects who did not participate in OFCs. Among 160 subjects, 54% were male; median age at diagnosis was 15 months. We performed 180 OFCs to 15 foods in 82 subjects; 30% of the study population had FPIES confirmed based on OFC results. The most common foods were cow's milk (44%), soy (41%), rice (22.5%), and oat (16%). The majority (65%) reacted to 1 food, 26% reacted to 2 foods, and 9% reacted to 3 or more foods. The majority were atopic, and 39% had IgE sensitization to another food. Thirty-nine (24%) subjects had positive specific IgE levels to the food inducing FPIES. Among children with specific IgE to cow's milk, 41% changed from a milk FPIES to an IgE-mediated phenotype over time. The median age when tolerance was established was 4.7 years for rice, 4 years for oat, and 6.7 years for soy. Median age when milk tolerance was established for subjects with undetectable milk-specific IgE levels was 5.1 years, whereas none of the subjects with detectable milk-specific IgE became tolerant to milk during the study (P = .003). FPIES typically resolves by age 5 years. Milk FPIES, especially with detectable food-specific IgE, can have a protracted course and eventually transition to acute reactions. Copyright © 2014. Published by Mosby, Inc.

Six year effectiveness of a population based two tier infant hearing screening programme.

PubMed

Russ, S A; Rickards, F; Poulakis, Z; Barker, M; Saunders, K; Wake, M

2002-04-01

To determine whether a two tier universal infant hearing screening programme (population based risk factor ascertainment and universal distraction testing) lowered median age of diagnosis of bilateral congenital hearing impairment (CHI) >40 dB HL in Victoria, Australia. Comparison of whole population birth cohorts pre and post introduction of the Victorian Infant Hearing Screening Program (VIHSP). All babies surviving the neonatal period born in Victoria in 1989 (pre-VIHSP) and 1993 (post-VIHSP) were studied. (1) Pre-1992: distraction test at 7-9 months. (2) Post-1992: infants with risk factors for CHI referred for auditory brain stem evoked response (ABR) assessment; all others screened by modified distraction test at 7-9 months. Of the 1989 cohort (n = 63 454), 1.65/1000 were fitted with hearing aids for CHI by end 1995, compared with 2.09/1000 of the 1993 cohort (n = 64 116) by end 1999. Of these, 79 cases from the 1989 cohort (1.24/1000) and 72 cases from the 1993 cohort (1.12/1000) had CHI >40 dB HL. Median age at diagnosis of CHI >40 dB HL for the 1989 birth cohort was 20.3 months, and for the 1993 cohort was 14.2 months. Median age at diagnosis fell significantly for severe CHI but not for moderate or profound CHI. Significantly more babies with CHI >40 dB HL were diagnosed by 6 months of age in 1993 than in 1989 (21.7% v 6.3%). Compared to the six years pre-VIHSP, numbers aided by six months were consistently higher in the six years post-VIHSP (1.05 per 100 000 births versus 13.4 per 100 000 births per year). VIHSP resulted in very early diagnosis for more infants and lowered median age of diagnosis of severe CHI. However, overall results were disappointing.

Educational inequalities in smoking among Japanese adults aged 25-94 years: Nationally representative sex- and age-specific statistics.

PubMed

Tabuchi, Takahiro; Kondo, Naoki

2017-04-01

Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years. Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Positive life orientation in old age: a 15-year follow-up.

PubMed

Eloranta, Sini; Arve, Seija; Lavonius, Sirkku; Routasalo, Pirkko; Lehtonen, Aapo; Viitanen, Matti; Isoaho, Hannu

2012-01-01

Positive life orientation (PLO) is considered an important dimension of successful aging. To investigate how self-reported PLO changed among home-dwelling people from age 70 to 80 and 85 years. A prospective, population-based 15-year follow-up study of the age cohort of 70-year-olds living in the city of Turku, Finland. The data were collected in 1991 by a postal questionnaire that was sent to all residents of Turku, Finland, born in 1920 (N=1530). Follow-ups using the same procedure were conducted in 2001 and 2006. PLO was assessed with the following items: life satisfaction, feeling needed, having plans for the future, having zest for life, feeling depressed, and suffering from loneliness. We created a PLO score from the answers to these questions, where 1 represented the best PLO and 0 the poorest. At baseline, the participants showed rather high levels of positive life orientation (PLO total score 0.83). PLO declined markedly after the 70-year-old participants reached the age of 80 and 85 years (p<.001). However, depressive feelings remained quite stable. The decrease was similar among men and women except for the items suffering from loneliness and feeling needed. At age 70 and 80 years women suffered more from loneliness than men, while men experienced feeling needed more than women. Positive life orientation declines during old age, especially from age 70 to 80 years. Thereafter the decline is less steep except for changes in future plans and feeling needed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Mammography in asymptomatic women aged 40-49 years

PubMed Central

Silva, Flávio Xavier; Katz, Leila; Souza, Alex Sandro Rolland; Amorim, Melania Maria Ramos

2014-01-01

OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality. PMID:26039396

Age Effects on Upper Limb Kinematics Assessed by the REAplan Robot in Healthy Subjects Aged 3 to 93 Years.

PubMed

Gilliaux, Maxime; Lejeune, Thierry M; Sapin, Julien; Dehez, Bruno; Stoquart, Gaëtan; Detrembleur, Christine

2016-04-01

Kinematics is recommended for the quantitative assessment of upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish normative values in healthy subjects. Three hundred and seventy healthy subjects, aged 3-93 years, participated in the study. They performed two unidirectional and two geometrical tasks ten consecutive times with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-six kinematic indices were computed for the four tasks. For the four tasks, nineteen of the computed kinematic indices showed an age effect. Seventeen indices (the accuracy, speed and smoothness indices and the reproducibility of the accuracy, speed and smoothness) improved in young subjects aged 3-30 years, showed stabilization in adults aged 30-60 years and declined in elderly subjects aged 60-93 years. Additionally, for both geometrical tasks, the speed index exhibited a decrease throughout life. Finally, a principal component analysis provided the relations between the kinematic indices, tasks and subjects' age. This study is the first to assess age effects on upper limb kinematics and establish normative values in subjects aged 3-93 years.

Influence of median surgeon operative duration on adverse outcomes in bariatric surgery.

PubMed

Reames, Bradley N; Bacal, Daniel; Krell, Robert W; Birkmeyer, John D; Birkmeyer, Nancy J O; Finks, Jonathan F

2015-01-01

Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure (median [interquartile range] 139 [133-150] versus 86 [69-91], P<.001). After adjustment for patient characteristic only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, emergency department visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% versus 7.1%, P=.039), prolonged length of stay (14.0% versus 4.4%, P=.002), and VTE (0.39% versus .22%, P<.001). Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery. Copyright © 2015 American Society for

Calculating summary statistics for population chemical biomonitoring in women of childbearing age with adjustment for age-specific natality.

PubMed

Axelrad, Daniel A; Cohen, Jonathan

2011-01-01

The effects of chemical exposures during pregnancy on children's health have been an increasing focus of environmental health research in recent years, leading to greater interest in biomonitoring of chemicals in women of childbearing age in the general population. Measurements of mercury in blood from the National Health and Nutrition Examination Survey are frequently reported for "women of childbearing age," defined to be of ages 16-49 years. The intent is to represent prenatal chemical exposure, but blood mercury levels increase with age. Furthermore, women of different ages have different probabilities of giving birth. We evaluated options to address potential bias in biomonitoring summary statistics for women of childbearing age by accounting for age-specific probabilities of giving birth. We calculated median and 95th percentile levels of mercury, PCBs, and cotinine using these approaches: option 1: women aged 16-49 years without natality adjustment; option 2: women aged 16-39 years without natality adjustment; option 3: women aged 16-49 years, adjusted for natality by age; option 4: women aged 16-49 years, adjusted for natality by age and race/ethnicity. Among the three chemicals examined, the choice of option has the greatest impact on estimated levels of serum PCBs, which are strongly associated with age. Serum cotinine levels among Black non-Hispanic women of childbearing age are understated when age-specific natality is not considered. For characterizing in utero exposures, adjustment using age-specific natality provides a substantial improvement in estimation of biomonitoring summary statistics. Copyright © 2010 Elsevier Inc. All rights reserved.

Common variants modify the age of onset for basal cell carcinomas in Gorlin syndrome.

PubMed

Yasar, Binnaz; Byers, Helen J; Smith, Miriam J; Lear, John; Oudit, Deemesh; Bholah, Zaynab; Roberts, Stephen A; Newman, William G; Evans, D Gareth

2015-05-01

Gorlin syndrome is an autosomal dominant disorder, characterized by multiple early-onset basal cell carcinomas (BCCs) and jaw keratocysts. Through association studies in cohorts of sporadic BCC, nine genetic variants have previously been identified to increase the risk of BCC. The nine SNPs were genotyped by Taqman allelic discrimination in 125 individuals with Gorlin syndrome. Kaplan-Meier survival curves and Cox proportional-Hazard regression analysis were applied to determine the association between genotypes and age of first BCC in individuals with Gorlin syndrome. The p.(Arg151Cys) variant in MC1R (rs1805007) was associated with an earlier median age of onset of BCC of 27 years (95% CI: 20-34) compared with 34 years (95% CI: 30-40) for wild-type individuals (hazard ratio (HR)=1.64, 95% CI: 1.04-2.58, P=0.034). The risk allele of the variant at the chromosome 5p15 locus encompassing TERT-CLPTM1L (rs401681) was also associated with an earlier median onset of BCC, 31 years (95% CI: 28-37) compared with 41 years (95% CI: 32-48, HR=1.44, 95% CI: 1.08-1.93, P=0.014). In individuals with a risk allele at either rs1805007 or rs401681 the median time to BCC was 31 years of age (95% CI: 28-34) compared with 44 years of age (95% CI: 38-53) in wild-type individuals (HR=2.48, 95% CI: 1.47-4.17, P=0.0002). Our findings may have implications for future personalized risk estimates and BCC screening strategies in individuals with Gorlin syndrome.

Cost-Effectiveness of Herpes Zoster Vaccine for Persons Aged 50 Years.

PubMed

Le, Phuc; Rothberg, Michael B

2015-10-06

Each year, herpes zoster (HZ) affects 1 million U.S. adults, many of whom develop postherpetic neuralgia (PHN). Zoster vaccine is licensed for persons aged 50 years or older, but its cost-effectiveness for those aged 50 to 59 years is unknown. To estimate the cost-effectiveness of HZ vaccine versus no vaccination. Markov model. Medical literature. Adults aged 50 years. Lifetime. Societal. HZ vaccine. Number of HZ and PHN cases prevented and incremental cost per quality-adjusted life-year (QALY) saved. For every 1000 persons receiving the vaccine at age 50 years, 25 HZ cases and 1 PHN case could be prevented. The incremental cost-effectiveness ratio (ICER) for HZ vaccine versus no vaccine was $323 456 per QALY. In deterministic and scenario sensitivity analyses, the only variables that produced an ICER less than $100 000 per QALY were vaccine cost (at a value of $80) and the rate at which efficacy wanes. In probabilistic sensitivity analysis, the mean ICER was $500 754 per QALY (95% CI, $93 510 to $1 691 211 per QALY). At a willingness-to-pay threshold of $100 000 per QALY, the probability that vaccination would be cost-effective was 3%. Long-term effectiveness data for HZ vaccine are lacking for 50-year-old adults. Herpes zoster vaccine for persons aged 50 years does not seem to represent good value according to generally accepted standards. Our findings support the decision of the Advisory Committee on Immunization Practices not to recommend the vaccine for adults in this age group. None.

Increase of body mass index (BMI) from 1.5 to 3 years of age augments the degree of insulin resistance corresponding to BMI at 12 years of age.

PubMed

Arisaka, Osamu; Sairenchi, Toshimi; Ichikawa, Go; Koyama, Satomi

2017-04-01

To elucidate the effect of early growth patterns on the metabolic sensitivity to adiposity, we examined the relationship between the homeostatic model assessment of insulin resistance (HOMA-IR) and body mass index (BMI) levels at 12 years of age in 101 boys and 91 girls in a birth cohort. Children with an increase in BMI from the ages of 1.5 to 3 years exhibited a greater increase of HOMA-IR per BMI increase at 12 years of age compared to those with a decrease in BMI or stable BMI from 1.5 to 3 years. This suggests that children who show an increase in BMI from 1.5 to 3 years, a period normally characterized by a decreased or stable BMI, are more prone to developing insulin resistance at 12 years of age.

Time course and predictors of median nerve conduction after carpal tunnel release.

PubMed

Rotman, Mitchell B; Enkvetchakul, Bobby V; Megerian, J Thomas; Gozani, Shai N

2004-05-01

To identify predictors of outcome and of electrophysiologic recovery in patients with carpal tunnel syndrome (CTS) treated by endoscopic carpal tunnel release using a nerve conduction testing system (NC-Stat; NEUROMetrix, Inc, Waltham, MA). Validity of the automated nerve conduction testing system was shown by comparing presurgical distal motor latencies (DMLs) against a reference obtained by referral to an electromyography laboratory. The DML was evaluated in 48 patients with CTS. Measurements were obtained within 1 hour of surgery and at 2 weeks, 6 weeks, 3 months, and 6 months after carpal tunnel release. Presurgical and postsurgical DMLs were then compared and correlated with variables and possible predictors of outcome including age, body mass index, gender, and presurgical DMLs. The automated nerve conduction testing system DMLs matched those of reference electromyography/nerve conduction study values with high correlation. Sensitivity of the automated nerve conduction testing system when compared with a standardized CTS case definition was 89%, with a specificity of 95%. A significant correlation was found between the DML before release and the DML 1 hour after release. Moreover, maximal postsurgical DML improvement was highly dependent on the presurgical DML, with no improvement shown for the <4-ms group, mild improvement for the 4-to-6-ms group, and maximal improvement in the >6-ms group. Among the clinical variables of age, gender, and body mass index only age was mildly predictive of postrelease DML changes at 6 months. No other correlations between clinical variables and postsurgical DMLs were significant. In addition the predictive value of age was lost when combined with the presurgical DML in a multivariate analysis. Postsurgical changes in the median nerve DML were highly dependent on the prerelease latency. The sensitivity and specificity of a nerve conduction monitoring system in detecting and aiding in the diagnosis of CTS is useful in the long

Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil

PubMed Central

Graudenz, Gustavo Silveira; Carneiro, Dominique Piacenti; Vieira, Rodolfo de Paula

2017-01-01

ABSTRACT Objective: To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years. Methods: Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups. Results: There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population. Conclusions: Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate. PMID:28380185

Adherence to Dietary Guidelines and Successful Aging Over 10 Years.

PubMed

Gopinath, Bamini; Russell, Joanna; Kifley, Annette; Flood, Victoria M; Mitchell, Paul

2016-03-01

We aimed to prospectively examine the relationship between overall diet quality (reflecting adherence to dietary guidelines) and successful aging in a population-based cohort of older adults. In this population-based cohort study, we analyzed 10-year follow-up data from 1,609 adults aged 49 years and older, who were free of cancer, coronary artery disease, and stroke at the baseline and who had complete dietary data. Dietary data were collected using a semiquantitative food frequency questionnaire. Total diet scores (TDS) were allocated for intake of selected food groups and nutrients for each participant as described in the national dietary guidelines. Higher scores indicated closer adherence to dietary guidelines. Successful aging was defined as the absence of disability, depressive symptoms, cognitive impairment, respiratory symptoms, and chronic diseases (cancer, coronary artery disease, and stroke). At 10-year follow-up, 610 (37.9%) participants had died and 249 (15.5%) participants aged successfully. After multivariable adjustment, each 1-unit increase in TDS at baseline was associated with a 8% increased odds of successful aging 10 years later, odds ratio 1.08 (95% confidence interval 1.00-1.15). Participants in the highest (high adherence to dietary guidelines) versus lowest quartile (poor adherence to guidelines) of TDS at baseline had 58% higher odds of successful aging after 10 years, odds ratio 1.58 (95% confidence interval 1.02-2.46). Greater compliance with recommended national dietary guidelines (higher diet quality) was associated with an increased likelihood of successful aging, as determined through a multidomain approach. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mean, Median, and Skew: Correcting a Textbook Rule

ERIC Educational Resources Information Center

von Hippel, Paul T.

2005-01-01

Many textbooks teach a rule of thumb stating that the mean is right of the median under right skew, and left of the median under left skew. This rule fails with surprising frequency. It can fail in multimodal distributions, or in distributions where one tail is long but the other is heavy. Most commonly, though, the rule fails in discrete…

Age differences in health care spending, fiscal year 1976.

PubMed

Gibson, R M; Mueller, M S; Fisher, C R

1977-08-01

Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65.

Guidelines for signal operations at intersections with wide medians.

DOT National Transportation Integrated Search

2010-03-01

The objective of this project is to evaluate the operations at signalized intersections with wide medians in : order to improve safety and efficiency. Intersections with wide medians are characterized by two : intersections and operate differently co...

Infliximab therapy in pediatric patients 7 years of age and younger.

PubMed

Kelsen, Judith R; Grossman, Andrew B; Pauly-Hubbard, Helen; Gupta, Kernika; Baldassano, Robert N; Mamula, Petar

2014-12-01

Infliximab (IFX) is efficacious for induction and maintenance of remission in pediatric patients with moderate-to-severe inflammatory bowel disease (IBD). It has, however, not been studied in patients 7 years old and younger. Our aim was to characterize efficacy and safety of IFX therapy in this cohort. This was a retrospective study of patients with IBD ages 7 years and younger, treated with IFX between 1999 and 2011. Medical records were reviewed for age of diagnosis, disease phenotype, therapy, surgery, IFX infusion dates, dose, and intervals. Outcome measures included physician global assessment, corticosteroid requirement, and adverse events. Thirty-three children (ages 2.4-7 years) were included. Twenty patients had Crohn disease, 4 had ulcerative colitis, and 9 had indeterminate colitis. Maintenance of IFX therapy at 1, 2, and 3 years was 36%, 18%, and 12%, respectively. Patients of age 5 years and younger had the lowest rates of maintenance of therapy at 25% at year 1, and 10% at years 2 and 3 combined. Nine percent of all of the patients demonstrated response measured by the physician global assessment and were steroid free at 1 year. There were 8 infusion reactions. There were no malignancies, serious infections, or deaths. IFX demonstrated a modest response rate and a low steroid-sparing effect in patients with IBD 7 years old and younger. Although this is a limited study, there appears to be a trend for decreased sustained efficacy with IFX in this age group, particularly in children 5 years old and younger, when compared with the previously published literature in older children.

Ciliated median raphe cyst of perineum presenting as perianal polyp: a case report with immunohistochemical study, review of literature, and pathogenesis.

PubMed

Sagar, Jayesh; Sagar, Bethani; Patel, Adam F; Shak, D K

2006-03-05

Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus and anus. We report a case of median raphe cyst in the perineum presenting as a perianal polyp in a 65-year-old, English white male with exceptionally rare ciliated epithelium. According to our knowledge, this is the third such case of ciliated median raphe cyst in the English literature. This case, also the first case of ciliated median raphe cyst in the perineum location, focuses on pathogenesis of median raphe cyst.

Prediction of Cognitive Abilities at the Age of 5 Years Using Developmental Follow-Up Assessments at the Age of 2 and 3 Years in Very Preterm Children

ERIC Educational Resources Information Center

Potharst, Eva S.; Houtzager, Bregje A.; van Sonderen, Loekie; Tamminga, Pieter; Kok, Joke H.; Last, Bob F.; van Wassenaer, Aleid G.

2012-01-01

Aim: This study investigated prediction of separate cognitive abilities at the age of 5 years by cognitive development at the ages of both 2 and 3 years, and the agreement between these measurements, in very preterm children. Methods: Preterm children (n=102; 44 males; 58 females) with a gestational age less than 30 weeks and/or birthweight less…

Recipient Age and Mortality Risk after Liver Transplantation: A Population-Based Cohort Study.

PubMed

Chen, Hsiu-Pin; Tsai, Yung-Fong; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

2016-01-01

The aim of the present large population-based cohort study is to explore the risk factors of age-related mortality in liver transplant recipients in Taiwan. Basic information and data on medical comorbidities for 2938 patients who received liver transplants between July 1, 1998, and December 31, 2012, were extracted from the National Health Insurance Research Database on the basis of ICD-9-codes. Mortality risks were analyzed after adjusting for preoperative comorbidities and compared among age cohorts. All patients were followed up until the study endpoint or death. This study finally included 2588 adults and 350 children [2068 (70.4%) male and 870 (29.6%) female patients]. The median age at transplantation was 52 (interquartile range, 43-58) years. Recipients were categorized into the following age cohorts: <20 (n = 350, 11.9%), 20-39 (n = 254, 8.6%), 40-59 (n = 1860, 63.3%), and ≥60 (n = 474, 16.1%) years. In the total population, 428 deaths occurred after liver transplantation, and the median follow-up period was 2.85 years (interquartile range, 1.2-5.5 years). Dialysis patients showed the highest risk of mortality irrespective of age. Further, the risk of death increased with an increase in the age at transplantation. Older liver transplant recipients (≥60 years), especially dialysis patients, have a higher mortality rate, possibly because they have more medical comorbidities. Our findings should make clinicians aware of the need for better risk stratification among elderly liver transplantation candidates.

Associations between education and brain structure at age 73 years, adjusted for age 11 IQ

PubMed Central

Dickie, David Alexander; Ritchie, Stuart J.; Karama, Sherif; Pattie, Alison; Royle, Natalie A.; Corley, Janie; Aribisala, Benjamin S.; Valdés Hernández, Maria; Muñoz Maniega, Susana; Starr, John M.; Bastin, Mark E.; Evans, Alan C.; Wardlaw, Joanna M.; Deary, Ian J.

2016-01-01

Objective: To investigate how associations between education and brain structure in older age were affected by adjusting for IQ measured at age 11. Methods: We analyzed years of full-time education and measures from an MRI brain scan at age 73 in 617 community-dwelling adults born in 1936. In addition to average and vertex-wise cortical thickness, we measured total brain atrophy and white matter tract fractional anisotropy. Associations between brain structure and education were tested, covarying for sex and vascular health; a second model also covaried for age 11 IQ. Results: The significant relationship between education and average cortical thickness (β = 0.124, p = 0.004) was reduced by 23% when age 11 IQ was included (β = 0.096, p = 0.041). Initial associations between longer education and greater vertex-wise cortical thickness were significant in bilateral temporal, medial-frontal, parietal, sensory, and motor cortices. Accounting for childhood intelligence reduced the number of significant vertices by >90%; only bilateral anterior temporal associations remained. Neither education nor age 11 IQ was significantly associated with total brain atrophy or tract-averaged fractional anisotropy. Conclusions: The association between years of education and brain structure ≈60 years later was restricted to cortical thickness in this sample; however, the previously reported associations between longer education and a thicker cortex are likely to be overestimates in terms of both magnitude and distribution. This finding has implications for understanding, and possibly ameliorating, life-course brain health. PMID:27664981

Associations between education and brain structure at age 73 years, adjusted for age 11 IQ.

PubMed

Cox, Simon R; Dickie, David Alexander; Ritchie, Stuart J; Karama, Sherif; Pattie, Alison; Royle, Natalie A; Corley, Janie; Aribisala, Benjamin S; Valdés Hernández, Maria; Muñoz Maniega, Susana; Starr, John M; Bastin, Mark E; Evans, Alan C; Wardlaw, Joanna M; Deary, Ian J

2016-10-25

To investigate how associations between education and brain structure in older age were affected by adjusting for IQ measured at age 11. We analyzed years of full-time education and measures from an MRI brain scan at age 73 in 617 community-dwelling adults born in 1936. In addition to average and vertex-wise cortical thickness, we measured total brain atrophy and white matter tract fractional anisotropy. Associations between brain structure and education were tested, covarying for sex and vascular health; a second model also covaried for age 11 IQ. The significant relationship between education and average cortical thickness (β = 0.124, p = 0.004) was reduced by 23% when age 11 IQ was included (β = 0.096, p = 0.041). Initial associations between longer education and greater vertex-wise cortical thickness were significant in bilateral temporal, medial-frontal, parietal, sensory, and motor cortices. Accounting for childhood intelligence reduced the number of significant vertices by >90%; only bilateral anterior temporal associations remained. Neither education nor age 11 IQ was significantly associated with total brain atrophy or tract-averaged fractional anisotropy. The association between years of education and brain structure ≈60 years later was restricted to cortical thickness in this sample; however, the previously reported associations between longer education and a thicker cortex are likely to be overestimates in terms of both magnitude and distribution. This finding has implications for understanding, and possibly ameliorating, life-course brain health. © 2016 American Academy of Neurology.

Aging in Mexico: Population Trends and Emerging Issues.

PubMed

Angel, Jacqueline L; Vega, William; López-Ortega, Mariana

2016-12-07

Although all nations in the America's face a common demographic reality of longevity, declining fertility rates and changes in family roles a growing body of research points to a dramatic demographic transformation in Mexico. Although Mexico's population is relatively young, with a median age of 27.9 in 2015, it will age rapidly in coming years, increasing to 42 years by 2050. The rapid median age in the nation also reflects the growing proportion of people 65 or older, and is expected to triple to 20.2% by 2050. This article examines how the age and gender structure of Mexico offers important insights about current and future political and social stability, as well as economic development. Mexico is the world's eleventh largest country in terms of population size and the "demographic dividend" of a large youthful population is giving way to a growing older population that will inevitably place demands on health care and social security. The shift in age structure will result in increased dependency of retirees on the working-age population in the next 20 years. Mexico does not provide universal coverage of social security benefits and less than half of the labor force is covered by any pension or retirement plan. As a result, elderly Mexicans often continue working into old age. The high total poverty rate in the country, especially among the older population magnifies the problem of the potential dependency burden. The article ends with a discussion of key public policy issues related to aging in Mexico. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Temperament and body weight from ages 4 to 15 years.

PubMed

Sutin, A R; Kerr, J A; Terracciano, A

2017-07-01

In adulthood, conscientiousness and neuroticism are correlates of body weight and weight gain. The present research examines whether the childhood antecedents of these traits, persistence and negative reactivity, respectively, are associated with weight gain across childhood. We likewise examine sociability as a predictor of childhood weight gain and whether these three traits are associated with weight concerns and weight-management strategies in adolescence. Participants (N=4153) were drawn from the Longitudinal Study of Australian Children, an ongoing, population-based study of child and family health and well-being. At the baseline assessment, caregivers reported on their child's temperament. At every assessment from ages 4-5 to 14-15 years, study children were weighed and measured by trained staff; there were up to six biennial assessments of body mass index and waist circumference. At ages 14-15 years, study children (n=2975) also self-reported on their weight concerns and weight-management strategies. Study children rated lower in persistence or higher in negative reactivity in early childhood gained more weight between the ages of 4 and 15 years. Sociability was associated with weight gain among girls but not among boys. Lower persistence and higher negative reactivity at ages 4-5 years were also associated with greater weight concerns, restrained eating and use of unhealthy weight-management strategies at ages 14-15 years. Childhood traits related to conscientiousness and neuroticism are associated with objective weight gain across childhood and with concerns and strategies to manage weight in adolescence. These results are consistent with a lifespan perspective that indicates that trait psychological functioning contributes to health-related markers from childhood through old age.

Trends in induced abortion among Nordic women aged 40-44 years

PubMed Central

2011-01-01

Objectives Women aged 40-44 years in 2005 ought to have been subjected to much more influence on attitudes and knowledge on contraceptive methods during their fertile period than women who were in the same age span in 1975 when the abortion laws were introduced. Material From official statistics, the rates of induced abortion and birth rates in women aged 40-44 years were collected for Sweden, Denmark, Norway and Finland for each five-year during the period 1975-2005. Results With the exception of Sweden all other studied Scandinavian countries have lowered their abortion rates since 1975 (p < 0.001) and reduced the proportion of induced abortions in relation to birth rate (p < 0.001). In 2005 these countries also had lower rates of induced abortion than Sweden in the age group 40-44 years (p < 0.001). Conclusion There is a significant change in rates of induced abortion in women aged 40-44 years in Finland, Norway, Denmark, and at status quo in Sweden. 40-44 years in Finland, Norway, Denmark, and at status quo in Sweden. This indicates that family planning programs works well in the Nordic countries. The differences found may be assumed to possible diverging focus on attitudes or ethical considerations. PMID:21846348

Vital signs: births to teens aged 15-17 years--United States, 1991-2012.

PubMed

Cox, Shanna; Pazol, Karen; Warner, Lee; Romero, Lisa; Spitz, Alison; Gavin, Lorrie; Barfield, Wanda

2014-04-11

Teens who give birth at age 15-17 years are at increased risk for adverse medical and social outcomes of teen pregnancy. To examine trends in the rate and proportion of births to teens aged 15-19 years that were to teens aged 15-17 years, CDC analyzed 1991-2012 National Vital Statistics System data. National Survey of Family Growth (NSFG) data from 2006-2010 were used to examine sexual experience, contraceptive use, and receipt of prevention opportunities among female teens aged 15-17 years. During 1991-2012, the rate of births per 1,000 teens declined from 17.9 to 5.4 for teens aged 15 years, 36.9 to 12.9 for those aged 16 years, and 60.6 to 23.7 for those aged 17 years. In 2012, the birth rate per 1,000 teens aged 15-17 years was higher for Hispanics (25.5), non-Hispanic blacks (21.9), and American Indians/Alaska Natives (17.0) compared with non-Hispanic whites (8.4) and Asians/Pacific Islanders (4.1). The rate also varied by state, ranging from 6.2 per 1,000 teens aged 15-17 years in New Hampshire to 29.0 in the District of Columbia. In 2012, there were 86,423 births to teens aged 15-17 years, accounting for 28% of all births to teens aged 15-19 years. This percentage declined from 36% in 1991 to 28% in 2012 (p<0.001). NSFG data for 2006-2010 indicate that although 91% of female teens aged 15-17 years received formal sex education on birth control or how to say no to sex, 24% had not spoken with parents about either topic; among sexually experienced female teens, 83% reported no formal sex education before first sex. Among currently sexually active female teens (those who had sex within 3 months of the survey) aged 15-17 years, 58% used clinical birth control services in the past 12 months, and 92% used contraception at last sex; however, only 1% used the most effective reversible contraceptive methods. Births to teens aged 15-17 years have declined but still account for approximately one quarter of births to teens aged 15-19 years. These data highlight

Design criteria for median turn lanes.

DOT National Transportation Integrated Search

1978-03-01

This study was initiated with an extensive literature review and survey of : left-turn median lane practices in Texas cities. The initial phase identified : characteristics of urban arterial accidents, basic design elements, current use of : left-tur...

Effect of radiation on age at menopause among atomic bomb survivors.

PubMed

Sakata, Ritsu; Shimizu, Yukiko; Soda, Midori; Yamada, Michiko; Hsu, Wan-Ling; Hayashi, Mikiko; Ozasa, Kotaro

2011-12-01

Exposure to ionizing radiation has been thought to induce ovarian failure and premature menopause. Proximally exposed female atomic bomb survivors were reported to experience menopause immediately after the exposure more often than those who were distally exposed. However, it remains unclear whether such effects were caused by physical injury and psychological trauma or by direct effects of radiation on the ovaries. The objective of this study was to see if there are any late health effects associated with the exposure to atomic bomb radiation in terms of age at menopause in a cohort of 21,259 Life Span Study female A-bomb survivors. Excess absolute rates (EAR) of natural and artificial menopause were estimated using Poisson regression. A linear threshold model with a knot at 0.40 Gy [95% confidence interval (CI): 0.13, 0.62] was the best fit for a dose response of natural menopause (EAR at 1 Gy at age of 50 years = 19.4/1,000 person-years, 95% CI: 10.4, 30.8) and a linear threshold model with a knot at 0.22 Gy (95% CI: 0.14, 0.34) was the best fit for artificial menopause (EAR at 1 Gy at age of 50 years for females who were exposed at age of 20 years = 14.5/1,000 person-years, 95% CI: 10.2, 20.1). Effect modification by attained age indicated that EARs peaked around 50 years of age for both natural and artificial menopause. Although effect modification by age at exposure was not significant for natural menopause, the EAR for artificial menopause tended to be larger in females exposed at young ages. On the cumulative incidence curve of natural menopause, the median age at menopause was 0.3 years younger in females exposed to radiation of 1 Gy compared with unexposed females. The median age was 1 year younger for combined natural and artificial menopause in the same comparison. In conclusion, age at menopause was thought to decrease with increasing radiation dose for both natural and artificial menopause occurring at least 5 years after the exposure.

Association of Age at Menarche with Anthropometric Measures in Punjabi Bania Girls.

PubMed

Goyal, Pratibha; Singh, Zora; Sethi, Gurmeet Kaur

2016-11-01

Menarcheal age is the age at which menstruation begins. Menarcheal age is regarded as a sensitive indicator of physical, biological and psychological environment. 1) To determine the menarcheal age and to examine the relationship between current age at menarche with anthropometric measures in Punjabi bania girls. 2) To develop maturity standards for Bania girls. The present cross-sectional survey was carried out on 200 bania girls at the age of onset of menarche. Menarcheal data was obtained by status quo method by asking about whether menarche has been experienced or not. In the present survey adolescent girls were interviewed with the help of pre-designed questionnaire. Statistical analysis was carried out in SPSS software, version 16.0. The data were analysed using descriptive statistics and one-way ANOVA. Pearson's correlation coefficient was used for correlation studies. A total of 200 Punjabi bania girls were examined in the study. The median age of onset of menarche in these girls was 12.3 years. Menarcheal age was positively associated with bi-acromial width, bi-iliac width and arm span. The present research has revealed secular trend in the age of onset of menarche as indicated by median age of 12.3 years in Bania girls. The bi-acromial width, bi-iliac width and arm span were also correlated with the age of menarche.

Dental age estimation: the role of probability estimates at the 10 year threshold.

PubMed

Lucas, Victoria S; McDonald, Fraser; Neil, Monica; Roberts, Graham

2014-08-01

The use of probability at the 18 year threshold has simplified the reporting of dental age estimates for emerging adults. The availability of simple to use widely available software has enabled the development of the probability threshold for individual teeth in growing children. Tooth development stage data from a previous study at the 10 year threshold were reused to estimate the probability of developing teeth being above or below the 10 year thresh-hold using the NORMDIST Function in Microsoft Excel. The probabilities within an individual subject are averaged to give a single probability that a subject is above or below 10 years old. To test the validity of this approach dental panoramic radiographs of 50 female and 50 male children within 2 years of the chronological age were assessed with the chronological age masked. Once the whole validation set of 100 radiographs had been assessed the masking was removed and the chronological age and dental age compared. The dental age was compared with chronological age to determine whether the dental age correctly or incorrectly identified a validation subject as above or below the 10 year threshold. The probability estimates correctly identified children as above or below on 94% of occasions. Only 2% of the validation group with a chronological age of less than 10 years were assigned to the over 10 year group. This study indicates the very high accuracy of assignment at the 10 year threshold. Further work at other legally important age thresholds is needed to explore the value of this approach to the technique of age estimation. Copyright © 2014. Published by Elsevier Ltd.

Age of Achievement of Gross Motor Milestones in Infancy and Adiposity at Age 3 Years

PubMed Central

Neelon, Sara E. Benjamin; Oken, Emily; Taveras, Elsie M.; Rifas-Shiman, Sheryl L.; Gillman, Matthew W.

2011-01-01

Early life physical activity may help prevent obesity but is difficult to measure. The purpose of this study was to examine associations of age of achievement of gross motor milestones in infancy with adiposity at age 3 years. Seven forty one mother/infant dyads participated in a longitudinal study in Massachusetts. Exposures were age of attainment of 4 gross motor milestones—rolling over, sitting up, crawling, and walking. Outcomes were 3-year sum of subscapular and triceps skinfold thickness (SS + TR) for overall adiposity, their ratio (SS:TR) for central adiposity, and body mass index (BMI) z-score. We used linear regression models adjusted for confounders to examine motor milestone achievement and later adiposity. Rolling over (0.04, 95% CI: 0.008, 0.07) and sitting up (0.02, 95% CI: 0.001, 0.05) at ≥6 months were associated with increased SS:TR compared with attainment before 6 months. Walking at ≥15 months was associated with 0.98 mm higher SS + TR (95% CI: 0.05, 1.91) compared with walking before 12 months. Age at crawling was not associated with the outcomes. None of the milestones were associated with BMI z-score. Age of motor milestone achievement was only a modest predictor of adiposity. Later rolling over and sitting up were associated with greater central adiposity, and later age at walking was associated with greater overall adiposity at age 3 years. Although we controlled for birth weight and 6-month weight-for-length in our models, more detailed assessment of early adiposity prior to achievement of motor milestones is needed to help determine causality. PMID:21643834

Subjective physical and cognitive age among community-dwelling older people aged 75 years and older: differences with chronological age and its associated factors.

PubMed

Ihira, Hikaru; Furuna, Taketo; Mizumoto, Atsushi; Makino, Keitaro; Saitoh, Shigeyuki; Ohnishi, Hirofumi; Shimada, Hiroyuki; Makizako, Hyuma

2015-01-01

The aim of this cross-sectional study was to determine the associations between self-reported subjective physical and cognitive age, and actual physical and cognitive functions among community-dwelling older people aged 75 years and older. The sample comprised 275 older adults aged 75-91 years. Two questions were asked regarding subjective age: 'How old do you feel physically?' and 'How old do you feel cognitively?' To assess physical functions, we measured handgrip strength, knee extension strength, standing balance and walking speed. Tests of attention, executive function, processing speed and memory were performed to assess actual cognitive function. Subjective physical and cognitive age was associated with performance on all of the physical and cognitive tests, respectively (p < 0.01). We also found that older adults who reported themselves as feeling older than their chronological age had a slower walking speed and lower scores for word-list memory recall than those who did not report themselves as feeling older than their actual age. These findings suggest that promoting a fast walking speed and good memory function may help to maintain a younger subjective physical and cognitive age in older adults aged 75 years and older.

Sex-Related and Age-Related Differences in Knee Strength of Basketball Players Ages 11–17 Years

PubMed Central

Vardaxis, Vassilios G.

2003-01-01

Objective: To assess hamstrings and quadriceps strength of basketball players ages 11–13 and 15–17 years. Design and Setting: This cross-sectional study occurred during the 2000 American Youth Basketball Tour National Tournament. We investigated whether sex- or age-related strength differences existed among study participants. Subjects: Forty-one tournament participants (22 girls, 19 boys; 11–13 or 15–17 years old) who reported no history of knee sprain or surgery were recruited. Measurements: We used a Cybex II dynamometer to obtain isokinetic concentric peak torques relative to body mass (Nm/kg) at 60°/s for hamstrings and quadriceps bilaterally. From average peak torques, we determined ipsilateral hamstrings:quadriceps and homologous muscle-group ratios. Results: Correlations between hamstrings and quadriceps strength measures ranged from 0.78 to 0.97. Players 15–17 years old had greater relative hamstrings and quadriceps strength than 11- to 13-year-old athletes. Age and sex interacted significantly for quadriceps strength. The quadriceps strength of 15- to 17-year-old girls did not differ from that of 11- to 13-year-old girls, whereas 15- to 17-year-old boys had stronger quadriceps than 11- to 13-year-old boys. Boys 15–17 years old had greater quadriceps strength than girls 15–17 years old. Conclusions: This study is unique in providing normative data for the hamstrings and quadriceps strength of basketball players 11–13 and 15–17 years old. Age-related strength differences did not occur consistently between the sexes, as girls 11–13 and 15–17 years old had similar relative quadriceps strength. PMID:14608433

Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years

PubMed Central

Wolosker, Nelson; Krutman, Mariana; Teivelis, Marcelo Passos; de Paula, Rafael Pessanha; Kauffman, Paulo; de Campos, Jose Ribas Milanez; Puech-Leão, Pedro

2014-01-01

ABSTRACT Objective: Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years. Methods: Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation. Results: In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement. Conclusion: Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis. PMID:24728245

Median u-turn intersection : informational guide.

DOT National Transportation Integrated Search

2014-08-01

This document provides information and guidance on Median U-Turn (MUT) intersections, resulting in designs suitable for a : variety of typical conditions commonly found in the United States. To the extent possible, the guide provides information on t...

[Intima-media thickness in a middle-old age sample of the Spanish general population].

PubMed

Calmarza, Pilar; Trejo, José María; Lapresta, Carlos; López, Pilar

2015-01-01

To ascertain reference values of carotid intima-media thickness (cIMT) in a middle and old-aged sample of the Spanish general population and to establish the 75(th) percentile above which it is necessary to control more strictly other cardiovascular risk factors. To determine cIMT values and the number of carotid plaques in age and sex subgroups, and whether there are differences between them. Lipids, apolipoproteins, number of carotid atherosclerotic plaques if any, and cIMT of both common carotid arteries were determined in 171 individuals, representative of the adult general population of Burgos (Spain). The median age of the patients was 63 years (interquartile range = 20) and the 75th percentile of carotid IMT was 0,88 mm and 0,81 mm in men and women, respectively. This study shows that the values of cIMT median increase with age and are higher in men than in women in all age groups, except in individuals over 74 years where cIMT median values are similar. The presence or absence of atherosclerotic plaques was not statistically different between men and women at different ages. This population study shows the reference values of cIMT in a middle and old-aged sample of the Spanish population and shows that age, male gender, systolic blood pressure (SBP) and personal history of coronary heart disease are the main determinants of increased cIMT. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

Sleep and Television and Computer Habits of Swedish School-Age Children

ERIC Educational Resources Information Center

Garmy, Pernilla; Nyberg, Per; Jakobsson, Ulf

2012-01-01

The aim of this study was to investigate sleep, television and computer habits and enjoyment and feelings of tiredness in school of school-age children and adolescents in Sweden. An instrument found to be valid and reliable here was distributed to 3,011 children aged 6, 7, 10, 14, and 16 years. Those sleeping less than the median length of time…

Adverse Childhood Experiences and ADHD Diagnosis at Age 9 Years in a National Urban Sample.

PubMed

Jimenez, Manuel E; Wade, Roy; Schwartz-Soicher, Ofira; Lin, Yong; Reichman, Nancy E

To examine associations between adverse childhood experiences (ACEs) and attention-deficit/hyperactivity disorder (ADHD) at age 9 years using longitudinal data and assess the extent to which ACEs during middle childhood are independently associated with ADHD at age 9 years. We conducted a secondary analysis of data from the Fragile Families urban birth cohort 5- and 9-year interviews. The sample was limited to children for whom mothers were the primary caregiver and mother-reported information on 8 ACEs and ADHD were available at age 5 and 9 years. We examined associations between ACEs and parent-reported ADHD at age 9 years using logistic regression and controlling for potential confounders. We included 1572 children; 48% were African American, 11% had parent-reported ADHD at age 9 years, 41% and 42% experienced ≥1 ACE by age 5 years and between the ages of 5 and 9 years, respectively. ACEs before age 5 years were associated with ADHD at age 9 years. One, 2, and ≥3 ACEs between age 5 and 9 years were associated with ADHD at age 9 years even after controlling for ACEs before age 5 years and ADHD at age 5 years (adjusted odds ratio [AOR], 1.9; 95% confidence interval [CI], 1.2-3; AOR, 2.1; 95% CI, 1.2-3.8; and AOR, 2.2; 95% CI, 1.1-4.3). In this study of urban children, ACEs occurring before age 5 years as well as between the ages of 5 and 9 years were associated with ADHD at age 9 years. Even after controlling for early childhood ACEs and ADHD at age 5 years, the association between ADHD and ACEs in middle childhood remained significant, highlighting the importance of screening and intervention throughout childhood. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Median Growth Percentiles (MGPs): Assessment of Intertemporal Stability and Correlations with Observational Scores

ERIC Educational Resources Information Center

Pivovarova, Margarita; Amrein-Beardsley, Audrey

2018-01-01

While states are no longer required to set up teacher evaluation systems based in significant part on student test scores, quite a few continue to use value-added (VAMs) or student growth percentile (SGP) models for that purpose. In this study, we analyzed three years of teacher data to illustrate the performance of teachers' median growth…

Association of Autistic Traits With Depression From Childhood to Age 18 Years.

PubMed

Rai, Dheeraj; Culpin, Iryna; Heuvelman, Hein; Magnusson, Cecilia M K; Carpenter, Peter; Jones, Hannah J; Emond, Alan M; Zammit, Stanley; Golding, Jean; Pearson, Rebecca M

2018-06-13

Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear. To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying. Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017. Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule-Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years. The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6

Nonfatal Assaults Among Persons Aged 10-24 Years - United States, 2001-2015.

PubMed

David-Ferdon, Corinne F; Haileyesus, Tadesse; Liu, Yang; Simon, Thomas R; Kresnow, Marcie-Jo

2018-02-09

In 2015, persons aged 10-24 years who were treated for nonfatal assault injuries in emergency departments (EDs) in the United States accounted for 32% of the approximately 1.5 million patients of all ages that EDs treated for nonfatal assault injuries (1). CDC analyzed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) to examine 2001-2015 trends in nonfatal assault injuries among youths treated in EDs, by sex and age group, and to assess current rates by sex, age group, mechanism of injury, and disposition (1). Rates for 2001-2015 were significantly higher among males than among females and among young adults aged 20-24 years than among youths aged 10-14 and 15-19 years. During 2011-2015, rates declined for all groups. The 2015 rate among persons aged 10-24 years was 753.2 per 100,000 population, the lowest in the 15-year study period. Despite encouraging trends, the assault rate among young persons remains high. Rates in 2015 were higher among males, persons aged 20-24 years, and those who incurred intentional strike or hit injuries. Nearly one in 10 patients were admitted to the hospital, transferred to another hospital, or held for observation. Youth violence prevention strategies, including primary prevention approaches that build individual skills, strengthen family relationships, or connect young persons treated in EDs to immediate and ongoing support, can be implemented to decrease injuries and fatalities (2).

Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA.

PubMed

Filli, Lukas; Piccirelli, Marco; Kenkel, David; Boss, Andreas; Manoliu, Andrei; Andreisek, Gustav; Bhat, Himanshu; Runge, Val M; Guggenberger, Roman

2016-06-01

To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA. After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil. An EPI sequence (b-value, 1,000 s/mm(2); 20 gradient directions) was acquired without acceleration as well as with twofold and threefold slice acceleration. Fractional anisotropy (FA), mean diffusivity (MD) and quality of nerve tractography (number of tracks, average track length, track homogeneity, anatomical accuracy) were compared between the acquisitions using multivariate ANOVA and the Kruskal-Wallis test. Acquisition time was 6:08 min for standard DTI, 3:38 min for twofold and 2:31 min for threefold acceleration. No differences were found regarding FA (standard DTI: 0.620 ± 0.058; twofold acceleration: 0.642 ± 0.058; threefold acceleration: 0.644 ± 0.061; p ≥ 0.217) and MD (standard DTI: 1.076 ± 0.080 mm(2)/s; twofold acceleration: 1.016 ± 0.123 mm(2)/s; threefold acceleration: 0.979 ± 0.153 mm(2)/s; p ≥ 0.074). Twofold acceleration yielded similar tractography quality compared to standard DTI (p > 0.05). With threefold acceleration, however, average track length and track homogeneity decreased (p = 0.004-0.021). Accelerated DTI of the median nerve is feasible. Twofold acceleration yields similar results to standard DTI. • Standard DTI of the median nerve is limited by its long acquisition time. • Simultaneous multi-slice acquisition is a new technique for accelerated DTI. • Accelerated DTI of the median nerve yields similar results to standard DTI.

Routine Eye Examinations for Persons 20-64 Years of Age

PubMed Central

2006-01-01

Executive Summary Objective The objective of this analysis was to determine the strength of association between age, gender, ethnicity, family history of disease and refractive error and the risk of developing glaucoma or ARM? Clinical Need A routine eye exam serves a primary, secondary, and tertiary care role. In a primary care role, it allows contact with a doctor who can provide advice about eye care, which may reduce the incidence of eye disease and injury. In a secondary care role, it can via a case finding approach, diagnose persons with degenerative eye diseases such as glaucoma and or AMD, and lead to earlier treatment to slow the progression of the disease. Finally in a tertiary care role, it provides ongoing monitoring and treatment to those with diseases associated with vision loss. Glaucoma is a progressive degenerative disease of the optic nerve, which causes gradual loss of peripheral (side) vision, and in advanced disease states loss of central vision. Blindness may results if glaucoma is not diagnosed and managed. The prevalence of primary open angle glaucoma (POAG) ranges from 1.1% to 3.0% in Western populations, and from 4.2% to 8.8% in populations of African descent. It is estimated up to 50% of people with glaucoma are aware that they have the disease. In Canada, glaucoma disease is the second leading cause of blindness in people aged 50 years and older. Tonometry, inspection of the optic disc and perimetry are used concurrently by physicians and optometrists to make the diagnosis of glaucoma. In general, the evidence shows that treating people with increased IOP only, increased IOP and clinical signs of early glaucoma or with normal-tension glaucoma can reduce the progression of disease. Age-related maculopathy (ARM) is a degenerative disease of the macula, which is a part of the retina. Damage to the macula causes loss of central vision affecting the ability to read, recognize faces and to move about freely. ARM can be divided into an early

Prenatal famine exposure and cognition at age 59 years

PubMed Central

Stein, Aryeh D; Jolles, Jelle; van Boxtel, Martin PJ; Blauw, Gerard-Jan; van de Bor, Margot; Lumey, LH

2011-01-01

Background Despite the perceived importance of early life nutrition for mental development, few studies have related gestational undernutrition to later-life cognitive functioning. We investigated the consequences of gestational exposure to the Dutch famine of 1944–45 for cognitive functioning at the age of 59 years. Methods We recruited men and women who were (i) born in birth clinics in Amsterdam, Rotterdam and Leiden, between January 1945 and March 1946, whose mothers experienced famine during or immediately preceding pregnancy (n = 354); (ii) born in the same three institutions during 1943 and 1947, whose mothers did not experience famine during this pregnancy (n = 292); or (iii) same-sex siblings of those in the first two categories (n = 311). We assessed cognitive performance at the age of 59 years by means of a comprehensive test battery. Results All cognitive functioning test scores were within normal ranges for this age group. There were no differences in cognitive performance at the age of 59 years between individuals exposed to gestational undernutrition and those without this exposure. For the general cognitive index, a summary measure across six functional domains (mean 100, standard deviation (SD) 15 points), famine exposure was associated with a decrease of 0.57 points [95% confidence interval (95% CI) −2.41 to 1.28] points. Individuals exposed to famine in gestational weeks 1–10 had a cognitive functioning index 4.36 (95% CI 8.04–0.67) points lower than those without this exposure. Within-sibling-pair analyses gave consistent results. Conclusion We found no overall association between maternal exposure to acute famine in pregnancy and cognitive performance of the offspring at the age of 59 years, but cannot rule out an association specific to early pregnancy exposure. PMID:21247885

Prenatal famine exposure and cognition at age 59 years.

PubMed

de Groot, Renate Hm; Stein, Aryeh D; Jolles, Jelle; van Boxtel, Martin Pj; Blauw, Gerard-Jan; van de Bor, Margot; Lumey, Lh

2011-04-01

Despite the perceived importance of early life nutrition for mental development, few studies have related gestational undernutrition to later-life cognitive functioning. We investigated the consequences of gestational exposure to the Dutch famine of 1944-45 for cognitive functioning at the age of 59 years. We recruited men and women who were (i) born in birth clinics in Amsterdam, Rotterdam and Leiden, between January 1945 and March 1946, whose mothers experienced famine during or immediately preceding pregnancy (n = 354); (ii) born in the same three institutions during 1943 and 1947, whose mothers did not experience famine during this pregnancy (n = 292); or (iii) same-sex siblings of those in the first two categories (n = 311). We assessed cognitive performance at the age of 59 years by means of a comprehensive test battery. All cognitive functioning test scores were within normal ranges for this age group. There were no differences in cognitive performance at the age of 59 years between individuals exposed to gestational undernutrition and those without this exposure. For the general cognitive index, a summary measure across six functional domains (mean 100, standard deviation (SD) 15 points), famine exposure was associated with a decrease of 0.57 points [95% confidence interval (95% CI) -2.41 to 1.28] points. Individuals exposed to famine in gestational weeks 1-10 had a cognitive functioning index 4.36 (95% CI 8.04-0.67) points lower than those without this exposure. Within-sibling-pair analyses gave consistent results. We found no overall association between maternal exposure to acute famine in pregnancy and cognitive performance of the offspring at the age of 59 years, but cannot rule out an association specific to early pregnancy exposure.

Autologous stem cell transplantation for patients aged 60 years or older with refractory or relapsed classical Hodgkin's lymphoma: a retrospective analysis from the French Society of Bone Marrow Transplantation and Cell Therapies (SFGM-TC).

PubMed

Stamatoullas, A; Brice, P; Gueye, M S; Mareschal, S; Chevallier, P; Bouabdallah, R; Nguyenquoc, S; Francois, S; Turlure, P; Ceballos, P; Monjanel, H; Bourhis, J-H; Guillerm, G; Mohty, M; Biron, P; Cornillon, J; Belhadj, K; Bonmati, C; Dilhuydy, M-S; Huynh, A; Bernard, M; Chrétien, M-L; Peffault de Latour, R; Tilly, H

2016-07-01

This report retrospectively analyzed the outcome of 91 patients aged 60 years or older with refractory/relapsed (R/R) classical Hodgkin's lymphoma (cHL) who underwent autologous stem cell transplantation (ASCT) between 1992 and 2013 and were reported to the French Society of Bone Marrow Transplantation and Cell Therapies registry. The median age at transplant was 63 years. The majority of patients exhibited disease chemosensitivity to salvage treatment (57 complete responses, 30 partial responses, 1 progressive disease and 3 unknown). The most frequent conditioning regimen consisted of BCNU, cytarabine, etoposide, melphalan (BEAM) chemotherapy (93%). With a median follow-up of 54 months, 5-year estimates of overall survival (OS) and progression free survival (PFS) for the entire group were 67 and 54%, respectively. Despite the missing data, in univariate analysis, the number of salvage chemotherapy lines (1-2 versus ⩾3) significantly influenced the OS, unlike the other prognostic factors (stage III-IV at relapse, disease status before ASCT and negative positron emission tomography (PET) scan) encountered in younger patients. In spite of its limitations, this retrospective study with a long-term follow-up suggests that ASCT is a valid treatment option for chemosensitive R/R cHL in selected elderly patients, with an acceptable rate of toxicity.

Incidence and survival of hematological cancers among adults ages ≥75 years.

PubMed

Krok-Schoen, Jessica L; Fisher, James L; Stephens, Julie A; Mims, Alice; Ayyappan, Sabarish; Woyach, Jennifer A; Rosko, Ashley E

2018-04-13

Evaluating population-based data of hematologic malignancies (HMs) in older adults provides prognostic information for this growing demographic. Incidence rates and one- and five-year relative survival rates were examined for specific HMs among adults ages ≥75 years using data from the Surveillance, Epidemiology and End Results (SEER) Program. Hematologic malignancy cases (Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML)) were reported to one of 18 SEER registries. Recent average annual (2010-2014) incidence rates and incidence trends from 1973 to 2014 were examined for cases ages ≥75 years. One- and five-year relative cancer survival rates were examined for adults ages ≥75 years diagnosed 2007-2013, with follow-up into 2014. From 1973 to 2014, incidence rates increased for NHL, MM, and AML, decreased for HL, and remained relatively stable for ALL, CLL, and CML among adults ages ≥75 years. The highest one- and five-year relative survival rates were observed among adults with CLL ages 75-84 years (1 year: 91.8% (95% CI = 91.8-90.8)) and 5 years: 76.5% (95% CI = 74.2-78.6)). The lowest one- and five-year survival rates were observed among adults with AML ages 75-84 (1 year: 18.2% (95% CI = 74.2-78.6) and 5 years: 2.7% (95% CI = 2.0-3.6)). Survival for older adults ages ≥75 years with HMs is poor, particularly for acute leukemia. Understanding the heterogeneity in HM outcomes among older patients may help clinicians better address the hematological cancer burden and mortality in the aging population. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Age 80 years and over is not associated with increased morbidity and mortality following pancreaticoduodenectomy.

PubMed

Kim, Sandy Y; Fink, Michael A; Perini, Marcos; Houli, Nezor; Weinberg, Laurence; Muralidharan, Vijayaragavan; Starkey, Graham; Jones, Robert M; Christophi, Christopher; Nikfarjam, Mehrdad

2018-05-01

Pancreaticoduodenectomy (PD) is associated with high morbidity, which is perceived to be increased in the elderly. To our knowledge there have been no Australian series that have compared outcomes of patients over the age of 80 undergoing PD to those who are younger. Patients who underwent PD between January 2008 and November 2015 were identified from a prospectively maintained database. A total of 165 patients underwent PD of whom 17 (10.3%) were aged 80 or over. The pre-operative health status, according to American Society of Anesthesiologists class was similar between the groups (P = 0.420). The 90-day mortality rates (5.9% in the elderly and 2% in the younger group; P = 0.355) and the post-operative complication rates (64.7% in the elderly versus 62.8% in the younger group; P = 0.88) were similar. Overall median length of hospital stay was also similar between the groups, but older patients were far more likely to be discharged to a rehabilitation facility than younger patients (47.1 versus 12.8%; P < 0.0001). Older patients with pancreatic adenocarcinoma (n = 10) had significantly lower median survival than the younger group (n = 69) (16.6 versus 22.5 months; P = 0.048). No significant differences were seen in the rate of complications following PD in patients aged 80 or over compared to younger patients, although there appears to be a shorter survival in the elderly patients treated for pancreatic cancer. Careful selection of elderly patients and optimal peri-operative care, rather than age should be used to determine whether surgical intervention is indicated in this patient group. © 2017 Royal Australasian College of Surgeons.

Age- and sex-related growth patterns of the craniofacial complex in European children aged 3-6 years.

PubMed

Tutkuviene, Janina; Cattaneo, Cristina; Obertová, Zuzana; Ratnayake, Melanie; Poppa, Pasquale; Barkus, Arunas; Khalaj-Hedayati, Kerstin; Schroeder, Inge; Ritz-Timme, Stefanie

2016-11-01

Craniofacial growth changes in young children are not yet completely understood. Up-to-date references for craniofacial measurements are crucial for clinical assessment of orthodontic anomalies, craniofacial abnormalities and subsequent planning of interventions. To provide normal reference data and to identify growth patterns for craniofacial dimensions of European boys and girls aged 3-6 years. Using standard anthropometric methodology, body weight, body height and 23 craniofacial measurements were acquired for a cross-sectional sample of 681 healthy children (362 boys and 319 girls) aged 3-6 years from Germany, Italy and Lithuania. Descriptive statistics, correlation coefficients, percentage annual changes and percentage growth rates were used to analyse the dataset. Between the ages of 3-6 years, craniofacial measurements showed age- and sex-related patterns independent from patterns observed for body weight and body height. Sex-related differences were observed in the majority of craniofacial measurements. In both sexes, face heights and face depths showed the strongest correlation with age. Growth patterns differed by craniofacial measurement and can be summarised into eight distinct age- and sex-related patterns. This study provided reference data and identified sex- and age-related growth patterns of the craniofacial complex of young European children, which may be used for detailed assessment of normal growth in paediatrics, maxillofacial reconstructive surgery and possibly for forensic age assessment.

Fuzzy scalar and vector median filters based on fuzzy distances.

PubMed

Chatzis, V; Pitas, I

1999-01-01

In this paper, the fuzzy scalar median (FSM) is proposed, defined by using ordering of fuzzy numbers based on fuzzy minimum and maximum operations defined by using the extension principle. Alternatively, the FSM is defined from the minimization of a fuzzy distance measure, and the equivalence of the two definitions is proven. Then, the fuzzy vector median (FVM) is proposed as an extension of vector median, based on a novel distance definition of fuzzy vectors, which satisfy the property of angle decomposition. By defining properly the fuzziness of a value, the combination of the basic properties of the classical scalar and vector median (VM) filter with other desirable characteristics can be succeeded.

Age-Specific Prevalence of Visual Impairment and Refractive Error in Children Aged 3-10 Years in Shanghai, China.

PubMed

Ma, Yingyan; Qu, Xiaomei; Zhu, Xiaofeng; Xu, Xun; Zhu, Jianfeng; Sankaridurg, Padmaja; Lin, Senlin; Lu, Lina; Zhao, Rong; Wang, Ling; Shi, Huijing; Tan, Hui; You, Xiaofang; Yuan, Hong; Sun, Sifei; Wang, Mingjin; He, Xiangui; Zou, Haidong; Congdon, Nathan

2016-11-01

We assessed changes in age-specific prevalence of refractive error at the time of starting school, by comparing preschool and school age cohorts in Shanghai, China. A cross-sectional study was done in Jiading District, Shanghai during November and December 2013. We randomly selected 7 kindergartens and 7 primary schools, with probability proportionate to size. Chinese children (n = 8398) aged 3 to 10 years were enumerated, and 8267 (98.4%) were included. Children underwent distance visual acuity assessment and refraction measurement by cycloplegic autorefraction and subjective refraction. The prevalence of uncorrected visual acuity (UCVA), presenting visual acuity, and best-corrected visual acuity in the better eye of ≤20/40 was 19.8%, 15.5%, and 1.7%, respectively. Among those with UCVA ≤ 20/40, 93.2% could achieve visual acuity of ≥20/32 with refraction. Only 28.7% (n = 465) of children with UCVA in the better eye of ≤20/40 wore glasses. Prevalence of myopia (spherical equivalent ≤-0.5 diopters [D] in at least one eye) increased from 1.78% in 3-year-olds to 52.2% in 10-year-olds, while prevalence of hyperopia (spherical equivalent ≥+2.0 D) decreased from 17.8% among 3-year-olds to 2.6% by 10 years of age. After adjusting for age, attending elite "high-level" school was statistically associated with greater myopia prevalence. The prevalence of myopia was lower or comparable to that reported in other populations from age 3 to 5 years, but increased dramatically after 6 years, consistent with a strong environmental role of schooling on myopia development.

[Idiopathic normal pressure hydrocephalus: High incidence in people over 80 years of age].

PubMed

Aragonès, Josep Maria; Altimiras, Jacint; Alonso, Francisco; Roura, Pere; Alfonso, Sebastián; Bajo, Lorena

Idiopathic normal pressure hydrocephalus is usually observed in adults over 60 years of age. The highest incidence of cases is between 70 and 80 years-old, and it could be under-diagnosed in over 80 year-olds. A description is presented on the overall incidence and age group incidence, the delay in the diagnosis, and main outcomes. A descriptive study was performed on patients with idiopathic normal pressure hydrocephalus, in the population of Osona County during the years 2010-2015. The annual incidence rate was 4.43 per 100,000 inhabitants. The incidence increased with age; from 8.09 per 100,000 in the 60 to 69 years age group, to 23.61 per 100,000 in the 70-79 years age group of, and to 37.02 per 100,000 in the 80-89 years age. The delay in the diagnosis was 15.01 ± 10.35 months. All the patients improved after surgery, but only 73.3% of the patients maintained the improvement after one year. Idiopathic normal pressure hydrocephalus is an age related disease and probably underdiagnosed in the elderly. An early diagnosis and a clinical suspicion are essential in patients over 80 years old. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Outcomes of childhood asthma to the age of 50 years.

PubMed

Tai, Andrew; Tran, Haily; Roberts, Mary; Clarke, Nadeene; Gibson, Anne-Marie; Vidmar, Suzanna; Wilson, John; Robertson, Colin F

2014-06-01

In 1964, The Melbourne Asthma Study was established to describe the spectrum and natural history of childhood asthma. To describe the clinical and lung function outcome of childhood asthma to the age of 50 years. Subjects were invited to complete an interviewer-administered questionnaire, skin prick testing, and measurement of lung function from the age of 7 years to the age of 50 years at 7-year intervals. Of 458 survivors (from the original 484 subjects at recruitment), 346 subjects (76%) participated, of whom, 197 completed lung function measurement. Asthma remission at the age of 50 years was 64% in those with wheezy bronchitis, 47% for those with persistent asthma, and 15% for those with severe asthma in childhood. Multivariable analysis identified severe asthma in childhood (odds ratio [OR] 11.9 [95% CI, 3.4-41.8]), female sex (OR 2.0 [95% CI, 1.1-3.6]), and childhood hay fever (OR 2.0 [95% CI, 1.0-4.0]) as risk factors for "current asthma" at age 50 years. There was no evidence of a difference in the rate of decline in FEV1 (mL/y, 95% CI) between the severe asthma group (15 mL/y [95% CI, 9-22 mL/y]) and all the other recruitment groups: control (16 mL/y [95% CI, 12-20 mL/y]), mild wheezy bronchitis (14 mL/y [95% CI, 8-19 mL/y]), wheezy bronchitis (16 mL/y [95% CI, 11-20 mL/y]), and persistent asthma (19 mL/y [95% CI, 13-24 mL/y]). The clinical and lung function outcome in adult life is strongly determined by asthma severity in childhood. The reduced lung function seen in adults is established in childhood and does not appear to decline more rapidly in adult years despite continuing symptoms. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Case Report: Bullous Scabies in Two Children below 10 Years.

PubMed

Luo, Ze-Yu; Zeng, Mei; Gao, Qian; Zhao, Yu-Kun; Sarkar, Rashmi; Liao, Shu-Ping; Luo, Di-Qing

2017-12-01

Bullous scabies is an infrequent and atypical presentation of scabies, with predilection for elderly and males. Its median age of presentation is 70 years. We report two male cases of bullous scabies who were 7 years and 6 months old. Both patients had excellent response to sulfur 10% ointment alone and have had no recurrence in more than 3 months of follow-up.

Predictors of dental rehabilitation in children aged 3-12 years.

PubMed

Gopinath, Vellore Kannan; Awad, Manal A

2015-01-01

The aim of this study was to evaluate the proportion of completed treatments and to study the factors affecting the full mouth dental rehabilitation in pediatric patients treated by undergraduate students at the College of Dental Medicine Teaching Clinics, University of Sharjah. A retrospective study was conducted on 270 children aged less than 12 years (mean age 7.6, SD 2.04). Comprehensive dental rehabilitation reports of child patients that were completed by final year dental undergraduate students from the year 2009 to 2011 were reviewed. Data on complete history, oral examination, dental charting, and treatment plan were collected from pediatric dentistry case sheet. Dental caries was charted using WHO 1997 criteria. Dental treatment needs and completion of dental care delivered to children involved in this study were assessed using DMFT/deft scores. Percentages of treatment provided included completed restorations (94%) and space management (84%) in primary dentition, whereas 98% of restoration and 94% of required sealants were completed in permanent dentition. The percentage of completed dental treatment including sealant placement was 61%. Age of the child and the number of decayed teeth present before the start of the treatment significantly correlated with the children in the incomplete treatment category (P < 0.05). Therefore, a worthy dental care was provided in a holistic approach to the children attending College of Dental Medicine training clinics. Age of the child and the number of decayed teeth were the factors affecting dental rehabilitation in children aged 3-12 years.

Renal safety of short-term empiric gentamicin therapy in aged patients.

PubMed

Sia, Christopher Sb; Ananda-Rajah, Michelle R; Adler, Nikki R; Yi-Wei, Baey; Liew, Danny; Tong, Erica Y; Aung, Ar Kar

2018-04-27

To determine the incidence of acute kidney injury (AKI) in aged patients receiving empiric gentamicin therapy. Patients aged ≥65 years receiving gentamicin upon admission between 2013 and 2015 at two Australian hospitals were retrospectively studied. AKI was defined as a rise in creatinine by ≥50% and/or ≥26.5 μmol/L. Most patients (95%) received a single dose of gentamicin. The incidence of AKI was 15% (36/242 patients). A composite outcome of persistent kidney injury, requirement for renal replacement therapy or inpatient death in a patient with AKI occurred in 10 (4%) patients. Patients who developed AKI were older (median 80.5 vs 78 years, P = 0.03), had higher Charlson Co-morbidity Index (median 7 vs 5, P = 0.0004) and had more advanced chronic kidney disease at baseline (Stages IV and V) (OR 4.38, 95% confidence interval 1.45-13.2, P = 0.01). Empiric gentamicin use in patients with advancing age is associated with low rates of predominantly transient renal impairment. © 2018 AJA Inc.

Maternal Depression Trajectories and Children's Behavior at Age 5 Years.

PubMed

van der Waerden, Judith; Galéra, Cédric; Larroque, Béatrice; Saurel-Cubizolles, Marie-Josèphe; Sutter-Dallay, Anne-Laure; Melchior, Maria

2015-06-01

To assess the relationship between trajectories of maternal depression from pregnancy to the child's age of 5 years and children's emotional and behavioral difficulties at age 5 years. Mother-child pairs (n = 1183) from the EDEN mother-child birth cohort study based in France were followed from 24 to 28 weeks of pregnancy to the child's fifth birthday. Children's behavior at age 5 years was assessed with the Strengths and Difficulties Questionnaire. Maternal depression was assessed repeatedly with the Center for Epidemiological Studies Depression questionnaire (pregnancy, 3, and 5 years of age) and the Edinburgh Postnatal Depression Scale (4, 8, and 12 months postpartum). Homogeneous latent trajectory groups of maternal depression were identified within the study population and correlated with Strengths and Difficulties Questionnaire scores by the use of multivariate linear regression analyzes. Five trajectories of maternal symptoms of depression were identified: no symptoms (62.0%); persistent intermediate-level depressive symptoms (25.3%); persistent high depressive symptoms (4.6%); high symptoms in pregnancy only (3.6%); and high symptoms in the child's preschool period only (4.6%). Children whose mothers had persistent depressive symptoms--either intermediate or high--had the greatest levels of emotional and behavioral difficulties at age 5 years. In addition, compared with children whose mothers were never depressed, those whose mothers had high symptoms in the preschool period also had increased levels of emotional symptoms, conduct problems, and peer problems. Maternal depression symptoms are related to children's emotional and behavioral problems, particularly if they are persistent (29.9%) or occur during early childhood (4.6%). Copyright © 2015 Elsevier Inc. All rights reserved.

Secular trends in age at menarche among Chinese girls from 24 ethnic minorities, 1985 to 2010

PubMed Central

Song, Yi; Ma, Jun; Agardh, Anette; Lau, Patrick W.C.; Hu, Peijin; Zhang, Bing

2015-01-01

Background Declining age at menarche has been observed in many countries. In China, a decrease of 4.5 months per decade in the average age at menarche among the majority Han girls has recently been reported. However, the trends in age at menarche among ethnic minority girls over the past 25 years remain unknown. Objectives To compare the differences in median age at menarche among girls aged 9–18 years across 24 ethnic minorities in 2010 and to estimate the trends in age at menarche in different ethnic minorities from 1985 to 2010. Design We used data from six cross-sectional Chinese National Surveys on Students’ Constitution and Health (1985, 1991, 1995, 2000, 2005, and 2010). The median age at menarche was estimated by using probit analysis. Results In 2010, the ethnic minorities with the earliest age at menarche were the Koreans (11.79 years), Mongolians (12.44 years), and Zhuang (12.52 years). The three ethnic minorities with the latest age at menarche were the Sala (14.32 years), Yi (13.74 years), and Uighurs (13.67 years). From 1985 to 2010, the age at menarche declined in all 24 minority groups. The Lisu, Kazakh, and Korean minorities showed the largest reductions in age at menarche by 1.79 (p<0.05), 1.69 (p<0.05), and 1.57 (p<0.05) years, respectively, from 1985 to 2010. The Yi, Sala, and Li minorities showed the smallest reductions, with age at menarche declining by only 0.06 (p>0.05), 0.15 (p>0.05), and 0.15 (p>0.05) years, respectively, in the same period. Conclusion A large variation in age at menarche was observed among different ethnic minorities, with the earliest age at menarche found among Korean girls. A reduction in the average age at menarche appeared among most of the ethnic minorities over time, and the largest decrease was observed in Lisu, Kazakh, and Korean girls. Thus, health education should focus on targeting the specific needs of each ethnic minority group. PMID:26220757

Age at menarche and its socioeconomic determinants among female students in an urban area in Bangladesh.

PubMed

Islam, Md Serajul; Hussain, Md Altaf; Islam, Saimul; Mahumud, Rashidul Alam; Biswas, Tuhin; Islam, Sheikh Mohammed Shariful

2017-06-01

This cross-sectional study aimed to determine the age at menarche and its socioeconomic determinants among urban female students (n=680) in Bangladesh. The mean age of the respondents was 14±1.43years. Majority of the respondents were unmarried (98.4%). The mean age at menarche was 11.6±3.6years, median 12years. Almost one-third (35.7%) of the participants had menarche at the age of 12years. There was no statistically significant difference between age at menarche before and after 12years with the socio-economic characteristics, except education (p=<0.001). In the multivariate model, only higher education was statistically significant predictor of age at menarche. Copyright © 2017 Elsevier B.V. All rights reserved.

Update on herpes zoster vaccine: licensure for persons aged 50 through 59 years.

PubMed

2011-11-11

Herpes zoster vaccine (Zostavax, Merck & Co., Inc.) was licensed and recommended in 2006 for prevention of herpes zoster among adults aged 60 years and older. In March 2011, the Food and Drug Administration (FDA) approved the use of Zostavax in adults aged 50 through 59 years. In June 2011, the Advisory Committee on Immunization Practices (ACIP) declined to recommend the vaccine for adults aged 50 through 59 years and reaffirmed its current recommendation that herpes zoster vaccine be routinely recommended for adults aged 60 years and older.

Head Circumference Charts for Turkish Children Aged Five to Eighteen Years.

PubMed

Kara, Bülent; Etiler, Nilay; Aydoğan Uncuoğlu, Ayşen; Maraş Genç, Hülya; Ulak Gümüşlü, Esen; Gökçay, Gülbin; Furman, Andrezej

2016-03-01

Most head circumference growth references are useful during the first years of life, but they are also useful for older children when screening for developmental, neurological, and genetic disorders. We aimed to develop head circumference growth reference charts for age, height, and waist circumference for Turkish children aged 5-18 years. Head circumference, height, and waist circumference measurements were obtained from 5079 students aged 5-18 years from İzmit, Kocaeli Province, Turkey. The LMS method was used to construct reference centile curves. Head circumference measurements were strongly correlated with height (r=0.74), weight (r=0.76), and waist circumference (r=0.68). The mean head circumference values for boys were larger than those for girls at all ages. Compared with data from the United States, the World Health Organization, and other studies from Turkey, our data showed a decrease in head circumference at all ages for both sexes. Local growth charts can be used to evaluate head circumference growth in older Turkish children and adolescents.

Menarcheal age of girls from dysfunctional families.

PubMed

Toromanović, Alma; Tahirović, Husref

2004-07-01

The objective of the present study was to determine median age at menarche and the influence of familial instability on maturation. The sample included 7047 girls between the ages of 9 and 17 years from Tuzla Canton. The girls were divided into two groups. Group A (N=5230) comprised girls who lived in families free of strong traumatic events. Group B (N=1817) included girls whose family dysfunction exposed them to prolonged distress. Probit analysis was performed to estimate mean menarcheal age using the Probit procedure of SAS package. The mean menarcheal age calculated by probit analysis for all the girls studied was 13.07 years. In girls from dysfunctional families a very clear shift toward earlier maturation was observed. The mean age at menarche for group B was 13.0 years, which was significantly lower that that for group A, 13.11 years (t=2.92, P<0.01). The results surveyed here lead to the conclusion that girls from dysfunctional families mature not later but even earlier than girls from normal families. This supports the hypothesis that stressful childhood life events accelerate maturation of girls.

Six year effectiveness of a population based two tier infant hearing screening programme

PubMed Central

Russ, S; Rickards, F; Poulakis, Z; Barker, M; Saunders, K; Wake, M

2002-01-01

Aims: To determine whether a two tier universal infant hearing screening programme (population based risk factor ascertainment and universal distraction testing) lowered median age of diagnosis of bilateral congenital hearing impairment (CHI) >40 dB HL in Victoria, Australia. Methods: Comparison of whole population birth cohorts pre and post introduction of the Victorian Infant Hearing Screening Program (VIHSP). All babies surviving the neonatal period born in Victoria in 1989 (pre-VIHSP) and 1993 (post-VIHSP) were studied. (1) Pre-1992: distraction test at 7–9 months. (2) Post-1992: infants with risk factors for CHI referred for auditory brain stem evoked response (ABR) assessment; all others screened by modified distraction test at 7–9 months. Results: Of the 1989 cohort (n = 63 454), 1.65/1000 were fitted with hearing aids for CHI by end 1995, compared with 2.09/1000 of the 1993 cohort (n = 64 116) by end 1999. Of these, 79 cases from the 1989 cohort (1.24/1000) and 72 cases from the 1993 cohort (1.12/1000) had CHI >40 dB HL. Median age at diagnosis of CHI >40 dB HL for the 1989 birth cohort was 20.3 months, and for the 1993 cohort was 14.2 months. Median age at diagnosis fell significantly for severe CHI but not for moderate or profound CHI. Significantly more babies with CHI >40 dB HL were diagnosed by 6 months of age in 1993 than in 1989 (21.7% v 6.3%). Compared to the six years pre-VIHSP, numbers aided by six months were consistently higher in the six years post-VIHSP (1.05 per 100 000 births versus 13.4 per 100 000 births per year). Conclusions: VIHSP resulted in very early diagnosis for more infants and lowered median age of diagnosis of severe CHI. However, overall results were disappointing. PMID:11919095

Investigation of risk factors for mortality in aged guide dogs: A retrospective cohort study.

PubMed

Hoummady, S; Hua, J; Muller, C; Pouchelon, J L; Blondot, M; Gilbert, C; Desquilbet, L

2016-09-15

The overall median lifespan of domestic dogs has been estimated to 9-12 years, but little is known about risk factors for mortality in aged and a priori healthy dogs. The objective of this retrospective cohort study was to determine which characteristics are associated with mortality in aged and a priori healthy guide dogs, in a retrospective cohort study of 116 guide dogs followed from a systematic geriatric examination at the age of 8-10 years old. A geriatric grid collected the clinical data and usual biological parameters were measured at the time of examination. Univariate (Kaplan-Meier estimates) and multivariable (Cox proportional hazard model) survival analyses were used to assess the associations with time to all-cause death. The majority of dogs were Golden Retrievers (n=48) and Labrador Retrievers (n=27). Median age at geriatric examination was 8.9 years. A total of 76 dogs died during follow-up, leading to a median survival time from geriatric examination of 4.4 years. After adjustment for demographic and biological variables, an increased alanine amionotransferase level (adjusted Hazard Ratio (adjusted HR), 6.2; 95% confidence interval [95%CI], 2.0-19.0; P<0.01), presenting skin nodules (adjusted HR, 1.9; 95% CI, 1.0-3.4; P=0.04), and not being a Labrador Retriever (adjusted HR, 3.3; 95%CI, 1.4-10; P<0.01) were independently associated with a shorter time to death. This study documents independent associations of alanine aminotransferase level, skin nodules and breed with mortality in aged guide dogs. These results may be useful for preventive medical care when conducting a geriatric examination in working dogs. Copyright © 2016 Elsevier B.V. All rights reserved.

Bronchopulmonary dysplasia: improvement in lung function between 7 and 10 years of age.