Defining Extreme Events: A Cross-Disciplinary Review

Science.gov (United States)

McPhillips, Lauren E.; Chang, Heejun; Chester, Mikhail V.; Depietri, Yaella; Friedman, Erin; Grimm, Nancy B.; Kominoski, John S.; McPhearson, Timon; Méndez-Lázaro, Pablo; Rosi, Emma J.; Shafiei Shiva, Javad

2018-03-01

Extreme events are of interest worldwide given their potential for substantial impacts on social, ecological, and technical systems. Many climate-related extreme events are increasing in frequency and/or magnitude due to anthropogenic climate change, and there is increased potential for impacts due to the location of urbanization and the expansion of urban centers and infrastructures. Many disciplines are engaged in research and management of these events. However, a lack of coherence exists in what constitutes and defines an extreme event across these fields, which impedes our ability to holistically understand and manage these events. Here, we review 10 years of academic literature and use text analysis to elucidate how six major disciplines—climatology, earth sciences, ecology, engineering, hydrology, and social sciences—define and communicate extreme events. Our results highlight critical disciplinary differences in the language used to communicate extreme events. Additionally, we found a wide range in definitions and thresholds, with more than half of examined papers not providing an explicit definition, and disagreement over whether impacts are included in the definition. We urge distinction between extreme events and their impacts, so that we can better assess when responses to extreme events have actually enhanced resilience. Additionally, we suggest that all researchers and managers of extreme events be more explicit in their definition of such events as well as be more cognizant of how they are communicating extreme events. We believe clearer and more consistent definitions and communication can support transdisciplinary understanding and management of extreme events.

Deep learning aided decision support for pulmonary nodules diagnosing: a review.

Science.gov (United States)

Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo

2018-04-01

Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.

[Defining AIDS terminology. A practical approach].

Science.gov (United States)

Locutura, Jaime; Almirante, Benito; Berenguer, Juan; Muñoz, Agustín; Peña, José María

2003-01-01

Since the appearance of AIDS, the study of this disease has generated a large amount of information and an extensive related vocabulary comprised of new terms or terms borrowed from other scientific fields. The urgent need to provide names for newly described phenomena and concepts in this field has resulted in the application of terms that are not always appropriate from the linguistic and scientific points of view. We discuss the difficulties in attempting to create adequate AIDS terminology in the Spanish language, considering both the general problems involved in building any scientific vocabulary and the specific problems inherent to this activity in a field whose defining illness has important social connotations. The pressure exerted by the predominance of the English language in reporting scientific knowledge is considered, and the inappropriate words most often found in a review of current literature are examined. Finally, attending to the two most important criteria for the creation of new scientific terms, accuracy and linguistic correction, we propose some well thought-out alternatives that conform to the essence of the Spanish language.

Long-term trends in mortality and AIDS-defining events after combination ART initiation among children and adolescents with perinatal HIV infection in 17 middle- and high-income countries in Europe and Thailand: A cohort study.

Directory of Open Access Journals (Sweden)

Ali Judd

2018-01-01

Full Text Available Published estimates of mortality and progression to AIDS as children with HIV approach adulthood are limited. We describe rates and risk factors for death and AIDS-defining events in children and adolescents after initiation of combination antiretroviral therapy (cART in 17 middle- and high-income countries, including some in Western and Central Europe (W&CE, Eastern Europe (Russia and Ukraine, and Thailand.Children with perinatal HIV aged 6 months of cART death and progression to AIDS were assessed. Of 3,526 children included, 32% were from the United Kingdom or Ireland, 30% from elsewhere in W&CE, 18% from Russia or Ukraine, and 20% from Thailand. At cART initiation, median age was 5.2 (IQR 1.4-9.3 years; 35% of children aged 400 c/mL predicted late death. Predictors of early and late progression to AIDS were similar. Study limitations include incomplete recording of US Centers for Disease Control (CDC disease stage B events and serious adverse events in some countries; events that were distributed over a long time period, and that we lacked power to analyse trends in patterns and causes of death over time.In our study, 3,526 children and adolescents with perinatal HIV infection initiated antiretroviral therapy (ART in countries in Europe and Thailand. We observed that over 40% of deaths occurred ≤6 months after cART initiation. Greater early mortality risk in infants, as compared to older children, and in Russia, Ukraine, or Thailand as compared to W&CE, raises concern. Current severe immune suppression, being underweight, and unsuppressed viral load were associated with a higher risk of death at >6 months after initiation of cART.

Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

1994-01-01

. The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

Systematic Review of Decision Aids for Newly Diagnosed Patients with Prostate Cancer Making Treatment Decisions.

Science.gov (United States)

Adsul, Prajakta; Wray, Ricardo; Spradling, Kyle; Darwish, Oussama; Weaver, Nancy; Siddiqui, Sameer

2015-11-01

Despite established evidence for using patient decision aids, use with newly diagnosed patients with prostate cancer remains limited partly due to variability in aid characteristics. We systematically reviewed decision aids for newly diagnosed patients with prostate cancer. Published peer reviewed journal articles, unpublished literature on the Internet and the Ottawa decision aids web repository were searched to identify decision aids designed for patients with prostate cancer facing treatment decisions. A total of 14 aids were included in study. Supplementary materials on aid development and published studies evaluating the aids were also included. We studied aids designed to help patients make specific choices among options and outcomes relevant to health status that were specific to prostate cancer treatment and in English only. Aids were reviewed for IPDAS (International Patient Decision Aid Standards) and additional standards deemed relevant to prostate cancer treatment decisions. They were also reviewed for novel criteria on the potential for implementation. Acceptable interrater reliability was achieved at Krippendorff α = 0.82. Eight of the 14 decision aids (57.1%) were developed in the United States, 6 (42.8%) were print based, 5 (35.7%) were web or print based and only 4 (28.5%) had been updated since 2013. Ten aids (71.4%) were targeted to prostate cancer stage. All discussed radiation and surgery, 10 (71.4%) discussed active surveillance and/or watchful waiting and 8 (57.1%) discussed hormonal therapy. Of the aids 64.2% presented balanced perspectives on treatment benefits and risks, and/or outcome probabilities associated with each option. Ten aids (71.4%) presented value clarification prompts for patients and steps to make treatment decisions. No aid was tested with physicians and only 4 (28.6%) were tested with patients. Nine aids (64.2%) provided details on data appraisal and 4 (28.6%) commented on the quality of evidence used. Seven of the 8

Is HIV-2- induced AIDS different from HIV-1-associated AIDS? Data from a West African clinic

NARCIS (Netherlands)

Martinez-Steele, Euridice; Awasana, Akum Aveika; Corrah, Tumani; Sabally, Saihou; van der Sande, Marianne; Jaye, Assan; Togun, Toyin; Sarge-Njie, Ramu; McConkey, Samuel J.; Whittle, Hilton; Schim van der Loeff, Maarten F.

2007-01-01

Although AIDS is less frequent following HIV-2 than HIV-1 infection, it is unclear whether the clinical picture and clinical course of AIDS are similar in the two infections. To compare the pattern of AIDS-defining events, CD4 cell count at the time of AIDS diagnosis, survival from time of AIDS, and

Cerebral toxoplasmosis in Danish AIDS patients

DEFF Research Database (Denmark)

Smith, E; Pers, C; Aschow, C

1991-01-01

We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring......-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had...... was 83% (10/12 patients) while among patients diagnosed in 1987 or earlier the accuracy was 41% (7/17 patients). Four patients were diagnosed with Pneumocystis carinii pneumonia (PCP) prior to the diagnosis of CNS toxoplasmosis, while among patients with toxoplasmosis as the AIDS-defining diagnosis, 3...

Intelligent decision aids for abnormal events in nuclear power plants

International Nuclear Information System (INIS)

Kafka, P.; Polke, H.

1988-01-01

German nuclear power plants are characterized by a high degree of automation, not only for normal operation but also for abnormal events. Therefore the role of the operating personnel is mainly a supervisory function. Nevertheless, for a spectrum of unexpected events the operating personnel have to react with manual recovery actions. In order to minimize human error in such recovery actions, different kinds of intelligent decision aid support the operators today. In this paper such aids are discussed and one of them is described in more detail. (author)

Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa.

Science.gov (United States)

Olley, B O; Zeier, M D; Seedat, S; Stein, D J

2005-07-01

This study examined the prevalence of and factors associated with post-traumatic stress disorder in recently diagnosed HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male, 105 female) recently diagnosed HIV/AIDS patients (mean duration since diagnosis = 5.8 months, SD = 4.1) were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviours were assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current psychiatric conditions more likely to be associated with PTSD included major depressive disorder (29% in PTSD patients versus 7% in non-PTSD patients, p = 0.004), suicidality (54% versus 11%, p = 0.001) and social anxiety disorder (40% versus 13%, p = 0.04). Further patients with PTSD reported significantly more work impairment and demonstrated a trend towards higher usage of alcohol as a means of coping. Discriminant function analysis indicated that female gender and a history of sexual violation in the past year were significantly associated with a diagnosis of PTSD. Patients whose PTSD was a direct result of an HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD on demographic or clinical features. In the South African context, PTSD is not an uncommon disorder in patients with HIV/AIDS. In some cases, PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is seen after other traumas, with sexual violation and intimate partner violence in women being particularly important.

Mental health disorders and the risk of AIDS-defining illness and death in HIV-infected veterans.

Science.gov (United States)

Nurutdinova, Diana; Chrusciel, Timothy; Zeringue, Angelique; Scherrer, Jeffrey F; Al-Aly, Ziyad; McDonald, Jay R; Overton, Edgar T

2012-01-14

Mental health comorbidities are common in HIV-infected veterans and can impact clinical outcomes for HIV. We examined the impact of mental health diagnoses on progression to AIDS-defining illness (ADI) and death in a large cohort of HIV-infected veterans who accessed care between 2001 and 2006. Retrospective cohort study using the national Veterans Health Administration (VHA) HIV Clinical Case Registry. We identified HIV-infected veterans initiating combination antiretroviral therapy (cART) within the VHA between 2000 and 2006. The prevalences of the following mental health diagnoses were examined: schizophrenia, bipolar disorder, depression, anxiety, and substance use disorder. Cox proportional hazards models were constructed to examine the relationship between mental health conditions and two outcomes, all-cause mortality and ADI. Models were computed before and after adjusting for confounding factors including age, race, baseline CD4 cell count, comorbidities and cART adherence. Among 9003 veterans receiving cART, 31% had no mental health diagnosis. Age, race, baseline comorbidity score, CD4, and cART adherence were associated with shorter time to ADI or death. All-cause mortality was more likely among veterans with schizophrenia, bipolar disorder and substance use, and ADI was more likely to occur among veterans with substance use disorder. Our results demonstrate the high prevalence of mental health diagnoses among HIV-infected veterans. In the era of highly active antiretroviral therapy, presence of psychiatric diagnoses impacted survival and development of ADI. More aggressive measures addressing substance abuse and severe mental illness in HIV-infected veterans are necessary.

Contribution of past and future self-defining event networks to personal identity.

Science.gov (United States)

Demblon, Julie; D'Argembeau, Arnaud

2017-05-01

Personal identity is nourished by memories of significant past experiences and by the imagination of meaningful events that one anticipates to happen in the future. The organisation of such self-defining memories and prospective thoughts in the cognitive system has received little empirical attention, however. In the present study, our aims were to investigate to what extent self-defining memories and future projections are organised in networks of related events, and to determine the nature of the connections linking these events. Our results reveal the existence of self-defining event networks, composed of both memories and future events of similar centrality for identity and characterised by similar identity motives. These self-defining networks expressed a strong internal coherence and frequently organised events in meaningful themes and sequences (i.e., event clusters). Finally, we found that the satisfaction of identity motives in represented events and the presence of clustering across events both contributed to increase in the perceived centrality of events for the sense of identity. Overall, these findings suggest that personal identity is not only nourished by representations of significant past and future events, but also depends on the formation of coherent networks of related events that provide an overarching meaning to specific life experiences.

HIV/AIDS among women in Havana, Cuba: 1986-2011.

Science.gov (United States)

Oliva, Dinorah C; Viñas, Arturo L; Saavedra, Clarivel; Oliva, Maritza; González, Ciro; de la Torre, Caridad

2013-10-01

Women are being diagnosed with HIV infection in increasing numbers, and now account for 50% of cases worldwide. In Cuba, HIV is more frequent in men, but in recent years, a growing number of women have been diagnosed. Describe patterns of HIV among women in Havana, Cuba, 1986-2011. Descriptive study of women with HIV aged >14 years, residents of Havana, Cuba, who were diagnosed with HIV from 1 January 1986 through 31 December 2011. Information was obtained from the limited-access HIV/AIDS database of Cuba's Ministry of Public Health. Data were studied from all reported cases, a total of 1274 women. Variables selected were age at diagnosis, education, municipality of residence, screening group, year of HIV diagnosis, late presentation, AIDS-defining condition, year of diagnosis as AIDS case, vital status at the end of 2011, and year of death (if applicable). Incidence of HIV and AIDS, cumulative incidence by municipality of residence, and case fatality rates were calculated. Those aged 20-29 years were most affected by HIV. Almost half (46.7%) the women had completed middle school, and a further 35.4% had completed high school or middle-level technical studies. HIV incidence began to increase more steeply starting in 1998, as did AIDS incidence by year of diagnosis, though to a lesser extent. Central Havana and Old Havana municipalities had the highest cumulative incidence. Late presentation was seen in 7.4% of cases; mean age of those diagnosed late was 38.9 years. Wasting syndrome and Pneumocystis jirovecii pneumonia were the most frequent AIDS-defining conditions. Case fatality rates started to decline in 1998. HIV infection in women is occurring in a predominantly young, relatively well-educated population. Increasing rates of HIV and AIDS in the past decade are a warning sign of the possible expansion of HIV infection in women, even though mortality is declining.

Defining Features of Unhealthy Exercise Associated with Disordered Eating and Eating Disorder Diagnoses.

Science.gov (United States)

Holland, Lauren A; Brown, Tiffany A; Keel, Pamela K

2014-01-01

The current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution. Cross-sectional epidemiological study. A community-based sample of men (n=592) and women (n=1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms. Compulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women. Including the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology.

The AFFORD clinical decision aid to identify emergency department patients with atrial fibrillation at low risk for 30-day adverse events.

Science.gov (United States)

Barrett, Tyler W; Storrow, Alan B; Jenkins, Cathy A; Abraham, Robert L; Liu, Dandan; Miller, Karen F; Moser, Kelly M; Russ, Stephan; Roden, Dan M; Harrell, Frank E; Darbar, Dawood

2015-03-15

There is wide variation in the management of patients with atrial fibrillation (AF) in the emergency department (ED). We aimed to derive and internally validate the first prospective, ED-based clinical decision aid to identify patients with AF at low risk for 30-day adverse events. We performed a prospective cohort study at a university-affiliated tertiary-care ED. Patients were enrolled from June 9, 2010, to February 28, 2013, and followed for 30 days. We enrolled a convenience sample of patients in ED presenting with symptomatic AF. Candidate predictors were based on ED data available in the first 2 hours. The decision aid was derived using model approximation (preconditioning) followed by strong bootstrap internal validation. We used an ordinal outcome hierarchy defined as the incidence of the most severe adverse event within 30 days of the ED evaluation. Of 497 patients enrolled, stroke and AF-related death occurred in 13 (3%) and 4 (aid included the following: age, triage vitals (systolic blood pressure, temperature, respiratory rate, oxygen saturation, supplemental oxygen requirement), medical history (heart failure, home sotalol use, previous percutaneous coronary intervention, electrical cardioversion, cardiac ablation, frequency of AF symptoms), and ED data (2 hours heart rate, chest radiograph results, hemoglobin, creatinine, and brain natriuretic peptide). The decision aid's c-statistic in predicting any 30-day adverse event was 0.7 (95% confidence interval 0.65, 0.76). In conclusion, in patients with AF in the ED, Atrial Fibrillation and Flutter Outcome Risk Determination provides the first evidence-based decision aid for identifying patients who are at low risk for 30-day adverse events and candidates for safe discharge. Copyright © 2015 Elsevier Inc. All rights reserved.

A computer aided treatment event recognition system in radiation therapy

International Nuclear Information System (INIS)

Xia, Junyi; Mart, Christopher; Bayouth, John

2014-01-01

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

A computer aided treatment event recognition system in radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Xia, Junyi, E-mail: junyi-xia@uiowa.edu; Mart, Christopher [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Bayouth, John [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Human Oncology, University of Wisconsin - Madison, 600 Highland Avenue, K4/B55, Madison, Wisconsin 53792-0600 (United States)

2014-01-15

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

Accident Diagnosis and Prognosis Aide (ADPA)

International Nuclear Information System (INIS)

Gunter, A.D.; Touchton, R.A.

1987-01-01

This presentation provides a demonstration of a prototypical expert system developed by Technology Applications, Inc. (TAI) under a contract with the Department of Energy as a part of their Small Business Innovation Research Program. The Accident Diagnosis and Prognosis Aide (ADPA) Demonstration Prototype is a working scale model of a real-time expert system which: Diagnoses an accident situation (as well as a number of underlying failures, events, and conditions deduced along the way). Calculates the change in the likelihood of core damage as a function of the events and failures diagnosed. Dynamically generates a recovery procedure tailored to the specific plant state at hand

Immuno-Virological Discordance and the Risk of NonAIDS and AIDS Events in a Large Observational Cohort of HIV-Patients in Europe

DEFF Research Database (Denmark)

Zoufaly, Alexander; Cozzi-Lepri, Alessandro; Reekie, Joanne

2014-01-01

The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated....

Constructing Identities through Literacy Events in HIV/AIDS Education

Science.gov (United States)

Higgins, Christina

2014-01-01

This article examines the literacy events in HIV/AIDS education in Tanzania to investigate how they construct social identities for participants and to what extent they provide opportunities for critical health literacies. The projects took place as collaborative research partnerships with local Tanzanian NGOs in an effort to analyse and improve…

A cross-sectional study of leukopenia and thrombocytopenia among Chinese adults with newly diagnosed HIV/AIDS.

Science.gov (United States)

Shen, Yinzhong; Wang, Jiangrong; Wang, Zhenyan; Shen, Jiayin; Tangkai Qi; Song, Wei; Tang, Yang; Liu, Li; Zhang, Renfang; Zeng, Yi; Lu, Hongzhou

2015-04-01

We conducted a cross-sectional study to determine the prevalence and risk factors of leukopenia and thrombocytopenia among Chinese adults with newly diagnosed HIV/AIDS. One thousand nine hundred and forty-eight newly diagnosed HIV-infected patients were enrolled between 2009 and 2010. Serum samples obtained from each individual were collected for complete blood count. Factors associated with the presence of leukopenia and thrombocytopenia were analyzed by multiple logistic regression. The overall prevalence of leukopenia and of thrombocytopenia was 33.2% and 15.6%, respectively. The prevalence of leukopenia was higher among females than among males (39.4% versus 31.2%). The prevalence of leukopenia increased with decreasing CD4 count (8.2%, 26.5%, 33.4%, and 41.5% among patients with CD4 count of ≥ 350, 200-349, 50-199, and risk of leukopenia, and that lower CD4 count, and HIV transmission by blood were significantly associated with an increased risk of thrombocytopenia. The study reflects that leukopenia and thrombocytopenia are common among Chinese adults with newly diagnosed HIV/AIDS; and lower CD4 count is associated with an increased risk of both leukopenia and thrombocytopenia. We propose that a routine assessment of these parameters is necessary for timely and adequate clinical management.

Impact of gender on the risk of AIDS-defining illnesses and mortality in Danish HIV-1-infected patients

DEFF Research Database (Denmark)

Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren

2012-01-01

Abstract Background: Gender differences in the risk of AIDS-defining illness (ADI) and mortality have been reported in the HIV-1-infected (HIV-positive) population, with conflicting findings. We aimed to assess the impact of gender on the risk of ADI and death in HIV-positive patients infected...... sexually. Methods: This was a population-based, nationwide cohort study of incident Danish HIV-positive individuals infected by sexual contact. Outcomes were progression to AIDS and death. We used Cox proportional hazards models and Poisson regression analyses to calculate the risk of progression to AIDS...... diagnosis MSM had a lower prevalence of AIDS compared to MSW. Women and MSW presented more often with tuberculosis and less often with AIDS-defining cancers compared to MSM. In the adjusted analyses we observed no differences in progression to AIDS. In the adjusted analyses of risk of death, there were...

The Development and Implementation of Cognitive Aids for Critical Events in Pediatric Anesthesia: The Society for Pediatric Anesthesia Critical Events Checklists.

Science.gov (United States)

Clebone, Anna; Burian, Barbara K; Watkins, Scott C; Gálvez, Jorge A; Lockman, Justin L; Heitmiller, Eugenie S

2017-03-01

Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event. Committee members, who represented children's hospitals from across the nation, used the recent literature and established guidelines (where available) and incorporated the expertise of colleagues at their institutions to develop these checklists, which included relevant factors to consider and steps to take in response to critical events. Human factors principles were incorporated to enhance checklist usability, facilitate error-free accomplishment, and ensure a common approach to checklist layout, formatting, structure, and design.The checklists were made available in multiple formats: a PDF version for easy printing, a mobile application, and at some institutions, a Web-based application using the anesthesia information management system. After the checklists were created, training commenced, and plans for validation were begun. User training is essential for successful implementation and should ideally include explanation of the organization of the checklists; familiarization of users with the layout, structure, and formatting of the checklists; coaching in how to use the checklists in a team environment; reviewing of the items; and simulation of checklist use. Because of the rare and unpredictable nature of critical events, clinical trials that use crisis checklists are difficult to conduct

A case-control study of non-AIDS-defining cancers in a prospective cohort of HIV-infected patients.

Science.gov (United States)

Rodríguez Arrondo, Francisco; von Wichmann, Miguel Ángel; Camino, Xabier; Goenaga, Miguel Ángel; Ibarguren, Maialen; Azcune, Harkaitz; Bustinduy, María Jesús; Ferrero, Oscar; Muñoz, Josefa; Ibarra, Sofía; Aguirrebengoa, Koldo; Goicoetxea, Josune; Bereciartua, Elena; Montejo, Miguel; García, M Asunción; Martínez, Eduardo; Portu, Joseba; Metola, Luis; Silvariño, Rafael; Sarasqueta, Cristina; Arrizabalaga, Julio; Iribarren, Jose Antonio

2018-04-23

We present a case-control study of non-AIDS-defining cancers (NADCs) in a cohort of HIV-infected patients where we value the incidence, survival and prognostic factors of mortality. All NADCs diagnosis conducted from 2007 to 2011 in 7 hospitals were collected prospectively, with a subsequent follow up until December 2013. A control group of 221 HIV patients without a diagnosis of cancer was randomly selected. Two hundred and twenty-one NADCs were diagnosed in an initial cohort of 7,067 HIV-infected patients. The most common were: hepatocellular carcinoma 20.5%, lung 18.7%, head and neck 11.9% and anal 10.5%. The incidence rate of NADCs development was 7.84/1,000 people-year. In addition to aging and smoking, time on ART (OR 1.11; 95% CI 1.05-1.17) and PI use (OR 1.72; 95% CI 1.0-2.96) increased the risk of developing a NADC. During follow-up 53.42% died, with a median survival time of 199.5 days. In the analysis of the prognostic factors of mortality the low values of CD4 at tumour diagnosis (OR 0.99; 95% CI 0.99-1.0; P=.033), and the previous diagnosis of AIDS (OR 2.06; 95% CI 1.08-3.92) were associated with higher mortality. Predictors of NADCs in our cohort were age, smoking, CD4 lymphocytes and time on ART. Mortality is high, with NADC risk factors being low CD4 count and previous diagnosis of AIDS. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS.

Science.gov (United States)

Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

2013-01-11

The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women "where they are"; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately assess the effectiveness of women-specific services on HIV

Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS

Science.gov (United States)

Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

2013-01-01

Introduction The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. Methods A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. Results and discussion The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women “where they are”; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. Conclusions This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately

Defining molecular initiating events in the adverse outcome pathway framework for risk assessment.

Science.gov (United States)

Allen, Timothy E H; Goodman, Jonathan M; Gutsell, Steve; Russell, Paul J

2014-12-15

Consumer and environmental safety decisions are based on exposure and hazard data, interpreted using risk assessment approaches. The adverse outcome pathway (AOP) conceptual framework has been presented as a logical sequence of events or processes within biological systems which can be used to understand adverse effects and refine current risk assessment practices in ecotoxicology. This framework can also be applied to human toxicology and is explored on the basis of investigating the molecular initiating events (MIEs) of compounds. The precise definition of the MIE has yet to reach general acceptance. In this work we present a unified MIE definition: an MIE is the initial interaction between a molecule and a biomolecule or biosystem that can be causally linked to an outcome via a pathway. Case studies are presented, and issues with current definitions are addressed. With the development of a unified MIE definition, the field can look toward defining, classifying, and characterizing more MIEs and using knowledge of the chemistry of these processes to aid AOP research and toxicity risk assessment. We also present the role of MIE research in the development of in vitro and in silico toxicology and suggest how, by using a combination of biological and chemical approaches, MIEs can be identified and characterized despite a lack of detailed reports, even for some of the most studied molecules in toxicology.

Dialectical Behavior Therapy for Substance Abusers Adapted for Persons Living with HIV/AIDS with Substance Use Diagnoses and Borderline Personality Disorder

Science.gov (United States)

Wagner, Elizabeth E.; Miller, Alec L.; Greene, Lori I.; Winiarski, Mark G.

2004-01-01

The primary aim of this article is to describe modifications made to Dialectical Behavior Therapy (DBT) for a predominantly ethnic minority population of persons living with HIV/AIDS with substance-use diagnoses and borderline personality disorder (BPD) or three features of BPD plus suicidality (i.e., the triply diagnosed). Despite the myriad…

Diagnosing causes of extreme aerosol optical depth events

Science.gov (United States)

Bernstein, D. N.; Sullivan, R.; Crippa, P.; Thota, A.; Pryor, S. C.

2017-12-01

Aerosol burdens and optical properties exhibit substantial spatiotemporal variability, and simulation of current and possible future aerosol burdens and characteristics exhibits relatively high uncertainty due to uncertainties in emission estimates and in chemical and physical processes associated with aerosol formation, dynamics and removal. We report research designed to improve understanding of the causes and characteristics of extreme aerosol optical depth (AOD) at the regional scale, and diagnose and attribute model skill in simulating these events. Extreme AOD events over the US Midwest are selected by identifying all dates on which AOD in a MERRA-2 reanalysis grid cell exceeds the local seasonally computed 90th percentile (p90) value during 2004-2016 and then finding the dates on which the highest number of grid cells exceed their local p90. MODIS AOD data are subsequently used to exclude events dominated by wildfires. MERRA-2 data are also analyzed within a synoptic classification to determine in what ways the extreme AOD events are atypical and to identify possible meteorological `finger-prints' that can be detected in regional climate model simulations of future climate states to project possible changes in the occurrence of extreme AOD. Then WRF-Chem v3.6 is applied at 12-km resolution and regridded to the MERRA-2 resolution over eastern North America to quantify model performance, and also evaluated using in situ measurements of columnar AOD (AERONET) and near-surface PM2.5 (US EPA). Finally the sensitivity to (i) spin-up time (including procedure used to spin-up the chemistry), (ii) modal versus sectional aerosol schemes, (iii) meteorological nudging, (iv) chemistry initial and boundary conditions, and (v) anthropogenic emissions is quantified. Despite recent declines in mean AOD, supraregional (> 1000 km) extreme AOD events continue to occur. During these events AOD exceeds 0.6 in many Midwestern grid cells for multiple consecutive days. In all

Sexuality of adolescents living with HIV/AIDS: sources of information defining learning

Directory of Open Access Journals (Sweden)

Graciela Dutra Sehnem

2018-01-01

Full Text Available ABSTRACT Objective: To know the sources of information of adolescents living with HIV/AIDS that define learning about sexuality. Methods: A qualitative study was performed in a Specialized Care Service of a city in the state of Rio Grande do Sul, Southern Brazil, with 15 adolescents living with HIV/AIDS. A semi-structured interview and thematic analysis were used. Results: Adolescents have built up their knowledge about sexuality, especially through relationships with friends and older family members, or through access to media sources. Schools and health services were spaces for sharing information about biological aspects of sexuality. Conclusion: Nurses need to address adolescent sexuality beyond the biological dimension and support it through critical and dialogical health education.

The Reinforcing Event (RE) Menu

Science.gov (United States)

Addison, Roger M.; Homme, Lloyd E.

1973-01-01

A motivational system, the Contingency Management System, uses contracts in which some amount of defined task behavior is demanded for some interval of reinforcing event. The Reinforcing Event Menu, a list of high probability reinforcing behaviors, is used in the system as a prompting device for the learner and as an aid for the administrator in…

Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV?

DEFF Research Database (Denmark)

Mocroft, Amanda; Laut, Kamilla; Reiss, Peter

2018-01-01

, viral load ≥10,000 copies/ml], low risk [CD4 ≥500/mm, viral load events. RESULTS: 16839...... differences in patient management as well as underlying socioeconomic circumstances. The difference between those at high, intermediate and low risk of non-AIDS ≥2013 likely reflects better quality of care....

Defining initiating events for purposes of probabilistic safety assessment

International Nuclear Information System (INIS)

1993-09-01

This document is primarily directed towards technical staff involved in the performance or review of plant specific Probabilistic Safety Assessment (PSA). It highlights different approaches and provides typical examples useful for defining the Initiating Events (IE). The document also includes the generic initiating event database, containing about 300 records taken from about 30 plant specific PSAs. In addition to its usefulness during the actual performance of a PSA, the generic IE database is of the utmost importance for peer reviews of PSAs, such as the IAEA's International Peer Review Service (IPERS) where reference to studies on similar NPPs is needed. 60 refs, figs and tabs

Defining the optimal cut-off values for liver enzymes in diagnosing blunt liver injury.

Science.gov (United States)

Koyama, Tomohide; Hamada, Hirohisa; Nishida, Masamichi; Naess, Paal A; Gaarder, Christine; Sakamoto, Tetsuya

2016-01-25

Patients with blunt trauma to the liver have elevated levels of liver enzymes within a short time post injury, potentially useful in screening patients for computed tomography (CT). This study was performed to define the optimal cut-off values for serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in patients with blunt liver injury diagnosed with contrast enhanced multi detector-row CT (CE-MDCT). All patients admitted from May 2006 to July 2013 to Teikyo University Hospital Trauma and Critical Care Center, and who underwent abdominal CE-MDCT within 3 h after blunt trauma, were retrospectively enrolled. Using receiver operating characteristic (ROC) curve analysis, the optimal cut-off values for AST and ALT were defined, and sensitivity and specificity were calculated. Of a total of 676 blunt trauma patients 64 patients were diagnosed with liver injury (Group LI+) and 612 patients without liver injury (Group LI-). Group LI+ and LI- were comparable for age, Revised Trauma Score, and Probability of survival. The groups differed in Injury Severity Score [median 21 (interquartile range 9-33) vs. 17 (9-26) (p tool for CT scan in patients otherwise eligible for observation only or as a transfer criterion to a facility with CT scan capability.

Cashing In or Cashing Out: Tools for Measuring the Effectiveness & Outcomes of Financial Aid Events

Science.gov (United States)

Kennedy, Brianna; Oliverez, Paz M.; Tierney, William G.

2007-01-01

Financial aid-related information and services are provided to students and families in a variety of ways. The timing of when information is shared with these groups also varies. Financial aid information is typically provided through events sponsored by high schools, colleges and universities, and multiple community and government-sponsored…

The clinical impact of continuing to prescribe antiretroviral therapy in patients with advanced AIDS who manifest no virologic or immunologic benefit.

Directory of Open Access Journals (Sweden)

David A Wohl

Full Text Available Despite the efficacy and tolerability of modern antiretroviral therapy (ART, many patients with advanced AIDS prescribed these regimens do not achieve viral suppression or immune reconstitution as a result of poor adherence, drug resistance, or both. The clinical outcomes of continued ART prescription for such patients have not been well characterized.We examined the causes and predictors of all-cause mortality, AIDS-defining conditions, and serious non-AIDS-defining events among a cohort of participants in a clinical trial of pre-emptive therapy for CMV disease. We focused on participants who, despite ART had failed to achieve virologic suppression and substantive immune reconstitution.233 ART-receiving participants entered with a median baseline CD4+ T cell count of 30/mm(3 and plasma HIV RNA of 5 log10 copies/mL. During a median 96 weeks of follow-up, 24.0% died (a mortality rate of 10.7/100 patient-years; 27.5% reported a new AIDS-defining condition, and 22.3% a new serious non-AIDS event. Of the deaths, 42.8% were due to an AIDS-defining condition, 44.6% were due to a non-AIDS-defining condition, and 12.5% were of unknown etiology. Decreased risk of mortality was associated with baseline CD4+ T cell count ≥25/mm(3 and lower baseline HIV RNA.Among patients with advanced AIDS prescribed modern ART who achieve neither virologic suppression nor immune reconstitution, crude mortality percentages appear to be lower than reported in cohorts of patients studied a decade earlier. Also, in contrast to the era before modern ART became available, nearly half of the deaths in our modern-era study were caused by serious non-AIDS-defining events. Even among the most advanced AIDS patients who were not obtaining apparent immunologic and virologic benefit from ART, continued prescription of these medications appears to alter the natural history of AIDS--improving survival and shifting the causes of death from AIDS- to non-AIDS-defining conditions.

Using Weighted Constraints to Diagnose Errors in Logic Programming--The Case of an Ill-Defined Domain

Science.gov (United States)

Le, Nguyen-Thinh; Menzel, Wolfgang

2009-01-01

In this paper, we introduce logic programming as a domain that exhibits some characteristics of being ill-defined. In order to diagnose student errors in such a domain, we need a means to hypothesise the student's intention, that is the strategy underlying her solution. This is achieved by weighting constraints, so that hypotheses about solution…

Malignancies in HIV/AIDS patients attending an outpatient clinic in Vitória, State of Espírito Santo, Brazil

Directory of Open Access Journals (Sweden)

Lauro Ferreira da Silva Pinto Neto

2012-12-01

Full Text Available INTRODUCTION: The present study investigated cancer prevalence and associated factors among HIV-infected individuals attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. METHODS: A sectional study was conducted among HIV infected adults attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. Demographic, epidemiological and clinical data were abstracted from medical records, including cancer diagnoses; nadir and current CD4 cell count, HIV viral load, time on antiretroviral treatment (ART, type of ART and smoking status. RESULTS: A total of 730 (91.3% patients were included in the study. Median age was 44.0 [interquartile range (IQR: 35-50.3] years; median time since HIV diagnosis was 5.5 years (IQR: 2-10; 60% were male; and 59% were white. Thirty (4.1% cases of cancer were identified of which 16 (53% were AIDS defining cancers and 14 (47% were non-AIDS defining malignancies. Patients diagnosed with cancer presented higher chance of being tobacco users [OR 2.2 (95% CI: 1.04-6.24]; having nadir CD4 ≤200 cells/mm³ [OR 3.0 (95% CI: 1.19-7.81] and higher lethality [OR 13,3 (95% CI: 4,57-38,72]. CONCLUSIONS: These results corroborate the importance of screening for and prevention of non-AIDS defining cancers focus in HIV-infected population, as these cancers presented with similar frequency as AIDS defining cancers.

Unchanged Levels of Soluble CD14 and IL-6 Over Time Predict Serious Non-AIDS Events in HIV-1-Infected People

Science.gov (United States)

Sunil, Meena; Nigalye, Maitreyee; Somasunderam, Anoma; Martinez, Maria Laura; Yu, Xiaoying; Arduino, Roberto C.; Bell, Tanvir K.

2016-01-01

Abstract HIV-1-infected persons have increased risk of serious non-AIDS events (SNAEs) despite suppressive antiretroviral therapy. Increased circulating levels of soluble CD14 (sCD14), soluble CD163 (sCD163), and interleukin-6 (IL-6) at a single time point have been associated with SNAEs. However, whether changes in these biomarker levels predict SNAEs in HIV-1-infected persons is unknown. We hypothesized that greater decreases in inflammatory biomarkers would be associated with fewer SNAEs. We identified 39 patients with SNAEs, including major cardiovascular events, end stage renal disease, decompensated cirrhosis, non-AIDS-defining malignancies, and death of unknown cause, and age- and sex-matched HIV-1-infected controls. sCD14, sCD163, and IL-6 were measured at study enrollment (T1) and proximal to the event (T2) or equivalent duration in matched controls. Over ∼34 months, unchanged rather than decreasing levels of sCD14 and IL-6 predicted SNAEs. Older age and current illicit substance abuse, but not HCV coinfection, were associated with SNAEs. In a multivariate analysis, older age, illicit substance use, and unchanged IL-6 levels remained significantly associated with SNAEs. Thus, the trajectories of sCD14 and IL-6 levels predict SNAEs. Interventions to decrease illicit substance use may decrease the risk of SNAEs in HIV-1-infected persons. PMID:27344921

Clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre in Kashmir

International Nuclear Information System (INIS)

Mir, M.A.; Ahmad, P.M.; Siddeque, M.A.; Sofi, F.A.; Ahmad, S.N.; Dar, M.R.

2010-01-01

Objectives: To study the clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre. Methods: The study was conducted on a group of 1141 patients suspected of having HIV/AIDS on clinical grounds. Screening was done using different Elisa's as advised by NACO and those confirmed as HIV positive were studied for their clinical spectrum and different demographic parameters. Results: Out of 1141 patients tested, 26 proved to have HIV 1 infection with no case of HIV 2 detected. Mean age of presentation was 40.04 +- 7 years, main age group affected 31-40 years and a male: female ratio of 4.2:1 was observed. More than 42% were non Kashmiris with armed forces outnumbering all other occupational classes. Heterosexual transmission was the commonest with married out numbering unmarried. Fever, asthenia and weight loss were the predominant symptoms and pulmonary tuberculosis and oropharyngeal candidiasis commonest opportunistic infections. Conclusion: The clinical and demographic profile of HIV/AIDS patients in Kashmir is largely similar to the rest of India. Kashmir no longer stands immune to the menace of HIV/AIDS. With increasing globalization, frequent travel and change in social values the state is likely to witness an alarming rise in new cases unless a multi pronged approach is undertaken to control the spread. (author)

Relationships of different types of event to cardiovascular death in trials of antihypertensive treatment: an aid to definition of total cardiovascular disease risk in hypertension.

Science.gov (United States)

Zambon, Antonella; Arfè, Andrea; Corrao, Giovanni; Zanchetti, Alberto

2014-03-01

Guidelines for management of cardiovascular diseases stratify absolute cardiovascular risk into categories with a high-risk threshold defined at a 20% cardiovascular events risk in 10 years, but it is unclear whether only major events or the Framingham-extended definition should be considered. The 2013 ESH-ESC hypertension guidelines, instead, define cardiovascular risk as a risk of cardiovascular death in 10 years, as in the SCORE model, setting the threshold for high risk at the 5% level. It would be therefore convenient to know the quantitative relationship between the risks of the different outcomes adopted by the different guidelines, especially because some outcome definitions include serious nonfatal cardiovascular events relevant in cardiovascular prevention. We have therefore analysed these relationships in trials of antihypertensive therapy as an aid to defining total cardiovascular risk in hypertensive patients. Sixty-one trials were identified, and 51 retained for analysis of the relationship of cardiovascular death to the incidence of all-cause death, major cardiovascular events and inclusive (Framingham) cardiovascular events. The relationship between cardiovascular death rates and each type of event rates was explored by fitting flexible regression models. The included trials provided 15164 cardiovascular deaths and 1674427 patient-years. The relation of each event rate to cardiovascular death rate was best explained by a model considering the logarithm of each event rate as a dependent variable and the logarithm of cardiovascular death rate as a predictor. Mean patients' age and treatment were also predictors, but to a minor extent. The increase of the incidence rates of all types of events was less steep the higher the CV death rate: the rate ratios of all-cause death to cardiovascular death were 2.2, 1.9 and 1.8 at low-moderate (cardiovascular death hypertensive patients whose cardiovascular death risk is calculated by the SCORE model.

Positive future orientation as a mediator between traumatic events and mental health among children affected by HIV/AIDS in rural China.

Science.gov (United States)

Zhang, Jintao; Zhao, Guoxiang; Li, Xiaoming; Hong, Yan; Fang, Xiaoyi; Barnett, Douglas; Lin, Xiuyun; Zhao, Junfeng; Zhang, Liying

2009-12-01

The current study was designed to explore the effect of future orientation in mediating the relationship between traumatic events and mental health in children affected by HIV/AIDS in rural China. Cross-sectional data were collected from 1221 children affected by HIV/AIDS (755 AIDS orphans and 466 vulnerable children). Future orientation among children was measured using three indicators (future expectation, hopefulness toward the future, and perceived control over the future). Measures of mental health consisted of depression, loneliness, and self-esteem. Children's experience of any traumatic events was measured using a modified version of the Life Incidence of Traumatic Events-Student Form. Mediation analysis was conducted using structural equation modeling (SEM) methods. Among the children surveyed, most of the traumatic indicators were negatively associated with future expectation, hopefulness, perceived control, and self-esteem, and positively associated with depression and loneliness. The SEM of mediation analysis demonstrated an adequate fit. Future orientation fully mediated the relationship between traumatic events and mental health and accounted for 67.9% of the total effect of traumatic events on mental health. Results of this study support the positive effect of future expectation in mediating the relationship between traumatic events and mental health among children affected by HIV/AIDS in China. Future mental health promotion and intervention efforts targeting children affected by HIV/AIDS should include components that can mitigate the negative impact of traumatic events on their lives. These components may aim to develop children's positive future expectations, increase their hopefulness toward the future, and improve their perceived control over the future.

Impact of public health strategies on reducing AIDS mortality in southern Brazil.

Science.gov (United States)

Raboni, Sonia M; Ribeiro, Clea E; Almeida, Sergio M; Telles, João Paulo M; Azevedo, Marcos; Schaitza, Gustavo A

2017-01-01

In Brazil, all patients who fulfill the criteria for AIDS have had free access to antiretroviral therapy since 1996. We performed this cross-sectional study to evaluate the causes of death among 643 HIV-infected patients over three non-consecutive years (2000, 2006, and 2010), using their epidemiological, clinical, and laboratory data. The causes of death were classified as AIDS-defining or non-AIDS-defining conditions. We observed a progressive increase in the prevalence of HIV infection over the study period, although there was also a decrease in the mortality rate for various groups, and especially among pediatric patients. An AIDS-defining condition was recorded as the cause of death for approximately 30% of the patients. There was also a high frequency (>70%) of infectious and parasitic diseases, including opportunistic infections, and the most common diagnoses were septicemia, pneumonia, tuberculosis, and pneumocystosis. Acute respiratory failure was the underlying cause of death in 30% of these cases. Despite advances in HIV therapy, the mortality rate remains high in Brazil. As few Brazilian studies have investigated HIV/AIDS-related mortality, it is important to evaluate and improve the mortality notification databases, in order to provide information regarding the effects of HIV and to guide the implementation of appropriate healthcare measures.

Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

NARCIS (Netherlands)

Lodi, Sara; Del Amo, Julia; Moreno, Santiago; Bucher, Heiner C.; Furrer, Hansjakob; Logan, Roger; Sterne, Jonathan; Pérez-Hoyos, Santiago; Jarrín, Inma; Phillips, Andrew; Olson, Ashley; Van Sighem, Ard; Reiss, Peter; Sabin, Caroline; Jose, Sophie; Justice, Amy; Goulet, Joseph; Miró, José M.; Ferrer, Elena; Meyer, Laurence; Seng, Rémonie; Vourli, Georgia; Antoniadou, Anastasia; Dabis, Francois; Vandenhede, Mari-Anne; Costagliola, Dominique; Abgrall, Sophie; Hernán, Miguel A.; Hernan, Miguel; Bansi, L.; Hill, T.; Sabin, C.; Dunn, D.; Porter, K.; Glabay, A.; Orkin, C.; Thomas, R.; Jones, K.; Fisher, M.; Perry, N.; Pullin, A.; Churchill, D.; Gazzard, B.; Nelson, M.; Asboe, D.; Bulbeck, S.; Mandalia, S.; Clarke, J.; Delpech, V.; Anderson, J.; Munshi, S.; Post, F.; Easterbrook, P.; Khan, Y.; Patel, P.; Karim, F.; Duffell, S.; Gilson, R.; Man, S.-L.; Williams, I.; Gompels, M.; Dooley, D.; Schwenk, A.; Ainsworth, J.; Johnson, M.; Youle, M.; Lampe, F.; Smith, C.; Grabowska, H.; Chaloner, C.; Ismajani Puradiredja, D.; Bansi, L.; Hill, T.; Phillips, A.; Sabin, C.; Walsh, J.; Weber, J.; Kemble, C.; Mackie, N.; Winston, A.; Leen, C.; Wilson, A.; Bezemer, D.O.; Gras, L.A.J.; Kesselring, A.M.; Van Sighem, A.I.; Zaheri, S.; Van Twillert, G.; Kortmann, W.; Branger, J.; Prins, J.M.; Kuijpers, T.W.; Scherpbier, H.J.; Van Der Meer, J.T.M.; Wit, F.W.M.N.; Godfried, M.H.; Reiss, P.; Van Der Poll, T.; Nellen, F.J.B.; Lange, J.M.A.; Geerlings, S.E.; Van Vugt, M.; Pajkrt, D.; Bos, J.C.; van der Valk, M.; Grijsen, M.L.; Wiersinga, W.J.; Brinkman, K.; Blok, W.L.; Frissen, P.H.J.; Schouten, W.E.M.; Van Den Berk, G.E.L.; Veenstra, J.; Lettinga, K.D.; Mulder, J.W.; Vrouenraets, S.M.E.; Lauw, F.N.; Van Eeden, A.; Verhagen, D.W.M.; Van Agtmael, M.A.; Perenboom, R.M.; Claessen, F.A.P.; Bomers, M.; Peters, E.J.G.; Richter, C.; Van Der Berg, J.P.; Gisolf, E.H.; Schippers, E.F.; Van Nieuwkoop, C.; Van Elzakker, E.P.; Leyten, E.M.S.; Gelinck, L.B.S.; Pronk, M.J.H.; Bravenboer, B.; Kootstra, G.J.; Delsing, C.E.; Sprenger, H.G.; Doedens, R.; Scholvinck, E.H.; Van Assen, S.; Bierman, W.F.W.; Soetekouw, R.; Ten Kate, R.W.; Van Vonderen, M.G.A.; Van Houte, D.P.F.; Kroon, F.P.; Van Dissel, J.T.; Arend, S.M.; De Boer, M.G.J.; Jolink, H.; Ter Vollaard, H.J.M.; Bauer, M.P.; Weijer, S.; El Moussaoui, R.; Lowe, S.; Schreij, G.; Oude Lashof, A.; Posthouwer, D.; Koopmans, P.P.; Keuter, M.; Van Der Ven, A.J.A.M.; Ter Hofstede, H.J.M.; Dofferhoff, A.S.M.; Warris, A.; Van Crevel, R.; van der Ende, Marchina E.; De Vries-Sluijs, T.E.M.S.; Schurink, C.A.M.; Nouwen, J.L.; Nispen Tot Pannerden, M.H.; Verbon, A.; Rijnders, B.J.A.; Van Gorp, E.C.M.; Hassing, R.J.; Smeulders, A.W.M.; Hartwig, N.G.; Driessen, G.J.A.; Den Hollander, J.G.; Pogany, K.; Juttmann, J.R.; Van Kasteren, M.E.E.; Hoepelman, A.I.M.; Mudrikova, T.; Schneider, M.M.E.; Jaspers, C.A.J.J.; Ellerbroek, P.M.; Oosterheert, J.J.; Arends, J.E.; Wassenberg, M.W.M.; Barth, R.E.; Geelen, S.P.M.; Wolfs, T.F.W.; Bont, L.J.; Van Den Berge, M.; Stegeman, A.; Groeneveld, P.H.P.; Alleman, M.A.; Bouwhuis, J.W.; Barin, F.; Burty, C.; Duvivier, C.; Enel, P.; Fredouille-Heripret, L.; Gasnault, J.; Khuong, M.A.; Mahamat, A.; Pilorgé, F.; Tattevin, P.; Salomon, Valérie; Jacquemet, N.; Abgrall, S.; Costagliola, D.; Grabar, S.; Guiguet, M.; Lanoy, E.; Lièvre, L.; Mary-Krause, M.; Selinger-Leneman, H.; Lacombe, J.M.; Potard, V.; Bricaire, F.; Herson, S.; Katlama, C.; Simon, A.; Desplanque, N.; Girard, P.M.; Meynard, J.L.; Meyohas, M.C.; Picard, O.; Cadranel, J.; Mayaud, C.; Pialoux, G.; Clauvel, J.P.; Decazes, J.M.; Gerard, L.; Molina, J.M.; Diemer, M.; Sellier, P.; Bentata, M.; Honoré, P.; Jeantils, V.; Tassi, S.; Mechali, D.; Taverne, B.; Bouvet, E.; Crickx, B.; Ecobichon, J.L.; Matheron, S.; Picard-Dahan, C.; Yeni, P.; Berthé, H.; Dupont, C.; Chandemerle, C.; Mortier, E.; De Truchis, P.; Tisne-Dessus, D.; Weiss, L.; Salmon, D.; Auperin, I.; Gilquin, J.; Roudière, L.; Viard, J.P.; Boué, F.; Fior, R.; Delfraissy, J.F.; Goujard, C.; Jung, C.; Lesprit, Ph.; Vittecoq, D.; Fraisse, P.; Lang, J.M.; Rey, D.; Beck-Wirth, G.; Stahl, J.P.; Lecercq, P.; Gourdon, F.; Laurichesse, H.; Fresard, A.; Lucht, F.; Bazin, C.; Verdon, R.; Chavanet, P.; Arvieux, C.; Michelet, C.; Choutet, P.; Goudeau, A.; Maître, M.F.; Hoen, B.; Eglinger, P.; Faller, J.P.; Borsa-Lebas, F.; Caron, F.; Reynes, J.; Daures, J.P.; May, T.; Rabaud, C.; Berger, J.L.; Rémy, G.; Arlet-Suau, E.; Cuzin, L.; Massip, P.; Thiercelin Legrand, M.F.; Pontonnier, G.; Viget, N.; Yasdanpanah, Y.; Dellamonica, P.; Pradier, C.; Pugliese, P.; Aleksandrowicz, K.; Quinsat, D.; Ravaux, I.; Tissot-Dupont, H.; Delmont, J.P.; Moreau, J.; Gastaut, J.A.; Poizot-Martin, I.; Retornaz, F.; Soubeyrand, J.; Galinier, A.; Ruiz, J.M.; Allegre, T.; Blanc, P.A.; Bonnet-Montchardon, D.; Lepeu, G.; Granet-Brunello, P.; Esterni, J.P.; Pelissier, L.; Cohen-Valensi, R.; Nezri, M.; Chadapaud, S.; Laffeuillade, A.; Billaud, E.; Raffi, F.; Boibieux, A.; Peyramond, D.; Livrozet, J.M.; Touraine, J.L.; Cotte, L.; Trepo, C.; Strobel, M.; Bissuel, F.; Pradinaud, R.; Sobesky, M.; Cabié, A.; Gaud, C.; Contant, M.; Aubert, V.; Barth, J.; Battegay, M.; Bernasconi, E.; Böni, J.; Bucher, H.C.; Burton-Jeangros, C.; Calmy, A.; Cavassini, M.; Egger, M.; Elzi, L.; Fehr, J.; Fellay, J.; Furrer, H.; Haerry, D.; Fux, C.A.; Gorgievski, M.; Günthard, H.; Hasse, B.; Hirsch, H.H.; Hösli, I.; Kahlert, C.; Kaiser, L.; Keiser, O.; Klimkait, T.; Kovari, H.; Ledergerber, B.; Martinetti, G.; Martinez De Tejada, B.; Metzner, K.; Müller, N.; Nadal, D.; Pantaleo, G.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schultze, D.; Schöni-Affolter, F.; Schüpbach, J.; Speck, R.; Taffé, P.; Tarr, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Weber, R.; Yerly, S.; Casabona, J.; Gallois, A.; Esteve, A.; Podzamczer, D.; Murillas, J.; Gatell, J.M.; Manzardo, C.; Tural, C.; Clotet, B.; Ferrer, E.; Riera, M.; Segura, F.; Navarro, G.; Force, L.; Vilaró, J.; Masabeu, A.; García, I.; Guadarrama, M.; Cifuentes, C.; Dalmau, D.; Jaen, À.; Agustí, C.; Montoliu, A.; Pérez, I.; Gargoulas, Freyra; Blanco, J.L.; Garcia-Alcaide, F.; Martínez, E.; Mallolas, J.; López-Dieguez, M.; García-Goez, J.F.; Sirera, G.; Romeu, J.; Jou, A.; Negredo, E.; Miranda, C.; Capitan, M.C.; Saumoy, M.; Imaz, A.; Tiraboschi, J.M.; Murillo, O.; Bolao, F.; Peña, C.; Cabellos, C.; Masó, M.; Vila, A.; Sala, M.; Cervantes, M.; Jose Amengual, Ma.; Navarro, M.; Penelo, E.; Barrufet, P.; Bejarano, G.; Molina, J.; Guadarrama, M.; Alvaro, M.; Mercadal, J.; Fernandez, Juanse; Ospina, Jesus E.; Muñoz, M.A.; Caro-Murillo, A.M.; Sobrino, P.; Jarrín, I.; Gomez Sirvent, J.L.; Rodríguez, P.; Aleman, M.R.; Alonso, M.M.; Lopez, A.M.; Hernandez, M.I.; Soriano, V.; Labarga, P.; Barreiro, P.; Medrano, J.; Rivas, P.; Herrero, D.; Blanco, F.; Vispo, M.E.; Martín, L.; Ramírez, G.; De Diego, M.; Rubio, R.; Pulido, F.; Moreno, V.; Cepeda, C.; Hervás, Rl.; Iribarren, J.A.; Arrizabalaga, J.; Aramburu, M.J.; Camino, X.; Rodrí-guez-Arrondo, F.; Von Wichmann, M.A.; Pascual, L.; Goenaga, M.A.; Gutierrez, F.; Masia, M.; Ramos, J.M.; Padilla, S.; Sanchez-Hellín, V.; Bernal, E.; Escolano, C.; Montolio, F.; Peral, Y.; Berenguer, J.; Lopez, J.C.; Miralles, P.; Cosín, J.; Sanchez, M.; Gutierrez, I.; Ramírez, M.; Padilla, B.; Vidal, F.; Sanjuan, M.; Peraire, J.; Veloso, S.; Vilades, C.; Lopez-Dupla, M.; Olona, M.; Vargas, M.; Aldeguer, J.L.; Blanes, M.; Lacruz, J.; Salavert, M.; Montero, M.; Cuéllar, S.; De Los Santos, I.; Sanz, J.; Oteo, J.A.; Blanco, J.R.; Ibarra, V.; Metola, L.; Sanz, M.; Pérez-Martínez, L.; Sola, J.; Uriz, J.; Castiello, J.; Reparaz, J.; Arriaza, M.J.; Irigoyen, C.; Moreno, S.; Antela, A.; Casado, J.L.; Dronda, F.; Moreno, A.; Pérez, M.J.; López, D.; Gutiérrez, C.; Hernández, B.; Pumares, M.; Martí, P.; García, L.; Page, C.; García, F.; Hernández, J.; Peña, A.; Muñoz, L.; Parra, J.; Viciana, P.; Leal, M.; López-Cortés, L.F.; Trastoy, M.; Mata, R.; Justice, A.C.; Fiellin, D.A.; Rimland, D.; Jones-Taylor, C.; Oursler, K.A.; Titanji, R.; Brown, S.; Garrison, S.; Rodriguez-Barradas, M.; Masozera, N.; Goetz, M.; Leaf, D.; Simberkoff, M.; Blumenthal, D.; Leung, J.; Butt, A.; Hoffman, E.; Gibert, C.; Peck, R.; Mattocks, K.; Braithwaite, S.; Brandt, C.; Bryant, K.; Cook, R.; Conigliaro, J.; Crothers, K.; Chang, J.; Crystal, S.; Day, N.; Erdos, J.; Freiberg, M.; Kozal, M.; Gandhi, N.; Gaziano, M.; Gerschenson, M.; Good, B.; Gordon, A.; Goulet, J.L.; Hernán, M.A.; Kraemer, K.; Lim, J.; Maisto, S.; Miller, P.; Mole, L.; O'Connor, P.; Papas, R.; Robins, J.M.; Rinaldo, C.; Roberts, M.; Samet, J.; Tierney, B.; Whittle, J.; Babiker, A.; Brettle, R.; Darbyshire, J.; Gilson, R.; Goldberg, D.; Hawkins, D.; Jaffe, H.; Johnson, A.; McLean, K.; Pillay, D.; Cursley, Adam; Ewings, Fiona; Fairbrother, Keith; Louisa Gnatiuc, S.L.; Murphy, Brendan; Douglas, G.; Kennedy, N.; Pritchard, J.; Andrady, U.; Rajda, N.; Maw, R.; McKernan, S.; Drake, S.; Gilleran, G.; White, D.; Ross, J.; Toomer, S.; Hewart, R.; Wilding, H.; Woodward, R.; Dean, G.; Heald, L.; Horner, P.; Glover, S.; Bansaal, D.; Eduards, S.; Carne, C.; Browing, M.; Das, R.; Stanley, B.; Estreich, S.; Magdy, A.; O'Mahony, C.; Fraser, P.; Hayman, B.; Jebakumar, S.P.R.; Joshi, U.; Ralph, S.; Wade, A.; Mette, R.; Lalik, J.; Summerfield, H.; El-Dalil, A.; France, J.A.; White, C.; Robertson, R.; Gordon, S.; McMillan, S.; Morris, S.; Lean, C.; Vithayathil, K.; McLean, L.; Winter, A.; Gale, D.; Jacobs, S.; Tayal, S.; Short, L.; Roberts, M.; Green, S.; Williams, G.; Sivakumar, K.; Bhattacharyya, N.D.; Monteiro, E.; Minton, J.; Dhar, J.; Nye, F.; De Souza, C.B.; Isaksen, A.; McDonald, L.; McLean, K.; Franca, A.; Hawkins, D.; William, L.; Jendrulek, I.; Peters, B.; Shaunak, S.; El-Gadi, S.; Easterbrook, P.J.; Mazhude, C.; Gilson, R.; Johnstone, R.; Fakoya, A.; McHale, J.; Waters, A.; Kegg, S.; Mitchell, S.; Byrne, P.; Johnson, M.; Rice, P.; Fidler, S.; Mullaney, S.A.; McCormack, S.; David, D.; Melville, R.; Phillip, K.; Balachandran, T.; Mabey-Puttock, S.; Sukthankar, A.; Murphy, C.; Wilkins, E.; Ahmad, S.; Tayal, S.; Haynes, J.; Evans, E.; Ong, E.; Das, R.; Grey, R.; Meaden, J.; Bignell, C.; Loay, D.; Peacock, K.; Girgis, M.R.; Morgan, B.; Palfreeman, A.; Wilcox, J.; Tobin, J.; Tucker, L.; Saeed, A.M.; Chen, F.; Deheragada, A.; Williams, O.; Lacey, H.; Herman, S.; Kinghorn, D.; Devendra, V.S.; Wither, J.; Dawson, S.; Rowen, D.; Harvey, J.; Wilkins, E.; Bridgwood, A.; Singh, G.; Chauhan, M.; Kellock, D.; Young, S.; Dannino, S.; Kathir, Y.; Rooney, G.; Currie, J.; Fitzgerald, M.; Devendra, S.; Keane, F.; Booth, G.; Green, T.; Arumainayyagam, J.; Chandramani, S.; Rajamanoharan, S.; Robinson, T.; Curless, E.; Gokhale, R.; Tariq, A.; Roberts, M.; Williams, O.; Luzzi, G.; FitzGerald, M.; Fairley, I.; Wallis, F.; Smit, E.; Ward, F.; Molina, J.M.; Loze, B.; Morlat, P.; Bonarek, M.; Bonnet, F.; Nouts, C.; Louis, I.; Raffi, F.; Reliquet, V.; Sauser, F.; Biron, C.; Mounoury, O.; Hue, H.; Brosseau, D.; Delfraissy, J.F.; Goujard, C.; Ghosn, J.; Rannou, M.T.; Bergmann, J.F.; Badsi, E.; Rami, A.; Diemer, M.; Parrinello, M.; Girard, P.M.; Samanon-Bollens, D.; Campa, P.; Tourneur, M.; Desplanques, N.; Livrozet, J.M.; Jeanblanc, F.; Chiarello, P.; Makhloufi, D.; Blanc, A.P.; Allègre, T.; Reynes, J.; Baillat, V.; Lemoing, V.; Merle De Boever, C.; Tramoni, C.; Cabié, A.; Sobesky, G.; Abel, S.; Beaujolais, V.; Pialoux, G.; Slama, L.; Chakvetadze, C.; Berrebi, V.; Yeni, P.; Bouvet, E.; Fournier, I.; Gerbe, J.; Trepo, C.; Koffi, K.; Augustin-Normand, C.; Miailhes, P.; Thoirain, V.; Brochier, C.; Thomas, R.; Souala, F.; Ratajczak, M.; Beytoux, J.; Jacomet, C.; Gourdon, F.; Rouveix, E.; Morelon, S.; Dupont, C.; Olivier, C.; Lortholary, O.; Dupont, B.; Viard, J.P.; Maignan, A.; Ragnaud, J.M.; Raymond, I.; Leport, C.; Jadand, C.; Jestin, C.; Longuet, P.; Boucherit, S.; Sereni, D.; Lascoux, C.; Prevoteau, F.; Sobel, A.; Levy, Y.; Lelièvre, J.D.; Lascaux, A.S.; Dominguez, S.; Dumont, C.; Aumâitre, H.; Delmas, B.; Saada, M.; Medus, M.; Guillevin, L.; Salmon, D.; Tahi, T.; Yazdanpanah, Y.; Pavel, S.; Marien, M.C.; Drenou, B.; Beck-Wirth, G.; Beck, C.; Benomar, M.; Katlama, C.; Tubiana, R.; Ait Mohand, H.; Chermak, A.; Ben Abdallah, S.; Bentata, M.; Touam, F.; Hoen, B.; Drobacheff, C.; Folzer, A.; Massip, P.; Obadia, M.; Prudhomme, L.; Bonnet, E.; Balzarin, F.; Pichard, E.; Chennebault, J.M.; Fialaire, P.; Loison, J.; Galanaud, P.; Boué, F.; Bornarel, D.; Verdon, R.; Bazin, C.; Six, M.; Ferret, P.; Weiss, L.; Batisse, D.; Gonzales-Canali, G.; Tisne-Dessus, D.; Devidas, A.; Chevojon, P.; Turpault, I.; Lafeuillade, A.; Cheret, A.; Philip, G.; Morel, P.; Timsit, J.; Herson, S.; Amirat, N.; Simon, A.; Brancion, C.; Cabane, J.; Picard, O.; Tredup, J.; Stein, A.; Ravault, I.; Chavanet, C.; Buisson, M.; Treuvetot, S.; Choutet, P.; Nau, P.; Bastides, F.; May, T.; Boyer, L.; Wassoumbou, S.; Oksenhendeler, E.; Gérard, L.; Bernard, L.; De Truchis, P.; Berthé, H.; Domart, Y.; Merrien, D.; Greder Belan, A.; Gayraud, M.; Bodard, L.; Meudec, A.; Beuscart, C.; Daniel, C.; Pape, E.; Vinceneux, P.; Simonpoli, A.M.; Zeng, A.; Fournier, L.; Fuzibet, J.G.; Sohn, C.; Rosenthal, E.; Quaranta, M.; Dellamonica, P.; Chaillou, S.; Sabah, M.; Audhuy, B.; Schieber, A.; Moreau, P.; Niault, M.; Vaillant, O.; Huchon, G.; Compagnucci, A.; De Lacroix Szmania, I.; Richier, L.; Lamaury, I.; Saint-Dizier, F.; Garipuy, D.; Gastaut, J.A.; Drogoul, M.P.; Poizot Martin, I.; Fabre, G.; Lambert De Cursay, G.; Abraham, B.; Perino, C.; Lagarde, P.; David, F.; Roche-Sicot, J.; Saraux, J.L.; Leprêtre, A.; Fampin, B.; Uludag, A.; Morin, A.S.; Bletry, O.; Zucman, D.; Regnier, A.; Girard, J.J.; Quinsat, D.T.; Heripret, L.; Grihon, F.; Houlbert, D.; Ruel, M.; Chemlal, K.; Caron, F.; Debab, Y.; Tremollieres, F.; Perronne, V.; Lepeu, G.; Slama, B.; Perré, P.; Miodovski, C.; Guermonprez, G.; Dulioust, A.; Boudon, P.; Malbec, D.; Patey, O.; Semaille, C.; Deville, J.; Remy, G.; Béguinot, I.; Galanaud, P.; Boue, F.; Chambrin, V.; Pignon, C.; Estocq, G.A.; Levy, A.; Delfraissy, J.F.; Goujard, C.; Duracinsky, M.; Le Bras, P.; Ngussan, M.S.; Peretti, D.; Medintzeff, N.; Lambert, T.; Segeral, O.; Lezeau, P.; Laurian, Y.; Weiss, L.; Buisson, M.; Piketty, C.; Karmochkine, M.; Batisse, D.; Eliaszewitch, M.; Jayle, D.; Tisne-Dessus, D.; Kazatchkine, M.; Leport, C.; Colasante, U.; Jadand, C.; Jestin, C.; Duval, X.; Nouaouia, W.; Boucherit, S.; Vilde, J.L.; Girard, P.M.; Bollens, D.; Binet, D.; Diallo, B.; Meyohas, M.C.; Fonquernie, L.; Lagneau, J.L.; Salmon, D.; Guillevin, L.; Tahi, T.; Launay, O.; Pietrie, M.P.; Sicard, D.; Stieltjes, N.; Michot, J.; Sobel, A.; Levy, Y.; Bourdillon, F.; Lascaux, A.S.; Lelievre, J.D.; Dumont, C.; Dupont, B.; Obenga, G.; Viard, J.P.; Maignan, A.; Vittecoq, D.; Escaut, L.; Bolliot, C.; Bricaire, F.; Katlama, C.; Schneider, L.; Herson, S.; Simon, A.; Iguertsira, M.; Stein, A.; Tomei, C.; Ravaux, I.; Dhiver, C.; Tissot Dupont, H.; Vallon, A.; Gallais, J.; Gallais, H.; Gastaut, J.A.; Drogoul, M.P.; Fabre, G.; Dellamonica, P.; Durant, J.; Mondain, V.; Perbost, I.; Cassuto, J.P.; Karsenti, J.M.; Venti, H.; Fuzibet, J.G.; Rosenthal, E.; Ceppi, C.; Quaranta, M.; Krivitsky, J.A.; Bentata, M.; Bouchaud, O.; Honore, P.; Sereni, D.; Lascoux, C.; Delgado, J.; Rouzioux, C.; Burgard, M.; Boufassa, L.; Peynet, J.; Pérez-Hoyos, S.; Del Amo, J.; Alvarez, D.; Monge, S.; Muga, R.; Sanvisens, A.; Clotet, B.; Tor, J.; Bolao, F.; Rivas, I.; Vallecillo, G.; Del Romero, J.; Raposo, P.; Rodríguez, C.; Vera, M.; Hurtado, I.; Belda, J.; Fernandez, E.; Alastrue, I.; Santos, C.; Tasa, T.; Juan, A.; Trullen, J.; Garcia De Olalla, P.; Cayla, J.; Masdeu, E.; Knobel, H.; Mirò, J.M.; Sambeat, M.A.; Guerrero, R.; Rivera, E.; Guerrero, R.; Marco, A.; Quintana, M.; Gonzalez, C.; Castilla, J.; Guevara, M.; De Mendoza, C.; Zahonero, N.; Ortíz, M.; Paraskevis, D.; Touloumi, G.; Pantazis, N.; Bakoyannis, G.; Gioukari, V.; Antoniadou, A.; Papadopoulos, A.; Petrikkos, G.; Daikos, G.; Psichogiou, M.; Gargalianos-Kakolyris, P.; Xylomenos, G.; Katsarou, O.; Kouramba, A.; Ioannidou, P.; Kordossis, T.; Kontos, A.; Lazanas, M.; Chini, M.; Tsogas, N.; Panos, G.; Paparizos, V.; Leuow, K.; Kourkounti, S.; Sambatakou, H.; Mariolis, I.; Skoutelis, A.; Papastamopoulos, V.; Baraboutis, I.

2014-01-01

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis,

Changing Patterns of lung, liver, and head and neck non-AIDS-defining cancers relative to HIV status in Tanzania between 2002-2014

Directory of Open Access Journals (Sweden)

Julee A. Campbell

2016-11-01

Full Text Available Abstract Background Tanzania, like other low-income countries, has an increasing cancer burden that remains underestimated. Infection-associated malignancies, particularly HIV-infection, represent a great proportion of cancer burden in Tanzania and throughout Africa. Availability of HIV treatment and improved survival of HIV patients are suggested factors related to increasing prevalence of non-AIDS-defining cancers (NADCs. This study examined patterns of NADCs and proportions of HIV-positivity at the Ocean Road Cancer Institute (ORCI. Methods We reviewed logbooks of all ORCI patients diagnosed and/or treated for lung, liver, and head and neck cancers during 2002–2014. The number of total cancers diagnosed at ORCI during this period was used to calculate proportions of NADCs. We abstracted medical records to obtain demographic and clinical profiles and HIV status information for 1127 patients diagnosed or treated during 2010–2014. Trends in numbers and proportions of NADCs were analyzed using Joinpoint regression. Characteristics of NADC patients were analyzed using multinomial logistic regression. Results NADCs diagnosed at ORCI increased by 33.8% from 2002 to 2014 while the proportion of NADCs relative to all cancers significantly decreased from 6.8% in 2002 to 5.6% in 2014 (APC = -2.74%. Numbers and proportions of lung and liver cancers increased compared to all cancer diagnoses from 2002 to 2014. The number of head and neck cancers increased while decreasing proportionally compared to all cancer diagnoses from 2002 to 2014. Among patients with pathologically confirmed NADCs between 2010 and 2014, HIV prevalence showed a non-statistically significant decrease from 8.1 to 7.1% (APC = -3.77%. Conclusions Absolute numbers of lung, liver, and head and neck cancers increased at ORCI by 1/3 since 2002. Improving survivorship of HIV patients and varying immunodeficiency status may have contributed to the increasing number of NADCs. Total

Defining Spaces of Potential Art: The significance of representation in computer-aided creativity

DEFF Research Database (Denmark)

Dahlstedt, Palle

2005-01-01

One way of looking at the creative process is as a search in a space of possible answers. One way of simulating such a process is through evolutionary algorithms, i.e., simulated evolution by random variation and selection. The search space is defined by the chosen genetic representation, a kind...... of formal description, and the ways of navigating the space are defined by the choice of genetic operators (e.g., mutations). In creative systems, such as computer-aided music composition tools, these choices determine the efficiency of the system, in terms of the diversity of the results, the degree...... of novelty and the coherence within the material. Based on various implementations developed during five years of research, and experiences from real-life artistic applications, I will explain and discuss these mechanisms, from a perspective of the creative artist....

An abnormal event advisory expert system prototype for reactor operators

International Nuclear Information System (INIS)

Hance, D.C.

1989-01-01

Nuclear plant operators must respond correctly during abnormal conditions in the presence of dynamic and potentially overwhelming volumes of information. For this reason, considerable effort has been directed toward the development of nuclear plant operator aids using artificial intelligence techniques. The objective of such systems is to diagnose abnormal conditions within the plant, possibly predict consequences, and advise the operators of corrective actions in a timely manner. The objective of the work is the development of a prototype expert system to diagnose abnormal events at a nuclear power plant and advise plant operators of the event and applicable procedures in an on-line mode. The major difference between this effort and previous work is the use of plant operating procedures as a knowledge source and as an integral part of the advice provided by the expert system. The acceptance by utilities of expert systems as operator aids requires that such systems be compatible with the regulatory environment and provide economic benefits. For this reason, commercially viable operator aid systems developed in the near future must complement existing plant procedures rather than reach beyond them in a revolutionary manner. A knowledge source is the resource providing facts and relationships that are coded into the expert system program. In this case, the primary source of knowledge is a set of selected abnormal operating procedures for a modern Westinghouse pressurized water reactor

Development of diagnostic criteria for serious non-AIDS events in HIV clinical trials

DEFF Research Database (Denmark)

Lifson, Alan R; Belloso, Waldo H; Davey, Richard T

2010-01-01

PURPOSE: Serious non-AIDS (SNA) diseases are important causes of morbidity and mortality in the HAART era. We describe development of standard criteria for 12 SNA events for Endpoint Review Committee (ERC) use in START, a multicenter international HIV clinical trial. METHODS: SNA definitions were...... was reached. CONCLUSION: HIV clinical trials that include SNA diseases as clinical outcomes should have standardized SNA definitions to optimize event reporting and validation and should have review by an experienced ERC with opportunities for adjudication......., peripheral arterial disease, pulmonary embolism, and stroke. Of 563 potential SNA events reported in ESPRIT and reviewed by an ERC, 72% met "confirmed" and 13% "probable" criteria. Twenty-eight percent of cases initially reviewed by the ERC required follow-up discussion (adjudication) before a final decision...

A novel GLM-based method for the Automatic IDentification of functional Events (AIDE) in fNIRS data recorded in naturalistic environments.

Science.gov (United States)

Pinti, Paola; Merla, Arcangelo; Aichelburg, Clarisse; Lind, Frida; Power, Sarah; Swingler, Elizabeth; Hamilton, Antonia; Gilbert, Sam; Burgess, Paul W; Tachtsidis, Ilias

2017-07-15

Recent technological advances have allowed the development of portable functional Near-Infrared Spectroscopy (fNIRS) devices that can be used to perform neuroimaging in the real-world. However, as real-world experiments are designed to mimic everyday life situations, the identification of event onsets can be extremely challenging and time-consuming. Here, we present a novel analysis method based on the general linear model (GLM) least square fit analysis for the Automatic IDentification of functional Events (or AIDE) directly from real-world fNIRS neuroimaging data. In order to investigate the accuracy and feasibility of this method, as a proof-of-principle we applied the algorithm to (i) synthetic fNIRS data simulating both block-, event-related and mixed-design experiments and (ii) experimental fNIRS data recorded during a conventional lab-based task (involving maths). AIDE was able to recover functional events from simulated fNIRS data with an accuracy of 89%, 97% and 91% for the simulated block-, event-related and mixed-design experiments respectively. For the lab-based experiment, AIDE recovered more than the 66.7% of the functional events from the fNIRS experimental measured data. To illustrate the strength of this method, we then applied AIDE to fNIRS data recorded by a wearable system on one participant during a complex real-world prospective memory experiment conducted outside the lab. As part of the experiment, there were four and six events (actions where participants had to interact with a target) for the two different conditions respectively (condition 1: social-interact with a person; condition 2: non-social-interact with an object). AIDE managed to recover 3/4 events and 3/6 events for conditions 1 and 2 respectively. The identified functional events were then corresponded to behavioural data from the video recordings of the movements and actions of the participant. Our results suggest that "brain-first" rather than "behaviour-first" analysis is

AIDS in Mexican prisons.

Science.gov (United States)

Olivero, J M; Roberts, J B

1995-01-01

The human rights organization Americas Watch, which toured Mexican prisons, reported in 1991 that all prisoners with HIV infection in the Mexico City area were housed in a single AIDS ward in Santa Marta Prison. In 1991, the 16-bed facility had 15 patients; in 1993, this number had increased by 5. In Mexico City, with 3 prisons holding over 2000 male adults each, there were only 20 known infected prisoners in the AIDS ward at Santa Marta. In 1991, authorities at Matamoros, in the state of Tamaulipas, insisted that none of their inmates had ever been diagnosed as infected with HIV. The prison physician at Reynosa indicated that only 2 inmates since 1985 had ever been diagnosed as infected. In 1992, the prison in Saltillo, in the state of Coahuila, reported that here had yet to be a single positive test for HIV. The prison at Reynosa held 1500 people and only 2 inmates were diagnosed as having AIDS between 1985 and 1991. Prisons at Matamoros and Saltillo held similar numbers but had no experience of infected inmates. A survey of 2 prisons in the state of Tamaulipas indicates that around 12% of the population may use IV drugs, and 9% indicate sharing needles. It is possible for prisoners to die of diseases like pneumonia, associated with AIDS, without the connection to AIDS being diagnosed. Each state, and possibly each prison in Mexico, has its own particular AIDS policies. Santa Marta was the single facility in Mexico City used to house AIDS-infected prisoners, who were segregated. Finally, the prison at Saltillo required all women entering the facility to have a medical examination, including a test for HIV. High-level prison personnel have demonstrated ignorance and fear of AIDS and intolerance of infected prisoners. Mexico must reassess the need to provide adequate medical care to offenders who are sick and dying behind bars.

Non-AIDS defining cancers in the D:A:D Study - time trends and predictors of survival : A cohort study

NARCIS (Netherlands)

Worm, Signe W.; Bower, Mark; Reiss, Peter; Bonnet, Fabrice; Law, Matthew; Fätkenheuer, Gerd; d'Arminio Monforte, Antonella; Abrams, Donald I.; Grulich, Andrew; Fontas, Eric; Kirk, Ole; Furrer, Hansjakob; Wit, Stephane D.; Phillips, Andrew; Lundgren, Jens D.; Sabin, Caroline A.; Butcher, D.; Delforge, M.; Fanti, I.; Fontas, E.; Franquet, X.; Geffard, S.; Gras, L.; Helweg-Larsen, J.; Hillebregt, M.; Kamara, D.; Kjær, J.; Krum, E.; Lundgren, J.D.; McManus, H.; Meidahl, P.; Mocroft, A.; Nielsen, J.; Phillips, A.; Powderl, W.; Rickenbach, M.; Rode, R.; Ryom, L.; Sabin, C.A.; Salbøl Brandt, R.; Schmidt Iversen, J.; Shortman, N.; Sjøl, A.; Smith, C.; Torres, F.; Tverland, J.; Wright, S.; Zaheri, S.; de Wolf, F.; Smidt, J.; Ristola, M.; Katlama, C.; Viard, J-P.; Girard, P.-M.; Livrozet, J.M.; Vanhems, P.; Pradier, C.; Dabis, F.; Neau, D.; Rockstroh, J.; Schmidt, R.; Degen, O.; van Lunzen, J.; Stellbrink, H.J.; Staszewski, S.; Bogner, J.; Fätkenheuer, G.; Gargalianos, P.; Kosmidis, J.; Perdios, J.; Xylomenos, G.; Filandras, A.; Karabatsaki, E.; Panos, G.; Sambatakou, H.; Banhegyi, D.; Mulcahy, F.; Burke, M.; Turner, D.; Yust, I.; Hassoun, G.; Pollack, S.; Maayan, S.; Vella, S.; Esposito, R.; Mazeu, I.; Mussini, C.; Arici, C.; Pristera, R.; Gabbuti, A.; Mazzotta, F.; Lichtner, M.; Vullo, V.; Boer, K.; Geerlings, S.E.; Godfried, M.H.; Kuijpers, T.W.; Lange, J.M.A.; Nellen, F.J.B.; Pajkrt, D.; Prins, J.M.; Reiss, P.; Scherpbier, H.J.; Vrouenraets, S.M.E.; Wit, F.W.M.N.; van Vugt, M.; van der Meer, J.T.M.; van der Poll, T.; van der Valk, M.; Chirianni, A.; Gargiulo, M.; Montesarchio, E.; Antonucci, G.; Narciso, P.; Testa, A.; Vlassi, C.; Zaccarelli, M.; Castagna, A.; Gianotti, N.; Lazzarin, A.; Galli, M.; Ridolfo, A.; d'Arminio Monforte, A.; Rozentale, B.; Zeltina, I.; Chaplinskas, S.; Hemmer, R.; Staub, T.; Reiss, P.; Bruun, J.; Maeland, A.; Ormaasen, V.; Lowe, S.; Oude Lashof, A.; Schreij, G.; Gasiorowski, J.; Knysz, B.; Bakowska, E.; Horban, A.; Flisiak, R.; Grzeszczuk, A.; Boron-Kaczmarska, A.; Parczewski, M.; Pynka, M.; Beniowski, M.; Mularska, E.; Trocha, H.; Jablonowska, E.; Malolepsza, E.; Wojcik, K.; Antunes, F.; Caldeira, L.; Doroana, M.; Mansinho, K.; Maltez, F.; Bravenboer, B.; Pronk, M.J.H.; Duiculescu, D.; Rakhmanova, A.; Zakharova, N.; Buzunova, S.; Jevtovic, D.; Mokráš, M.; Staneková, D.; Tomazic, J.; González-Lahoz, J.; Labarga, P.; Medrano, J.; Soriano, V.; Moreno, S.; Rodriguez, J.M.; Bravo, I.; Clotet, B.; Jou, A.; Paredes, R.; Puig, J.; Tural, C.; Gelinck, L.B.S.; Nouwen, J.L.; Rijnders, B.J.A.; Schurink, C.A.M.; Slobbe, L.; Verbon, A.; de Vries-Sluijs, T.E.M.S.; van der Ende, Marchina E.; van der Feltz, M.; Gatell, J.M.; Miró, J.M.; Domingo, P.; Gutierrez, M.; Mateo, G.; Sambeat, M.A.; Karlsson, A.; Flamholc, L.; Ledergerber, B.; Weber, R.; Cavassini, M.; Francioli, P.; Boffi, E.; Hirschel, B.; Furrer, H.; Battegay, M.; Elzi, L.; Chentsova, N.; Kravchenko, E.; Driessen, G.J.A.; Hartwig, N.G.; Frolov, V.; Kutsyna, G.; Servitskiy, S.; Krasnov, M.; Barton, S.; Johnson, A.M.; Mercey, D.; Johnson, M.A.; Mocroft, A.; Phillips, A.; Murphy, M.; Scullard, G.; Weber, J.; Fisher, M.; Leen, C.; Branger, J.; Åkerlund, B.; Morfeldt, L.; Sundström., A.; Thulin, G.; Karlsson, A.; Koppel, K.; Flamholc, L.; Ho̊kangård, C.; Angarano, G.; Antinori, A.; Armignacco, O.; Castelli, F.; Cauda, R.; Di Perri, G.; Galli, M.; Iardino, R.; Ippolito, G.; Lazzarin, A.; Moroni, M.; Perno, C.F.; Viale, P.L.; Von Schlosser, F.; Ammassari, A.; Andreoni, M.; Antinori, A.; Balotta, C.; Bonfanti, P.; Bonora, S.; Borderi, M.; Capobianchi, M.R.; Castagna, A.; Ceccherini-Silberstein, F.; Cinque, P.; Cozzi-Lepri, A.; De Luca, A.; Gargiulo, M.; Gervasoni, C.; Girardi, E.; Gori, A.; Guaraldi, G.; Lichtner, M.; Lo Caputo, S.; Madeddu, G.; Maggiolo, F.; Marchetti, G.; Marcotullio, S.; Monno, L.; Murri, R.; Mussini, C.; Puoti, M.; Torti, C.; d'Arminio Monforte, A.; Cicconi, P.; Cozzi-Lepri, A.; Fanti, I.; Formenti, T.; Galli, L.; Lorenzini, P.; Costantini, A.; Giacometti, A.; Riva, A.; Angarano, G.; Carrisa, C.; Monno, L.; Lazzari, G.; Maggiolo, F.; Borderi, M.; Verucchi, G.; Viale, P.L.; Kauffmann, R.H.; Schippers, E.F.; Castelli, F.; Minardi, C.; Torti, C.; Abeli, C.; Quirino, T.; Manconi, P.E.; Piano, P.; Falasca, K.; Vecchiet, J.; Segala, D.; Sighinolfi, L.; Lo Caputo, S.; Mazzotta, F.; Alessandrini, A.; Cassola, G.; Mazzarello, G.; Piscopo, R.; Viscoli, G.; Belvisi, V.; Mastroianni, C.; Bonfanti, P.; Caramma, I.; Castelli, P.; Chiodera, A.; Alleman, M.A.; Bouwhuis, J.W.; Groeneveld, P.H.P.; Bigoloni, A.; Carenzi, L.; Castagna, A.; Cicconi, P.; Formenti, T.; Galli, A.; Galli, M.; Lazzarin, A.; Moioli, M.C.; Piolini, R.; Puoti, M.; Ridolfo, A.L.; Rizzardini, G.; Rossotti, R.; Salpietro, S.; Spagnuolo, V.; Zucchi, P.; d'Arminio Monforte, A.; Bisio, L.; Mussini, C.; Gori, A.; Lapadula, G.; Abrescia, N.; Chirianni, A.; Gargiulo, M.; Guida, M.G.; Baldelli, F.; Belfiori, B.; Parruti, G.; Ursini, T.; Magnani, G.; Ursitti, M.A.; Acinapura, R.; Andreoni, M.; Antinori, A.; Capozzi, M.; Cauda, R.; De Luca, A.; Gallo, L.; Libertone, R.; Lichtner, M.; Nicastro, E.; Tebano, G.; Tozzi, V.; Vullo, V.; Zaccarelli, M.; d'Avino, A.; Madeddu, G.; Mura, M.S.; Caramello, P.; Di Perri, G.; Orofino, G.C.; Sciandra, M.; Soetekouw, R.; ten Kate, R.W.; Manfrin, V.; Pellizzer, G.; Bernard, E.; Caissotti, C.; Cua, E.; De Salvador-Guillouet, F.; Dellamonica, P.; Dollet, K.; Durant, J.; Ferrando, S.; Fontas, E.; Mondain-Miton, V.; Naqvi, A.; Perbost, I.; Pillet, S.; Pradier, C.; Prouvost-Keller, B.; Pugliese, P.; Rahelinirina, V.; Roger, P.M.; Barth, J.; Battegay, M.; Bernasconi, E.; Böni, J.; Bucher, H.C.; Burton-Jeangros, C.; Calmy, A.; Cavassini, M.; Cellerai, C.; Dubs, R.; Egger, M.; Elzi, L.; Fehr, J.; Flepp, M.; Francioli, P.; Furrer, H.; Fux, C.A.; Gorgievski, M.; Günthard, H.; Hasse, B.; Hirsch, H.H.; Hirschel, B.; Hösli, I.; Kahlert, C.; Kaiser, L.; Keiser, O.; Kind, C.; Klimkait, T.; Kovari, H.; Ledergerber, B.; Martinetti, G.; Martinez de Tejada, B.; Müller, N.; Nadal, D.; Pantaleo, G.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schöni-Affolter, F.; Schüpbach, J.; Schultze, D.; Speck, R.; Taffé, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Weber, R.; Yerly, S.; von Wyl, V.; Arend, S.M.; Jolink, H.; Kroon, F.P.; de Boer, M.G.J.; van Dissel, J.T.; van Nieuwkoop, C.; van den Broek, P.J.; Pogany, K.; den Hollander, J.G.; Kortmann, W.; van Twillert, G.; Leyten, E.M.S.; Vriesendorp, R.; Kootstra, G.J.; ten Napel, C.H.H.; Blok, W.L.; Brinkman, K.; Frissen, P.H.J.; Schouten, W.E.M.; van den Berk, G.E.L.; Brouwer, A.E.; Juttmann, J.R.; van Kasteren, M.E.E.; Lettinga, K.D.; Veenstra, J.; Mulder, J.W.; Smit, P.M.; Weijer, S.; van Gorp, E.C.M.; Verhagen, D.W.M.; van Eeden, A.; Doedens, R.; Scholvinck, E.H.; Sprenger, H.G.; Stek, C.J.; van Assen, S.; Brouwer, A.M.; Dofferhoff, A.S.M.; Keuter, M.; Koopmans, P.P.; de Groot, R.; ter Hofstede, H.J.M.; van der Flier, M.; van der Ven, A.J.A.M.; Arends, J.E.; Ellerbroek, P.M.; Hoepelman, A.I.M.; Jaspers, C.A.J.J.; Maarschalk-Ellerbroek, L.J.; Mudrikova, T.; Oosterheert, J.J.; Peters, E.J.G.; Schneider, M.M.E.; Wassenberg, M.W.M.; van der Hilst, J.C.H.; Bierman, W.F.W.; Claessen, F.A.P.; Danner, S.A.; Perenboom, R.M.; bij de Vaate, E.A.; de Jong, E.V.; de Vocht, J.; van Agtmael, M.A.; Geelen, S.P.M.; Wolfs, T.F.W.; Gisolf, E.H.; Richter, J.P.; van der Berg, C.; Stegeman, A.; van den Berge, M.; Polée, M.B.; van Houte, D.P.F.; van Vonderen, M.G.A.; Duits, A.J.; Winkel, C.; Dabis, F.; Bonnet, F.; Chêne, G.; Dabis, F.; Dupon, M.; Fleury, H.; Lacoste, D.; Malvy, D.; Mercié, P.; Morlat, P.; Neau, D.; Pellegrin, I.; Pellegrin, J.L.; Thiébaut, R.; Titier, K.; Bruyand, M.; Chêne, G.; Dabis, F.; Lawson-Ayayi, S.; Thiébaut, R.; Wittkop, L.; Bernard, N.; Bonnal, F.; Bonnet, F.; Caunègre, L.; Cazanave, C.; Ceccaldi, J.; Chambon, D.; Chossat, I.; Courtaud, K.; Dauchy, F.A.; De Witte, S.; Duffau, P.; Dupon, M.; Dupont, A.; Dutronc, H.; Farbos, S.; Gaboriau, V.; Gemain, M.C.; Gerard, Y.; Greib, C.; Hessamfar, M.; Lacoste, D.; Lafarie-Castet, S.; Lataste, P.; Lazaro, E.; Longy-Boursier, M.; Malvy, D.; Meraud, J.P.; Mercié, P.; Monlun, E.; Morlat, P.; Neau, D.; Ochoa, A.; Pellegrin, J.L.; Pistone, T.; Ragnaud, J.M.; Receveur, M.C.; Roger-Schmeltz, J.; Tchamgoué, S.; Thibaut, P.; Vandenhende, M.A.; Viallard, J.F.; Moreau, J.F.; Pellegrin., I.; Fleury, H.; Lafon, M.E.; Masquelier, B.; Trimoulet, P.; Breilh, D.; Titier, K.; Haramburu, F.; Miremont-Salamé, G.; Blaizeau, M.J.; D'Ivernois, C.; Decoin, M.; Delaune, J.; Delveaux, S.; Hanappier, C.; Leleux, O.; Sicard, X.; Uwamaliya-Nziyumvira, B.; Geffard, S.; Leray, J.; Palmer, G.; Touchard, D.; Baker, D.; Bendall, C.; Bloch, M.; Carr, A.; Cooper, D.; Franic, T.; Law, M.; McManus, H.; Petoumenos, K.; Vale, R.; Wright, S.; Edwards, S.; Hoy, J.; Moore, R.; Nicholson, J.; Roth, N.; Watson, K.; Chuah, J.; Ngieng, M.; Nolan, D.; Skett, J.; Cadafalch, J.; Calvo, G.; Codina, C.; Del Cacho, E.; Domingo, P.; Fuster, M.; Gatell, J.; Mateu, S.; Sambeat, M.A.; Sirera, G.; Torres, F.; Vaqué, A.; Clumeck, N.; De Wit, S.; Delforge, M.; Gennotte, A.F.; Gerard, M.; Kabeya, K.; Konopnicki, D.; Libois, A.; Martin, C.; Necsoi, C.; Payen, M.C.; Semaille, P.; Van Laethem, Y.; Bartsch, G.; El-Sadr, W.M.; Krum, E.; Neaton, J.; Thompson, G.; Wentworth, D.; Luskin-Hawk, R.; Telzak, E.; El-Sadr, W.M.; Abrams, D.I.; Cohn, D.; Markowitz, N.; Arduino, R.; Mushatt, D.; Friedland, G.; Perez, G.; Tedaldi, E.; Fisher, E.; Gordin, F.; Crane, L.R.; Sampson, J.; Baxter, J.; Cozzi-Lepri, A.; Fischer, A.H.; Grint, D.; Kirk, O.; Kjaer, J.; Kowalska, J.; Lundgren, J.; Mocroft, A.; Nielsen, J.; Peters, L.; Podlekareva, D.; Reekie, J.; Tverland, J.; Elias, C.; Losso, M.; Vetter, N.; Zangerle, R.; Vetter, N.; Zangerle, R.; Karpov, I.; Vassilenko, A.; Mitsura, V.M.; Suetnov, O.; Clumeck, N.; De Wit, S.; Delforge, M.; Colebunders, R.; Vandekerckhove, L.; Hadziosmanovic, V.; Kostov, K.; Begovac, J.; Jilich, D.; Machala, L.; Sedlacek, D.; Benfield, T.; Kronborg, G.; Larsen, M.; Nielsen, J.; Gerstoft, J.; Hansen, A.-B.E.; Katzenstein, T.; Skinhøj, P.; Pedersen, C.; Ostergaard, L.; Zilmer, K.

2013-01-01

Background: Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors

Tuberculosis and AIDS co-morbidity in Brazil: linkage of the tuberculosis and AIDS databases

Directory of Open Access Journals (Sweden)

Angelica Espinosa Miranda

Full Text Available This study evaluated differences in AIDS patients with and without tuberculosis (TB in Espírito Santo State, Brazil. Standard regional AIDS (SINAN, SISCEL, SICLOM and SIM and tuberculosis (SINAN databases were used. TB and AIDS databases were linked using Reclink software, version 3, with SPSS software support to identify co-infected cases. Data from July 2000 to June 2006 in Espírito Santo State were linked. The results showed 3,523 adult AIDS cases and 9,958 adult TB cases resulted in 430 co-infected patients, who were compared to 1,290 AIDS patients who never developed TB. Among 430 co-infected patients, TB was diagnosed first in 223 (51.9%, AIDS was first in 44 (10.2%, and AIDS and TB were diagnosed concurrently in 163 (37.9%. Median age did not differ between co-infected cases (36 years (interquartile range [IQR] 29-43 and non-co-infected cases (34 years; IQR 28-42. Pulmonary tuberculosis was diagnosed in 239 (55.6%; 109 (25.3% had extra-pulmonary TB and 82 (19.1% had both presentations. In the final logistic regression model, living in a metropolitan area [Odds Ratio (OR=1.43 (95% Confidence Interval (CI 1.05-1.95], education < 3 years [OR=3.03 (95%CI 1.56-5.88] and CD4 counts < 200/mm³ [OR=1.14 (95%CI 1.09-1.18] were associated with co-infection. This report emphasizes the significance of tuberculosis among AIDS cases in Brazil, and highlights the importance of evaluating secondary data for purposes of improving data quality and developing public health interventions.

Psychological first-aid: a practical aide-memoire.

Science.gov (United States)

Leach, J

1995-07-01

Despite advances made in recent years in medical first aid, psychiatric intervention, survival training and equipment design, many people still perish quickly during and immediately following a disastrous event. In this study, individuals and groups of survivors of life-threatening events were debriefed and the behavior of those who coped well during such a threat to life were compared with those who did not. The behaviors of those who coped well were distilled into a set of principles for psychological first aid; that is, a series of simple actions for use within a disaster which serves to recover victims to functional behavior as quickly as possible, thus increasing their chance for survival. These principles of psychological first aid have recently been introduced into basic first aid and survival training courses for both military and civilian units.

TurbinAID

International Nuclear Information System (INIS)

Moradian, M.A.; Chow, M.P.; Osborne, R.L.; Jenkins, M.A.

1991-01-01

The Westinghouse Turbine Artificial Intelligence Diagnostics system or TurbinAID, can diagnose both thermodynamic and mechanical component anomalies within the turbine, and around the turbine cycle. any monitoring system can detect that a variable is in an abnormal state, but TurbinAID can also indicate the cause, and provide recommended corrective action(s). The TurbinAID Expert Systems utilize multiple sensor and variable inputs, and their interdependencies in the generation of a diagnosis. The system performs sensor validation as part of the data acquisition scheme. The TurbinAID system has been in operation for several years. This paper describes the monitoring and diagnostic functions provided by TurbinAID, and how the utility industry both nuclear and fossil, can utilize the system to enhance unit operation

Burden of non-AIDS-defining and non-virus-related cancers among HIV-infected patients in the combined antiretroviral therapy era.

Science.gov (United States)

Albini, Laura; Calabresi, Alessandra; Gotti, Daria; Ferraresi, Alice; Festa, Andrea; Donato, Francesco; Magoni, Michele; Castelli, Francesco; Quiros-Roldan, Eugenia

2013-08-01

The risk of cancer is substantially increased in HIV-infected patients. However, little is known about non-AIDS-defining cancers (NADCs) without an infectious etiology. A total of 5,090 HIV-infected patients registered in the Local Health Authority (LHA) of Brescia and receiving primary care at our clinic were included in a retrospective (1999-2009) analysis. The cancer diagnoses were obtained through a record-linkage procedure between our database and the LHA general database and population-based Cancer Registry of LHA. We compared risks of these malignancies with those of the general population living in the same health area by using age-standardized incidence ratios (SIRs). Poisson regression analysis was used to assess factors associated with non-virus-related NADCs. We recorded an increase in the SIR of non-virus-related NADCs over time, with 138 cancers diagnosed in 131 patients. The mean incidence rate was 42.6/10,000 person years and the median age at the diagnosis was 49 (range, 28-78) years old. Stratifying for gender, only HIV-infected males had an increased risk of non-virus-related NADCs [SIR=1.86; 95% confidence interval (CI), 1.55-2.26]. Risk was higher for lung (SIR=3.59; 95% CI, 2.36-5.45) and testis cancer (SIR=3.11; 95% CI, 1.48-6.52). However,, cancers of the prostate and breast in HIV-positive men and women were null (SIR=1.10; 95% CI, 0.53-2.32 and SIR=0.91; 95% CI, 0.47-1.74, respectively). The only predictors of non-virus-related NADCs included older age [incidence rate ratio (IRR)=1.10; 95% CI, 1.08-1.12 per each additional year, prisk of non-virus-related NADCs compared to the general population. However, the use of cART appeared to be beneficial in protecting against the development of these malignancies.

JPRS Report, Epidemiology, AIDS

National Research Council Canada - National Science Library

1993-01-01

Partial Contents: AIDS in Burundi, Rwanda AIDS Situation in Country Examined, Estimated Over 750,000 HIV Positive, In 3 Years 4 Million May Be AIDS Carriers, Events at National AIDS Convention Analyzed, Senior Army...

Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote Prospective Cohort Study.

Directory of Open Access Journals (Sweden)

Mariam Noelie Hema

Full Text Available To study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART.The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997-1999. The association between occurrence of first non AIDS-defining severe events (NADE and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4, CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4 500/mm3 and CD4/CD8 ratio 500/mm3 and CD4/CD8 ratio > 1. Models adjusted on baseline characteristics and time-dependent viral load were compared using Akaike Information Criterion.We included 1227 patients. Median duration of follow-up was 9.2 years (IQR: 4.2-11.4. Median CD4 was 530/mm3 at 9 years. Median CD4/CD8 ratio was 0.3 (IQR: 0.2-0.5 at baseline and 0.6 (IQR: 0.4-0.9 after 9 years. Incidence of first NADE was 7.4/100 person-years, the most common being bacterial infections (21%, cardiovascular events (14% and cancers (10%. For both bacterial infections and cardiovascular events, the CD4/CD8 ratio did not add predictive information to the CD4 cell count. However, low CD4/CD8 ratio was the best predictor of non-AIDS cancers (adjusted HR = 2.13 for CD4/CD8 < 0.5; 95% CI = 1.32-3.44.CD4/CD8 ratio remains < 1 in most HIV-infected patients despite long-term CD4+ cell counts restoration on ART. A CD4/CD8 ratio < 0.5 could identify patients who require a more intensive strategy of cancer prevention or screening.

The Role of Transforming Growth Factor Beta-1 in the Progression of HIV/AIDS and Development of Non-AIDS-Defining Fibrotic Disorders

Directory of Open Access Journals (Sweden)

Annette J. Theron

2017-11-01

Full Text Available Even after attainment of sustained viral suppression following implementation of highly active antiretroviral therapy, HIV-infected persons continue to experience persistent, low-grade, systemic inflammation. Among other mechanisms, this appears to result from ongoing microbial translocation from a damaged gastrointestinal tract. This HIV-related chronic inflammatory response is paralleled by counteracting, but only partially effective, biological anti-inflammatory processes. Paradoxically, however, this anti-inflammatory response not only exacerbates immunosuppression but also predisposes for development of non-AIDS-related, non-communicable disorders. With respect to the pathogenesis of both sustained immunosuppression and the increased frequency of non-AIDS-related disorders, the anti-inflammatory/profibrotic cytokine, transforming growth factor-β1 (TGF-β1, which remains persistently elevated in both untreated and virally suppressed HIV-infected persons, may provide a common link. In this context, the current review is focused on two different, albeit related, harmful activities of TGF-β1 in HIV infection. First, on the spectrum of anti-inflammatory/immunosuppressive activities of TGF-β1 and the involvement of this cytokine, derived predominantly from T regulatory cells, in driving disease progression in HIV-infected persons via both non-fibrotic and profibrotic mechanisms. Second, the possible involvement of sustained elevations in circulating and tissue TGF-β1 in the pathogenesis of non-AIDS-defining cardiovascular, hepatic, pulmonary and renal disorders, together with a brief comment on potential TGF-β1-targeted therapeutic strategies.

Dissemination of a highly virulent pathogen: tracking the early events that define infection.

Directory of Open Access Journals (Sweden)

Rodrigo J Gonzalez

2015-01-01

Full Text Available The series of events that occurs immediately after pathogen entrance into the body is largely speculative. Key aspects of these events are pathogen dissemination and pathogen interactions with the immune response as the invader moves into deeper tissues. We sought to define major events that occur early during infection of a highly virulent pathogen. To this end, we tracked early dissemination of Yersinia pestis, a highly pathogenic bacterium that causes bubonic plague in mammals. Specifically, we addressed two fundamental questions: (1 do the bacteria encounter barriers in disseminating to draining lymph nodes (LN, and (2 what mechanism does this nonmotile bacterium use to reach the LN compartment, as the prevailing model predicts trafficking in association with host cells. Infection was followed through microscopy imaging in addition to assessing bacterial population dynamics during dissemination from the skin. We found and characterized an unexpected bottleneck that severely restricts bacterial dissemination to LNs. The bacteria that do not pass through this bottleneck are confined to the skin, where large numbers of neutrophils arrive and efficiently control bacterial proliferation. Notably, bottleneck formation is route dependent, as it is abrogated after subcutaneous inoculation. Using a combination of approaches, including microscopy imaging, we tested the prevailing model of bacterial dissemination from the skin into LNs and found no evidence of involvement of migrating phagocytes in dissemination. Thus, early stages of infection are defined by a bottleneck that restricts bacterial dissemination and by neutrophil-dependent control of bacterial proliferation in the skin. Furthermore, and as opposed to current models, our data indicate an intracellular stage is not required by Y. pestis to disseminate from the skin to draining LNs. Because our findings address events that occur during early encounters of pathogen with the immune response

Cerebral toxoplasmosis in Danish AIDS patients

DEFF Research Database (Denmark)

Smith, E; Pers, C; Aschow, C

1991-01-01

We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring......-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had...... the diagnosis confirmed but since 5 patients, who were never treated, were diagnosed at autopsy, the overall cumulated incidence was 8% (22/266 patients). The overall diagnostic accuracy was 59% (17/29 patients) showing some changes over time. Among patients diagnosed with AIDS in 1988 or later, the accuracy...

Differential improvement in survival among patients with AIDS after the introduction of HAART

OpenAIRE

2007-01-01

Abstract We explored changes in the survival of patients with AIDS (PWA) according to the availability of antiretroviral drugs (1994-2002). We tested whether changes in the hazard ratio of progression to death (HR) have been homogeneous among various groups of PWA. We included 4158 PWA diagnosed in Paris, notified to the French National Surveillance Institute by 2002. Four calendar periods were defined: monotherapy (1994-1995), bitherapy-HAART transition (1996), early HAART (19...

A new prognostic score for AIDS-related lymphomas in the rituximab-era

Science.gov (United States)

Barta, Stefan K.; Xue, Xiaonan; Wang, Dan; Lee, Jeannette Y.; Kaplan, Lawrence D.; Ribera, Josep-Maria; Oriol, Albert; Spina, Michele; Tirelli, Umberto; Boue, Francois; Wilson, Wyndham H.; Wyen, Christoph; Dunleavy, Kieron; Noy, Ariela; Sparano, Joseph A.

2014-01-01

While the International Prognostic Index is commonly used to predict outcomes in immunocompetent patients with aggressive B-cell non-Hodgkin lymphomas, HIV-infection is an important competing risk for death in patients with AIDS-related lymphomas. We investigated whether a newly created prognostic score (AIDS-related lymphoma International Prognostic Index) could better assess risk of death in patients with AIDS-related lymphomas. We randomly divided a dataset of 487 patients newly diagnosed with AIDS-related lymphomas and treated with rituximab-containing chemoimmunotherapy into a training (n=244) and validation (n=243) set. We examined the association of HIV-related and other known risk factors with overall survival in both sets independently. We defined a new score (AIDS-related lymphoma International Prognostic Index) by assigning weights to each significant predictor [age-adjusted International Prognostic Index, extranodal sites, HIV-score (composed of CD4 count, viral load, and prior history of AIDS)] with three risk categories similar to the age-adjusted International Prognostic Index (low, intermediate and high risk). We compared the prognostic value for overall survival between AIDS-related lymphoma International Prognostic Index and age-adjusted International Prognostic Index in the validation set and found that the AIDS-related lymphoma International Prognostic Index performed significantly better in predicting risk of death than the age-adjusted International Prognostic Index (P=0.004) and better discriminated risk of death between each risk category (P=0.015 vs. P=0.13). Twenty-eight percent of patients were defined as low risk by the ARL-IPI and had an estimated 5-year overall survival (OS) of 78% (52% intermediate risk, 5-year OS 60%; 20% high risk, 5-year OS 50%). PMID:25150257

AIDS defining disease: Disseminated cryptococcosis

Directory of Open Access Journals (Sweden)

Roshan Anupama

2006-01-01

Full Text Available Disseminated cryptococcosis is one of the acquired immune deficiency syndrome defining criteria and the most common cause of life threatening meningitis. Disseminated lesions in the skin manifest as papules or nodules that mimic molluscum contagiosum (MC. We report here a human immunodeficiency virus positive patient who presented with MC like lesions. Disseminated cryptococcosis was confirmed by India ink preparation and histopathology. The condition of the patient improved with amphotercin B.

An Intelligent Computer-aided Training System (CAT) for Diagnosing Adult Illiterates: Integrating NASA Technology into Workplace Literacy

Science.gov (United States)

Yaden, David B., Jr.

1991-01-01

An important part of NASA's mission involves the secondary application of its technologies in the public and private sectors. One current application being developed is The Adult Literacy Evaluator, a simulation-based diagnostic tool designed to assess the operant literacy abilities of adults having difficulties in learning to read and write. Using Intelligent Computer-Aided Training (ICAT) system technology in addition to speech recognition, closed-captioned television (CCTV), live video and other state-of-the-art graphics and storage capabilities, this project attempts to overcome the negative effects of adult literacy assessment by allowing the client to interact with an intelligent computer system which simulates real-life literacy activities and materials and which measures literacy performance in the actual context of its use. The specific objectives of the project are as follows: (1) to develop a simulation-based diagnostic tool to assess adults' prior knowledge about reading and writing processes in actual contexts of application; (2) to provide a profile of readers' strengths and weaknesses; and (3) to suggest instructional strategies and materials which can be used as a beginning point for remediation. In the first and development phase of the project, descriptions of literacy events and environments are being written and functional literacy documents analyzed for their components. From these descriptions, scripts are being generated which define the interaction between the student, an on-screen guide and the simulated literacy environment.

An Event-based Approach to Hybrid Systems Diagnosability

Data.gov (United States)

National Aeronautics and Space Administration — Diagnosability is an important issue in the design of diagnostic systems, because it helps identify whether sufficient information is available to distinguish all...

What's at Stake in the Lives of People with Intellectual Disability? Part I: The Power of Naming, Defining, Diagnosing, Classifying, and Planning Supports

Science.gov (United States)

Schalock, Robert L.; Luckasson, Ruth

2013-01-01

This article focuses on the power of naming, defining, diagnosing, classifying, and planning supports for people with intellectual disability. The article summarizes current thinking regarding these five functions, states the essential question addressed by the respective function, and provides an overview of the high stakes involved for people…

A review of critical in-flight events research methodology

Science.gov (United States)

Giffin, W. C.; Rockwell, T. H.; Smith, P. E.

1985-01-01

Pilot's cognitive responses to critical in-flight events (CIFE's) were investigated, using pilots, who had on the average about 2540 flight hours each, in four experiments: (1) full-mission simulation in a general aviation trainer, (2) paper and pencil CIFE tests, (3) interactive computer-aided scenario testing, and (4) verbal protocols in fault diagnosis tasks. The results of both computer and paper and pencil tests showed only 50 percent efficiency in correct diagnosis of critical events. The efficiency in arriving at a diagnosis was also low: over 20 inquiries were made for 21 percent of the scenarios diagnosed. The information-seeking pattern was random, with frequent retracing over old inquiries. The measures for developing improved cognitive skills for CIFE's are discussed.

Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses.

Directory of Open Access Journals (Sweden)

Martha L Carvour

Full Text Available Neurologic complications of human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS.Retrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neurologic diagnosis for men and women with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. A second, non-independent cohort was formed using university-based cases to confirm and extend the findings from the statewide data. Kaplan-Meier analysis was used to compare the survival experiences for men and women in the cohorts. Cox regression was employed to characterize survival while controlling for potential confounders in the study population.Women (n=27 had significantly poorer outcomes than men (n=198 in the statewide cohort (adjusted hazard ratio=2.31, 95% CI: 1.22 to 4.35, and a similar, non-significant trend was observed among university-based cases (n=17 women, 154 men. Secondary analyses suggested that this difference persisted over the course of the AIDS epidemic and was not attributable to differential antiretroviral therapy responses among men and women.The survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. If this relationship is confirmed, targeted clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS.

Can Concentration - Discharge Relationships Diagnose Material Source During Extreme Events?

Science.gov (United States)

Karwan, D. L.; Godsey, S.; Rose, L.

2017-12-01

Floods can carry >90% of the basin material exported in a given year as well as alter flow pathways and material sources. In turn, sediment and solute fluxes can increase flood damages and negatively impact water quality and integrate physical and chemical weathering of landscapes and channels. Concentration-discharge (C-Q) relationships are used to both describe export patterns as well as compute them. Metrics for describing C-Q patterns and inferring their controls are vulnerable to infrequent sampling that affects how C-Q relationships are interpolated and interpreted. C-Q relationships are typically evaluated from multiple samples, but because hydrological extremes are rare, data are often unavailable for extreme events. Because solute and sediment C-Q relationships likely respond to changes in hydrologic extremes in different ways, there is a pressing need to define their behavior under extreme conditions, including how to properly sample to capture these patterns. In the absence of such knowledge, improving load estimates in extreme floods will likely remain difficult. Here we explore the use of C-Q relationships to determine when an event alters a watershed system such that it enters a new material source/transport regime. We focus on watersheds with sediment and discharge time series include low-frequency and/or extreme events. For example, we compare solute and sediment patterns in White Clay Creek in southeastern Pennsylvania across a range of flows inclusive of multiple hurricanes for which we have ample ancillary hydrochemical data. TSS is consistently mobilized during high flow events, even during extreme floods associated with hurricanes, and sediment fingerprinting indicates different sediment sources, including in-channel remobilization and landscape erosion, are active at different times. In other words, TSS mobilization in C-Q space is not sensitive to the source of material being mobilized. Unlike sediments, weathering solutes in this watershed

Late presentation to HIV care despite good access to health services

DEFF Research Database (Denmark)

Darling, Katharine Ea; Hachfeld, Anna; Cavassini, Matthias

2016-01-01

infection rates are rising, and diagnosing HIV early in the course of infection remains a challenge. Late presentation to care in HIV refers to individuals newly presenting for HIV care with a CD4 count below 350 cells/µl or with an acquired immune deficiency syndrome (AIDS)-defining event. Late...

CLINICAL DESCRIPTION AND DIAGNOSIS OF HIV/AIDS

Directory of Open Access Journals (Sweden)

Suryono Suryono

2014-01-01

Full Text Available Infections ofHIV/AIDS currently has become very serious problems for the world health. In the country the first case ofHIV/AIDS was discovered in Bali in 1987, in its progress has not the meaning but after 1985 HIV transmission increased considerably. The complex problem that the living and the increasing number ofcases should indeed, medical practitioners understand more the clinical and how to diagnose infections ofHIV/AIDS. A snapshot ofthe clinical HIV infection/aids can be seen from grievances and a disease that often accompanies it, a complaint which is found at HIV/AIDS sufferers in the form of suds retroviral acute: fever, weight loss, diarrhea chronic, disphagi, limpadenopati, infections in the skin respiratory disorders and nervous breakdown center. While a disease that often been gained by those with HIV / AIDS as candidiasis, tuberculosis, pneumonia bakterialis, toksoplasmosis and pneumonia pneumocystic carinii. Diagnose HIV infection created based on clinical symptoms which includes major symptoms and symptoms of minor, and the result ofthe examination ofthe laboratory.

Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is ...

African Journals Online (AJOL)

Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is Pre and Post Counseling Still Being Adequately Practiced? ... A case of attempted suicide in a recently diagnosed HIV positive subject without adequate counseling is reported. Subject ... Key Words: Suicide Attempt, HIV/AIDS, Pre and Post test Counseling.

Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.

LENUS (Irish Health Repository)

Hamilton, Hilary

2011-06-13

Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.

D-Dimer Levels before HIV Seroconversion Remain Elevated Even after Viral Suppression and Are Associated with an Increased Risk of Non-AIDS Events.

Directory of Open Access Journals (Sweden)

Matthew S Freiberg

Full Text Available The mechanism underlying the excess risk of non-AIDS diseases among HIV infected people is unclear. HIV associated inflammation/hypercoagulability likely plays a role. While antiretroviral therapy (ART may return this process to pre-HIV levels, this has not been directly demonstrated. We analyzed data/specimens on 249 HIV+ participants from the US Military HIV Natural History Study, a prospective, multicenter observational cohort of >5600 active duty military personnel and beneficiaries living with HIV. We used stored blood specimens to measure D-dimer and Interleukin-6 (IL-6 at three time points: pre-HIV seroconversion, ≥6 months post-HIV seroconversion but prior to ART initiation, and ≥6 months post-ART with documented HIV viral suppression on two successive evaluations. We evaluated the changes in biomarker levels between time points, and the association between these biomarker changes and future non-AIDS events. During a median follow-up of 3.7 years, there were 28 incident non-AIDS diseases. At ART initiation, the median CD4 count was 361cells/mm3; median duration of documented HIV infection 392 days; median time on ART was 354 days. Adjusted mean percent increase in D-dimer levels from pre-seroconversion to post-ART was 75.1% (95% confidence interval 24.6-148.0, p = 0.002. This increase in D-dimer was associated with a significant 22% increase risk of future non-AIDS events (p = 0.03. Changes in IL-6 levels across time points were small and not associated with future non-AIDS events. In conclusion, ART initiation and HIV viral suppression does not eliminate HIV associated elevation in D-dimer levels. This residual pathology is associated with an increased risk of future non-AIDS diseases.

Community engagement among men who have sex with men living with HIV/AIDS in Taiwan.

Science.gov (United States)

Chuang, Deng-Min; Lacombe-Duncan, Ashley

2016-01-01

Community engagement was developed as a global principle in the provision of HIV/AIDS services, yet evidence-based research of implementation of the principle is lacking in Taiwan. This short report aims to understand factors associated with engagement in two types of activities with varying levels of visibility: HIV-related community events and HIV-related community action, in Taiwanese men who have sex with men (MSM) living with HIV. A cross-sectional survey was distributed to a purposive sample of participants recruited from AIDS service organizations (ASOs). Among participants (n = 178), 63.6% were involved in HIV-related community events, while less than half (47.7%) were involved in HIV-related community action. In multivariable analysis, age, involvement in ASOs, and AIDS knowledge were positively associated with engagement in community events, and living in the north of Taiwan, years of infection, and self-stigma were negatively associated with this type of engagement. Few factors, with the exception of involvement in ASOs, were positively associated with engagement in HIV-related community action. To this end, ASOs appear to play a strong role in improving and organizing both types of community engagement in Taiwan. Future studies should evaluate tailored programs delivered through ASOs for strengthening community connectedness among younger, stigmatized, and longer diagnosed MSM living with HIV.

A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States.

Science.gov (United States)

Goswami, Neela D; Colasanti, Jonathan; Khoubian, Jonathan J; Huang, Yijian; Armstrong, Wendy S; Del Rio, Carlos

Prompt antiretroviral therapy (ART) initiation after AIDS diagnosis, in the absence of certain opportunistic infections such as tuberculosis and cryptococcal meningitis, delays disease progression and death, but system barriers to inpatient ART initiation at large hospitals in the era of modern ART have been less studied. We reviewed hospitalizations for persons newly diagnosed with AIDS at Grady Memorial Hospital in Atlanta, Georgia in 2011 and 2012. Individual- and system-level variables were collected. Logistic regression models were used to estimate the odds ratios (ORs) for ART initiation prior to discharge. With Georgia Department of Health surveillance data, we estimated time to first clinic visit, ART initiation, and viral suppression. In the study population (n = 81), ART was initiated prior to discharge in 10 (12%) patients. Shorter hospital stay was significantly associated with lack of ART initiation at the time of HIV diagnosis (8 versus 24 days, OR: 1.14, 95% confidence interval: 1.04-1.25). Reducing barriers to ART initiation for newly diagnosed HIV-positive patients with short hospital stays may improve time to viral suppression.

«Dallas Buyers Club (2013» clinical research with drugs for the AIDS epidemic 80

Directory of Open Access Journals (Sweden)

Marian de HAAN-BOSCH

2015-07-01

Full Text Available Dallas Buyers Club (2013, inspired by true events, tells the story of Ron Woodroof, a middle?aged elec? trician from Dallas (Texas, who is diagnosed with AIDS in 1985. With few treatment options, he estab? lishes the Dallas Buyers Club in order to provide unapproved drugs to the AIDS community. This results in constant business travels, disputes with the FDA and problems with the law and the IRS. The article analyzes the buyers’ clubs phenomenon in the US, the drugs cited in the film and the clinical trial with zidovudine shown in the movie. The film could be useful as a teaching tool providing an introduction to the AIDS epidemic, clinical research and drug development, bioethics of human research and the agen? cies that regulate drug approval and their availability. Finally, the article presents a possible guideline for the use of the film in a teaching environment.

CLINICAL DESCRIPTION AND DIAGNOSIS OF HIV/AIDS

OpenAIRE

Suryono Suryono; Nasronudin Nasronudin

2014-01-01

Infections ofHIV/AIDS currently has become very serious problems for the world health. In the country the first case ofHIV/AIDS was discovered in Bali in 1987, in its progress has not the meaning but after 1985 HIV transmission increased considerably. The complex problem that the living and the increasing number ofcases should indeed, medical practitioners understand more the clinical and how to diagnose infections ofHIV/AIDS. A snapshot ofthe clinical HIV infection/aids can be seen fro...

Contribution of the anti HIV/AIDS community conversation programs ...

African Journals Online (AJOL)

Background: HIV/AIDS has now been around for about three and half decades since first diagnosed in 1981. If we wish to curb the spread of HIV/AIDS effectively and sustainably, we need to design strategies that help mobilizing communities at large. Anti-HIV/AIDS Community Conversation (CC) Programs are part of ...

Cryptococcal Meningitis in a Newly Diagnosed AIDS Patient: A Case ...

African Journals Online (AJOL)

BACKGROUND: Cryptococcus neoformans is a very important cause of fungal meningitis in immunosuppressed patients. OBJECTIVE: To describe a case of cryptococcal meningoencephalitis in an HIV/AIDS patient from the University of Ilorin Teaching Hospital. METHODS: An 18 -year -old male student presented with ...

Defining asthma in genetic studies

NARCIS (Netherlands)

Koppelman, GH; Postma, DS; Meijer, G.

1999-01-01

Genetic studies have been hampered by the lack of a gold standard to diagnose asthma. The complex nature of asthma makes it more difficult to identify asthma genes. Therefore, approaches to define phenotypes, which have been successful in other genetically complex diseases, may be applied to define

The mental health impact of AIDS-related mortality in South Africa: a national study

Science.gov (United States)

Myer, L; Seedat, S; Stein, D J; Moomal, H; Williams, D R

2011-01-01

Background Few data exist on how the HIV/AIDS epidemic may influence population mental health. The associations were examined between knowing someone who died of HIV/AIDS and common mental disorders among South African adults. Methods Between 2002 and 2004, a nationally representative sample of 4351 adults were interviewed about personally knowing someone who died of HIV/AIDS, and the World Health Organization Composite International Diagnostic Interview was used to generate psychiatric diagnoses for depression, anxiety and substance abuse disorders during the preceding 12 months based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). Results Overall, 42.2% of the sample knew someone who died of HIV/AIDS, and 16.5% met the criteria for at least one DSM-IV diagnosis. Individuals who knew someone who died of HIV/AIDS were significantly more likely to have any DSM-IV defined disorder, including any depressive, anxiety or substance-related disorder (pdrug dependence or abuse. Based on these results, it is estimated that up to 15% of 12-month DSM-IV disorders in the South African adult population may be related to knowing someone who died of HIV/AIDS. Conclusion These novel data suggest that AIDS-related mortality may contribute substantially to the burden of mental disorders in settings of high HIV prevalence. While this finding requires further investigation, these data suggest the need to strengthen mental health services in communities where HIV/AIDS is prevalent. PMID:19074926

Pediatric Ocular Manifestations of HIV/AIDS in Makurdi Benue State ...

African Journals Online (AJOL)

A retrospective study of all the children aged 1-16 years, diagnosed cases of ... Visual acuity and Ocular diagnosis of all Seropositive HIV/AIDS children reviewed. ... HIV/AIDS were the major causes of ocular morbidity and visual impairment.

Categorization of the best practices of oil movement and storage according to its internal losses base structure, aiding to define solutions to the increase of the reliability in the area; Categorizacao das boas praticas da transferencia e estocagem do petroleo, de acordo com a estrutura de sua base de perdas interna, subsidiando a definicao de solucoes para o aumento da confiabilidade do setor

Energy Technology Data Exchange (ETDEWEB)

Carelli, Alain Cognac; Smarcaro, Joanna; Versiani, Bernardo; Caulliraux, Heitor [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Escola Politecnica. Grupo de Producao Integrada; Lima, Mario Jorge; Warrak, Jorge Alam [PETROBRAS, Rio de Janeiro, RJ (Brazil)

2008-07-01

Nowadays, in the dynamic and globalized context that have been verified by petroleum and gas industry, the competitiveness behind the organizations depends on its capacity more and more. It is important to promote the company's employees creative power to set up the solutions for the problems that are found in the organization. These problems should be well defined, diagnosing recent operational routine. In ambit of the Oil Movement and Storage Sector of the refinery, it was developed a tool which turns into possible to evaluate the historic problems which have occurred along years. This tool permits also make cause-effect diagrams and temporal graphics that are stratified by occurrences standard characteristics. These diagrams and graphics structure information, matching them with the undesired events diagnostics and aiding the decision maker to understand about the problem systematic. After the needs that should be attacked are defined toward increase the level of sector reliability, it should study the possible solutions. In agreement of these solutions, there is a reference model that contemplates the best practices of this sector. This model enables the identification of possible solutions for problems that were found in this sector. The Oil Movement and Storage Sector Best Practices Manual involve a conjunct of found recommendations and solutions that can be utilized to improve the sector operational performance. (author)

Urinary incontinence nursing diagnoses in patients with stroke

Directory of Open Access Journals (Sweden)

Telma Alteniza Leandro

2015-12-01

Full Text Available Abstract OBJECTIVE Identifying the prevalence of Stress urinary incontinence (SUI, Urge urinary incontinence (UUI, Functional urinary incontinence (FUI, Overflow urinary incontinence (OUI and Reflex urinary incontinence (RUI nursing diagnoses and their defining characteristics in stroke patients. METHOD A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%, followed by FUI (53.2%, RUI (50.0%, UUI (41.0% and SUI (37.8%. Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.

Event-related potential evidence of accessing gender stereotypes to aid source monitoring.

Science.gov (United States)

Leynes, P Andrew; Crawford, Jarret T; Radebaugh, Anne M; Taranto, Elizabeth

2013-01-23

Source memory for the speaker's voice (male or female) was investigated when semantic knowledge (gender stereotypes) could and could not inform the episodic source judgment while event-related potentials (ERPs) were recorded. Source accuracy was greater and response times were faster when stereotypes could predict the speaker's voice at test. Recollection supported source judgments in both conditions as indicated by significant parietal "old/new" ERP effects (500-800ms). Prototypical late ERP effects (the right frontal "old/new" effect and the late posterior negativity, LPN) were evident when source judgment was based solely on episodic memory. However, these two late ERP effects were diminished and a novel, frontal-negative ERP with left-central topography was observed when stereotypes aided source judgments. This pattern of ERP activity likely reflects activation of left frontal or left temporal lobes when semantic knowledge, in the form of a gender stereotype, is accessed to inform the episodic source judgment. Copyright © 2012 Elsevier B.V. All rights reserved.

AIDS and Chemical Dependency.

Science.gov (United States)

Pohl, Melvin I.

After defining HIV and the AIDS disease and outlining symptoms and means of infection, this fact sheet lists the ways alcohol and drugs are involved with the AIDS epidemic, noting that needle-sharing transmits the virus; that alcohol or mood-altering drugs like crack cocaine cause disinhibition, increase sex drive, encourage sex for drugs, and…

Relationship between current level of immunodeficiency and non-acquired immunodeficiency syndrome-defining malignancies

DEFF Research Database (Denmark)

Reekie, Joanne; Kosa, Csaba; Engsig, Frederik

2010-01-01

In the combined antiretroviral therapy (cART) era, non-acquired immunodeficiency syndrome (AIDS)-defining malignancies account for more morbidity and mortality in human immunodeficiency virus-infected patients than AIDS-defining malignancies. However, conflicting data have been reported...

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

Science.gov (United States)

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

2016-11-01

Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs. This study had 2 primary objectives: (1) to describe the relationship between ADL workload and the level of nurse aide staffing reported by NHs; and, (2) to use a DES model to determine the relationship between ADL workload and nurse aide staffing necessary for consistent, timely ADL care. Minimum Data Set data related to the level of dependency on staff for ADL care for residents in over 13,500 NHs nationwide were converted into 7 workload categories that captured 98% of all residents. In addition, data related to the time to provide care for the ADLs within each workload category was used to calculate a workload score for each facility. The correlation between workload and reported nurse aide staffing levels was calculated to determine the association between staffing reported by NHs and workload. Simulations to project staffing requirements necessary to provide ADL care were then conducted for 65 different workload scenarios, which included 13 different nurse aide staffing levels (ranging from 1.6 to 4.0 total hours per resident day) and 5 different workload percentiles (ranging from the 5th to the 95th percentile). The purpose of the simulation model was to determine the staffing necessary to provide care within each workload

Evaluation of the British Columbia AIDS Information Line.

Science.gov (United States)

Parsons, D C; Bell, M A; Gilchrist, L D

1991-01-01

We evaluated implementation of the British Columbia AIDS Information Line during its initial 15 weeks of operation. Data collected during daily operation of the line included call frequency, caller characteristics, response patterns, caller concerns and community referrals. Information on activities and resources required to implement the AIDS Line was also assembled. The study concluded that the advertising campaign sponsored by the provincial government and other AIDS-related media events had a strong impact on the frequency of calls made to the AIDS Line. However, the effect of both advertising and media events was of relatively short duration, suggesting that utilization of an AIDS information line is dependent on continuing promotional activities. The evaluation results demonstrate the importance of continuous collection of data online utilization, to track public awareness of and response to AIDS-related issues, and to facilitate planning of public education.

Nurses' Attitudes toward Gay and Hemophiliac Patients with AIDS.

Science.gov (United States)

Strasser, Judith A.; Damrosch, Shirley

A sample of nurses (N=183) enrolled in a School of Nursing's master degree program was randomly assigned to read one of six vignettes about a patient who differed only in terms of diagnosis and lifestyle. Possible diagnoses were Acquired Immune Deficiency Syndrome (AIDS), AIDS acquired by a hemophiliac through blood therapy, and leukemia; possible…

Exploitation of a component event data bank for common cause failure analysis

International Nuclear Information System (INIS)

Games, A.M.; Amendola, A.; Martin, P.

1985-01-01

Investigations into using the European Reliability Data System Component Event Data Bank for common cause failure analysis have been carried out. Starting from early exercises where data were analyzed without computer aid, different types of linked multiple failures have been identified. A classification system is proposed based on this experience. It defines a multiple failure event space wherein each category defines causal, modal, temporal and structural links between failures. It is shown that a search algorithm which incorporates the specific interrogative procedures of the data bank can be developed in conjunction with this classification system. It is concluded that the classification scheme and the search algorithm are useful organizational tools in the field of common cause failures studies. However, it is also suggested that the use of the term common cause failure should be avoided since it embodies to many different types of linked multiple failures

Women and AIDS: introduction.

Science.gov (United States)

Krieger, N; Margo, G

1991-01-01

Around the world, more and more women--principally poor women of color--are being diagnosed with and are dying of AIDS, the acquired immune deficiency syndrome. Yet, effective and appropriate prevention programs for women are sorely missing from the global program to control AIDS. To help us understand why this gap exists, and what we must do to close it, the three articles in this issue focus on women and AIDS. Examining the situation in such countries as Zimbabwe and South Africa, as well as in other economically underdeveloped and developed regions, the authors argue that women with the least control over their bodies and their lives are at greatest risk of acquiring AIDS. For example, the high rate of infection among women in Africa cannot be understood apart from the legacy of colonialism (including land expropriation and the forced introduction of a migrant labor system) and the insidious combination of traditional and European patriarchal values. Only by recognizing the socioeconomic and cultural determinants of both disease and sexual behavior, and only by incorporating these insights into our AIDS prevention programs, will we be able to curb the spread of this lethal disease.

Thrombocytopenia is associated with an increased risk of cancer during treated HIV disease.

Science.gov (United States)

Borges, Álvaro H; Lundgren, Jens D; Ridolfo, Annalisa; Katlama, Christine; Antunes, Francisco; Grzeszczuk, Anna; Blaxhult, Anders; Mitsura, Viktar M; Doroana, Manuela; Battegay, Manuel; Gargalianos, Panagiotis; Mocroft, Amanda

2014-11-13

To assess the relationship between platelet counts and risk of AIDS and non-AIDS-defining events. Prospective cohort. EuroSIDA patients with at least one platelet count were followed from baseline (first platelet ≥ 1 January 2005) until last visit or death. Multivariate Poisson regression was used to assess the relationship between current platelet counts and the incidence of non-AIDS-defining (pancreatitis, end-stage liver/renal disease, cancer, cardiovascular disease) and AIDS-defining events. There were 62 898 person-years of follow-up (PYFU) among 12 279 patients, including 1168 non-AIDS-defining events [crude incidence 18.6/1000 PYFU, 95% confidence interval (CI) 17.5-19.6] and 735 AIDS-defining events (crude incidence 11.7/1000 PYFU, 95% CI 10.8-12.5). Patients with thrombocytopenia (platelet count ≤100 × 10/l) had a slightly increased incidence of AIDS-defining events [adjusted incidence rate ratio (aIRR) 1.42, 95% CI 1.07-1.86], when compared to those with platelet counts 101-200 × 10/l, whereas the incidence of non-AIDS-defining events was more than two-fold higher (aIRR 2.66, 95% CI 2.17-3.26). Among non-AIDS-defining events, the adjusted incidence of cancer (aIRR 2.20, 95% CI 1.61-3.01), but not cardiovascular disease (aIRR 0.66, 95% CI 0.32-1.34), was significantly higher in patients with thrombocytopenia. The association between thrombocytopenia and cancer remained unaltered in sensitivity analyses requiring repeated platelet counts to confirm thrombocytopenia and lagging platelets by 1 year prior to clinical events. Patients with thrombocytopenia had increased incidence of AIDS-defining and non-AIDS-defining events, but the association with the latter, in particular cancer, was stronger. Future studies should investigate whether the pathophysiological processes underlying thrombocytopenia are associated with the development of cancer during treated HIV disease.

Defining Moments in MMWR History: The AIDS Epidemic, Pneumocystis Pneumonia --- Los Angeles 1981

Centers for Disease Control (CDC) Podcasts

On June 5, 1981, MMWR published a report of Pneumocystis pneumonia in five previously healthy young gay men in Los Angeles, California. This report was later acknowledged as the first published account of what would become known as human immunodeficiency virus, or HIV, and acquired immunodeficiency syndrome, or AIDS. It was the first of many MMWR reports that led to a better understanding of this new condition. In this podcast, Dr. Harold Jaffe recalls CDC's investigation and response to the AIDS Epidemic.

Defining upper gastrointestinal bleeding from linked primary and secondary care data and the effect on occurrence and 28 day mortality.

Science.gov (United States)

Crooks, Colin John; Card, Timothy Richard; West, Joe

2012-11-13

Primary care records from the UK have frequently been used to identify episodes of upper gastrointestinal bleeding in studies of drug toxicity because of their comprehensive population coverage and longitudinal recording of prescriptions and diagnoses. Recent linkage within England of primary and secondary care data has augmented this data but the timing and coding of concurrent events, and how the definition of events in linked data effects occurrence and 28 day mortality is not known. We used the recently linked English Hospital Episodes Statistics and General Practice Research Database, 1997-2010, to define events by; a specific upper gastrointestinal bleed code in either dataset, a specific bleed code in both datasets, or a less specific but plausible code from the linked dataset. This approach resulted in 81% of secondary care defined bleeds having a corresponding plausible code within 2 months in primary care. However only 62% of primary care defined bleeds had a corresponding plausible HES admission within 2 months. The more restrictive and specific case definitions excluded severe events and almost halved the 28 day case fatality when compared to broader and more sensitive definitions. Restrictive definitions of gastrointestinal bleeding in linked datasets fail to capture the full heterogeneity in coding possible following complex clinical events. Conversely too broad a definition in primary care introduces events not severe enough to warrant hospital admission. Ignoring these issues may unwittingly introduce selection bias into a study's results.

Feasibility study of technologies to aid in the diagnosis of nuclear plant transients

International Nuclear Information System (INIS)

Bertch, W.J.; Bray, M.A.; Esparza, V.; Fink, R.K.; Shepherd, J.C.; Venhuizen, J.R.

1985-08-01

A technical feasibility study was performed to identify and evaluate the various computerized techniques available to diagnose and identify nuclear power plant transients in support of improving operator response to emergencies. Five categories of methods were investigated: expert system technology, computerized alarm handling, data driven displays, estimation and failure detection, and fault tree/event tree techniques. Literature searches and personal contacts were used to obtain information on specific methods and their applications within these categories. A set of evaluation criteria was established and an Analytic Hierarchy Process evaluation of the methods was performed. An integrated approach for a computerized operator aid, combining the strong features from the various methods, appears to be the most promising. 91 refs., 1 tab

Online resources for persons recently diagnosed with HIV/AIDS: an analysis of HIV-related webpages.

Science.gov (United States)

Horvath, Keith J; Harwood, Eileen M; Courtenay-Quirk, Cari; McFarlane, Mary; Fisher, Holly; Dickenson, Tina; Kachur, Rachel; Rosser, B R Simon; O'Leary, Ann

2010-07-01

The Internet is a major source of HIV-related information and resources for persons recently diagnosed with HIV/AIDS (PRDHA). This study examined the types of HIV-related websites that appear as a result of HIV-related keyword searches and the extent to which website information targets PRDHA. The first page of HIV-related webpages from 18 keyword searches was coded. Among 137 webpages meeting inclusion criteria, 63% represented HIV-informational websites, 31% targeted HIV-positive individuals, and over half contained or provided access to HIV prevention, treatment, and transmission information. Thirty-three percent of webpages contained or provided access to PRDHA-targeted information, with a greater percentage of those webpages having mobile, non-English, and "Ask the Expert" features compared with non-PRDHA targeted webpages. Implications for PRDHA include the following: (1) they should explore HIV-related websites to gain insight into the credibility of the information contained on those sites; (2) PRDHA must be aware that HIV-related websites have the potential to elicit dated, emotionally distressing, or irrelevant information; and (3) to obtain information that relates to their demographic and situational profile, they may wish to use specific key terms (e.g., "HIV women") rather than attempting to navigate webpages that arise from general search terms (e.g., "HIV"). Recommendations for future development of online resources for PRDHA include providing HIV-relevant information in a stepwise fashion, providing demographically targeted HIV information, and greater utilization of mobile technology.

Computer Aided Diagnosis for Confocal Laser Endomicroscopy in Advanced Colorectal Adenocarcinoma.

Directory of Open Access Journals (Sweden)

Daniela Ştefănescu

Full Text Available Confocal laser endomicroscopy (CLE is becoming a popular method for optical biopsy of digestive mucosa for both diagnostic and therapeutic procedures. Computer aided diagnosis of CLE images, using image processing and fractal analysis can be used to quantify the histological structures in the CLE generated images. The aim of this study is to develop an automatic diagnosis algorithm of colorectal cancer (CRC, based on fractal analysis and neural network modeling of the CLE-generated colon mucosa images.We retrospectively analyzed a series of 1035 artifact-free endomicroscopy images, obtained during CLE examinations from normal mucosa (356 images and tumor regions (679 images. The images were processed using a computer aided diagnosis (CAD medical imaging system in order to obtain an automatic diagnosis. The CAD application includes image reading and processing functions, a module for fractal analysis, grey-level co-occurrence matrix (GLCM computation module, and a feature identification module based on the Marching Squares and linear interpolation methods. A two-layer neural network was trained to automatically interpret the imaging data and diagnose the pathological samples based on the fractal dimension and the characteristic features of the biological tissues.Normal colon mucosa is characterized by regular polyhedral crypt structures whereas malignant colon mucosa is characterized by irregular and interrupted crypts, which can be diagnosed by CAD. For this purpose, seven geometric parameters were defined for each image: fractal dimension, lacunarity, contrast correlation, energy, homogeneity, and feature number. Of the seven parameters only contrast, homogeneity and feature number were significantly different between normal and cancer samples. Next, a two-layer feed forward neural network was used to train and automatically diagnose the malignant samples, based on the seven parameters tested. The neural network operations were cross

AIDS Review 2005 : What's Cooking? AIDS and the Politics of Food ...

International Development Research Centre (IDRC) Digital Library (Canada)

It will critically examine how HIV/AIDS is affecting rural small-scale food production, ... IDRC “unpacks women's empowerment” at McGill University Conference ... New website will help record vital life events to improve access to services for all.

Defining Moments in MMWR History: The AIDS Epidemic, Pneumocystis Pneumonia --- Los Angeles 1981

Centers for Disease Control (CDC) Podcasts

2017-12-01

On June 5, 1981, MMWR published a report of Pneumocystis pneumonia in five previously healthy young gay men in Los Angeles, California. This report was later acknowledged as the first published account of what would become known as human immunodeficiency virus, or HIV, and acquired immunodeficiency syndrome, or AIDS. It was the first of many MMWR reports that led to a better understanding of this new condition. In this podcast, Dr. Harold Jaffe recalls CDC’s investigation and response to the AIDS Epidemic.  Created: 12/1/2017 by MMWR.   Date Released: 12/1/2017.

Risk of melanoma in people with HIV/AIDS in the pre- and post-HAART eras: a systematic review and meta-analysis of cohort studies.

Science.gov (United States)

Olsen, Catherine M; Knight, Lani L; Green, Adèle C

2014-01-01

Following the introduction of highly active antiretroviral therapy (HAART) the risk of AIDS-defining cancers decreased but incidence of many non-AIDS-defining cancers has reportedly increased in those with HIV/AIDS. Whether melanoma risk has also changed in HIV/AIDS patients post-HAART is unknown and therefore we evaluated this in comparison with the risk before HAART. Systematic review and meta-analysis. We searched Medline, Embase and ISI science citation index databases to April 2013. All cohort studies of patients diagnosed with HIV/AIDS that permitted quantitative assessment of the association with melanoma were eligible. Detailed quality assessment of eligible studies was conducted, focussing particularly on adjustment for ethnicity, a priori considered essential for an unbiased assessment of melanoma risk. Data were pooled using a random effects model. From 288 articles, we identified 21 that met the inclusion criteria, 13 presenting data for the post-HAART era and 8 for the pre-HAART era. Post-HAART the pooled relative risk (pRR) for the association between HIV/AIDS and melanoma was 1.26 (95% CI, 0.97-1.64) and 1.50 (95% CI 1.12-2.01) among studies that accounted for ethnicity, with evidence of significant heterogeneity (P = 0.004, I2 = 55.5). Pre-HAART pRRs were 1.26 (95% CI 1.11-1.43; P het = 0.82) and 1.28 (95% CI 1.10-1.49) among studies adjusted for ethnicity. People with HIV/AIDS remain at a significantly increased risk of developing melanoma in the post-HAART era. White skinned people with HIV/AIDS should be screened regularly and counselled against excessive sun exposure.

[Diseases diagnosed at a pneumology unit integrated with its health area. Comparison with historical controls].

Science.gov (United States)

Martín Escribano, P; López Encuentra, A; Martín García, I; Cienfuegos Agustín, M I; Caballero Borda, C

1996-01-01

An understanding of changes in pulmonology disease patterns observed at a general hospital before and after implantation of a population-based model of health care not only provides useful insight into the diseases treated but also aids adjustment of health care service organization. The aim of this study was to compare data collected after 1992 (when the new system was established) with records kept by the same pulmonology group in earlier years (1974-1986). Data after 1992 described patients attended in Health District 11 by the newly organized pneumologists. For the two periods the most common pneumological diagnoses were chronic air flow obstruction and chronic hypersecretory bronchitis. The most common non pneumological diagnoses were systemic arterial hypertension, obesity, diabetes, liver disease and hiatus hernia/gastroesophageal reflux. The prospective study covered a larger population and was closer to primary care, including as it did patients at clinics unattached to hospitals. In the earlier hospital-based experience the most common diagnoses were acute respiratory infection, chronic air flow obstruction and asthma, apart from those patients referred in whom no respiratory disease was found. With the organizational integration of hospital and health district pulmonology service, contact between patients and specialists has increased. Record systems have been established for a well-defined population to permit better forecasting at less cost and facilitate contact with primary care givers and epidemiological studies.

Defining Population Health Vulnerability Following an Extreme Weather Event in an Urban Pacific Island Environment: Honiara, Solomon Islands

Science.gov (United States)

Natuzzi, Eileen S.; Joshua, Cynthia; Shortus, Matthew; Reubin, Reginald; Dalipanda, Tenneth; Ferran, Karen; Aumua, Audrey; Brodine, Stephanie

2016-01-01

Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development. PMID:27091867

DINAMIKA DEPRESI PADA PENDERITA AIDS

Directory of Open Access Journals (Sweden)

Imadduddin Parhani

2016-12-01

Full Text Available Depression is a major mental health problem today. This is very important because people with depression productivity will decrease and this is very bad for a society and a country that is building. There are at least four chronic diseases that allow the depression sufferer, one of which is HIV and AIDS. Given the uncertainty over the fate of people living with HIV and AIDS had the potential to give rise to feelings of anxiety and depression. Someone who is infected with HIV and AIDS will be overcome by a feeling of dying, guilt about the behavior that makes infection, and taste sequestered by others.The cause of depression in people with HIV and AIDS by cognitive approach that is the mindset of people who deviate from the pattern of the logical interpretation or misinterprets an event or events, focusing on the negative situations that happened to him, and hope that pessimistic and negative about the future. Symptoms are raised is their depressed mood, decreased interest or pleasure in absolute terms, average of worthlessness or excessive guilt, thoughts of death. Response or reaction that occurs is refused, angry, and depressed when he learned he was infected with HIV and AIDS, and eventually be able to accept his situation. Efforts are being made to reduce depression are manifold. One is through social support to colleagues who also have HIV and AIDS.

Tracking Progress in Improving Diagnosis: A Framework for Defining Undesirable Diagnostic Events.

Science.gov (United States)

Olson, Andrew P J; Graber, Mark L; Singh, Hardeep

2018-01-29

Diagnostic error is a prevalent, harmful, and costly phenomenon. Multiple national health care and governmental organizations have recently identified the need to improve diagnostic safety as a high priority. A major barrier, however, is the lack of standardized, reliable methods for measuring diagnostic safety. Given the absence of reliable and valid measures for diagnostic errors, we need methods to help establish some type of baseline diagnostic performance across health systems, as well as to enable researchers and health systems to determine the impact of interventions for improving the diagnostic process. Multiple approaches have been suggested but none widely adopted. We propose a new framework for identifying "undesirable diagnostic events" (UDEs) that health systems, professional organizations, and researchers could further define and develop to enable standardized measurement and reporting related to diagnostic safety. We propose an outline for UDEs that identifies both conditions prone to diagnostic error and the contexts of care in which these errors are likely to occur. Refinement and adoption of this framework across health systems can facilitate standardized measurement and reporting of diagnostic safety.

Nuclear medicine in the management of the AIDS patient

International Nuclear Information System (INIS)

Kramer, E.L.; Sanger, J.J.

1990-01-01

For the medical diagnostic imaging specialist in general, and for the nuclear medicine physician specifically, the AIDS epidemic has generated an enormous demand to develop a means of making early diagnoses of the complications of AIDS. For the most part this has meant the early detection, and when possible, the characterization of the opportunistic infections and neoplasms that are a major source of morbidity and mortality for the AIDS patient. Detection of opportunistic infections has been helpful in reclassifying HIV-seropositive patients as having AIDS. This paper reports on nuclear medicine used to evaluate the efficacy and the complications of treatment in human immunodeficiency virus infection. Most recently, functional brain imaging has been used for the diagnosis and follow-up of the AIDS dementia complex

Estimating Effective Subsidy Rates of Student Aid Programs

OpenAIRE

Stacey H. CHEN

2008-01-01

Every year millions of high school students and their parents in the US are asked to fill out complicated financial aid application forms. However, few studies have estimated the responsiveness of government financial aid schemes to changes in financial needs of the students. This paper identifies the effective subsidy rate (ESR) of student aid, as defined by the coefficient of financial needs in the regression of financial aid. The ESR measures the proportion of subsidy of student aid under ...

AIDS in South Africa.

Science.gov (United States)

Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H

1993-01-01

The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African

LIFEbeat, the music industry fights AIDS.

Science.gov (United States)

Applestone, J

1998-02-01

LIFEbeat is a not-for-profit AIDS resource and awareness organization supported primarily by people in the music industry. It was founded in 1982 and provides grants to many community-based organizations and to members of the music industry who are living with HIV/AIDS. Among its programs is Hearts and Voices, a program that eases the suffering and isolation of patients by providing live musical entertainment at hospitals and health care facilities. The group also sets up information booths at concerts and sponsors events such as SkateAID and BoardAID, fundraisers designed to appeal to in-line skaters and snowboarders.

Business Event Notification Service (BENS)

Data.gov (United States)

Department of Veterans Affairs — BENS provides a notification of pre-defined business events to applications, portals, and automated business processes. Such events are defined in the Event Catalog,...

Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses. Findings from the national DenHeart survey."

DEFF Research Database (Denmark)

Berg, Selina Kikkenborg; Thorup, Charlotte Brun; Borregaard, Britt

2018-01-01

-reported outcomes at hospital discharge as a predictor of mortality and cardiac events. Design: A cross-sectional survey with register follow-up. Methods: Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark. Main outcomes: Patient-reported outcomes......Aims: Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient...

“Dhoulath's method” – An investigative probe into mortality rate to aid diagnoses

Directory of Open Access Journals (Sweden)

J. Dhoulath Beegum

2016-09-01

Full Text Available Inspired by the urgent need to save life, during cardiac arrest, time is an important factor, and time factors, if not speeded up, may lead to death. Baby cries proved to be an obstacle for cardiac diagnosis. To speed up the diagnoses, ‘Dhoulath's method’ was proposed and result proved that the data quality of cardiac data, ‘aortic regurgitation sound’ from a mixture of ‘crying baby's cry’ was faithfully separated out. This separation, by utilizing the features of blind source component separation, in the case of medical emergency, can lead to a speedy diagnoses, to reduce the mortality rate.

First-aid boxes - Reminder

CERN Multimedia

GS Department

2010-01-01

With a view to ensuring optimum use of the first-aid boxes on the CERN site, we should like to remind you of various changes introduced in March 2009: The TSO of the buildings concerned is responsible for the first-aid boxes, including checking their contents.   First-aid boxes may be restocked ONLY at the CERN stores (SCEM No. 54.99.80). This is no longer possible at the Infirmary. The associated cost is charged to the Departments.   First-aid boxes should be used only for mild injuries. All other cases should be referred to the Medical Service Infirmary (Bldg. 57 – ground-floor, tel. 73802) between 8.00 a.m. and 5.30 p.m. or to the Fire and Rescue Service (tel. 74444). N.B.: This information does not apply to the red emergency first-aid boxes in the underground areas or to the emergency kits for use in the event of being splashed with hydrofluoric acid.

Constructing narratives to describe video events using aided communication

NARCIS (Netherlands)

Smith, M.M.; Batorowicz, B.; Sandberg, A.D.; Murray, J.; Stadskleiv, K.; Balkom, L.J.M. van; Neuvonen, K.; Tetzchner, S. von

2018-01-01

Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be

[The new methods to define the staffing requirements for doctors,nurses and nurses aides: an example of their implementation in an Italian hospital].

Science.gov (United States)

Laquintana, Dario; Pazzaglia, Silvia; Demarchi, Antonia

2017-01-01

. The new methods to define the staffing requirements for doctors, nurses and nurses aides: an example of their implementation in an Italian hospital. The Italian government, after the transposition of European Union legislation on working hours, made a declaration of commitment to increase the number of staff of the National Health Service (NHS). The method for assessing the staffing needs innovates the old one that dated back a few decades. To implement the method proposed by the Ministry of Health to an Italian hospital and assess its impact on staffing and costs. The model was implemented on all the wards, multiplying the minutes of care expected in 2016, dividing the result by 60 to obtain the hours of care, and further dividing by the number of yearly hours of work of a nurse (1418). Same was done for nurses aides. The minutes of care were related to mean weight of the Diagnosis Related Groups of the ward and the results obtained compared to the actual staffing of nurses and nurses aides. The costs of the differences were calculated. The implementation of the model produced an excess of 23 nurses and a scarcity of 95 nurses aides compared to the actual staffing, with an increase of the costs of € 1.828.562,00. The results obtained and the criticisms received so far show the need of major changes. The data from international studies that associate staffing and patients outcomes and the nurse/patient ratio are macro-indicators already available that may orient choices and investments on the health care professions.

COMPUTATIONAL ANALYSIS BASED ON ARTIFICIAL NEURAL NETWORKS FOR AIDING IN DIAGNOSING OSTEOARTHRITIS OF THE LUMBAR SPINE

Science.gov (United States)

Veronezi, Carlos Cassiano Denipotti; de Azevedo Simões, Priscyla Waleska Targino; dos Santos, Robson Luiz; da Rocha, Edroaldo Lummertz; Meláo, Suelen; de Mattos, Merisandra Côrtes; Cechinel, Cristian

2015-01-01

Objective: To ascertain the advantages of applying artificial neural networks to recognize patterns on lumbar spine radiographies in order to aid in the process of diagnosing primary osteoarthritis. Methods: This was a cross-sectional descriptive analytical study with a quantitative approach and an emphasis on diagnosis. The training set was composed of images collected between January and July 2009 from patients who had undergone lateral-view digital radiographies of the lumbar spine, which were provided by a radiology clinic located in the municipality of Criciúma (SC). Out of the total of 260 images gathered, those with distortions, those presenting pathological conditions that altered the architecture of the lumbar spine and those with patterns that were difficult to characterize were discarded, resulting in 206 images. The image data base (n = 206) was then subdivided, resulting in 68 radiographies for the training stage, 68 images for tests and 70 for validation. A hybrid neural network based on Kohonen self-organizing maps and on Multilayer Perceptron networks was used. Results: After 90 cycles, the validation was carried out on the best results, achieving accuracy of 62.85%, sensitivity of 65.71% and specificity of 60%. Conclusions: Even though the effectiveness shown was moderate, this study is still innovative. The values show that the technique used has a promising future, pointing towards further studies on image and cycle processing methodology with a larger quantity of radiographies. PMID:27027010

Quality of life in children with undiagnosed and diagnosed asthma

NARCIS (Netherlands)

van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

Towards the development of multilevel-multiagent diagnostic aids

International Nuclear Information System (INIS)

Stratton, R.C.; Jarrell, D.B.

1991-10-01

Presented here is our methodology for developing automated aids for diagnosing faults in complex systems. We have designed these aids as multilevel-multiagent diagnostic aids based on principles that should be generally applicable to any complex system. In this methodology, ''multilevel'' refers to information models described at successful levels of abstraction that are tied together in such a way that reasoning is directed to the appropriate level as determined by the problem solving requirements. The concept of ''multiagent'' refers to the method of information processing within the multilevel model network; each model in the network is an independent information processor, i.e., an intelligent agent. 19 refs., 15 figs., 9 tabs

[HIV/AIDS masks in a therapist's practice].

Science.gov (United States)

Roshchina, A A; Ponomareva, E Yu; Rebrov, A P

2015-01-01

To investigate clinical manifestations and diagnostic difficulties in patients with HIV/AIDS in the practice of therapeutic units of a multidisciplinary hospital. The investigation included 65 HIV/AIDS patients admitted to the therapy units of a Saratov Regional clinical hospital in 2007 to 2011. The clinical features of HIV/AIDS, immunological status, and viral load were studied. The structure of the clinical manifestation of HIV/AIDS showed a preponderance of lung injury in 45 (69%) patients. There were hematological disorders in 38 (58%) patients and nephropathy in 33 (51 %); 11 (17%) patients were diagnosed with infective endocarditis. Rheumatic symptoms and syndromes mimicking HIV/AIDS were found in 10 (15.4%) patients. The degree of immune disorders was most severe in patients with pulmonary dissemination and rheumatic masks and mutually related to the rate of cutaneous manifestations. The specific features of lung injury, infective endocarditis, pulmonary hypertension, rheumatic symptoms, and kidney injury were discussed in HIV/AIDS patients having different causes for admission to specialized therapy units. In connection with the clinical polymorphism of HIV/AIDS, physicians of all specialties should be alert for the possible clinical manifestations of this disease to timely examine patients.

Nuclear medicine in the management of the aids patient

International Nuclear Information System (INIS)

Kramer, E.L.; Sanger, J.J.

1995-01-01

For the medical diagnostic imaging specialist in general, and for the nuclear medicine physician specifically, the AIDS epidemic has generated an enormous demand to develop a means of making early diagnoses of the complications of AIDS. For the most part this has meant the early detection, and when possible, the characterization of the opportunistic infections and neoplasms that are a major source of morbidity and mortality for the AIDS patient. Detection of opportunistic infections has been helpful in reclassifying HIV-seropositive patients as having AIDS. This paper reports on nuclear medicine used to evaluate the efficacy and the complications of treatment in human immunodeficiency virus infection. Most recently, functional brain imaging has been used for the diagnosis and follow-up of the AIDS dementia complex. (author). 77 refs., 8 figs

Sensitivity of Billing Claims for Cardiovascular Disease Events among Kidney Transplant Recipients

Science.gov (United States)

Lentine, Krista L.; Schnitzler, Mark A.; Abbott, Kevin C.; Bramesfeld, Kosha; Buchanan, Paula M.; Brennan, Daniel C.

2009-01-01

Background and objectives: Billing claims are increasingly examined beyond administrative functions as outcomes measures in observational research. Few studies have described the performance of billing claims as surrogate measures of clinical events among kidney transplant recipients. Design, setting, participants, & measurements: We investigated the sensitivity of Medicare billing claims for clinically verified cardiovascular diagnoses (five categories) and procedures (four categories) in a novel database linking Medicare claims to electronic medical records of one transplant program. Cardiovascular events identified in medical records for 571 Medicare-insured transplant recipients in 1991 through 2002 served as reference measures. Results: Within a claims-ascertainment period spanning ±30 d of clinically recorded dates, aggregate sensitivity of single claims was higher for case definitions incorporating Medicare Parts A and B for diagnoses and procedures (90.9%) compared with either Part A (82.3%) or Part B (84.6%) alone. Perfect capture of the four procedures was possible within ±30 d or with short claims window expansion, but sensitivity for the diagnoses trended lower with all study algorithms (91.2% with window up to ±90 d). Requirement for additional confirmatory diagnosis claims did not appreciably reduce sensitivity. Sensitivity patterns were similar in the early compared with late periods of the study. Conclusions: Combined use of Medicare Parts A and B billing claims composes a sensitive measure of cardiovascular events after kidney transplant. Further research is needed to define algorithms that maximize specificity as well as sensitivity of claims from Medicare and other insurers as research measures in this population. PMID:19541817

A debate on current eating disorder diagnoses in light of neurobiological findings: is it time for a spectrum model?

Directory of Open Access Journals (Sweden)

Brooks Samantha

2012-07-01

Full Text Available Abstract Background Sixty percent of eating disorders do not meet criteria for anorexia- or bulimia nervosa, as defined by the Diagnostic and Statistical Manual version 4 (DSM-IV. Instead they are diagnosed as ‘eating disorders not otherwise specified’ (EDNOS. Discrepancies between criteria and clinical reality currently hampering eating disorder diagnoses in the DSM-IV will be addressed by the forthcoming DSM-V. However, future diagnoses for eating disorders will rely on current advances in the fields of neuroimaging and genetics for classification of symptoms that will ultimately improve treatment. Discussion Here we debate the classification issues, and discuss how brain imaging and genetic discoveries might be interwoven into a model of eating disorders to provide better classification and treatment. The debate concerns: a current issues in the classification of eating disorders in the DSM-IV, b changes proposed for DSM-V, c neuroimaging eating disorder research and d genetic eating disorder research. Summary We outline a novel evidence-based ‘impulse control’ spectrum model of eating disorders. A model of eating disorders is proposed that will aid future diagnosis of symptoms, coinciding with contemporary suggestions by clinicians and the proposed changes due to be published in the DSM-V.

A debate on current eating disorder diagnoses in light of neurobiological findings: is it time for a spectrum model?

Science.gov (United States)

2012-01-01

Background Sixty percent of eating disorders do not meet criteria for anorexia- or bulimia nervosa, as defined by the Diagnostic and Statistical Manual version 4 (DSM-IV). Instead they are diagnosed as ‘eating disorders not otherwise specified’ (EDNOS). Discrepancies between criteria and clinical reality currently hampering eating disorder diagnoses in the DSM-IV will be addressed by the forthcoming DSM-V. However, future diagnoses for eating disorders will rely on current advances in the fields of neuroimaging and genetics for classification of symptoms that will ultimately improve treatment. Discussion Here we debate the classification issues, and discuss how brain imaging and genetic discoveries might be interwoven into a model of eating disorders to provide better classification and treatment. The debate concerns: a) current issues in the classification of eating disorders in the DSM-IV, b) changes proposed for DSM-V, c) neuroimaging eating disorder research and d) genetic eating disorder research. Summary We outline a novel evidence-based ‘impulse control’ spectrum model of eating disorders. A model of eating disorders is proposed that will aid future diagnosis of symptoms, coinciding with contemporary suggestions by clinicians and the proposed changes due to be published in the DSM-V. PMID:22770364

Prehospital severity scoring at major rock concert events.

Science.gov (United States)

Erickson, T B; Koenigsberg, M; Bunney, E B; Schurgin, B; Levy, P; Willens, J; Tanner, L

1997-01-01

Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing. To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events. Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadium's first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a "DRUG-ROCK" Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests. Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5 +/- 22.5 minutes (+/- standard deviation; range: 5-150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (+/- 2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1-4), with 27% rated as moderate (score = 5-9), and 6% severe (score > 10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p rock concerts.

The usefulness of a computer-aided diagnosis scheme for improving the performance of clinicians to diagnose non-mass lesions on breast ultrasonographic images.

Science.gov (United States)

Shibusawa, Mai; Nakayama, Ryohei; Okanami, Yuko; Kashikura, Yumi; Imai, Nao; Nakamura, Takashi; Kimura, Hiroko; Yamashita, Masako; Hanamura, Noriko; Ogawa, Tomoko

2016-07-01

The purpose of this study was to evaluate the usefulness of a computer-aided diagnosis (CAD) scheme for improving the performance of clinicians to diagnose non-mass lesions appearing as hypoechoic areas on breast ultrasonographic images. The database included 97 ultrasonographic images with hypoechoic areas: 48 benign cases [benign lesion with benign mammary tissue or fibrocystic disease (n = 20), fibroadenoma (n = 11), and intraductal papilloma (n = 17)] and 49 malignant cases [ductal carcinoma in situ (n = 17) and invasive ductal carcinoma (n = 32)]. Seven clinicians, three expert breast surgeons, and four general surgeons participated in the observer study. They were asked their confidence level concerning the possibility of malignancy in all 97 cases with and without the use of the CAD scheme. Receiver operating characteristic (ROC) analysis was performed to evaluate the usefulness of the CAD scheme. The areas under the ROC curve (AUC) improved for all observers when they used the CAD scheme and increased from 0.649 to 0.783 (P = 0.0167). Notably, the AUC for the general surgeon group increased from 0.625 to 0.793 (P = 0.045). This study showed that the performance of clinicians to diagnose non-mass lesions appearing as hypoechoic areas on breast ultrasonographic images was improved by the use of a CAD scheme.

Causes of Death in HIV Patients and the Evolution of an AIDS Hospice: 1988–2008

Directory of Open Access Journals (Sweden)

Ann Stewart

2012-01-01

Full Text Available This paper reports on the transformation that has occurred in the care of people living with HIV/AIDS in a Toronto Hospice. Casey House opened in the pre-HAART era to care exclusively for people with HIV/AIDS, an incurable disease. At the time, all patients were admitted for palliative care and all deaths were due to AIDS-defining conditions. AIDS-defining malignancies accounted for 22 percent of deaths, mainly, Kaposi sarcoma and lymphoma. In the post-HAART era, AIDS-defining malignancies dropped dramatically and non-AIDS-defining malignancies became a significant cause of death, including liver cancer, lung cancer and gastric cancers. In the post-HAART era, people living with HIV/AIDS served at Casey House have changed considerably, with increasing numbers of patients facing homelessness and mental health issues, including substance use. Casey House offers a picture of the evolving epidemic and provides insight into changes and improvements made in the care of these patients.

Causes of Death in HIV Patients and the Evolution of an AIDS Hospice: 1988–2008

Science.gov (United States)

Stewart, Ann; Chan Carusone, Soo; To, Kent; Schaefer-McDaniel, Nicole; Halman, Mark; Grimes, Richard

2012-01-01

This paper reports on the transformation that has occurred in the care of people living with HIV/AIDS in a Toronto Hospice. Casey House opened in the pre-HAART era to care exclusively for people with HIV/AIDS, an incurable disease. At the time, all patients were admitted for palliative care and all deaths were due to AIDS-defining conditions. AIDS-defining malignancies accounted for 22 percent of deaths, mainly, Kaposi sarcoma and lymphoma. In the post-HAART era, AIDS-defining malignancies dropped dramatically and non-AIDS-defining malignancies became a significant cause of death, including liver cancer, lung cancer and gastric cancers. In the post-HAART era, people living with HIV/AIDS served at Casey House have changed considerably, with increasing numbers of patients facing homelessness and mental health issues, including substance use. Casey House offers a picture of the evolving epidemic and provides insight into changes and improvements made in the care of these patients. PMID:22666562

Defining a set of standardised outcome measures for newly diagnosed patients with multiple myeloma using the Delphi consensus method: the IMPORTA project.

Science.gov (United States)

Blade, Joan; Calleja, Miguel Ángel; Lahuerta, Juan José; Poveda, José Luis; de Paz, Héctor David; Lizán, Luis

2018-02-22

To define a standard set of outcomes and the most appropriate instruments to measure them for managing newly diagnosed patients with multiple myeloma (MM). A literature review and five discussion groups facilitated the design of two-round Delphi questionnaire. Delphi panellists (haematologists, hospital pharmacists and patients) were identified by the scientific committee, the Spanish Program of Haematology Treatments Foundation, the Spanish Society of Hospital Pharmacies and the Spanish Community of Patients with MM. Panellist's perception about outcomes' suitability and feasibility of use was assessed on a seven-point Likert scale. Consensus was reached when at least 75% of the respondents reached agreement or disagreement. A scientific committee led the project. Fifty-one and 45 panellists participated in the first and second Delphi rounds, respectively. Consensus was reached to use overall survival, progression-free survival, minimal residual disease and treatment response to assess survival and disease control. Panellists agreed to measure health-related quality of life, pain, performance status, fatigue, psychosocial status, symptoms, self-perception on body image, sexuality and preferences/satisfaction. However, panellist did not reach consensus about the feasibility of assessing in routine practice psychosocial status, symptoms, self-perception on body image and sexuality. Consensus was reached to collect patient-reported outcomes through the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Core questionnaire 30 (C30), three items from EORTC-QLQ-Multiple Myeloma (MY20) and EORTC-QLQ-Breast Cancer (BR23), pain Visual Analogue Scale, Morisky-Green and ad hoc questions about patients' preferences/satisfaction. A consensual standard set of outcomes for managing newly diagnosed patients with MM has been defined. The feasibility of its implementation in routine practice will be assessed in a future pilot

Law of health education on first aid

Directory of Open Access Journals (Sweden)

Witold Pawłowski

2018-05-01

Full Text Available Polish law requires all citizens to take action in order to assist in any case, where exist the danger of loss of life and serious bodily injury of victim, even if they can prove to be ineffective. Everyone can become a participant and / or witnessed of the events where human life is endangered. Therefore everyone should have the theoretical knowledge and practical skills in first aid, and know the consequences of inaction in the event of danger to life or health of another human being. The research presents an analysis of legal acts regulating the provision of first aid in Poland. An attempt was made to organize the interpretation presented ideas to the presented material was help and guidance for trainers in first aid. Particular emphasis is placed on the realization, that not helping the man appearing in the position of threatening an imminent danger of death or grievous bodily injury commits a crime by omission. However, first aid in their duties diligently, in accordance with the current guidelines will not conflict with the law.

Optimal diagnostic measures and thresholds for hypogonadism in men with HIV/AIDS: comparison between 2 transdermal testosterone replacement therapy gels.

Science.gov (United States)

Blick, Gary

2013-03-01

To determine the incidence of hypogonadism in men with human immunodeficiency virus (HIV)/acquired immunodeficiency virus (AIDS), the most useful serum testosterone measurement and threshold for diagnosing hypogonadism, and the comparative efficacy of 2 testosterone replacement therapy (TRT) 1% gels (AndroGel® [Abbott Laboratories] and Testim® [Auxilium Pharmaceuticals, Inc.]). This was a 2-stage observational study. In stage 1, patient records from 2 medical practices specializing in HIV/AIDS were reviewed. Eligible patients were aged ≥ 18 years; had HIV-seropositive status confirmed by enzyme-linked immunosorbent assay and western blot test or HIV-1 viremia confirmed by HIV-1 RNA polymerase chain reaction; and had prior baseline testosterone assessments for hypogonadism (ie, presence of signs/symptoms of hypogonadism as well as total testosterone [TT] and free testosterone [FT] level measurements). Stage 2 included the evaluation of patients from stage 1 who were treated with 5 to 10 g/day of TRT. The stage 2 inclusion criteria were a diagnosis of low testosterone (defined as TT level < 300 ng/dL and/or FT level < 50 pg/mL, as per The Endocrine Society guidelines and presence/absence of hypogonadal signs and symptoms); ≥ 12 months of evaluable sign and symptom assessments and TT/FT level measurements while on TRT with either Testim® or AndroGel®; and ≥ 4 weeks on initial TRT if the initial TRT was switched or discontinued. Four hundred one of 422 patients met the stage 1 inclusion criteria and 167 of 401 patients (AndroGel®, n = 92; Testim®, n = 75) met the stage 2 inclusion criteria. Total testosterone level < 300 ng/dL alone identified 24% (94 of 390) of patients as hypogonadal, but failed to diagnose an additional 111 patients (67.7%) with FT levels < 100 pg/mL and hypogonadal symptoms. Through month 12, AndroGel® increased mean TT levels by +42.8% and FT levels by +66.9%, compared with +178.7% (P = 0.017) and +191% (P = 0.039), respectively, for

Psychiatry: life events and social support in late life depression

Directory of Open Access Journals (Sweden)

Clóvis Alexandrino-Silva

2011-01-01

Full Text Available OBJECTIVES: To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION: Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS: We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE inventory. RESULTS: ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION: Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS: We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.

Cancer incidence in people living with HIV/AIDS in Israel, 1981-2010.

Science.gov (United States)

Zohar, Mor; Micha, Barchana

2015-09-01

Antiretroviral therapy (ART) improved the survival of people living with HIV/AIDS (PLWHA) and decreased HIV-related morbidities. This study assesses the cancer incidence of all adult PLWHA in Israel by transmission routes before and after 1996. This cohort study was based on cross-matching the National HIV/AIDS and Cancer Registries of all HIV/AIDS and cancer cases reported from 1981 to 2010 with the National civil census. PLWHA were followed-up until cancer diagnosis, death, leaving Israel, or 2010, whichever occurred first. Cancer incidence was adjusted for age, and compared with the National incidence. Of all 5,154 PLWHA followed-up for 36,296 person-years, 362 (7.0%) developed cancer (997.4 cases per 100,000 person-years). Higher hazard ratios to develop cancer were demonstrated among older PLWHA, Jewish people, and intravenous drug users. Cancer incidence among PLWHA was higher in the pre-ART period than after 1997 (1,232.0 and 846.7 cases per 100,000 person-years, respectively). The incidence of AIDS-defining cancers was higher than non-AIDS-defining malignancies, and higher in the pre-ART than the post-ART period (777.0 and 467.2 cases per 100,000 person-years, respectively), while the incidence of non-AIDS-defining cancers showed the opposite trend (376.5 and 455.0 cases per 100,000 person-years, respectively). The incidence of AIDS-defining and non-AIDS-defining cancers declined between the pre-ART and the post-ART period by 2.0 to 3.4 times. PLWHA had higher rates of malignancies than the general population. In conclusion, cancer incidence among PLWHA was associated with age, and declined after ART introduction; yet it was higher than that of the general population. PLWHA may benefit from age-related cancer screening, increased adherence to ART, and reduction of environmental oncogenes.

Radiology examination as a diagnostic aid in presentations with ...

African Journals Online (AJOL)

Radiology examination as a diagnostic aid in presentations with wide differential diagnoses: Case report of new Hodgkin's lymphoma on a background of poorly controlled HIV. Rachel Hubbard, Jalpa Kotecha, Thomas Nash, Yu Jin Lee, Nasir Khan, Farhat Kazmi ...

Brain american trypanosomiasis: chagoma with involvement of the corpus callosum in a patient with aids

International Nuclear Information System (INIS)

Rodriguez, Sonia; Sanz Margarita M; Aponte Milena

2009-01-01

Chagas's disease affects 7% of the Colombian population and is an uncommonly diagnosed disease due to its non-specific symptoms. In the acute phase of the disease, direct invasion of the brain can be present, with acute eningoencephalitis. In the chronic phase, there can be a residual meningoencephalitis or ischemic events related to cardiomyopathy. In acute reactivation,there is parasitaemia due to an immunosuppressed state with necrotizing meningoencephalitis and formation of cerebral masses, also called chagomas. There are no pathognomonic findings for chagomas, which consist of solitary or multiple nodular lesions, located in the white matter,basal ganglia, corpus callosum, cerebellum, brainstem or spinal cord. They present an irregular and peripheral gadolinium enhancement pattern. The main differential diagnoses include Toxoplasma gondii infection and neoplasms. This article presents a case of a 74-year-old female HIV + patient,with progressive walking impairment, presented with a corpus callosum and left periventricular white matter mass on MRI. The histological study revealed amastigotes. She had positive serum titles for Trypanosoma cruzi, confirming the diagnosis of a chagoma in a patient with AIDS.

Computer-Aided Methodology for Syndromic Strabismus Diagnosis.

Science.gov (United States)

Sousa de Almeida, João Dallyson; Silva, Aristófanes Corrêa; Teixeira, Jorge Antonio Meireles; Paiva, Anselmo Cardoso; Gattass, Marcelo

2015-08-01

Strabismus is a pathology that affects approximately 4 % of the population, causing aesthetic problems reversible at any age and irreversible sensory alterations that modify the vision mechanism. The Hirschberg test is one type of examination for detecting this pathology. Computer-aided detection/diagnosis is being used with relative success to aid health professionals. Nevertheless, the routine use of high-tech devices for aiding ophthalmological diagnosis and therapy is not a reality within the subspecialty of strabismus. Thus, this work presents a methodology to aid in diagnosis of syndromic strabismus through digital imaging. Two hundred images belonging to 40 patients previously diagnosed by an specialist were tested. The method was demonstrated to be 88 % accurate in esotropias identification (ET), 100 % for exotropias (XT), 80.33 % for hypertropias (HT), and 83.33 % for hypotropias (HoT). The overall average error was 5.6Δ and 3.83Δ for horizontal and vertical deviations, respectively, against the measures presented by the specialist.

Human papillomavirus-associated cancers as acquired immunodeficiency syndrome defining illnesses

Directory of Open Access Journals (Sweden)

Shohreh Shahabi

2013-04-01

Full Text Available The Centers for Disease Control currently report cervical, vulvar, vaginal, anal and some head and neck cancers as human papillomavirus (HPV-associated cancers. Only cervical cancer is listed amongst acquired immunodeficiency syndrome (AIDS defining illnesses. All of these cancers may represent progression of the immunocompromised state with the inability to eradicate viral infection. This study reports the case of a 27-year old HIV positive female presenting with a persistent right vulvar exophytic lesion. High-risk HPV analysis and immunostaining for P16 were both positive. A biopsy of the lesion revealed invasive squamous cell carcinoma. The patient underwent neoadjuvant radiation and chemotherapy followed by a radical vulvectomy. During treatment, her CD4 T-lymphocyte count decreased to 120 advancing her condition from HIV to AIDS. This case suggests that all HPV-associated cancers should be included as AIDS defining illnesses.

Image-processing techniques used in the computer-aided detection of radiographic lesions in anatomic background

International Nuclear Information System (INIS)

Giger, M.L.; Doi, K.; MacMahon, H.; Yin, F.F.

1988-01-01

The authors developed feature-extraction techniques for use in the computer-aided detection of pulmonary nodules in digital chest images. Use of such a computer-aided detection scheme, which would alert radiologists to the locations of suspected lung nodules, is expected to reduce the number of false-negative diagnoses. False-negative diagnoses (i.e., misses) are a current problem in chest radiology with ''miss-rates'' as high as 30%. This may be due to the camouflaging effect of surrounding anatomic background on the nodule, or to the subjective and varying decision criteria used by radiologists

AIDS: radiologic findings in the thorax and abdomen

International Nuclear Information System (INIS)

Langer, M.; Langer, R.

1993-01-01

Thoracic manifestation of AIDS are initially diagnosed on plain film studies. Pneumocystis carinii infections are characterised by bi-hilar streaky, interstitial and diffuse micronodular infiltrations. These findings are best seen on thoracic CT examinations. Thoracic Kaposi sarcoma is characterized by larger, rounded interstitial infiltrations. In abdominal AIDS ultrasound is the first screening method. It detects equally well lymph nodes in Kaposi sarcoma as in all lymphomas and opportunistic infections. CT can differentiate between mycobacterium tuberculosis and mycobacterium avium intracellulare infections, because of the central low-density lymphoma in tuberculosis. (orig.)

Case study: beverage temperature at aid stations in ironman triathlon.

Science.gov (United States)

Burdon, Catriona A; Johnson, Nathan A; Chapman, Phillip G; Munir Che Muhamed, Ahmad; O'Connor, Helen T

2013-08-01

The aim of this study was to measure the effect of environmental conditions and aid-station beverage- cooling practices on the temperature of competitor beverages. Environmental and beverage temperatures were measured at three cycling and two run course aid stations at the 2010 Langkawi, Malaysia (MA), and Port Macquarie, Australia (AU), Ironman triathlon events. To measure the specific effect of radiant temperature, additional fluid-filled (600 ml) drink bottles (n = 12) were cooled overnight (C) and then placed in direct sun (n = 6) or shade (n = 6) near to a cycle aid station at AU. During both events, beverage temperature increased over time (p beverage temperature ranged between 14-26°C and during both events was above the palatable range (15-22°C) for extended periods. At AU, bottles placed in direct sunlight heated faster (6.9 ± 2.3 °C·h-1) than those in the shade (4.8 ±1.1°C·h-1, p = .05). Simple changes to Ironman aid-station practices, including shade and chilling beverages with ice, result in the provision of cooler beverages. Future studies should investigate whether provision of cool beverages at prolonged endurance events influences heat-illness incidence, beverage-consumption patterns, and competitor performance.

Evaluation Influence: The Evaluation Event and Capital Flow in International Development.

Science.gov (United States)

Bell, David A

2017-12-01

Assessing program effectiveness in human development is central to informing foreign aid policy-making and organizational learning. Foreign aid effectiveness discussions have increasingly given attention to the devaluing effects of aid flow volatility. This study reveals that the external evaluation event influences actor behavior, serving as a volatility-constraining tool. A case study of a multidonor aid development mechanism served examining the influence of an evaluation event when considering anticipatory effects. The qualitative component used text and focus group data combined with individual interview data (organizations n = 10, including 26 individuals). Quantitative data included financial information on all 75 capital investments. The integrated theory of influence and model of alternative mechanisms used these components to identify the linkage between the evaluation event and capital flow volatility. Aid approved in the year of the midterm evaluation was disbursed by the mechanism with low capital volatility. Anticipating the evaluation event influenced behavior resulting in an empirical record that program outcomes were enhanced and the mechanism was an improved organization. Formative evaluations in a development program can trigger activity as an interim process. That activity provides for a more robust assessment of ultimate consequence of interest. Anticipating an evaluation can stimulate donor reality testing. The findings inform and strengthen future research on the influence of anticipating an evaluation. Closely examining activities before, during, and shortly after the evaluation event can aid development of other systematic methods to improve understanding this phenomenon, as well as improve donor effectiveness strategies.

Nursing diagnoses in elderly residents of a nursing home: a case in Turkey.

Science.gov (United States)

Güler, Elem Kocaçal; Eşer, Ismet; Khorshid, Leyla; Yücel, Sebnem Çinar

2012-01-01

There are limited studies on nursing diagnoses of the elderly living in nursing homes worldwide. This study aimed to define the most frequent nursing diagnoses in the elderly residents of a nursing home elder care and rehabilitation center. Seventy-four elderly individuals were included in the study. Data were collected using the "Elderly Individual's Introduction Form" between April 2007 to August 2007. The content of the form was based on a guide to gerontologic assessment, and Gordon's Functional Health Patterns. The nursing diagnoses (NANDA-I Taxonomy II) were identified by the 2 researchers separately according to the defining characteristics and the risk factors. The consistency between the nursing diagnoses defined by the 2 researchers was evaluated using Cohen's kappa (κ). There was an 84.7% agreement about nursing diagnoses defined by the 2 researchers separately. The weighted kappa consistency analyses showed there was an adequate level of consistency (κ = 0.710), and the findings were significant (p health maintenance (81.2%), risk for falls (77%), and impaired physical mobility (73%). The diagnosis of ineffective role performance was more frequent in patients with dementia (x(2) =10.993, df = 1, p = 0.001). There was a very significant relationship between dementia and the diagnosis of impaired verbal communication (x(2) = 32.718, df = 1, p = 0.0001). The relationship between mobility disorder and self-care deficit was also significant (x(2) = 19.411, df = 1, p = 0.0001). To improve quality in patient care, nurses should use nursing diagnoses with a systematic assessment and should help the elderly in health promotion or use of the maximum current potential. Copyright © 2012 Elsevier Inc. All rights reserved.

[AIDS and pain management-a survey of German AIDS and pain management units.].

Science.gov (United States)

Zech, D; Radbruch, L; Grond, S; Heise, W

1994-06-01

The number of AIDS patients is steadily increasing. According to the literature these patients are often in severe pain. We evaluated pain diagnoses and treatments with two almost identical questionnaires for AIDS treatment units (ATU) and pain management units (PMU). Questions dealt with unit type and size, number of patients treated per year and the proportion of intravenous drug users. The units were also asked to give an estimate of pain aetiologies, pain types and localizations and treatment modalities offered. Completed questionnaires were returned by 38 of 235 ATU and 85 of 127 PMU. In the ATU, 16% of the patients (estimated at 580 patients per year) had pain requiring treatment. In 26 of the PMU approximately 120 AIDS patients per year were treated, while 59 PMU had not yet seen any AIDS patients. Pain was caused mainly by opportunistic infections and by neurological syndromes connected with AIDS. Pain aetiologies could not be differentiated in the ATU in 22% of patients (PMU 9%), and pain types in 33% (PMU 9%). Neuropathic pain (ATU 38%, PMU 89%) was more frequent than nociceptive pain (ATU 29%, PMU 36%). The treatment modalities were systemic pharmacotherapy in 76% of ATU and 73% of PMU and nerve blocks in 37% of ATU and 42% of PMU. In 82% of ATU the staff thought their analgesic therapy was adequate, and in 92% staff were interested in closer cooperation with PMU such as was currently practised in only 6 of the 38 units (16%) that responded. The high incidence of complicated neuropathic pain syndromes in AIDS patients requires a sophisticated therapeutic approach. Closer cooperation between AIDS specialists and pain specialists, comparable to that already existing for other patient groups, is therefore desirable.

Tuberculosis screening among homeless persons with AIDS living in single-room-occupancy hotels.

Science.gov (United States)

Layton, M C; Cantwell, M F; Dorsinville, G J; Valway, S E; Onorato, I M; Frieden, T R

1995-11-01

Congregate facilities for homeless persons with the acquired immunodeficiency syndrome (AIDS) are often endemic for tuberculosis. We evaluated tuberculosis screening methods at single-room-occupancy hotels housing persons with AIDS. Residents were screened by cross matching the New York City Tuberculosis Registry, interviewing for tuberculosis history, skin testing, and chest radiography. Cases were classified as either previously or newly diagnosed. Among the 106 participants, 16 (15%) previously diagnosed tuberculosis cases were identified. Participants' tuberculosis histories were identified by the questionnaire (100%) or by registry match (69%). Eight participants (50%) were noncompliant with therapy. These findings prompted the establishment of a directly observed therapy program on site.

Immune reconstitution syndrome presenting as probable AIDS-related lymphoma: a case report

OpenAIRE

Christensen Charlotte B; Nielsen Susanne D; Mortensen Bo K; Helweg-Larsen Jannik

2011-01-01

Abstract We report an unusual case of HIV-related immune reconstitution inflammatory syndrome, presenting as suspected AIDS-related lymphoma. Symptoms, initial investigations including fine-needle biopsy and 18F-FDG PET/CT scan were highly compatible with high grade AIDS-related lymphoma, however subsequently IRIS was diagnosed. We discuss pitfalls in the interpretation of diagnostic results in ARL versus IRIS.

Design Aids for Real-Time Systems (DARTS)

Science.gov (United States)

Szulewski, P. A.

1982-01-01

Design-Aids for Real-Time Systems (DARTS) is a tool that assists in defining embedded computer systems through tree structured graphics, military standard documentation support, and various analyses including automated Software Science parameter counting and metrics calculation. These analyses provide both static and dynamic design quality feedback which can potentially aid in producing efficient, high quality software systems.

The Utility of Ambulatory Blood Pressure Monitoring for Diagnosing White Coat Hypertension in Older Adults.

Science.gov (United States)

Reynolds, Kristi; Bowling, C Barrett; Sim, John J; Sridharan, Lakshmi; Harrison, Teresa N; Shimbo, Daichi

2015-11-01

The beneficial effect of antihypertensive medication on reducing the risk of cardiovascular disease (CVD) events is supported by data from randomized controlled trials of older adults with hypertension. However, in clinical practice, overtreatment of hypertension in older adults may lead to side effects and an increased risk of falls. The diagnosis and treatment of hypertension is primarily based on blood pressure measurements obtained in the clinic setting. Ambulatory blood pressure monitoring (ABPM) complements clinic blood pressure by measuring blood pressure in the out-of-clinic setting. ABPM can be used to identify white coat hypertension, defined as elevated clinic blood pressure and non-elevated ambulatory blood pressure. White coat hypertension is common in older adults but does not appear to be associated with an increased risk of CVD events among this population. Herein, we review the current literature on ABPM in the diagnoses of white coat hypertension in older adults, including its potential role in preventing overtreatment.

The Utility of Ambulatory Blood Pressure Monitoring for Diagnosing White Coat Hypertension in Older Adults

Science.gov (United States)

Reynolds, Kristi; Bowling, C. Barrett; Sim, John J.; Sridharan, Lakshmi; Harrison, Teresa N.; Shimbo, Daichi

2015-01-01

The beneficial effect of antihypertensive medication on reducing the risk of cardiovascular disease (CVD) events is supported by data from randomized controlled trials of older adults with hypertension. However, in clinical practice, overtreatment of hypertension in older adults may lead to side effects and an increased risk of falls. The diagnosis and treatment of hypertension is primarily based on blood pressure measurements obtained in the clinic setting. Ambulatory blood pressure monitoring (ABPM) complements clinic blood pressure by measuring blood pressure in the out-of-clinic setting. ABPM can be used to identify white coat hypertension, defined as elevated clinic blood pressure and non-elevated ambulatory blood pressure. White coat hypertension is common in older adults but does not appear to be associated with an increased risk of CVD events among this population. Herein, we review the current literature on ABPM in the diagnoses of white coat hypertension in older adults, including its potential role in preventing overtreatment. PMID:26400076

Clinically significant cardiopulmonary events and the effect of definition standardization on apnea of prematurity management.

Science.gov (United States)

Powell, M B F; Ahlers-Schmidt, C R; Engel, M; Bloom, B T

2017-01-01

To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge. Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded. Data and records were used to indicate when the new definition of clinically significant cardiopulmonary events (CSCPEs) and concurrent education was implemented. Preimplementation and postimplementation cohorts were compared. Incidence fell from 74% diagnosed with apnea of prematurity at baseline to 49% diagnosed with CSCPE postimplementation (Pdefinitions and treatments reduced the use of caffeine and cardiorespiratory monitors upon NICU dismissal.

Impact of housing on the survival of persons with AIDS

Directory of Open Access Journals (Sweden)

Vittinghoff Eric

2009-07-01

Full Text Available Abstract Background Homeless persons with HIV/AIDS have greater morbidity and mortality, more hospitalizations, less use of antiretroviral therapy, and worse medication adherence than HIV-infected persons who are stably housed. We examined the effect of homelessness on the mortality of persons with AIDS and measured the effect of supportive housing on AIDS survival. Methods The San Francisco AIDS registry was used to identify homeless and housed persons who were diagnosed with AIDS between 1996 and 2006. The registry was computer-matched with a housing database of homeless persons who received housing after their AIDS diagnosis. The Kaplan-Meier product limit method was used to compare survival between persons who were homeless at AIDS diagnosis and those who were housed. Proportional hazards models were used to estimate the independent effects of homelessness and supportive housing on survival after AIDS diagnosis. Results Of the 6,558 AIDS cases, 9.8% were homeless at diagnosis. Sixty-seven percent of the persons who were homeless survived five years compared with 81% of those who were housed (p Conclusion Supportive housing ameliorates the negative effect of homelessness on survival with AIDS.

An Event-Based Approach to Distributed Diagnosis of Continuous Systems

Science.gov (United States)

Daigle, Matthew; Roychoudhurry, Indranil; Biswas, Gautam; Koutsoukos, Xenofon

2010-01-01

Distributed fault diagnosis solutions are becoming necessary due to the complexity of modern engineering systems, and the advent of smart sensors and computing elements. This paper presents a novel event-based approach for distributed diagnosis of abrupt parametric faults in continuous systems, based on a qualitative abstraction of measurement deviations from the nominal behavior. We systematically derive dynamic fault signatures expressed as event-based fault models. We develop a distributed diagnoser design algorithm that uses these models for designing local event-based diagnosers based on global diagnosability analysis. The local diagnosers each generate globally correct diagnosis results locally, without a centralized coordinator, and by communicating a minimal number of measurements between themselves. The proposed approach is applied to a multi-tank system, and results demonstrate a marked improvement in scalability compared to a centralized approach.

Spectrum of cancer risk late after AIDS onset in the United States.

Science.gov (United States)

Simard, Edgar P; Pfeiffer, Ruth M; Engels, Eric A

2010-08-09

Persons living with AIDS today remain at elevated cancer risk. Highly active antiretroviral therapy (HAART), widely available since 1996, prolongs life, but immune function is not fully restored. We conducted this study to assess long-term cancer risk among persons with AIDS relative to the general population and the impact of HAART on cancer incidence. Records of 263 254 adults and adolescents with AIDS (1980-2004) from 15 US regions were matched to cancer registries to capture incident cancers during years 3 through 5 and 6 through 10 after AIDS onset. Standardized incidence ratios (SIRs) were used to assess risks relative to the general population. Rate ratios (RRs) were used to compare cancer incidence before and after 1996 to assess the impact of availability of HAART. Risk was elevated for the 2 major AIDS-defining cancers: Kaposi sarcoma (SIRs, 5321 and 1347 in years 3-5 and 6-10, respectively) and non-Hodgkin lymphoma (SIRs, 32 and 15). Incidence of both malignancies declined in the HAART era (1996-2006). Risk was elevated for all non-AIDS-defining cancers combined (SIRs, 1.7 and 1.6 in years 3-5 and 6-10, respectively) and for the following specific non-AIDS-defining cancers: Hodgkin lymphoma and cancers of the oral cavity and/or pharynx, tongue, anus, liver, larynx, lung and/or bronchus, and penis. Anal cancer incidence increased between 1990-1995 and 1996-2006 (RR, 2.9; 95% confidence interval [CI], 2.1-4.0), as did that of Hodgkin lymphoma (RR, 2.0; 95% CI, 1.3-2.9). Among people who survived for several years or more after an AIDS diagnosis, we observed high risks of AIDS-defining cancers and increasing incidence of anal cancer and Hodgkin lymphoma.

Epidemiology of HIV/AIDS among Asians and Pacific Islanders in the United States

Science.gov (United States)

Zaidi, Irum F.; Crepaz, Nicole; Song, Ruiguang; Wan, Choi K.; Lin, Lillian S.; Hu, Dale J.; Sy, Francisco S.

2005-01-01

Although the percentage of overall AIDS diagnoses remains low among Asian and Pacific Islanders (APIs) in the United States compared with other racial/ethnic groups, research on API risk behaviors and health status suggest that the low number of AIDS cases may not provide a full picture of the epidemic and issues faced by this understudied and…

Validation studies of nursing diagnoses in neonatology

Directory of Open Access Journals (Sweden)

Pavlína Rabasová

2016-03-01

Full Text Available Aim: The objective of the review was the analysis of Czech and foreign literature sources and professional periodicals to obtain a relevant comprehensive overview of validation studies of nursing diagnoses in neonatology. Design: Review. Methods: The selection criterion was studies concerning the validation of nursing diagnoses in neonatology. To obtain data from relevant sources, the licensed professional databases EBSCO, Web of Science and Scopus were utilized. The search criteria were: date of publication - unlimited; academic periodicals - full text; peer-reviewed periodicals; search language - English, Czech and Slovak. Results: A total of 788 studies were found. Only 5 studies were eligible for content analysis, dealing specifically with validation of nursing diagnoses in neonatology. The analysis of the retrieved studies suggests that authors are most often concerned with identifying the defining characteristics of nursing diagnoses applicable to both the mother (parents and the newborn. The diagnoses were validated in the domains Role Relationship; Coping/Stress tolerance; Activity/Rest, and Elimination and Exchange. Diagnoses represented were from the field of dysfunctional physical needs as well as the field of psychosocial and spiritual needs. The diagnoses were as follows: Parental role conflict (00064; Impaired parenting (00056; Grieving (00136; Ineffective breathing pattern (00032; Impaired gas exchange (00030; and Impaired spontaneous ventilation (00033. Conclusion: Validation studies enable effective planning of interventions with measurable results and support clinical nursing practice.

HIV/AIDS stigma and religiosity among African American women.

Science.gov (United States)

Muturi, Nancy; An, Soontae

2010-06-01

African American women are disproportionately affected by HIV/AIDS compared with other ethnicities, accounting for two-thirds (67%) of all women diagnosed with HIV. Despite their increased risk of HIV infection, few studies have been conducted to understand culture-specific factors leading to their vulnerability. Given the central role of religious organizations in African American communities, this study explored whether and to what extent religiosity plays a role in stigma toward HIV/AIDS. Results of hierarchical regression showed that after controlling for key factors, religiosity was a significant factor predicting the level of religious stigma. Those with high religiosity displayed significantly higher stigma, associating HIV/AIDS with a curse or punishment from God. Verbatim responses to an open-ended question also revealed seemingly ingrained prejudice against HIV/AIDS from a religious perspective. The findings point to the important role of faith-based organizations (FBOs) in addressing HIV/AIDS issues within African American communities.

The Methods for Diagnosing the Attractiveness of Ecological Entrepreneurship in Rural Areas

Directory of Open Access Journals (Sweden)

Shuliak Bogdan V.

2018-03-01

Full Text Available The study is aimed at substantiating the methods for diagnosing the attractiveness of ecological entrepreneurship in rural areas. The article defines the objectives of diagnosing the attractiveness of ecological entrepreneurship in rural areas. It is determined that the methods for diagnosing the attractiveness of environmentally oriented entrepreneurial activity should take into account its effectiveness in the context of economic, ecological, and social components; current status, dynamics and tendencies of development of basic indicators of attractiveness; relationship between the actual and target values of such indicators. The system of methods which is expedient for use in the process of diagnosing, has been defined as follows: methods of correlation analysis (substantiation of the purposes of diagnostics; coefficient analysis and fuzzy logic methods (estimation of the actual levels of attractiveness indicators; regression analysis and mathematical-statistical method (estimation of tendencies, building of forecasts; cluster analysis, ranking, rationing, and integral estimation (comparative analysis of the estimation results.

Hospital environment: Generator of stigma and rejection of pregnant women with HIV/aids

Directory of Open Access Journals (Sweden)

Yolanda Munévar-Torres

2016-10-01

Full Text Available Introduction: For the mothers included in this study, pregnancy is normal until they are diagnosed with HIV/AIDS. Studies on experiences in hospital environments are scarce. Objective: To understand the experiences of pregnant women living with HIV/AIDS during prenatal attention in two hospitals. Materials and methods: Interpretative phenomenological qualitative study, in which ten women, diagnosed with HIV during pregnancy and selected according to relevance and adequacy, participated. The sample size was established by theoretical saturation. Data were collected during in-depth interviews and analyzed through Colaizzi strategy. Results: Categorizing the hospital environment as a generator of stigma and rejection of pregnant women with HIV/AIDS is part of a research project on living with HIV/AIDS during pregnancy. The hospital environment shows the spaces and actors around these mothers during diagnosis and treatment of this infection. Participants refer to the first stage as “accidental diagnosis” and described attention as full of “reckless professionals”. Conclusions: Attitudes and behaviors of health professionals can generate a hostile environment for pregnant women with HIV/AIDS, heightening negative feelings, fears and uncertainties. However, they can also offer a friendly and human scenario that contributes to care and trust between professionals and pregnant women, thus helping mothers to cope with this complex experience.

The dynamics of the production of AIDS-related stigma among pregnant women living with HIV/AIDS in Rio de Janeiro, Brazil

Directory of Open Access Journals (Sweden)

Simone Monteiro

Full Text Available The study analyses the relationship between AIDS-related stigma and the processes of discrimination prior to diagnosis among pregnant women living with HIV/AIDS. The fieldwork involved interviews about the life trajectories of 29 pregnant women living with HIV/AIDS, recruited at two AIDS services in Rio de Janeiro, Brazil. The analysis revealed that before HIV diagnosis, social and gender inequalities experienced by these women reduced their access to material and symbolic goods that could have enhanced educational and career prospects and their ability and autonomy to exercise sexual and reproductive rights. Being diagnosed with HIV triggered fear of moral judgment and of breakdown in social and family support networks. Given these fears, pregnant women living with HIV/AIDS opt for concealment of the diagnosis. It is necessary for health services, NGOs and government agencies to work together to face the factors that fuel stigma, such as socioeconomic and gender inequalities, taboos and prejudices related to sexuality, and also develop actions to enable women to redefine the meaning of the disease.

The psychosocial impact of hearing aids in children with otitis media with effusion.

Science.gov (United States)

Qureishi, A; Garas, G; Mallick, A; Parker, D

2014-11-01

In children, otitis media with effusion is treated using grommets or hearing aids. Parents considering treatment options express concerns regarding the psychosocial impact of hearing aids in terms of self-esteem and bullying. This study assessed the psychosocial impact of hearing aid use. A cross-sectional study was undertaken comparing hearing aid users to non hearing aid users with regard to their attitudes towards hearing aids. All subjects, who had been diagnosed with otitis media with effusion, were aged less than 16 years, were without disability and attended mainstream schools. A questionnaire was designed and utilised. The study comprised 47 children with hearing aids and 50 with grommets. Significant between-group differences (p negative perceptions of non hearing aid users were not reported by hearing aid users. Children with hearing aids do not suffer from bullying or low self-esteem to the extent perceived by parents. This information is useful for informed decisions regarding treatment of otitis media with effusion.

Trends on epidemiological, virological, and clinical features among newly diagnosed HIV-1 persons in Northwest Spain over the last 10 years.

Science.gov (United States)

Pernas, B; Mena, A; Cañizares, A; Grandal, M; Castro-Iglesias, A; Pértega, S; Pedreira, J D; Poveda, E

2015-08-01

To describe temporal trend and characteristics of newly HIV-diagnosed patients in a medical care area in Northwest Spain over the last 10 years. All newly diagnosed patients for HIV-infection from 2004 to 2013 at a reference medical care area in Northwest of Spain were identified. Epidemiological, virological, immunological, and clinical data, as well as HIV genotype and drug resistance information were recorded. A total of 565 newly HIV-diagnosed patients were identified. The number of new cases increased in the last 5 years (66 cases/year). Overall, 53.1% had a median CD4 counts study period was 3.7%, but a decreased to 2.6% was observed in the last 5 years. The most prevalent TDR mutations were: T215 revertants (1.5%), K219QENR (1.2%), for NRTIs; K103N (1.9%), for NNRTIs; L90M (0.3%), for PIs. Overall, 73.2% of patients started antiretroviral treatment and 9.9% of patients died during follow-up. The number of newly HIV diagnosed patients increased since year 2009. There is a high prevalence of late diagnosis (53%) and 33% had an AIDS defining criteria. Interestingly, the most prevalent non-B subtype in our population was F (25.8%). These findings support the need to facilitate the access for HIV testing to reduce the rate of late HIV diagnosis, improve the clinical outcome and prevent HIV transmission. © 2015 Wiley Periodicals, Inc.

Prevalence of chronic kidney disease in newly diagnosed patients with Human immunodeficiency virus in Ilorin, Nigeria.

Science.gov (United States)

Ayokunle, Dada Samuel; Olusegun, Olanrewaju Timothy; Ademola, Aderibigbe; Adindu, Chijioke; Olaitan, Rafiu Mojeed; Oladimeji, Ajayi Akande

2015-01-01

Human immunodeficiency virus (HIV) the causative agent of Acquired immunodeficiency syndrome (AIDS) is an important cause of renal diseases in sub-Saharan Africa. There is paucity of studies on the burden of chronic kidney disease (CKD) among patients with HIV/AIDS in the North-Central zone of Nigeria. This is a cross-sectional study of 227 newly-diagnosed, antiretroviral naïve patients with HIV/AIDS seen at the HIV clinic of the Medical Out-patient Department (MOPD) of University of Ilorin Teaching Hospital (UITH). They were matched with 108 control group. Laboratory investigations were performed for the participants. CKD was defined as estimated glomerular filtration rate (eGFR) 30 mg/g. There were 100 (44%) males among the patients and 47 (43.5%) among the control group. The mean ages of the patients and controls were 40.3 ± 10.3 years and 41.8 ± 9.5 years respectively. CKD was observed in 108 (47.6%) among the patients and 18 (16.7%) of the controls (p = 0.01). The median CD4 T-cell count was significantly lower in patients with CKD. Ninety-three (41.0%) of the patients had dipstick proteinuria of > 2 +. The median albumin creatinine ratio (ACR) was significantly higher among the HIV-positive patients (272.3 mg/g) compared with the HIV-negative controls (27.22 mg/g) p = 0.01. The CD4 T-cell count correlates positively with eGFR (r = 0.463, p = 0.001) and negatively with ACR (r = -0.806, p = 0.001). CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients.

Failure diagnosis using discrete event models

International Nuclear Information System (INIS)

Sampath, M.; Sengupta, R.; Lafortune, S.; Teneketzis, D.; Sinnamohideen, K.

1994-01-01

We propose a Discrete Event Systems (DES) approach to the failure diagnosis problem. We present a methodology for modeling physical systems in a DES framework. We discuss the notion of diagnosability and present the construction procedure of the diagnoser. Finally, we illustrate our approach using a Heating, Ventilation and Air Conditioning (HVAC) system

Socio-economic status of AIDS patients

DEFF Research Database (Denmark)

Laursen, E; Larsen, L

1995-01-01

The charts of 187 patients diagnosed at Hvidovre University Hospital, Copenhagen from 1981 through 1989 as having AIDS were reviewed retrospectively in order to examine the extent of their employment and alternative sources of income during the first 2 years after diagnosis. At the time...... of diagnosis. After 2 years, only 6% still worked, while 22% had a pension. Sixty-seven percent had died. The major source of income during these first 2 years after diagnosis was a pension, most often a disability pension. During this period the total average disbursement of public allowances per patient...... amounted to US$16,150. As shown here, the work capacity of AIDS patients is quite low, and alternative sources of income must be provided....

Psychological First Aid Field Operations Guide. 2nd Edition

Science.gov (United States)

Brymer, Melissa; Layne, Christopher; Jacobs, Anne; Pynoos, Robert; Ruzek, Josef; Steinberg, Alan; Vernberg, Eric; Watson, Patricia

2006-01-01

Psychological First Aid is an evidence-informed modular approach to help children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism. Psychological First Aid is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping. Principles and…

The relationship between stressful life events and Axis I diagnoses among adolescent offspring of probands with bipolar and non-bipolar psychiatric disorders and healthy controls

Science.gov (United States)

Pan, Lisa A.; Goldstein, Tina R.; Rooks, Brian T.; Hickey, Mary; Fan, Jie Yu; Merranko, John; Monk, Kelly; Diler, Rasim S.; Sakolsky, Dara J.; Hafeman, Daniella; Iyengar, Satish; Goldstein, Benjamin; Kupfer, David J.; Axelson, David; Brent, David A.; Birmaher, Boris

2018-01-01

Background Previous studies have explored the role of stressful life events in the development of mood disorders. We examined the frequency and nature of stressful life events as measured by the Stressful Life Events Scale(SLES) among three groups of adolescent offspring of probands: with bipolar(BD), with non-BD psychiatric disorders, and healthy control(HC). Furthermore, we examined the relationship between stressful life events and presence of DSM-IV Axis I disorders in these offspring. Stressful life events were characterized as dependent, independent, or uncertain (neither dependent or independent), and positive, negative, and neutral (neither positive or negative). Method Offspring of probands with BD aged 13–18 years(N=269), demographically-matched offspring of probands with non-BD Axis I disorders(N=88), and HC probands(N=81) from the Pittsburgh Bipolar Offspring Study were assessed from 2002–2007 with standardized instruments at intake. Probands completed the SLES for their offspring for life events within the prior year. Life events were evaluated with regard to current offspring Axis I diagnoses after adjusting for confounds. Results After adjusting for demographic and clinical between-group differences(in probands and offspring), offspring of BD probands had greater independent and neutral life events compared with HC offspring and greater number of more severe stressful life events than HC offspring, but not non-BD offspring. Offspring of BD probands with comorbid substance use disorder reported more independent stressful life events. Greater frequency and severity of stressful life events were associated with current Axis I disorder in offspring of both BD and non-BD affected probands regardless of dependency or valence. Greater frequency and severity of stressful life events were associated with greater current Axis I disorder in all offspring. Conclusions Offspring of BD probands have greater exposure to independent and neutral life events than

Clinical and Epidemiological Characteristics of HIV Infection/AIDS in Hospitalized Patients.

Science.gov (United States)

Ahmetagic, Sead; Porobić-Jahic, Humera; Piljic, Dilista; Custovic, Amer; Sabitovic, Damir; Zepic, Denis

2015-02-01

More than three decades after recognition of acquired immunodeficiency syndrome (AIDS) in the United States, the pandemic of human immunodeficiency virus (HIV) infection has dramatically changed the global burden of disease. The main goal of this research is retrospective analysis of epidemiological and clinical characteristics of 28 HIV infected patients, who were diagnosed and treated at the Clinic for Infectious Diseases in University Clinical Center Tuzla in the period from 1996 until the end of 2013. Retrospective analysis was performed using the medical records of 28 HIV-infected persons. Two rapid tests were used for HIV testing: OraQuick Advance test, Vikia HIV1/2, Elisa combo test, HIV RNA test. AIDS disease was determined by using the criteria from WHO. Among a total of 28 HIV-infected persons, 23 (82.14%) were males and 5 (17.86%) were females, with the male: female ratio of 4,6:1. In terms of the transmission route, a large proportion of cases were infected through heterosexual contact 19 (67.86%). At the time of the first visit, 16 (57.15%) patients showed asymptomatic HIV infection, 4 (14.28%) HIV infection with symptoms other than the AIDS defining diseases, and 8 (28.57) had AIDS. At the time of first hospital visit, the CD4 + cells count ranged from 40 to 1795/µl (conducted in 19 patients), and mean value of CD4 + cells was 365,31/µl, and mean HIV RNA titer was 287 118 copies/ml³. Of 28 HIV-infected persons 39 cases of opportunistic diseases developed in 12 patients (42.9%). In terms of the frequency of opportunistic diseases, tuberculosis (12 cases, 42.9%). Among a total of 28 HIV-infected patients, 6 (21.4%) of them died. This study characterizes the epidemiological and clinical patterns of HIV-infected patients in Tuzla region of Bosnia and Herzegovina to accurately understand HIV infection/AIDS in our region, in the hope to contribute in the establishment of effective HIV guidelines in the Tuzla region of B&H in the future.

The value of haematological screening for AIDS in an at risk population

OpenAIRE

1986-01-01

The haematological variables measured by automated full blood count in matched homosexual and heterosexual men attending a clinic for sexually transmitted diseases (STD) were compared with those of normal controls and patients infected with the human T lymphotropic virus type III (HTLV-III). Homosexual and heterosexual men were statistically identical for all variables, but both differed noticeably from patients with clinical diagnoses of the acquired immune deficiency syndrome (AIDS) or AIDS...

Epidemiology of cryptosporidiosis among European AIDS patients

DEFF Research Database (Denmark)

Pedersen, C; Danner, S; Lazzarin, A

1996-01-01

for intravenous drug users than for homosexual men (relative risk 0.34, 95% confidence limits 0.22-0.54) and for women compared with men (RR 0.43 (0.21-0.87)). The risk was higher in North Europe than in South and Central Europe. In a multivariate analysis only transmission category remained a significant.......6%) patients, 216 at time of the AIDS diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p...... Europe compared with patients from South Europe (4.1% versus 2.5%, p = 0.005). The rate of developing cryptosporidiosis after the diagnosis of AIDS was 3 per 100 patient years of follow-up. The rate was significantly lower...

"MedTRIS" (Medical Triage and Registration Informatics System): A Web-based Client Server System for the Registration of Patients Being Treated in First Aid Posts at Public Events and Mass Gatherings.

Science.gov (United States)

Gogaert, Stefan; Vande Veegaete, Axel; Scholliers, Annelies; Vandekerckhove, Philippe

2016-10-01

First aid (FA) services are provisioned on-site as a preventive measure at most public events. In Flanders, Belgium, the Belgian Red Cross-Flanders (BRCF) is the major provider of these FA services with volunteers being deployed at approximately 10,000 public events annually. The BRCF has systematically registered information on the patients being treated in FA posts at major events and mass gatherings during the last 10 years. This information has been collected in a web-based client server system called "MedTRIS" (Medical Triage and Registration Informatics System). MedTRIS contains data on more than 200,000 patients at 335 mass events. This report describes the MedTRIS architecture, the data collected, and how the system operates in the field. This database consolidates different types of information with regards to FA interventions in a standardized way for a variety of public events. MedTRIS allows close monitoring in "real time" of the situation at mass gatherings and immediate intervention, when necessary; allows more accurate prediction of resources needed; allows to validate conceptual and predictive models for medical resources at (mass) public events; and can contribute to the definition of a standardized minimum data set (MDS) for mass-gathering health research and evaluation. Gogaert S , Vande veegaete A , Scholliers A , Vandekerckhove P . "MedTRIS" (Medical Triage and Registration Informatics System): a web-based client server system for the registration of patients being treated in first aid posts at public events and mass gatherings. Prehosp Disaster Med. 2016;31(5):557-562.

Rate of new HIV diagnoses among Latinos living in Florida: disparities by country/region of birth.

Science.gov (United States)

Sheehan, Diana M; Trepka, Mary Jo; Fennie, Kristopher P; Maddox, Lorene M

2015-01-01

HIV incidence in the USA is three times higher for Latinos than for non-Latino whites. Latinos differ in educational attainment, poverty, insurance coverage, and health-care access, factors that affect HIV knowledge, risk behaviors, and testing. The purpose of this study was to identify differences in demographics, risk factors, and rate of new HIV diagnoses by birth country/region among Latinos in Florida to guide the targeting of primary and secondary prevention programs. Using Florida HIV/AIDS surveillance data from 2007 to 2011 and the American Community Survey, we compared demographic and risk factors, and calculated annual and five-year age-adjusted rates of new HIV diagnoses for 5801 Latinos by birth country/region. Compared to US-born Latinos, those born in Cuba and South America were significantly more likely to report the HIV transmission mode of MSM; those born in the Dominican Republic (DR) heterosexual transmission; and those born in Puerto Rico injection drug use. Mexican- and Central American-born Latinos were more likely to be diagnosed with AIDS within a month of HIV diagnosis. The rate of new HIV diagnoses among Latinos declined 33% from 2007 to 2011. HIV diagnoses over time decreased significantly for Latinos born in Mexico and increased nonsignificantly for those born in the DR. Although this study was limited to Latinos living in Florida, results suggest that tailoring HIV primary prevention and testing initiatives to specific Latino groups may be warranted.

Computer-aided event tree analysis by the impact vector method

International Nuclear Information System (INIS)

Lima, J.E.P.

1984-01-01

In the development of the Probabilistic Risk Analysis of Angra I, the ' large event tree/small fault tree' approach was adopted for the analysis of the plant behavior in an emergency situation. In this work, the event tree methodology is presented along with the adaptations which had to be made in order to attain a correct description of the safety system performances according to the selected analysis method. The problems appearing in the application of the methodology and their respective solutions are presented and discussed, with special emphasis to the impact vector technique. A description of the ETAP code ('Event Tree Analysis Program') developed for constructing and quantifying event trees is also given in this work. A preliminary version of the small-break LOCA analysis for Angra 1 is presented as an example of application of the methodology and of the code. It is shown that the use of the ETAP code sigmnificantly contributes to decreasing the time spent in event tree analyses, making it viable the practical application of the analysis approach referred above. (author) [pt

Gastrointestinal events and association with initiation of treatment for osteoporosis

Directory of Open Access Journals (Sweden)

Modi A

2015-11-01

Full Text Available Ankita Modi,1 Ethel S Siris,2 Jackson Tang,3 Shiva Sajjan,1 Shuvayu S Sen1 1Center for Observational and Real-World Evidence, Merck & Co., Inc, Kenilworth, NJ, 2Toni Stabile Osteoporosis Center, Columbia University Medical Center, NY Presbyterian Hospital, New York, NY, 3Asclepius Analytics Ltd, Brooklyn, NY, USA Background: Preexisting gastrointestinal (GI events may deter the use of pharmacologic treatment in patients diagnosed with osteoporosis (OP. The objective of this study was to examine the association between preexisting GI events and OP pharmacotherapy initiation among women diagnosed with OP. Methods: The study utilized claims data from a large US managed care database to identify women aged ≥55 years with a diagnosis code for OP (index date during 2002–2009. Patients with a claim for pharmacologic OP treatment in the 12-month pre-index period (baseline were excluded. OP treatment initiation in the post-index period was defined as a claim for bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid, calcitonin, raloxifene, or teriparatide. During the post-index period (up to 12 months, GI events were identified before treatment initiation. A time-dependent Cox regression model was used to investigate the likelihood of initiating any OP treatment. Among patients initiating OP treatment, a discrete choice model was utilized to assess the relationship between post-index GI events and likelihood of initiating with a bisphosphonate versus a non-bisphosphonate. Results: In total, 65,344 patients (mean age 66 years were included; 23.7% had a GI event post diagnosis and before treatment initiation. Post-index GI events were associated with a 75% lower likelihood of any treatment initiation (hazard ratio 0.25; 95% confidence interval 0.24–0.26. Among treated patients (n=23,311, those with post-index GI events were 39% less likely to receive a bisphosphonate versus a non-bisphosphonate (odds ratio 0.61; 95% confidence

Computer aids for plant operators

International Nuclear Information System (INIS)

Joly, J.P.

1992-01-01

For some time, particularly since the TMI accident, nuclear power plant operators have been aware of the difficulties involved in diagnosing accidents and returning plants to their stable, safe operating mode. There are various possible solutions to these problems: improve control organization during accident situations, rewrite control procedures, integrate safety engineers in shifts, improve control rooms, and implement additional computer aids. The purpose of this presentation is to describe the efforts undertaken by EDF over the last few years in this field

Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia

Directory of Open Access Journals (Sweden)

S Rai

2012-01-01

Full Text Available Idiopathic CD4 lymphocytopenia (ICL is a rare disorder which is often diagnosed as HIV-negative AIDS in the light of poor immunity and AIDS-defining illnesses. We present a case of a 50-year-old male who presented with a midline posterior fossa tumour with ICL diagnosed as cerebellar cryptococcoma.

Impact of housing on the survival of persons with AIDS.

Science.gov (United States)

Schwarcz, Sandra K; Hsu, Ling C; Vittinghoff, Eric; Vu, Annie; Bamberger, Joshua D; Katz, Mitchell H

2009-07-07

Homeless persons with HIV/AIDS have greater morbidity and mortality, more hospitalizations, less use of antiretroviral therapy, and worse medication adherence than HIV-infected persons who are stably housed. We examined the effect of homelessness on the mortality of persons with AIDS and measured the effect of supportive housing on AIDS survival. The San Francisco AIDS registry was used to identify homeless and housed persons who were diagnosed with AIDS between 1996 and 2006. The registry was computer-matched with a housing database of homeless persons who received housing after their AIDS diagnosis. The Kaplan-Meier product limit method was used to compare survival between persons who were homeless at AIDS diagnosis and those who were housed. Proportional hazards models were used to estimate the independent effects of homelessness and supportive housing on survival after AIDS diagnosis. Of the 6,558 AIDS cases, 9.8% were homeless at diagnosis. Sixty-seven percent of the persons who were homeless survived five years compared with 81% of those who were housed (p Homelessness increased the risk of death (adjusted relative hazard [RH] 1.20; 95% confidence limits [CL] 1.03, 1.41). Homeless persons with AIDS who obtained supportive housing had a lower risk of death than those who did not (adjusted RH 0.20; 95% CL 0.05, 0.81). Supportive housing ameliorates the negative effect of homelessness on survival with AIDS.

Bile duct-duodenal fistula caused by AIDS/HIV-associated tuberculosis

Directory of Open Access Journals (Sweden)

Patino Carlos

2003-01-01

Full Text Available Allthough infrequent, digestive fistulae in HIV/AIDS patients have been reported throughout the digestive tract from the esophagus to the anus, with predominance of esophageal fistulae. AIDS/HIV-associated opportunistic infections may invade the digestive system and lead to fistula formation. Tuberculosis is the most common infection associated with these esophageal fistulae. We report here one case of bile duct-duodenal fistula in a female AIDS patient with associated abdominal Mycobacterium tuberculosis infection compromising lymphnodes of the hepatic pedicle where the fistula was found. According to the reviewed literature, this is the third case of bile duct-duodenal fistula associated with abdominal tuberculosis in AIDS patient, and the first where both the fistula and the tuberculosis infection were diagnosed at laparotomy for acute abdomen. Whether the AIDS patient with abdominal pain needs or not a laparotomy to treat an infectious disease is often a difficult matter for the surgeon to decide, as most of the times appropriate medical treatment will bring more benefit.

AIDS-related primary central nervous system lymphoma: a Norwegian national survey 1989–2003

International Nuclear Information System (INIS)

Haldorsen, Ingfrid S; Kråkenes, Jostein; Goplen, Anne K; Dunlop, Oona; Mella, Olav; Espeland, Ansgar

2008-01-01

Primary central nervous system lymphoma (PCNSL) is a frequent complication in acquired immunodeficiency syndrome (AIDS). The objective of this survey was to investigate incidence, clinical features, radiological findings, histologic diagnosis, treatment and outcome for all patients with histologically verified AIDS-related PCNSL diagnosed in Norway in 1989–2003. We identified the patients by chart review of all cases recorded as PCNSL in The Norwegian Cancer Registry (by law recording all cases of cancer in Norway) and all cases recorded as AIDS-related PCNSL in the autopsy registry at a hospital having 67% autopsy rate and treating 59% of AIDS patients in Norway, from 1989 to 2003. Histologic material and radiological images were reviewed. We used person-time techniques to calculate incidence rates of PCNSL among AIDS patients based on recordings on AIDS at the Norwegian Surveillance System for Communicable Diseases (by law recording all cases of AIDS in Norway). Twenty-nine patients had histologically confirmed, newly diagnosed AIDS-related PCNSL in Norway from 1989–2003. Only 2 patients had this diagnosis established while alive. AIDS patients had 5.5% lifetime risk of PCNSL. Their absolute incidence rate of PCNSL per 100 person-years was 1.7 (95%CI: 1.1–2.4) and decreased during the consecutive 5-year periods from 3.6, to 2.5, and to 0.4 (p < 0.001). Median survival from initial symptom of PCNSL was 2.3 months, but one patient was still alive 4 years after completed radiotherapy. This is the first national survey to confirm decreasing incidence of AIDS-related PCNSL. Despite dismal survival in most patients, the possibility of long term survival should prompt more aggressive diagnostics in suspected PCNSL

A Hearing Aid Primer 1

Science.gov (United States)

Yetter, Carol J.

2009-01-01

This hearing aid primer is designed to define the differences among the three levels of hearing instrument technology: conventional analog circuit technology (most basic), digitally programmable/analog circuit technology (moderately advanced), and fully digital technology (most advanced). Both moderate and advanced technologies mean that hearing…

Poz-itively Transformational: Sex Workers and HIV/AIDS Education

Science.gov (United States)

Hill, Robert J.

2005-01-01

HIV and AIDS are complex events that offer numerous opportunities for adult education. However, mainstream education on this issue has often not been relevant to a number of subpopulations, including sex workers. This chapter explores sources and content of HIV/AIDS education in the sex work industry (including art and the Internet) and suggests…

THE IMPACT OF STRESSFUL LIFE EVENTS ON RELAPSE OF GENERALIZED ANXIETY DISORDER

Science.gov (United States)

Francis, Jennifer L.; Moitra, Ethan; Dyck, Ingrid; Keller, Martin B.

2013-01-01

Background Stressful life events (SLEs) are associated with the onset of psychiatric disorders but little is known about the effects of SLEs on individuals already diagnosed with an anxiety disorder, particularly generalized anxiety disorder (GAD) in which worry about life events is a defining characteristic. This study examined the impact of SLEs on relapse in adults already diagnosed with GAD. Methods Data are obtained from the Harvard/Brown Anxiety Research Project (HARP), a naturalistic longitudinal study of adults with a current or past history of anxiety disorders. One hundred and twelve adults recovered from an episode of GAD and 27 subsequently relapsed during the study. Eight categories of SLEs were assessed via interview and were examined as predictors of GAD relapse. Results An increased total number of SLEs was associated with a higher cumulative probability of relapse into episode of GAD and there was a nonsignificant statistical trend indicating specific categories of SLEs including health, death, and family/friends/household were related to an increased probability of relapse into episodes of GAD. Conclusions SLEs impact the course of GAD and certain types of stressors may be more relevant to symptomatology than others. The change and uncertainty associated with SLEs may exacerbate existing worry tendencies even among those who have recovered from GAD. PMID:22431499

Software For Computer-Aided Design Of Control Systems

Science.gov (United States)

Wette, Matthew

1994-01-01

Computer Aided Engineering System (CAESY) software developed to provide means to evaluate methods for dealing with users' needs in computer-aided design of control systems. Interpreter program for performing engineering calculations. Incorporates features of both Ada and MATLAB. Designed to be flexible and powerful. Includes internally defined functions, procedures and provides for definition of functions and procedures by user. Written in C language.

Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa

DEFF Research Database (Denmark)

Lewden, Charlotte; Drabo, Youssoufou J; Zannou, Djimon M

2014-01-01

%) and cerebral toxoplasmosis (10%). Overall, 315 (38%) patients died during hospitalization and the underlying cause of death was AIDS (63%), non-AIDS-defining infections (26%), other diseases (7%) and non-specific illness or unknown cause (4%). Among them, the most frequent fatal diseases were: tuberculosis (36......%), cerebral toxoplasmosis (10%), cryptococcosis (9%) and sepsis (7%). Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS-defining infectious diagnoses were associated with hospital fatality. CONCLUSIONS: AIDS-defining conditions, primarily tuberculosis, and bacterial infections were the most...

Late presentation to HIV testing is overestimated when based on the consensus definition.

Science.gov (United States)

Sasse, A; Florence, E; Pharris, A; De Wit, S; Lacor, P; Van Beckhoven, D; Deblonde, J; Delforge, M-L; Fransen, K; Goffard, J-C; Legrand, J-C; Moutschen, M; Piérard, D; Ruelle, J; Vaira, D; Vandercam, B; Van Ranst, M; Van Wijngaerden, E; Vandekerckhove, L; Verhofstede, C

2016-03-01

In 2011, a consensus was reached defining "late presenters" (LPs) as individuals presenting for care with a CD4 count account. Case surveillance data for newly diagnosed patients in Belgium in 1998-2012 were analysed, including CD4 count at diagnosis, the presence of AIDS-defining events, and recent infections (definition. Secondly, LPs were reclassified as "nonlate" if infections were reported as recent. A total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men (MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition (P definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. © 2015 British HIV Association.

Disaster preparedness and response improvement: comparison of the 2010 Haiti earthquake-related diagnoses with baseline medical data.

Science.gov (United States)

van Berlaer, Gerlant; Staes, Tom; Danschutter, Dirk; Ackermans, Ronald; Zannini, Stefano; Rossi, Gabriele; Buyl, Ronald; Gijs, Geert; Debacker, Michel; Hubloue, Ives

2017-10-01

Disaster medicine research generally lacks control groups. This study aims to describe categories of diagnoses encountered by the Belgian First Aid and Support Team after the 2010 Haiti earthquake and extract earthquake-related changes from comparison with comparable baseline data. The hypothesis is that besides earthquake-related trauma, medical problems emerge soon, questioning an appropriate composition of Foreign Medical Teams and Interagency Emergency Health Kits. Using a descriptive cohort study design, diagnoses of patients presenting to the Belgian field hospital were prospectively registered during 4 weeks after the earthquake and compared with those recorded similarly by Médecins Sans Frontières in the same area and time span in previous and later years. Of 7000 triaged postearthquake patients, 3500 were admitted, of whom 2795 were included and analysed. In the fortnight after the earthquake, 90% suffered from injury. In the following fortnight, medical diseases emerged, particularly respiratory (23%) and digestive (14%). More than 53% developed infections within 3 weeks after the event. Médecins Sans Frontières registered 6407 patients in 2009; 6033 in 2011; and 7300 in 2012. A comparison indicates that postearthquake patients suffered significantly less from violence, but more from wounds, respiratory, digestive and ophthalmological diseases. This is the first comparison of postearthquake diagnoses with baseline data. Within 2 weeks after the acute phase of an earthquake, respiratory, digestive and ophthalmological problems will emerge to the prejudice of trauma. This fact should be anticipated when composing Foreign Medical Teams and Interagency Emergency Health Kits to be sent to the disaster site.

gamAID: Greedy CP tensor decomposition for supervised EHR-based disease trajectory differentiation.

Science.gov (United States)

Henderson, Jette; Ho, Joyce; Ghosh, Joydeep

2017-07-01

We propose gamAID, an exploratory, supervised nonnegative tensor factorization method that iteratively extracts phenotypes from tensors constructed from medical count data. Using data from diabetic patients who later on get diagnosed with chronic kidney disorder (CKD) as well as diabetic patients who do not receive a CKD diagnosis, we demonstrate the potential of gamAID to discover phenotypes that characterize patients who are at risk for developing a disease.

What adult electrocardiogram (ECG) diagnoses and/or findings do residents in emergency medicine need to know?

Science.gov (United States)

Patocka, Catherine; Turner, Joel; Wiseman, Jeffrey

2015-11-01

There is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee. We developed a list of potentially important adult ECG diagnoses/findings and conducted a Delphi opinion-soliciting process. Participants used a 4-point Likert scale to rate the importance of each diagnosis for EM trainees. Consensus was defined as a minimum of 75% agreement at the second round or later. In the absence of consensus, stability was defined as a shift of 20% or less after successive rounds. A purposive sampling of 22 emergency physicians participated in the Delphi process, and 16 (72%) completed the process. Of those, 15 were from 11 different EM training programs across Canada and one was an expert in EM electrocardiography. Overall, 78 diagnoses reached consensus, 42 achieved stability and one diagnosis achieved neither consensus nor stability. Out of 121 potentially important adult ECG diagnoses, 53 (44%) were considered "must know" diagnoses, 61 (50%) "should know" diagnoses, and 7 (6%) "nice to know" diagnoses. We have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.

Recent infection testing algorithm (RITA) applied to new HIV diagnoses in England, Wales and Northern Ireland, 2009 to 2011.

Science.gov (United States)

Aghaizu, A; Murphy, G; Tosswill, J; DeAngelis, D; Charlett, A; Gill, O N; Ward, H; Lattimore, S; Simmons, Rd; Delpech, V

2014-01-16

In 2009, Public Health England (PHE) introduced the routine application of a recent infection testing algorithm (RITA) to new HIV diagnoses, where a positive RITA result indicates likely acquisition of infection in the previous six months. Laboratories submit serum specimens to PHE for testing using the HIV 1/2gO AxSYM assay modified for the determination of HIV antibody avidity. Results are classified according to avidity index and data on CD₄ count, antiretroviral treatment and the presence of an AIDS-defining illness. Between 2009 and 2011, 38.4% (6,966/18,134) of new HIV diagnoses in England, Wales and Northern Ireland were tested. Demographic characteristics of those tested were similar to all persons with diagnosed HIV. Overall, recent infection was 14.7% (1,022/6,966) and higher among men who have sex with men (MSM) (22.3%, 720/3,223) compared with heterosexual men and women (7.8%, 247/3,164). Higher proportions were among persons aged 15-24 years compared with those ≥50 years (MSM 31.2% (139/445) vs 13.6% (42/308); heterosexual men and women 17.3% (43/249) vs 6.2% (31/501)). Among heterosexual men and women, black Africans were least likely to have recent infection compared with whites (4.8%, 90/1,892 vs 13.3%, 97/728; adjusted odds ratio: 0.6; 95% CI: 0.4-0.9). Our results indicate evidence of ongoing HIV transmission during the study period, particularly among MSM.

Situational Awareness Analysis Tools for Aiding Discovery of Security Events and Patterns

National Research Council Canada - National Science Library

Kumar, Vipin; Kim, Yongdae; Srivastava, Jaideep; Zhang, Zhi-Li; Shaneck, Mark; Chandola, Varun; Liu, Haiyang; Choi, Changho; Simon, Gyorgy; Eilertson, Eric

2005-01-01

.... The University of Minnesota team has developed a comprehensive, multi-stage analysis framework which provides tools and analysis methodologies to aid cyber security analysts in improving the quality...

HIV INFECTION AND AIDS: EPIDEMIOLOGY AND PREVENTION

Directory of Open Access Journals (Sweden)

Mustafa Alparslan BABAYIÐIT

Full Text Available Human Immune-deficiency Virus (HIV was first discovered in 1981 in the United States of America and the day of December 1, was announced as ?World AIDS Day? by WHO (World Health Organization. In Turkey, the first announcement of the people living with HIV was made in 1985. HIV/AIDS has killed more than 20 millions people and more than 16,000 people become newly infected each day since the first cases were diagnosed in 1981. It is estimated that 39.4 million people would have been infected with HIV at the end of 2004, with 4.9 million new cases that year. Sub-Saharan Africa is the worst-hit region, with 70 percent of all people living with HIV. In Africa alone, 10,000 people become infected each day. This year?s main theme is ?Women, Girls, HIV and AIDS,? which reflects a focus on how the effects of HIV/AIDS have significantly increased among women. Women now make up half of all people living with HIV worldwide with the number of 17,6 million. [TAF Prev Med Bull 2004; 3(11.000: 280-290

A study on the development of the on-line operator aid system using rule based expert system and fuzzy logic for nuclear power plants

International Nuclear Information System (INIS)

Kang, Ki Sig

1995-02-01

The on - line Operator Aid SYStem (OASYS) has been developed to support operator's decision making process and to ensure the safety of nuclear power plants (NPPs) by timely providing operators with proper guidelines according to the plant operation mode. The OASYS consists of four systems such as the signal validation and management system (SVMS), the plant monitoring system (PMS), the alarm filtering and diagnostic system (AFDS), and the dynamic emergency procedure tracking system (DEPTS). The SVMS and the PMS help operators to maintain a plant as a normal operation condition. The AFDS covers the abnormal events until they result in exceeding the limit range of reactor trip signals, while after a reactor trip, the DEPTS aids operators with proper guidelines so as to shutdown safely. The OASYS uses a rule based expert system and a fuzzy logic. The rule based expert system is used to classify the pre-defined events and track the emergency operating procedures (EOPs) through data processing. The fuzzy logic is used to generate the conceptual high level alarms for the prognostic diagnosis and to evaluate the qualitative fuzzy criteria used in EOPs. Performance assessment of the OASYS demonstrates that it is capable of diagnosing plant abnormal conditions and providing operators appropriate guidelines with fast response time and consistency. The developed technology for OASYS will be used to design the Integrated Advanced Control Room in which a plant can be operated by one operator during normal operation. The advanced EOP for emergency operation has been developed by focusing attention on the importance of the operators' role in emergency conditions. To overcome the complexity of current EOPs and maintain the consistency of operators' action according to plant emergency conditions, operator's tasks were allocated according to their duties in the advanced EOP and the computerized operator aid system (COAS) has been developed as an alternative to reduce operator

Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium.

Directory of Open Access Journals (Sweden)

Agnes Ebotabe Arrey

Full Text Available Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into

Verification of Opacity and Diagnosability for Pushdown Systems

Directory of Open Access Journals (Sweden)

Koichi Kobayashi

2013-01-01

Full Text Available In control theory of discrete event systems (DESs, one of the challenging topics is the extension of theory of finite-state DESs to that of infinite-state DESs. In this paper, we discuss verification of opacity and diagnosability for infinite-state DESs modeled by pushdown automata (called here pushdown systems. First, we discuss opacity of pushdown systems and prove that opacity of pushdown systems is in general undecidable. In addition, a decidable class is clarified. Next, in diagnosability, we prove that under a certain assumption, which is different from the assumption in the existing result, diagnosability of pushdown systems is decidable. Furthermore, a necessary condition and a sufficient condition using finite-state approximations are derived. Finally, as one of the applications, we consider data integration using XML (Extensible Markup Language. The obtained result is useful for developing control theory of infinite-state DESs.

A Standardized Algorithm for Determining the Underlying Cause of Death in HIV Infection as AIDS or non-AIDS Related: Results from the EuroSIDA Study

DEFF Research Database (Denmark)

Kowalska, Justyna D; Mocroft, Amanda; Ledergerber, Bruno

2011-01-01

are a natural consequence of an increased awareness and knowledge in the field. To monitor and analyze changes in mortality over time, we have explored this issue within the EuroSIDA study and propose a standardized protocol unifying data collected and allowing for classification of all deaths as AIDS or non......-AIDS related, including events with missing cause of death. Methods: Several classifications of the underlying cause of death as AIDS or non-AIDS related within the EuroSIDA study were compared: central classification (CC-reference group) based on an externally standardised method (the CoDe procedures), local...

Patient flow improvement for an ophthalmic specialist outpatient clinic with aid of discrete event simulation and design of experiment.

Science.gov (United States)

Pan, Chong; Zhang, Dali; Kon, Audrey Wan Mei; Wai, Charity Sue Lea; Ang, Woo Boon

2015-06-01

Continuous improvement in process efficiency for specialist outpatient clinic (SOC) systems is increasingly being demanded due to the growth of the patient population in Singapore. In this paper, we propose a discrete event simulation (DES) model to represent the patient and information flow in an ophthalmic SOC system in the Singapore National Eye Centre (SNEC). Different improvement strategies to reduce the turnaround time for patients in the SOC were proposed and evaluated with the aid of the DES model and the Design of Experiment (DOE). Two strategies for better patient appointment scheduling and one strategy for dilation-free examination are estimated to have a significant impact on turnaround time for patients. One of the improvement strategies has been implemented in the actual SOC system in the SNEC with promising improvement reported.

Best waveform score for diagnosing keratoconus

Directory of Open Access Journals (Sweden)

Allan Luz

2013-12-01

Full Text Available PURPOSE: To test whether corneal hysteresis (CH and corneal resistance factor (CRF can discriminate between keratoconus and normal eyes and to evaluate whether the averages of two consecutive measurements perform differently from the one with the best waveform score (WS for diagnosing keratoconus. METHODS: ORA measurements for one eye per individual were selected randomly from 53 normal patients and from 27 patients with keratoconus. Two groups were considered the average (CH-Avg, CRF-Avg and best waveform score (CH-WS, CRF-WS groups. The Mann-Whitney U-test was used to evaluate whether the variables had similar distributions in the Normal and Keratoconus groups. Receiver operating characteristics (ROC curves were calculated for each parameter to assess the efficacy for diagnosing keratoconus and the same obtained for each variable were compared pairwise using the Hanley-McNeil test. RESULTS: The CH-Avg, CRF-Avg, CH-WS and CRF-WS differed significantly between the normal and keratoconus groups (p<0.001. The areas under the ROC curve (AUROC for CH-Avg, CRF-Avg, CH-WS, and CRF-WS were 0.824, 0.873, 0.891, and 0.931, respectively. CH-WS and CRF-WS had significantly better AUROCs than CH-Avg and CRF-Avg, respectively (p=0.001 and 0.002. CONCLUSION: The analysis of the biomechanical properties of the cornea through the ORA method has proved to be an important aid in the diagnosis of keratoconus, regardless of the method used. The best waveform score (WS measurements were superior to the average of consecutive ORA measurements for diagnosing keratoconus.

Joint model-based clustering of nonlinear longitudinal trajectories and associated time-to-event data analysis, linked by latent class membership: with application to AIDS clinical studies.

Science.gov (United States)

Huang, Yangxin; Lu, Xiaosun; Chen, Jiaqing; Liang, Juan; Zangmeister, Miriam

2017-10-27

Longitudinal and time-to-event data are often observed together. Finite mixture models are currently used to analyze nonlinear heterogeneous longitudinal data, which, by releasing the homogeneity restriction of nonlinear mixed-effects (NLME) models, can cluster individuals into one of the pre-specified classes with class membership probabilities. This clustering may have clinical significance, and be associated with clinically important time-to-event data. This article develops a joint modeling approach to a finite mixture of NLME models for longitudinal data and proportional hazard Cox model for time-to-event data, linked by individual latent class indicators, under a Bayesian framework. The proposed joint models and method are applied to a real AIDS clinical trial data set, followed by simulation studies to assess the performance of the proposed joint model and a naive two-step model, in which finite mixture model and Cox model are fitted separately.

HIV/AIDS Cancer and Impact on Surgical Practice: Implication for the ...

African Journals Online (AJOL)

Although HIV prevalence appears to be stable, much remains uncertain about the direction of the epidemic. In the developed countries, the increased cancer risk among immunocompromised persons with HIV/AIDS (PHA) is well observed. Now a person diagnosed with HIV as a young adult in a resourcerich country

Epidemiological trends of HIV/AIDS in Pakistan: a twelve year experience at the national AIDS Programme

International Nuclear Information System (INIS)

Kazi, B.M.; Saleem, M.; Salman, M.; Bokhari, A.

1999-01-01

A total of 23,40,000 blood samples were screened for the presence of antibodies against Human Immunodeficiency Virus (HIV) at various officially designated surveillance and diagnostic centers throughout the country, during the period of 12 years extending from 1986 to 1999. The reported positive cases screened before blood transfusion under the initiative launched in public sector hospitals during 1995 are also included in the total figure. A total of 1395 as symptomatic persons have been diagnosed and reported as HIV positive whereas 178 persons with signs and symptoms of full blown AIDS have been diagnosed. The tests were performed on selected categories of persons and include; persons with risky behavior, patients with sexually transmitted disease, professional blood donors, blood and blood product recipients intravenous drug injectors, patients with tuberculosis, women attending antenatal clinics, long distance drivers, and seaman. Apart from these identified groups, referred patients from the public and private hospitals, laboratories, clinics, nursing homes and HIV positive. The male to female ratio for HIV positive and AIDS cases as 7:1 and 8:1 respectively. Most of the cases acquired the disease through sexual contact including hetro, Homo and bisexual modes of transmission. Maximum numbers of the HIV positive individuals are between the age's 20-29 years. The data gives an overall prevalence rate of 0.07% which, although looking low, still deserves serious attention in view of system anomalies relating and under reporting and very long incubation period of the disease. (author)

An Optimization Model for the Allocation of University Based Merit Aid

Science.gov (United States)

Sugrue, Paul K.

2010-01-01

The allocation of merit-based financial aid during the college admissions process presents postsecondary institutions with complex and financially expensive decisions. This article describes the application of linear programming as a decision tool in merit based financial aid decisions at a medium size private university. The objective defined for…

Prolonged corrected QT interval is predictive of future stroke events even in subjects without ECG-diagnosed left ventricular hypertrophy.

Science.gov (United States)

Ishikawa, Joji; Ishikawa, Shizukiyo; Kario, Kazuomi

2015-03-01

We attempted to evaluate whether subjects who exhibit prolonged corrected QT (QTc) interval (≥440 ms in men and ≥460 ms in women) on ECG, with and without ECG-diagnosed left ventricular hypertrophy (ECG-LVH; Cornell product, ≥244 mV×ms), are at increased risk of stroke. Among the 10 643 subjects, there were a total of 375 stroke events during the follow-up period (128.7±28.1 months; 114 142 person-years). The subjects with prolonged QTc interval (hazard ratio, 2.13; 95% confidence interval, 1.22-3.73) had an increased risk of stroke even after adjustment for ECG-LVH (hazard ratio, 1.71; 95% confidence interval, 1.22-2.40). When we stratified the subjects into those with neither a prolonged QTc interval nor ECG-LVH, those with a prolonged QTc interval but without ECG-LVH, and those with ECG-LVH, multivariate-adjusted Cox proportional hazards analysis demonstrated that the subjects with prolonged QTc intervals but not ECG-LVH (1.2% of all subjects; incidence, 10.7%; hazard ratio, 2.70, 95% confidence interval, 1.48-4.94) and those with ECG-LVH (incidence, 7.9%; hazard ratio, 1.83; 95% confidence interval, 1.31-2.57) had an increased risk of stroke events, compared with those with neither a prolonged QTc interval nor ECG-LVH. In conclusion, prolonged QTc interval was associated with stroke risk even among patients without ECG-LVH in the general population. © 2014 American Heart Association, Inc.

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

Science.gov (United States)

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

1994-04-01

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

Risk factors for venous thromboembolic events in pediatric surgical patients: Defining indications for prophylaxis.

Science.gov (United States)

Cairo, Sarah B; Lautz, Timothy B; Schaefer, Beverly A; Yu, Guan; Naseem, Hibbut-Ur-Rauf; Rothstein, David H

2017-12-27

Venous thromboembolism (VTE) in pediatric surgical patients is a rare event. The risk factors for VTE in pediatric general surgery patients undergoing abdominopelvic procedures are unknown. The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015) was queried for patients with VTE after abdominopelvic general surgery procedures. Patient and operative variables were assessed to identify risk factors associated with VTE and develop a pediatric risk score. From 2012-2015, 68 of 34,813 (0.20%) patients who underwent abdominopelvic general surgery procedures were diagnosed with VTE. On multivariate analysis, there was no increased risk of VTE based on concomitant malignancy, chemotherapy, inflammatory bowel disease, or laparoscopic surgical approach, while a higher rate of VTE was identified among female patients. The odds of experiencing VTE were increased on stepwise regression for patients older than 15 years and those with preexisting renal failure or a diagnosis of septic shock, patients with American Society of Anesthesia (ASA) classification ≥ 2, and for anesthesia time longer than 2 h. The combination of age > 15 years, ASA classification ≥ 2, anesthesia time > 2 h, renal failure, and septic shock was included in a model for predicting risk of VTE (AUC = 0.907, sensitivity 84.4%, specificity 88.2%). VTE is rare in pediatric patients, but prediction modeling may help identify those patients at heightened risk. Additional studies are needed to validate the factors identified in this study in a risk assessment model as well as to assess the efficacy and cost-effectiveness of prophylaxis methods. Level III, retrospective comparative study. Copyright © 2018. Published by Elsevier Inc.

An Instructor's Diagnostic Aid for Feedback in Training.

Science.gov (United States)

Andrews, Dee H.; Uliano, Kevin C.

1988-01-01

Instructor's Diagnostic Aid for Feedback in Training (IDAFT) is a computer-assisted method based on error analysis, domains of learning, and events of instruction. Its use with Navy team instructors is currently being explored. (JOW)

Psychological First Aid

Science.gov (United States)

Shultz, James M; Forbes, David

2014-01-01

Psychological first aid (PFA) has become the flagship early intervention for disaster survivors, with recent adaptations for disaster responders, in the post-9/11 era. PFA is broadly endorsed by expert consensus and integrated into guidelines for mental health and psychosocial support in disasters and extreme events. PFA frameworks are proliferating, with increasing numbers of models developed for delivery by a range of providers for use with an expanding array of target populations. Despite popularity and promotion there remains a dearth of evidence for effectiveness and recent independent reviews of PFA have highlighted this important gap. This commentary juxtaposes the current propagation of PFA against the compelling need to produce evidence for effectiveness and suggests a series of actions to prioritize and expedite real-time, real-event field evaluation of PFA. PMID:28228996

Combining principles of Cognitive Load Theory and diagnostic error analysis for designing job aids: Effects on motivation and diagnostic performance in a process control task.

Science.gov (United States)

Kluge, Annette; Grauel, Britta; Burkolter, Dina

2013-03-01

Two studies are presented in which the design of a procedural aid and the impact of an additional decision aid for process control were assessed. In Study 1, a procedural aid was developed that avoids imposing unnecessary extraneous cognitive load on novices when controlling a complex technical system. This newly designed procedural aid positively affected germane load, attention, satisfaction, motivation, knowledge acquisition and diagnostic speed for novel faults. In Study 2, the effect of a decision aid for use before the procedural aid was investigated, which was developed based on an analysis of diagnostic errors committed in Study 1. Results showed that novices were able to diagnose both novel faults and practised faults, and were even faster at diagnosing novel faults. This research contributes to the question of how to optimally support novices in dealing with technical faults in process control. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

Science.gov (United States)

Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

2017-09-01

Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

Terrorism as Media Event

Directory of Open Access Journals (Sweden)

2012-07-01

Full Text Available Proving that terrorism should be seen as a media event (as defined by Dayan and Katzafter 9/11 and treated accordingly. We have turned to the work of Dayan and Katz and GeorgeGerbner’s for a definition of media events and of violence in the mass media. This paper is ahermeneutical interpretation of the concept of terrorism and its relation to communication. We haveput forward a better understanding of the complex concept of terrorism and its definitions in the massmedia context. Terrorism nowadays should always be defined within its inherent relation with themedia. The article is the first to define terrorism as media evenit in Dayan and Katz’s terms.

From CBCL to DSM: A Comparison of Two Methods to Screen for DSM–IV Diagnoses Using CBCL Data

NARCIS (Netherlands)

Krol, N.P.C.M.; Bruyn, E.E.J. De; Coolen, J.C.; Aarle, E.J.M. van

2006-01-01

The screening efficiency of 2 methods to convert Child Behavior Checklist (CBCL) assessment data into Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses was compared. The Machine-Aided Diagnosis (MAD) method converts CBCL input

Telling Successes of Japanese Foreign Aid

DEFF Research Database (Denmark)

Hansen, Annette Skovsted

Stakeholders of two success story events negotiated an idea of development as individual entrepreneurship. The sixty-five-year-old Japanese Foreign Aid history includes stories of successes told by professionals from developing countries throughout the world. Their stories reflect the cultural...... sector training programs partly financed by Japanese Official development Assistance (ODA)....

Postnatal outcomes of prenatally diagnosed 45,X/46,XX.

Science.gov (United States)

Tokita, Mari J; Sybert, Virginia P

2016-05-01

High quality information is critical for informed decision-making in pregnancy following a prenatal diagnosis of sex chromosome aneuploidy. The goal of this study was to define the spectrum of outcomes in patients with prenatally diagnosed 45,X/46,XX mosaic Turner syndrome in order to provide a better basis for genetic counseling at the time of intrauterine diagnosis. Phenotype data for twenty-five patients with prenatally diagnosed 45,X/46,XX mosaicism were collected by retrospective chart review and, when possible, semi-structured telephone interview. Existing data from a cohort of 58 patients with postnatally diagnosed 45,X/46,XX mosaicism were used for comparison. Relative to those diagnosed postnatally, prenatal patients were more likely to have normal growth and normal secondary sexual development, less likely to manifest distinctive Turner syndrome features such as nuchal webbing and edema, and had significantly fewer renal defects. These differences underscore the need for a nuanced approach to prenatal counseling in cases of 45,X/46,XX mosaicism. © 2016 Wiley Periodicals, Inc.

Sources of AIDS awareness among women in India.

Science.gov (United States)

Pallikadavath, S; Sreedharan, C; Stones, R W

2006-01-01

Sources of AIDS awareness among rural and urban Indian women were analysed using data from the National Family and Health Survey (1998-2000). Two measures were developed to study the impact each source had on knowledge. 'Effectiveness' was defined as the proportion of women who had heard of AIDS from only one source, from among women who had heard of AIDS from that particular source and other sources. 'Independent effect' was the proportion who had heard of AIDS from only one source in relation to all women who had heard of AIDS. Television was the most effective medium, and also had the highest independent effect. Radio and print had very low effectiveness and independent effect. Although television and print audiences are growing in India, it is likely a sub-group of women will continue to lack media access. There is an urgent need to disseminate AIDS awareness to this 'media underclass'. Since the media will not reach this group, other sources including health workers, community level activities such as adult education programmes, and networks of friends and relatives need to be explored.

Incidence and risk factors of AIDS-defining cancers in a cohort of HIV-positive adults: Importance of the definition of incident cases.

Science.gov (United States)

Suárez-García, Inés; Jarrín, Inmaculada; Iribarren, José Antonio; López-Cortés, Luis Fernando; Lacruz-Rodrigo, José; Masiá, Mar; Gómez-Sirvent, Juan Luis; Hernández-Quero, José; Vidal, Francesc; Alejos-Ferreras, Belén; Moreno, Santiago; Del Amo, Julia

2013-05-01

The aim of this study was to investigate the incidence and risk factors for the development of AIDS-defining cancers (ADCs); and to investigate the effect of making different assumptions on the definition of incident cases. A multicentre cohort study was designed. Poisson regression was used to assess incidence and risk factors. To account for misclassification, incident cases were defined using lag-times of 0, 14 and 30 days after enrolment. A total of 6393 HIV-positive subjects were included in the study. The incidences of ADCs changed as the lag periods were varied from 0 to 30 days. Different risk factors emerged as the definition of incident cases was changed. For a lag time of 0, the risk of Kaposi sarcoma [KS] and non-Hodgkin lymphoma [NHL] increased at CD4 counts sex with men had a higher risk of KS. KS and NHL were not associated with viral load, gender, or hepatitis B or C. The results were similar for a lag-time of 14 and 30 days; however, hepatitis C was significantly associated with NHL. This analysis shows the importance of the definition of incident cases in cohort studies. Alternative definitions gave different incidence estimates, and may have implications for the analysis of risk factors. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Computer-Aided Modelling Methods and Tools

DEFF Research Database (Denmark)

Cameron, Ian; Gani, Rafiqul

2011-01-01

The development of models for a range of applications requires methods and tools. In many cases a reference model is required that allows the generation of application specific models that are fit for purpose. There are a range of computer aided modelling tools available that help to define the m...

AIDS: A theological and pastoral response

Directory of Open Access Journals (Sweden)

G. G. Miller

1990-03-01

Full Text Available The anticipated A.I.D.S. crisis in Southern Africa presents an opportunity for the Christian church to respond positively rather than merely to react negatively. This requires both a theological understanding and a pastoral response. Theologically, A.I.D.S. may be seen as an object lesson in the interrelation of natural, personal and historical evil. Although both the Old Testament and the New Testament warn against a simplistic doctrine of individual retribution, there are also several different ways in which the A.I.D.S. crisis may indeed in some particular cases be seen as a judgement of God while in other cases it is rather a horrifying event. Other relevant issues include matters relating to justification and sanctification and the wider ethical issues of discrimination and human rights, of "public" and "private" morality. The Church's pastoral response should include both "corrective" education to remove irrational and fearful ignorance and also "preventative" education to encourage a monogamous lifestyle. Pastoral ministry must be "redemptive", appropriate to the varying needs of persons with A.I.D.S., of their families and friends and of professional care-providers. The Church cannot ignore the A.I.D.S. crisis, but must respond to it both Biblically and pastorally.

Public-private partnerships as a strategy against HIV/AIDS in South Africa: the influence of historical legacies.

Science.gov (United States)

Brunne, Viviane

2009-09-01

In the face of the extreme challenges posed by the South African HIV/AIDS epidemic, collaboration between public and private partners is often called for in an attempt to mobilise additional resources and generate synergies. This paper shows that the ability to successfully use public-private partnerships to address complex challenges, such as an HIV/AIDS epidemic, is influenced by the fabric of society, one important aspect being historical legacies. The first part of the article shows how South Africa's apartheid past affects the ability of public and private partners to collaborate in a response to HIV and AIDS today. It also takes into account how reconciliation and nation-building policies in the immediate post-transformation period have affected the ability to form and sustain partnerships concerning HIV/AIDS issues. The second part of the article analyses more recent developments regarding the information that these hold as to the feasibility of public-private partnerships and whether these continue to be affected by the legacies of the past. Two events with symbolic political value in South Africa, namely the 2010 FIFA World Cup soccer event and the recent changes in government, are systematically examined on the basis of three analytical queries, regarding: the impact of the event on nation-building and transcending cleavages in society; the event's impact on the ability to form public-private partnerships in general; and the role of HIV/AIDS in connection with the event. Conclusions are drawn a propos the influence of historic factors on the ability of South African society to effectively use public-private partnerships in the response to HIV and AIDS, and the continued dynamics and likely future directions of these partnerships.

AIDS: "it's the bacteria, stupid!".

Science.gov (United States)

Broxmeyer, Lawrence; Cantwell, Alan

2008-11-01

Acid-fast tuberculous mycobacterial infections are common in AIDS and are regarded as secondary "opportunistic infections." According to the National Institute of Allergy and Infectious Diseases, TB is the major attributable cause of death in AIDS patients. Could such bacteria play a primary or causative role in AIDS? Certainly, In screening tests for HIV, there is frequent, up to 70%, cross-reactivity, between the gag and pol proteins of HIV and patients with mycobacterial infections such as tuberculosis. By 1972, five years before gays started dying in the U.S., Rolland wrote Genital Tuberculosis, a Forgotten Disease? And ironically, in 1979, on the eve of AIDS recognition, Gondzik and Jasiewicz showed that even in the laboratory, genitally infected tubercular male guinea pigs could infect healthy females through their semen by an HIV-compatible ratio of 1 in 6 or 17%, prompting him to warn his patients that not only was tuberculosis a sexually transmitted disease, but also the necessity of the application of suitable contraceptives, such as condoms, to avoid it. Gondzik's solution and date of publication are chilling; his findings significant. Since 1982 Cantwell et al found acid-fast bacteria closely related to tuberculosis (TB) and atypical tuberculosis in AIDS tissue. On the other hand molecular biologist and virologist Duesberg, who originally defined retroviral ultrastructure, has made it clear that HIV is not the cause of AIDS and that the so-called AIDS retrovirus has never been isolated in its pure state. Dr. Etienne de Harven, first to examine retroviruses under the electron, agrees. In 1993 HIV co-discoverer Luc Montagnier reported on cell-wall-deficient (CWD) bacteria which he called "mycoplasma" in AIDS tissue. He suspected these as a necessary "co-factor" for AIDS. Remarkably, Montagnier remained silent on Cantwell's reports of acid-fast bacteria which could simulate "mycoplasma" in AIDS tissue. Mattman makes clear that the differentiation between

Underlying Event Studies for LHC Energies

International Nuclear Information System (INIS)

Barnafoeldi, Gergely Gabor; Levai, Peter; Agocs, Andras G.

2011-01-01

Underlying event was originally defined by the CDF collaboration decades ago. Here we improve the original definition to extend our analysis for events with multiple-jets. We introduce a definition for surrounding rings/belts and based on this definition the jet- and surrounding-belt-excluded areas will provide a good underlying event definition. We inverstigate our definition via the multiplicity in the defined geometry. In parallel, mean transverse momenta of these areas also studied in proton-proton collisions at √(s) = 7 TeV LHC energy.

[AIDS in Chile: a problem with multiple facets].

Science.gov (United States)

Ormazabal, B

1991-03-01

Chile's 1st case of AIDS was diagnosed in 1984. Some 250 AIDS cases and 1600 HIV positive persons have since been reported, although the actual number by some estimates may reach 5000. Chile, although in the initial stages of the epidemic, already has a serious problem which at present can only be combatted through education. It will be necessary to convince the population that significant modifications of sexual behavior are needed to control the spread of the disease. Education for AIDS prevention is a priority of the National Commission on AIDS (CONASIDA), which is basing its program on the premise that stable monogamy is the most natural form of expression of a couple. Manuals for prevention are under development, and the 1st, for health workers and the general population, is in process of publication. A series of pamphlets and educational videos for workers in sexually transmitted disease clinics are under development. Educational materials are also being created for specific groups such as university students and agricultural workers and for groups at high risk. A social communications campaign has been prepared and approved by the authorities, and is awaiting funding for dissemination. Education of the population is also a concern for the Catholic Church, which views reinforcement of the family and its mission of providing sex education as a primary means of preventing AIDS. CONASIDA is also responsible for epidemiological study of AIDS in Chile through surveillance of sentinel groups and in quality control of the blood supply. Condoms are to be distributed in sexually transmitted disease clinics for the purpose of AIDS prevention.

Radiological diagnosis in AIDS - associated diseases: survey and differential diagnosis

International Nuclear Information System (INIS)

Rademaker, J.; Frahm, C.

1997-01-01

Acute manifestations of illnesses in patients with HIV-infection or AIDS will benefit from rapid diagnosis. Radiologic examinations provide substantial information to narrow the differential diagnosis. This article reviews clinically important HIV-associated diseases for the radiologist. The braod spectrum of possible manifestations is illustrated by the accompanying case reports that typify the complexity of diagnoses in this growing problem worldwide. (orig.) [de

Profile of nursing diagnoses of hospitalized patients in an infectious disease unit

OpenAIRE

Souza Neto, Vinicius Lino de; Andrade, Lidiane Lima de; Agra, Glenda; Costa, Marta Miriam Lopes; Silva, Richardson Augusto Rosendo da

2015-01-01

Objective: To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit.Methods: This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPE(r) version 2.0 to construct the diagnoses.Results: Data analysis resulted in 3...

Trends in AIDS incidence and AIDS-related mortality in British Columbia between 1981 and 2013

Science.gov (United States)

Lima, Viviane D.; Lourenço, Lillian; Yip, Benita; Hogg, Robert S.; Phillips, Peter; Montaner, Julio S.G.

2015-01-01

Background Appropriate use of highly active antiretroviral therapy (HAART) can markedly decrease the risk of progression to acquired immunodeficiency syndrome (AIDS) and of premature mortality. We aimed to characterize the trends between 1981 and 2013 in AIDS-defining illnesses (ADIs) and in the number AIDS-related deaths in British Columbia (BC), Canada. Methods We included data of 3550 HIV-positive individuals, aged 19 years or older, from different administrative databases in BC. We estimated the relative risk of developing an ADI over time using a Negative Binomial model, and we investigated trends in the percentage of all deaths associated with AIDS using generalized additive models. Findings The number of ADIs has decreased dramatically to its lowest level in 2013. The peak of the AIDS epidemic in BC happened in 1994 with 696 ADIs being reported (rate 42 ADIs per 100 person-years). Since 1997, the number of ADIs decreased from 253 (rate 7 per 100 person-years) to 84 cases in 2013 (rate 1 per 100 person-years) (p-value equals to zero for the trend in the number of ADIs). We have also shown that out of 22 ADIs considered, only PCP maintained its prominent ranking (albeit with much reduced overall prevalence). Finally, we observed that over time very few deaths were related to AIDS-related causes, especially in the most recent years. Interpretation We showed that the number of new ADIs and AIDS-related mortality have been decreasing rapidly over time in BC. These results provide further evidence that integrated comprehensive free programs that facilitate testing, and deliver treatment and care to this population can be effective in markedly decreasing AIDS-related morbidity and mortality, thus suggesting that controlling and eventually ending AIDS is possible. Funding The British Columbia Ministry of Health, the US National Institutes of Health, the US National Institute on Drug Abuse, the Canadian Institutes of Health Research, and the Michael Institute for

Pattern of HIV/AIDS infection in Irrua, a rural community in Nigeria ...

African Journals Online (AJOL)

This study aims to observe the pattern of HIV infection in Irrua Hospital records of patients diagnosed and managed with HIV/AIDS between January 2001 and December 2004 were retrieved and subjected to statistical analysis. The results show that females have statistically significant lower age; more incidence of double ...

Radiation scanning aids tower diagnosis at Arun LNG plant

International Nuclear Information System (INIS)

Naklie, M.M.; Pless, L.; Gurning, T.P.; Hyasak, M.

1990-01-01

Radiation scanning has been used effectively to troubleshoot the treating towers of the Arun LNG plant in Sumatra, Indonesia. The plant is one of the world's largest such facilities. The analysis was part of an investigation aimed at increasing the capacity of the treater section of the plant. Radiation scanning is a tool which, in addition to tower differential pressure and product purity, can aid in diagnosing tower performance

CD4 cell count and the risk of AIDS or death in HIV-Infected adults on combination antiretroviral therapy with a suppressed viral load: a longitudinal cohort study from COHERE.

Directory of Open Access Journals (Sweden)

Jim Young

Full Text Available Most adults infected with HIV achieve viral suppression within a year of starting combination antiretroviral therapy (cART. It is important to understand the risk of AIDS events or death for patients with a suppressed viral load.Using data from the Collaboration of Observational HIV Epidemiological Research Europe (2010 merger, we assessed the risk of a new AIDS-defining event or death in successfully treated patients. We accumulated episodes of viral suppression for each patient while on cART, each episode beginning with the second of two consecutive plasma viral load measurements 500 copies/µl, the first of two consecutive measurements between 50-500 copies/µl, cART interruption or administrative censoring. We used stratified multivariate Cox models to estimate the association between time updated CD4 cell count and a new AIDS event or death or death alone. 75,336 patients contributed 104,265 suppression episodes and were suppressed while on cART for a median 2.7 years. The mortality rate was 4.8 per 1,000 years of viral suppression. A higher CD4 cell count was always associated with a reduced risk of a new AIDS event or death; with a hazard ratio per 100 cells/µl (95% CI of: 0.35 (0.30-0.40 for counts <200 cells/µl, 0.81 (0.71-0.92 for counts 200 to <350 cells/µl, 0.74 (0.66-0.83 for counts 350 to <500 cells/µl, and 0.96 (0.92-0.99 for counts ≥500 cells/µl. A higher CD4 cell count became even more beneficial over time for patients with CD4 cell counts <200 cells/µl.Despite the low mortality rate, the risk of a new AIDS event or death follows a CD4 cell count gradient in patients with viral suppression. A higher CD4 cell count was associated with the greatest benefit for patients with a CD4 cell count <200 cells/µl but still some slight benefit for those with a CD4 cell count ≥500 cells/µl.

Families, children, migration and AIDS.

Science.gov (United States)

Haour-Knipe, Mary

2009-01-01

Migration is very often a family affair, and often involves children, directly or indirectly. It may give rise to better quality of life for an entire family, or to bitter disappointment, and may also increase vulnerability to HIV and AIDS. This review, carried out for the Joint Learning Initiative on Children and AIDS, links the literature on "migration", on "HIV and AIDS" and on "families". Three themes are sketched: (1) As both HIV prevalence and circular migration increase, former migrant workers affected by AIDS may return to their families for care and support, especially at the end of life, often under crisis conditions. Families thus lose promising members, as well as sources of support. However, very little is known about the children of such migrants. (2) Following patterns of migration established for far different reasons, children may have to relocate to different places, sometimes over long distances, if their AIDS-affected parents can no longer care for them. They face the same adaptation challenges as other children who move, but complicated by loss of parent(s), AIDS stigma, and often poverty. (3) The issue of migrant families living with HIV has been studied to some extent, but mainly in developed countries with a long history of migration, and with little attention paid to the children in such families. Difficulties include involuntary separation from family members, isolation and lack of support, disclosure and planning for children's care should the parent(s) die and differences in treatment access within the same family. Numerous research and policy gaps are defined regarding the three themes, and a call is made for thinking about migration, families and AIDS to go beyond description to include resilience theory, and to go beyond prevention to include care.

Corporate Policy Conferences and Events

International Development Research Centre (IDRC) Digital Library (Canada)

André Lavoie

2015-10-15

Oct 15, 2015 ... Hospitality as defined in the Corporate Hospitality Policy; ... awards and recognition ceremonies; social events and any other ... The Convenor is the person who initiates an event and takes responsibility for its conduct.

Mapping fires and American Red Cross aid using demographic indicators of vulnerability.

Science.gov (United States)

Lue, Evan; Wilson, John P

2017-04-01

Social vulnerability indicators can assist with informing disaster relief preparation. Certain demographic segments of a population may suffer disproportionately during disaster events, and a geographical understanding of them can help to determine where to place strategically logistical assets and to target disaster-awareness outreach endeavours. Records of house fire events and American Red Cross aid provision over a five-year period were mapped for the County of Los Angeles, California, United States, to examine the congruence between actual events and expectations of risk based on vulnerability theory. The geographical context provided by the data was compared with spatially-explicit indicators of vulnerability, such as age, race, and wealth. Fire events were found to occur more frequently in more vulnerable areas, and Red Cross aid was found to have an even stronger relationship to those places. The findings suggest that these indicators speak beyond vulnerability and relate to patterns of fire risk. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Use of analytical aids for accident management

International Nuclear Information System (INIS)

Ward, L.W.

1991-01-01

The use of analytical aids by utility technical support teams can enhance the staff's ability to manage accidents. Since instrumentation is exposed to environments beyond design-basis conditions, instruments may provide ambiguous information or may even fail. While it is most likely that many instruments will remain operable, their ability to provide unambiguous information needed for the management of beyond-design-basis events and severe accidents is questionable. Furthermore, given these limitation in instrumentation, the need to ascertain and confirm current plant status and forecast future behavior to effectively manage accidents at nuclear facilities requires a computational capability to simulate the thermal and hydraulic behavior in the primary, secondary, and containment systems. With the need to extend the current preventive approach in accident management to include mitigative actions, analytical aids could be used to further enhance the current capabilities at nuclear facilities. This need for computational or analytical aids is supported based on a review of the candidate accident management strategies discussed in NUREG/CR-5474. Based on the review of the NUREG/CR-5474 strategies, two major analytical aids are considered necessary to support the implementation and monitoring of many of the strategies in this document. These analytical aids include (1) An analytical aid to provide reactor coolant and secondary system behavior under LOCA conditions. (2) An analytical aid to predict containment pressure and temperature response with a steam, air, and noncondensable gas mixture present

Computer-Aided Design in Further Education.

Science.gov (United States)

Ingham, Peter, Ed.

This publication updates the 1982 occasional paper that was intended to foster staff awareness and assist colleges in Great Britain considering the use of computer-aided design (CAD) material in engineering courses. The paper begins by defining CAD and its place in the Integrated Business System with a brief discussion of the effect of CAD on the…

[AIDS prevention in Germany].

Science.gov (United States)

Pott, E

2007-04-01

In 1987 the national AIDS prevention campaign "Gib AIDS keine Chance" (Don't give AIDS a chance) was started in Germany. After a very difficult and controversial political debate about a probably successful response to AIDS, in the end a political decision was made in favour of the implementation of a long term "social learning strategy". Thus, since then the Bundeszentrale für gesundheitliche Aufklärung (Federal Centre for Health Education, BZgA) has been running the campaign on behalf of the Federal Ministry of Health. The result of this prevention program is a low rate of infections. In Germany there were 2600 newly diagnosed infections in 2005: 59 % in homosexual men, 16 % by heterosexual contacts, 17 % in people from high prevalence countries and 7 % in i.v. drug users. In comparison to the international situation Germany has a relatively low HIV-prevalence even nowadays. However, Germany has also been confronted with an increasing number of newly diagnosed infections in the last few years. When the prevention program was started it was very important to build new structures for a successful implementation of the campaign. That meant for instance to build up an effective infrastructure for cooperation between the governmental and the nongovernmental sector, including organising the coordinated action among the partners at the federal, regional and local levels. Likewise, international networking was of great importance. A key element, relevant for the success of the campaign was the close cooperation at the federal level between the BZgA and the Deutsche AIDS Hilfe (German AIDS Help, DAH), to combine the highreach intervention in low-prevalence populations with intensive interventions for high prevalence groups. An effective national AIDS prevention campaign must reach the whole population; inform the public about the main risks of infection, about methods of protection and about what is not infectious. Moreover groups with a higher level of risk of

Human Performance Event Database

International Nuclear Information System (INIS)

Trager, E. A.

1998-01-01

The purpose of this paper is to describe several aspects of a Human Performance Event Database (HPED) that is being developed by the Nuclear Regulatory Commission. These include the background, the database structure and basis for the structure, the process for coding and entering event records, the results of preliminary analyses of information in the database, and plans for the future. In 1992, the Office for Analysis and Evaluation of Operational Data (AEOD) within the NRC decided to develop a database for information on human performance during operating events. The database was needed to help classify and categorize the information to help feedback operating experience information to licensees and others. An NRC interoffice working group prepared a list of human performance information that should be reported for events and the list was based on the Human Performance Investigation Process (HPIP) that had been developed by the NRC as an aid in investigating events. The structure of the HPED was based on that list. The HPED currently includes data on events described in augmented inspection team (AIT) and incident investigation team (IIT) reports from 1990 through 1996, AEOD human performance studies from 1990 through 1993, recent NRR special team inspections, and licensee event reports (LERs) that were prepared for the events. (author)

Comparison of radiological measures for diagnosing flatfoot

International Nuclear Information System (INIS)

Lo, Huan-Chu; Chu, Wencheng; Wu, Weikai; Hsieh, Hsin; Chou, Chiehping; Sun, Shaoen; Chou, Pinya; Liao, Chenhui; Guan, Xiaoyun; Li, Shuchee

2012-01-01

Background. In the Taiwanese military, flatfoot is indicated by a calcaneal-fifth metatarsal angle (arch angle) =165 deg . However, the arch angle is not always easily defined. Purpose. To assess correlations between the arch angle and other radiographic measures and thus identify an alternative radiographic measure for diagnosing flatfoot. Material and Methods Eighty-seven male Taiwanese military recruits were studied (median age 22 years, interquartile range 20-23 years). Lateral, weight-bearing radiographs were taken. Five radiographic measurements, including the calcaneal-fifth metatarsal angle (arch angle), medial arch angle (MAA), calcaneal pitch angle (CP), talus angle (TA), and talar-first metatarsal angle (TFM) were made. Correlations between the arch angle and all other measures were determined. A cut-off value for predicting flatfoot (arch angle ≥165 deg ) was determined for each measure using the Youden index and receiver-operating characteristic (ROC) curves were generated for each measure to assess diagnostic accuracy. Results. All measures were significantly correlated with arch angle (P 9.5 deg ) had the highest specificity (90.3% vs. 88.75 for CP <12.3 deg ). Conclusion. CP is inversely correlated with arch angle in Taiwanese male military recruits. CP < 12.3 deg is a significant predictor of flatfoot. Assessment of CP may be used as an alternative means of diagnosing flatfoot when the arch angle is not easily defined

Aortic events in a nationwide Marfan syndrome cohort.

Science.gov (United States)

Groth, Kristian A; Stochholm, Kirstine; Hove, Hanne; Kyhl, Kasper; Gregersen, Pernille A; Vejlstrup, Niels; Østergaard, John R; Gravholt, Claus H; Andersen, Niels H

2017-02-01

Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan syndrome cohort. The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome diagnosis prior or after the first aortic event. From the total cohort of 412 patients, 150 (36.4 %) had an aortic event. Fifty percent were event free at age 49.6. Eighty patients (53.3 %) had prophylactic surgery and seventy patients (46.7 %) a dissection. The yearly event rate was 0.02 events/year/patient in the period 1994-2014. Male patients had a significant higher risk of an aortic event at a younger age with a hazard ratio of 1.75 (CI 1.26-2.42, p = 0.001) compared with women. Fifty-three patients (12.9 %) were diagnosed with MFS after their first aortic event which primarily was aortic dissection [n = 44 (83.0 %)]. More than a third of MFS patients experienced an aortic event and male patients had significantly more aortic events than females. More than half of the total number of dissections was in patients undiagnosed with MFS at the time of their event. This emphasizes that diagnosing MFS is lifesaving and improves mortality risk by reducing the risk of aorta dissection.

Admissions and Readmissions Related to Adverse Events, 2007-2014

Science.gov (United States)

2015-12-01

DRG is a classification system primarily used for billing purposes. It uses the principle and secondary diagnoses to assign clinical conditions to...This study assessed adverse events as they relate to readmissions in the Military Health System (MHS). Among 142,579 admissions with an adverse event...The following study retrospectively assessed admissions and readmissions for adverse events in the Military Health System (MHS) by quantifying

Ebola virus disease in a humanitarian aid worker - New York City, October 2014.

Science.gov (United States)

Yacisin, Kari; Balter, Sharon; Fine, Annie; Weiss, Don; Ackelsberg, Joel; Prezant, David; Wilson, Ross; Starr, David; Rakeman, Jennifer; Raphael, Marisa; Quinn, Celia; Toprani, Amita; Clark, Nancy; Link, Nathan; Daskalakis, Demetre; Maybank, Aletha; Layton, Marcelle; Varma, Jay K

2015-04-03

In late October 2014, Ebola virus disease (Ebola) was diagnosed in a humanitarian aid worker who recently returned from West Africa to New York City (NYC). The NYC Department of Health and Mental Hygiene (DOHMH) actively monitored three close contacts of the patient and 114 health care personnel. No secondary cases of Ebola were detected. In collaboration with local and state partners, DOHMH had developed protocols to respond to such an event beginning in July 2014. These protocols included safely transporting a person at the first report of symptoms to a local hospital prepared to treat a patient with Ebola, laboratory testing for Ebola, and monitoring of contacts. In response to this single case of Ebola, initial health care worker active monitoring protocols needed modification to improve clarity about what types of exposure should be monitored. The response costs were high in both human resources and money: DOHMH alone spent $4.3 million. However, preparedness activities that include planning and practice in effectively monitoring the health of workers involved in Ebola patient care can help prevent transmission of Ebola.

USER-DEFINED CONTENT IN A MODERN LEARNING ENVIRONMENT FOR ENGINEERING GRAPHICS

Directory of Open Access Journals (Sweden)

DOLGA Lia

2008-07-01

Full Text Available New pedagogic methods are developed during the current “knowledge-based era”. They replace the “taught lesson” by collaboration, reflection and iteration; in this context, the internet should not remain only a convenient and cheep (if not free mechanism for delivering traditional materials online. As the amount of available information continues to enlarge and diversify, the skills needed to access and process this information become quickly outdated. The ability to use new technologies and a wide range of multimedia tools will define success. This paper outlines the important role played by the user-generated content in defining new pedagogical approaches to learning in the context of online communities. Graphical subjects, like “Computer Graphics” and “Computer Aided Design” require an active participation of the student. Students-led lessons and students generated content give consistency and aid value to the educational process. The term of “teaching” transforms in “studying”.

correlation of who clinical staging with cd4 counts in adult hiv/aids

African Journals Online (AJOL)

2011-02-02

Feb 2, 2011 ... AIDS and HIV/AIDS case definitions for surveillance. (African region) (12). Laboratory and radiological methods were carried out if they were required to make a clinical diagnosis. In the majority of the cases, the HIV clinical events were presumptive diagnosis and based on the WHO clinical staging for ...

Notification Event Architecture for Traveler Screening: Predictive Traveler Screening Using Event Driven Business Process Management

Science.gov (United States)

Lynch, John Kenneth

2013-01-01

Using an exploratory model of the 9/11 terrorists, this research investigates the linkages between Event Driven Business Process Management (edBPM) and decision making. Although the literature on the role of technology in efficient and effective decision making is extensive, research has yet to quantify the benefit of using edBPM to aid the…

From CBCL to DSM: A Comparison of Two Methods to Screen for DSM-IV Diagnoses Using CBCL Data

Science.gov (United States)

Krol, Nicole P. C. M.; De Bruyn, Eric E. J.; Coolen, Jolanda C.; van Aarle, Edward J. M.

2006-01-01

The screening efficiency of 2 methods to convert Child Behavior Checklist (CBCL) assessment data into Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses was compared. The Machine-Aided Diagnosis (MAD) method converts CBCL input data directly into DSM-IV symptom criteria. The…

Socio-economic monitoring of hiv/aids threat in the Russian Federation

Directory of Open Access Journals (Sweden)

Valeriy Aleksandrovich Chereshnev

2012-06-01

Full Text Available Thesubject of theinvestigation issocial and economic aspects of thethreat of HIV/AIDS in the Russian Federation.Theinvestigation was aimed at improving socio-economic monitoring of the HIV / AIDS threat. The methodology of systemic analysis and statistical methods were used. Three main sections of socio-economic monitoring of HIV / AIDS were defined with their problems, challenges and areas for improvement. Results of the study are applicable in justifying and shaping public policy to counter the threat of HIV / AIDS. Planned costs of measures to counter thethreat of HIV / AIDS must be based on requirements, allocation and results achieved. Systemic approach to planning requires an analysis of interrelation between costs, requirements and results. The absence of a systemic approach to coordination of costs and requirements leads to inefficient use of resources

Synchronous Parallel Emulation and Discrete Event Simulation System with Self-Contained Simulation Objects and Active Event Objects

Science.gov (United States)

Steinman, Jeffrey S. (Inventor)

1998-01-01

The present invention is embodied in a method of performing object-oriented simulation and a system having inter-connected processor nodes operating in parallel to simulate mutual interactions of a set of discrete simulation objects distributed among the nodes as a sequence of discrete events changing state variables of respective simulation objects so as to generate new event-defining messages addressed to respective ones of the nodes. The object-oriented simulation is performed at each one of the nodes by assigning passive self-contained simulation objects to each one of the nodes, responding to messages received at one node by generating corresponding active event objects having user-defined inherent capabilities and individual time stamps and corresponding to respective events affecting one of the passive self-contained simulation objects of the one node, restricting the respective passive self-contained simulation objects to only providing and receiving information from die respective active event objects, requesting information and changing variables within a passive self-contained simulation object by the active event object, and producing corresponding messages specifying events resulting therefrom by the active event objects.

Emergence of Azoles Resistance Candida species in Iranian AIDS defined patients with oropharyngeal candidiasis

Directory of Open Access Journals (Sweden)

Farzad Katiraee

2015-09-01

Conclusion: Based on the findings, it can be concluded that screening of resistant Candida isolates by disk diffusion or broth dilution method is essential for the surveillance and prevention of antifungal resistance in patient management. Although nystatin is widely used in clinical practice for HIV patients in Iran, no evidence of enhanced resistance against this agent was found on the other hand, resistance to azole antifungals, particularly fluconazole, increased. Considering the lack of resistance to caspofungin, administration of this agent is suggested for the treatment of OPC in AIDS patients.

Tumors associated with HIV / AIDS monitoring 45 patients between 1/1998 and 6/2004

International Nuclear Information System (INIS)

Krygier, G.; Lombardo, K.; Sosa, A.; Ocampo; Suárez P, R.; Muse, I.

2010-01-01

Full text: This paper is intended to show 45 patients with cancer associated the human immunodeficiency virus (HIV) / AIDS, diagnosed, treated and followed over a period of 6.5 years in our country. The medical records were retrospectively analyzed of cancer patients diagnosed HIV positive on 5 institutions public and private in our midst, in the period between 1/98 and 6/04 (Institute of Health, National Institute of Oncology, Hospital of Clinics, Service Comprehensive Medical, Spanish Mutual Aid Association). They took into account different variables (origin, medical record number, sex, age, sexual habits, addiction to injecting drugs, HIV diagnosis positive diagnosis of AIDS, infectious prophylaxis, antiretroviral therapy, lymphocyte start and in the evolution population viral load start and evolutionary, tumor type, stage, treatment received, date of last control and status the close of the work). We compared data collected by us AIDS Ministry report of Public Health. 24 cases were Kaposi sarcomas (one nodal exclusive), 11 were non-Hodgkin lymphomas (two of SNC and other gastric), 1 Hodgkin's Disease 1 rectal cancer, tongue cancer 1 1 laryngeal cancer, thyroid cancer 1 1 Melanoma 1 parotid cancer, cancer 1 Lung and breast cancer 1. No cervical tumors or recorded anal canal in the study population. Treatments received varied for each disease depending on the stage of the disease and viral load / Towns lymphocyte start. This is the first study with longer follow-up in our country HIV patients / AIDS-associated cancer, he reflected the difficulty in collecting data, various types of cancer in the study population and demand the need to create an accurate and accessible system of monitoring these patients

Investigating the Impact of Financial Aid on Student Dropout Risks: Racial and Ethnic Differences

Science.gov (United States)

Chen, Rong; DesJardins, Stephen L.

2010-01-01

This study focuses on the differences in college student dropout behavior among racial/ethnic groups. We employ event history methods and data from the Beginning Postsecondary Students (BPS) and National Postsecondary Student Aid Study (NPSAS) surveys to investigate how financial aid may differentially influence dropout risks among these student…

Diagnosing MOV problems using comparative trace analysis

International Nuclear Information System (INIS)

Leon, R.L.

1992-01-01

The paper presents the concept of comparative trace analysis and shows it to be very effective in diagnosing motor operated valve (MOV) problems. Comparative trace analysis is simply the process of interpreting simultaneously gathered traces, each presenting a different perspective on the same series of events. The opening and closing of a motor operated valve is such a series of events. The simultaneous traces are obtained using Liberty Technologies' Valve Operation Test and Evaluation System (VOTES)reg-sign. The traces include stem thrust, motor current, motor power factor, motor power, switch actuations, vibration in three different frequency bands, spring pack displacement, and spring pack force. Spare and auxiliary channels enable additional key parameters to be measured, such as differential pressure and stem displacement. Though not specifically illustrated in this paper, the VOTES system also provides for FFT analysis on all traces except switches

AIDS: the frightening facts.

Science.gov (United States)

Ryan, M

1986-01-01

Aquired Immune Deficiency Syndrome (AIDS) has succeeded in creating an unprecedented wave of panic among the Western public and some sections of the medical profession. Research clearly shows that the AIDS virus is transmissible in a number of ways: from man to woman and vice versa during sexual intercourse, through semen and possibly vaginal fluids; from mothers to their children through breast milk; through exchange of saliva (but not through just a casual kiss); and through blood and blood products. Far from being exclusive to homosexuals, studies in Europe have shown that female virus carriers can transmit AIDS to healthy men through sexual intercourse--the predominant means by which transmission appears to occur in Central Africa. Although cases of AIDS began being diagnosed in a few Central African countries at the beginning of the 1980s, at the same time as they were first being observed in Europe and North America, many commentators assumed that the virus originated in Africa. Yet, it is safe to say that the nature of the virus, let alone its origins, remains controversial among scientists and virologists. 1 supporter of the theory that the AIDS virus has African origins is Robert Gall of the US National Institute of Health (NIH). He is one of the co-discoverers of the virus, which he named HTLV3 (Human T-cell Lymphotropic Virus 3). The virus also was discovered at France's Pasteur Institute by Luc Montaigner, who called it LAV (Lymphadenpathy Associated Virus). Gallo named the virus as he did because he believes it to be related to a pair of other viruses, HTLV1 and HTLV2, which like the AIDS virus attack the body's immunity system. Unlike AIDS, these 2 viruses, do not destroy the T-cells but cause them to replicate into cancer tumors. In Gallo's view, HTLV1 has long been endemic to some parts of Africa, from where he believes it spread via the slave trade to other parts of the world. Montaigner does not agree. He denies that the AIDS virus is related to

[Politicized sexualities: AIDS activism and sexual orientation in Portugal].

Science.gov (United States)

Santos, Ana Cristina

2002-01-01

This article analyzes how both the Portuguese state and civil society have addressed the AIDS issue, focusing on participation by the lesbian, gay, bisexual, and transsexual community (LGBT) in the struggle against AIDS. The article begins by describing the situation of LGBT individuals in Portugal during the 1990s, when the Portuguese LGBT movement emerged and grew, and then characterizes the evolution of HIV/AIDS in Portugal, analyzing the relationship between civil society and sexuality in general and the situation of the epidemic in the country in particular, considering key facts, nongovernmental organizations, and state initiatives. Special attention is given to the role played by LGBT organizations in the struggle against HIV. Finally, the article reflects on the future of the struggle against both AIDS and discrimination in the 21st century, considering recent events in the country and the guidelines recommended by international policies.

A report of three cases of AIDS in Thailand.

Science.gov (United States)

Phanuphak, P; Locharernkul, C; Panmuong, W; Wilde, H

1985-12-01

Acquired immune deficiency syndrome (AIDS) has been rarely reported as occurring primarily in Asia. We report here on first three cases of AIDS diagnosed at Chulalongkorn Hospital Medical School. One case was an American who had been in Thailand for two years; the other two were Thai. The American and one of the Thai patients were male homosexuals but they had no connection with one another. The latter Thai male homosexual had sexual contact with a German man who showed no evidence of the disease. The other Thai patients was the mistress of the male Thai patient, which underlies the importance of heterosexual transmission of the disease. The two male patients had opportunistic infections whereas the female patient had only generalised lymphadenopathy (Pre-AIDS). Delayed type hypersensitivity response, T-cell subsets enumeration and the in vitro T-cell mitogen response served as diagnostic tools when combined with the clinical history. The diagnosis was made even before the results of tests to determine the presence of antibodies to HTLV-III were known. The presence of anti-HTLV-III simply confirmed our diagnosis.

Spectrum of acute clinical characteristics of diagnosed concussions in college athletes wearing instrumented helmets: clinical article.

Science.gov (United States)

Duhaime, Ann-Christine; Beckwith, Jonathan G; Maerlender, Arthur C; McAllister, Thomas W; Crisco, Joseph J; Duma, Stefan M; Brolinson, P Gunnar; Rowson, Steven; Flashman, Laura A; Chu, Jeffrey J; Greenwald, Richard M

2012-12-01

Concussive head injuries have received much attention in the medical and public arenas, as concerns have been raised about the potential short- and long-term consequences of injuries sustained in sports and other activities. While many student athletes have required evaluation after concussion, the exact definition of concussion has varied among disciplines and over time. The authors used data gathered as part of a multiinstitutional longitudinal study of the biomechanics of head impacts in helmeted collegiate athletes to characterize what signs, symptoms, and clinical histories were used to designate players as having sustained concussions. Players on 3 college football teams and 4 ice hockey teams (male and female) wore helmets instrumented with Head Impact Telemetry (HIT) technology during practices and games over 2-4 seasons of play. Preseason clinical screening batteries assessed baseline cognition and reported symptoms. If a concussion was diagnosed by the team medical staff, basic descriptive information was collected at presentation, and concussed players were reevaluated serially. The specific symptoms or findings associated with the diagnosis of acute concussion, relation to specific impact events, timing of symptom onset and diagnosis, and recorded biomechanical parameters were analyzed. Data were collected from 450 athletes with 486,594 recorded head impacts. Forty-eight separate concussions were diagnosed in 44 individual players. Mental clouding, headache, and dizziness were the most common presenting symptoms. Thirty-one diagnosed cases were associated with an identified impact event; in 17 cases no specific impact event was identified. Onset of symptoms was immediate in 24 players, delayed in 11, and unspecified in 13. In 8 cases the diagnosis was made immediately after a head impact, but in most cases the diagnosis was delayed (median 17 hours). One diagnosed concussion involved a 30-second loss of consciousness; all other players retained

Spirometer-controlled cine magnetic resonance imaging to diagnose tracheobronchomalacia in pediatric patients

DEFF Research Database (Denmark)

Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra

2014-01-01

is restricted by ionizing radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine-MRI as alternative to cine-CT in a retrospective study.12 children (mean 12 years, range 7-17), suspected to have TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration......Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard to diagnose TBM, but bronchoscopy has major disadvantages, such as general anaesthesia. Cine-CT is a non-invasive alternative to diagnose TBM, but its use in children...

Cancer as a cause of death among people with AIDS in the United States

Science.gov (United States)

Simard, Edgar P.; Engels, Eric A.

2010-01-01

Background People with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), are at increased risk for cancer. Highly active antiretroviral therapy [(HAART), widely available since 1996] has resulted in dramatic declines in AIDS-related deaths. Methods We evaluated cancer as a cause of death in a U.S. registry-based cohort of 83,282 people with AIDS (1980–2006). Causes of death due to AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) were assessed. We evaluated mortality rates and the fraction of deaths due to cancer. Poisson regression assessed rates according to calendar year of AIDS onset. Results Overall mortality declined from 302 (1980–1989), to 140 (1990–1995), to 29 per 1,000 person-years (1996–2006). ADC mortality declined from 2.95 (1980–1989) to 0.65 per 1,000 person-years (1996–2006) (PAIDS-related deaths. Non-Hodgkin lymphoma was the commonest cancer-related cause of death (36% during 1996–2006). Likewise, NADC mortality declined from 2.21 to 0.84 per 1,000 person-years (1980–1989 vs. 1996–2006, PAIDS, cancers account for a growing fraction of deaths. Improved cancer prevention and treatment, particularly for non-Hodgkin lymphoma and lung cancer, would reduce mortality among people with AIDS. PMID:20825305

Proceedings from Specialists Meeting on human performance in operational events

International Nuclear Information System (INIS)

1998-01-01

This conference on human performance in operational events is composed of 34 papers, grouped in 11 sessions. After an invited contribution on the human factor in the nuclear industry, the sessions are: session 1 (Operational events: Human performance in operational events - how to improve it?, Human performance research strategies for human performance, The development of a model of control room operator cognition), session 2 (Operational response: A study of the recovery from 120 events, Empirical study of the influence of organizational and procedural characteristics on team performance in the emergency situation using plant simulators, Cognitive skills and nuclear power plant operational decision making), session 3 (PSA for Probabilistic Safety Analysis: A sensitivity study of human errors in optimizing surveillance test interval (STI) and allowed outage time (AOT) of standby safety system, Analysis of Parks nuclear power plant personnel activity during safety related event sequences, An EDF project to update the Probabilistic Human Reliability Assessment PHRA methodology), session 4 (modelling with ATHEANA: Atheana, a technique for human error analysis, an overview of its methodological basis, Common elements on operational events across technologies, Results of nuclear power plant application of new technique for human error analysis), session 5 (Regulatory practice: US.NRC Research and analysis activities concerning human reliability assessment and human performance evaluation, Introduction of simulator-based examinations and its effects on the nuclear industry, Regulatory monitoring of human performance in PWR operation in France), session 6 (Simulation: Human performance in Bavarian nuclear power plant as a preventive element, Human performance event database, Crew situation awareness, diagnoses and performance in simulated nuclear power plant process disturbances), session 7 (Operator aids: Development of a plant navigation system, Operation system

Diagnósticos de enfermagem em portadores da Síndrome da Imunodeficiência Adquirida Diagnósticos de enfermería em portadores del Sindrome de Inmunodeficiencia Adquirida Nursing diagnoses for patients with Acquired Immunodeficiency Syndrome

Directory of Open Access Journals (Sweden)

Myria Ribeiro da Silva

2009-02-01

Full Text Available Os objetivos deste estudo foram identificar os diagnósticos de enfermagem mais freqüentes segundo a taxonomia II da NANDA em pacientes adultos portadores de HIV/aids e verificar com que freqüência as características definidoras, os fatores relacionados e de risco deram suporte para a elaboração destes. O levantamento dos dados foi realizado pelos pesquisadores nos 60 pacientes internados com HIV/aids e depois feita a verificação se os requisitos propostos pela NANDA para realização dos DE eram adequados. Foram selecionados 13 dos 38 diagnósticos com freqüência igual ou superior a 80%. Os resultados indicaram concordância e adequações para identificação. Porém, novos estudos serão necessários tanto para confirmação dos achados, assim como trazer novos conhecimentos ao assunto e estimular a pesquisa nesta população de pacientes.Los objetivos del estudio fuerón identificar los diagnósticos de enfermería según la taxonomia de Nanda en pacientes adultos portadores de HIV/Sida y observar con que frecuencia las caracteristicas que son definidas por los factores relacionados pelos investigadores en los 60 pacientes internados con VIH/SIDA y despúes hecha la verificación de los requisitos propuestos en Nanda para realización de los diagnósticos de la enfermeria que eran adequados. Fuerón relacionados 13 de los 38 diagnósticos con frecuencia igual al superior de 80%. Los resultados indican concordancia y sentido para identificar. Pues nuevos estudios fuerón necesarios tanto para a confirmación de los hallazgos asin como traer nuevos conhecimentos sobre el asunto y estimular a investigación neste grupo de pacientes.This study aims at identifying the most frequent nursing diagnoses, according to the NANDA's taxonomy II in adult patients of HIV/AIDS and to check how often the defining characteristics, the related factors and the risk factors provided support for their development. Data survey was conducted by

Diagnosing Breast Cancer with the Aid of Fuzzy Logic Based on Data Mining of a Genetic Algorithm in Infrared Images

Directory of Open Access Journals (Sweden)

Hossein Ghayoumi Zadeh

2012-10-01

Full Text Available Background: Breast cancer is one of the most prevalent cancers among women today. The importance of breast cancer screening, its role in the timely identification of patients, and the reduction in treatment expenses are considered to be among the highest sanitary priorities of a modern country. Thermal imaging clearly possesses a special role in this stage due to rapid diagnosis and use of harmless rays.Methods: We used a thermal camera for imaging of the patients. Important parameters were derived from the images for their posterior analysis with the aid of a genetic algorithm. The principal components that were entered in a fuzzy neural network for clustering breast cancer were identified.Results: The number of images considered for the test included a database of 200 patients out of whom 15 were diagnosed with breast cancer via mammography. Results of the base method show a sensitivity of 93%. The selection of parameters in the combination module gave rise measured errors, which in training of the fuzzy-neural network were of the order of clustering 1.0923×10-5, which reached 2%.Conclusion: The study indicates that thermal image scanning coupled with the presented method based on artificial intelligence can possess a special status in screening women for breast cancer due to the use of harmless non-radiation rays. There are cases where physicians cannot decisively say that the observed pattern in theimage is benign or malignant. In such cases, the response of the computer model can be a valuable support tool for the physician enabling an accurate diagnosis based on the type of imaging pattern as a response from the computer model.

Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

Science.gov (United States)

Korir, Anne; Mauti, Nathan; Moats, Pamela; Gurka, Matthew J; Mutuma, Geoffrey; Metheny, Christine; Mwamba, Peter M; Oyiro, Peter O; Fisher, Melanie; Ayers, Leona W; Rochford, Rosemary; Mwanda, Walter O; Remick, Scot C

2014-01-01

Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis. The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1) documentation of positive HIV serology; 2) antiretroviral drug prescription; 3) CD4+ lymphocyte count; and 4) WHO HIV clinical stage or immune suppression syndrome (ISS), which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3%) met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma) and 31% (53) were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27%) cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria. This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease in the

Cancer Treatment in Patients With HIV Infection and Non-AIDS-Defining Cancers: A Survey of US Oncologists.

Science.gov (United States)

Suneja, Gita; Boyer, Matthew; Yehia, Baligh R; Shiels, Meredith S; Engels, Eric A; Bekelman, Justin E; Long, Judith A

2015-05-01

HIV-infected individuals with non-AIDS-defining cancers are less likely to receive cancer treatment compared with uninfected individuals. We sought to identify provider-level factors influencing the delivery of oncology care to HIV-infected patients. A survey was mailed to 500 randomly selected US medical and radiation oncologists. The primary outcome was delivery of standard treatment, assessed by responses to three specialty-specific management questions. We used the χ(2) test to evaluate associations between delivery of standard treatment, provider demographics, and perceptions of HIV-infected individuals. Multivariable logistic regression identified associations using factor analysis to combine several correlated survey questions. Our response rate was 60%; 69% of respondents felt that available cancer management guidelines were insufficient for the care of HIV-infected patients with cancer; 45% never or rarely discussed their cancer management plan with an HIV specialist; 20% and 15% of providers were not comfortable discussing cancer treatment adverse effects and prognosis with their HIV-infected patients with cancer, respectively; 79% indicated that they would provide standard cancer treatment to HIV-infected patients. In multivariable analysis, physicians comfortable discussing adverse effects and prognosis were more likely to provide standard cancer treatment (adjusted odds ratio, 1.52; 95% CI, 1.12 to 2.07). Physicians with concerns about toxicity and efficacy of treatment were significantly less likely to provide standard cancer treatment (adjusted odds ratio, 0.67; 95% CI, 0.53 to 0.85). Provider-level factors are associated with delivery of nonstandard cancer treatment to HIV-infected patients. Policy change, provider education, and multidisciplinary collaboration are needed to improve access to cancer treatment. Copyright © 2015 by American Society of Clinical Oncology.

The Effects of HIV/AIDS on the Retention of Black Women in College

Science.gov (United States)

Henry, Wilma J.

2013-01-01

Although only contributing approximately 12% to the United States population, Black Americans account for the majority (51%) of new HIV/AIDS diagnoses in this country. Black women in college between the ages of 18 and 24 fall directly in the center of these alarming statistics. These young women are faced with the psychosocial manifestations of…

Understanding the working alliance with clients diagnosed with anorexia nervosa.

Science.gov (United States)

Oyer, Laura; O'Halloran, Mary Sean; Christoe-Frazier, Liesel

2016-01-01

The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment.

ArcAid Interactive Archery Assistant

Directory of Open Access Journals (Sweden)

Jeroen Vervaeke

2015-12-01

Full Text Available This paper describes the design process of a bow aiming system, called ArcAid, which is an interactive archery assistant. The main goal of ArcAid is to introduce a way for beginner Robin Hoods to learn the art of archery to its fullest. In order to achieve this goal, our smartphone-based design focuses on a fun and interactive learning process that gives constant feedback to the user on how to hit a certain goal. A SPIKE high- end laser sensor is used for the distance measurement and the smartphone’s accelerometer is used to define the angle of inclination. To measure the force on the arrow and the displacement of the string, a flex sensor is attached upon one of the arcs of the bow. All sensor data is processed in an Arduino Nano microprocessor and feedback to the user is given by a dedicated smartphone app. In this paper, we mainly focus on the construction, mechanics and electronics of the ArcAid bow and on the design of the mobile app, which is the game controller. Furthermore, we briefly discuss some future development ideas.

Toward Beijing: linking HIV / AIDS to other women's issues is imperative.

Science.gov (United States)

Forrest, K

1995-01-01

The senior advisor to the AIDSCAP Women's Initiative, Dr. E. Maxine Ankrah, is actively lobbying to secure the inclusion of HIV/AIDS language in the draft platform of the UN Fourth World Conference on Women: Action for Equality, Development and Peace scheduled for September 1995 in Beijing. She organized the only workshop on HIV/AIDS at the preparatory meeting in New York in March 1995. It examined the effects of poverty on the expanding epidemic among females. Workshop presentations included international perspectives on: the effect of structural adjustment programs on women's vulnerability; the relationship between poverty, female prostitution, and AIDS; credit schemes and education to empower rural women; reproductive rights; ethnic issues; and the need for women to help women. Obstacles that obscured the relationships between HIV/AIDS and other women's issues have been: that AIDS was initially defined as a medical problem; that risk groups were narrowly defined; and the emphasis on behavior that blames persons infected with HIV. Despite earlier obstacles, the draft platform has several sections with HIV/AIDS language. Strategic Objective C.3: Undertake Multi-Sectoral Initiatives Sensitive to Women's Life Situations addresses the HIV pandemic and other sexual and reproductive health issues. Some of the actions called for in this objective are involvement of women in decision making, expansion of peer education and outreach, and supporting research of woman-controlled prevention methods. AIDSCAP Women's Initiative and other nongovernmental organizations will work together focus attention on HIV/AIDS in Beijing. AIDSCAP plans to have resource publications available in Beijing as well as to host networking sessions. Unless it is waived, the policy prohibiting HIV-infected persons from entering China will preclude HIV-infected women from taking part in the Conference.

Learning to Diagnose Cirrhosis with Liver Capsule Guided Ultrasound Image Classification

Directory of Open Access Journals (Sweden)

Xiang Liu

2017-01-01

Full Text Available This paper proposes a computer-aided cirrhosis diagnosis system to diagnose cirrhosis based on ultrasound images. We first propose a method to extract a liver capsule on an ultrasound image, then, based on the extracted liver capsule, we fine-tune a deep convolutional neural network (CNN model to extract features from the image patches cropped around the liver capsules. Finally, a trained support vector machine (SVM classifier is applied to classify the sample into normal or abnormal cases. Experimental results show that the proposed method can effectively extract the liver capsules and accurately classify the ultrasound images.

Alpha- and beta-cell abnormalities in haemoglobin A1c-defined prediabetes and type 2 diabetes

DEFF Research Database (Denmark)

Calanna, Salvatore; Scicali, Roberto; Di Pino, Antonino

2014-01-01

New recommendations for the use of glycated haemoglobin A1c (HbA1c) to diagnose prediabetes and type 2 diabetes have changed the constitution of the two populations. We aimed to investigate the pathophysiological characteristics of individuals with HbA1c-defined prediabetes and type 2 diabetes......, respectively. Ten subjects with HbA1c-defined prediabetes, i.e. HbA1c from 5.7 to 6.4 % (39-46 mmol/mol), eight newly diagnosed patients with HbA1c-defined type 2 diabetes [HbA1c ≥6.5 % (≥48 mmol/mol)], and ten controls with HbA1c lower than 5.7 % (.... Subjects with HbA1c-defined prediabetes showed significantly lower insulinogenic index (P = 0.02), disposition index (P = 0.001), and glucagon suppression compared with controls; and similar (P = NS) insulinogenic index and glucagon suppression and higher disposition index (P = 0.02) compared to HbA1c...

Automated reasoning with dynamic event trees: a real-time, knowledge-based decision aide

International Nuclear Information System (INIS)

Touchton, R.A.; Gunter, A.D.; Subramanyan, N.

1988-01-01

The models and data contained in a probabilistic risk assessment (PRA) Event Sequence Analysis represent a wealth of information that can be used for dynamic calculation of event sequence likelihood. In this paper we report a new and unique computerization methodology which utilizes these data. This sub-system (referred to as PREDICTOR) has been developed and tested as part of a larger system. PREDICTOR performs a real-time (re)calculation of the estimated likelihood of core-melt as a function of plant status. This methodology uses object-oriented programming techniques from the artificial intelligence discipline that enable one to codify event tree and fault tree logic models and associated probabilities developed in a PRA study. Existence of off-normal conditions is reported to PREDICTOR, which then updates the relevant failure probabilities throughout the event tree and fault tree models by dynamically replacing the off-the-shelf (or prior) probabilities with new probabilities based on the current situation. The new event probabilities are immediately propagated through the models (using 'demons') and an updated core-melt probability is calculated. Along the way, the dominant non-success path of each event tree is determined and highlighted. (author)

Nursing diagnoses in patients having mechanical ventilation support in a respiratory intensive care unit in Turkey.

Science.gov (United States)

Yücel, Şebnem Çinar; Eşer, Ismet; Güler, Elem Kocaçal; Khorshid, Leyla

2011-10-01

This research was carried out to find out the nursing diagnoses in patients who have mechanical ventilation support in a respiratory intensive care unit. The study was conducted with 51 evaluations of critically ill adult patients who underwent invasive and non-invasive mechanical ventilation therapy in 2008. Data collection was based on Gordon's 11 Functional Health Patterns, and nursing diagnoses were determined according to North American Nursing Diagnosis Association-International (NANDA-I) Taxonomy II. The nursing diagnoses were determined by two researchers separately. The consistency between the nursing diagnoses defined by the two researchers was evaluated by using Cohen's kappa (κ). Forty men (78.4%) and 11 women (21.6%) whose mean ages were 70.19 (SD = 8.96) years were included in the study. Nineteen subgroups of nursing diagnoses about safety/protection domain, and 15 subgroups about activity/rest domain were seen at different rates in the patients. There was a statistically significant difference between mechanical ventilation via tracheostomy or endotracheal tube and decreased cardiac output (d.f. = 1, χ(2) = 4.760, P = 0.029). The relationship between the length of time under mechanical ventilation and impaired physical mobility was considerably significant (d.f. = 3, χ(2) = 24.459, P = 0.000). It was found out that there was a high degree of agreement (96.8%) between the nursing diagnoses defined by the two researchers separately (κ = 0.936, SE = 0.08). © 2011 Blackwell Publishing Asia Pty Ltd.

Nurse aide decision making in nursing homes: factors affecting empowerment.

Science.gov (United States)

Chaudhuri, Tanni; Yeatts, Dale E; Cready, Cynthia M

2013-09-01

To evaluate factors affecting structural empowerment among nurse aides in nursing homes. Structural empowerment can be defined as the actual rather than perceived ability to make autonomous decisions within an organisation. Given the paucity of research on the subject, this study helps to close the gap by identifying factors that affect nurse aide empowerment, that is, decision-making among nurse aides. The data for the study come from self-administered questionnaires distributed to direct-care workers (nurse aides) in 11 nursing homes in a southern state in the USA. Ordinary least square regression models were estimated to analyse the effects of demographic predictors, personal factors (competency, emotional exhaustion and positive attitude) and structural characteristics (coworker and supervisor support, information availability and shared governance) on nurse aide decision-making. Findings suggest race among demographic predictors, emotional exhaustion among personal characteristics, and supervisor support, and shared governance among structural factors, significantly affect nurse aide decision-making. It is important to explore race as one of the central determinants of structural empowerment among nurse aides. In addition, the nature and type of emotional exhaustion that propels decision-making needs to be further examined. The study shows the importance of shared governance and supervisor support for fostering nurse aide empowerment. © 2013 Blackwell Publishing Ltd.

Characteristics and Outcome of Patients Diagnosed With HIV at Older Age.

Science.gov (United States)

Asher, Ilan; Guri, Keren Mahlab; Elbirt, Daniel; Bezalel, Shira Rosenberg; Maldarelli, Frank; Mor, Orna; Grossman, Zehava; Sthoeger, Zev M

2016-01-01

To characterize the clinical, virological, and immunological status at presentation as well as the outcome of patients diagnosed with HIV above the age of 50. A retrospective study of 418 patients newly diagnosed with HIV in 1 Israeli center, between the years 2004 and 2013. Patients with new HIV diagnosis ≥ 50 years of age defined as "older' and < 50 defined as "younger.' Patients were evaluated every 1 to 3 months (mean follow-up 53 ± 33 months). Patients with < 2 CD4/viral-load measurements or with < 1 year of follow-up were excluded. Time of HIV infection was estimated by HIV sequence ambiguity assay. Ambiguity index ≤ 0.43 indicated recent (≤ 1 year) HIV infection. Eighty nine (21%) patients were diagnosed with HIV at an older age. Those older patients presented with significant lower CD4 cell counts and higher viral-load compared with the younger patients. At the end of the study, the older patients had higher mortality rate (21% vs 3.5%; P < 0.001) and lower CD4 cell counts (381 ± 228 vs 483 ± 26 cells/μL; P < 0.001) compared with the younger patients. This difference was also observed between older and younger patients with similar CD4 cell counts and viral load at the time of HIV diagnosis and among patients with a recent (≤ 1 year) HIV infection. One-fifth of HIV patients are diagnosed at older age (≥ 50 years). Those older patients have less favorable outcome compared with the younger patients. This point to the need of educational and screening programs within older populations and for a closer follow-up of older HIV patients.

Development of on-line operator aid system (OASYSTM) for nuclear power plants

International Nuclear Information System (INIS)

Kang, Ki Sig; Choi, Seong Soo; Kim, Han Gon; Chang, Soon Heung; Jeong, Hee Kyo; Yi, Chul Un

1994-01-01

In this paper, the development of On - line operator Aid SYStem (OASYS TM ) are discussed by focusing attention on the importance of the operator's role for nuclear power plants. The OASYS TM is under development to support the operator's decision making process and to enhance the safety of a nuclear power plant by providing the plant operators with timely and proper guideline during abnormal and emergency conditions. The OASYS TM has capabilities for the signal validation/management, the alarm processing, the failure diagnosis using abnormal operating procedures, and the dynamic tracking of emergency operating procedures using function restoration guidelines and optimal recovery guidelines with a series of complex logic steps covering a broad spectrum of event sequences. The proposed system is being implemented on a SUN-4/75 Workstation using C and Quintus TM prolog language. For verification studies a full-scope real-time simulator is being used. Test results show that the OASYS TM is capable of diagnosing a plant failure quickly and providing an operator guideline with fast response time. After verification the OASYS TM will be installed in the simulator II of Kori nuclear training center

HIV/AIDS - Related Stigma and Discrimination in Nigeria: Review of ...

African Journals Online (AJOL)

Erah

2009-09-03

Sep 3, 2009 ... KEYWORDS: HIV/AIDS, Stigma, discrimination, Nigeria. *Institute ... except South Africa and India. 1. The ... defined as a form of exclusion, or ... S&D like gender, age and background ..... levels of socio-economic development.

[HIV/AIDS related mortality in southern Shanxi province and its risk factors].

Science.gov (United States)

Ning, Shaoping; Xue, Zidong; Wei, Jun; Mu, Shengcai; Xu, Yajuan; Jia, Shaoxian; Qiu, Chao; Xu, Jianqing

2015-03-01

To explore factors influencing mortality rate of HIV/AIDS and to improve the effectiveness of antiretroviral therapy (ART). By means of retrospective cohort study and the AIDS control information system, HIV/AIDS case reports and antiviral treatment information of 4 cities in southern Shanxi province up to end of December 2012 were selected, to calculate the mortality rate and treatment coverage based on further data collected, along with analysis using the Cox proportional hazards survival regression. 4 040 cases confirmed of HIV/AIDS were included in this study. The average age was (36.0 ± 12.9) years, with 65.3% being male, 56.5% being married, 73.5% having junior high school education or lower, 58.4% being peasants, 54.3% with sexually transmitted infection (40.1% were heterosexual, 14.2% were homosexual), and 38.9% were infected via blood transmission (20.2% were former plasma donors, 16.2% blood transfusion or products recipients, 2.4% were injection drug users). Overall mortality decreased from 40.2 per 100 person/year in 2004 to 6.3 per 100 person/year in 2012, with treatment coverage concomitantly increasing from almost 14.8% to 63.4%. Cox proportional hazards survival regression was used on 4 040 qualified cases, demonstrating the top mortality risk factor was without antiretroviral therapy (RR = 14.9, 95% CI: 12.7-17.4). Cox proportional hazards survival regression was made on 1 938 cases of antiviral treatment, demonstrating that the mortality risk of underweight or obese before treatment was higher than those of normal and overweight cases (RR = 2.7, 95% CI: 1.6-4.5), and the mortality of those having a CD4(+) T-lymphocyte count ≤ 50 cells per µl before treatment was more than 50 cases (RR = 2.6, 95% CI: 1.5-4.5); Cox proportional hazards survival regression was made on 2 102 cases of untreated cases, demonstrating the mortality risk of those initially diagnosed as AIDS was higher than those initially diagnosed as HIV (RR = 3.4, 95% CI: 2

Profile of nursing diagnoses of hospitalized patients in an infectious disease unit

Directory of Open Access Journals (Sweden)

Vinicius Lino de Souza Neto

Full Text Available Objective: To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit.Methods: This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPE(r version 2.0 to construct the diagnoses.Results: Data analysis resulted in 36 nursing diagnoses statements, with a higher prevalence of impaired food intake, cachexia, impaired spontaneous bladder elimination, impaired oral cavity hygiene, exposure to contamination, rapid heart rate, insomnia, drug abuse, alcohol and tobacco abuse, social isolation, acceptance and fear.Conclusions: The identification of a diagnostics profile is critical to guide nursing interventions.

An Unsupervised Anomalous Event Detection and Interactive Analysis Framework for Large-scale Satellite Data

Science.gov (United States)

LIU, Q.; Lv, Q.; Klucik, R.; Chen, C.; Gallaher, D. W.; Grant, G.; Shang, L.

2016-12-01

Due to the high volume and complexity of satellite data, computer-aided tools for fast quality assessments and scientific discovery are indispensable for scientists in the era of Big Data. In this work, we have developed a framework for automated anomalous event detection in massive satellite data. The framework consists of a clustering-based anomaly detection algorithm and a cloud-based tool for interactive analysis of detected anomalies. The algorithm is unsupervised and requires no prior knowledge of the data (e.g., expected normal pattern or known anomalies). As such, it works for diverse data sets, and performs well even in the presence of missing and noisy data. The cloud-based tool provides an intuitive mapping interface that allows users to interactively analyze anomalies using multiple features. As a whole, our framework can (1) identify outliers in a spatio-temporal context, (2) recognize and distinguish meaningful anomalous events from individual outliers, (3) rank those events based on "interestingness" (e.g., rareness or total number of outliers) defined by users, and (4) enable interactively query, exploration, and analysis of those anomalous events. In this presentation, we will demonstrate the effectiveness and efficiency of our framework in the application of detecting data quality issues and unusual natural events using two satellite datasets. The techniques and tools developed in this project are applicable for a diverse set of satellite data and will be made publicly available for scientists in early 2017.

Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.

Science.gov (United States)

Harrison, Anne L; Shields, Nora; Taylor, Nicholas F; Frawley, Helena C

2016-10-01

Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? A systematic review of randomised trials. Pregnant women diagnosed with gestational diabetes mellitus. Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights

Aiding Lay Decision Making Using a Cognitive Competencies Approach

OpenAIRE

Maule, A. J.; Maule, Simon

2016-01-01

Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical pr...

Caracterization of the HIV-AIDS descentralization office in centro Havana

Directory of Open Access Journals (Sweden)

Bárbara Elena Hernández Rodríguez

2009-03-01

Full Text Available It was carried out a descriptive, retrospective and longitudinal study of the medical records of 245 people who have been diagnosed as having HIV-aids and who have been treated at the municipal decentralization office of Centro Havana from January 2006 through June 2008. The study was aimed at making a characterization of the office. The statistical analysis consisted on the calculation of the absolute and relative frequencies of each of the variables under study, using the SPSS statistical package, version 11.5. The study revealed that the highest percentage of patients was between 20 to 39 years old, in both sexes, with a prevalence of people who have completed either secondary or pre-university education. 60 % are retired, 60. 4% live crammed and the majority of them live on houses in regular or bad conditions. 72,6% of the studied group has a homosexual orientation. Based on the HIV and aids classification, 149 were diagnosed as having HIV. The studied group of highest incidence was the one selected. 99% became infected via sexual transmission. The more frequent unhealthy habit was a sedentary lifestyle. The most frequently reported side effect of the three-therapy treatment was the hyperlipidemia. The most prevalent opportunist infectious disease was Pneumonia by Pneumocistis Carini. Depressive neurosis was the main diagnosis at the medical office, while the most prevalent non-transmissible chronic disease was hypertension. Fourteen patients have died; 1873 consultations and 674 home visits have been made. We recommend that a medical multidisciplinary team be put together at the HIV-AIDS office, and that a plan of action will be created to solve the detected problems.

Diagnosis of pulmonary Kaposi's sarcoma in AIDS patients.

Science.gov (United States)

Jeyapalan, M; Steffenson, S

1997-02-01

Pulmonary Kaposi's sarcoma (KS) is one of the many manifestations of AIDS. There are no specific tests for its early diagnosis. Because its symptoms may be similar to tuberculosis, it may be diagnosed incorrectly and treated as such. Consequently, by the time of the correct diagnosis, valuable time will have been lost for effective medical care that could positively impact prognosis. The discussion in this case study is focused on pulmonary KS with an interest in improving premorbid diagnosis that may lead to an earlier recognition and better treatment of the disease.

An expert system for diagnosing environmentally induced spacecraft anomalies

Science.gov (United States)

Rolincik, Mark; Lauriente, Michael; Koons, Harry C.; Gorney, David

1992-01-01

A new rule-based, machine independent analytical tool was designed for diagnosing spacecraft anomalies using an expert system. Expert systems provide an effective method for saving knowledge, allow computers to sift through large amounts of data pinpointing significant parts, and most importantly, use heuristics in addition to algorithms, which allow approximate reasoning and inference and the ability to attack problems not rigidly defined. The knowledge base consists of over two-hundred (200) rules and provides links to historical and environmental databases. The environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose. The system's driver translates forward chaining rules into a backward chaining sequence, prompting the user for information pertinent to the causes considered. The use of heuristics frees the user from searching through large amounts of irrelevant information and allows the user to input partial information (varying degrees of confidence in an answer) or 'unknown' to any question. The modularity of the expert system allows for easy updates and modifications. It not only provides scientists with needed risk analysis and confidence not found in algorithmic programs, but is also an effective learning tool, and the window implementation makes it very easy to use. The system currently runs on a Micro VAX II at Goddard Space Flight Center (GSFC). The inference engine used is NASA's C Language Integrated Production System (CLIPS).

Examination of skin lesions for cancer : Which clinical decision aids and tools are available in general practice?

NARCIS (Netherlands)

Koelink, Cecile J. L.; Jonkman, Marcel F.; Van der Meer, Klaas; Van der Heide, Wouter K.

2014-01-01

Background While skin cancer incidence is rising throughout Europe, general practitioners (GP) feel unsure about their ability to diagnose skin malignancies. Objectives To evaluate whether the GP has sufficient validated clinical decision aids and tools for the examination of potentially malignant

Hybla Fair event: environmental report

International Nuclear Information System (INIS)

Roach, D.R.; Russell, W.L. Jr.

1975-01-01

A series of environmental measurements during the Hybla Fair nuclear event were made. Experimenters were unsure of conditions that would be created since there was no closure system and the experiments were close to the source. A variety of temperature, pressure, and load devices were tested. The results will aid in the design and engineering of future close-in diagnostic packages and pipes. (U.S.)

[Use of cognitive aids in pediatric emergency care : Interdisciplinary consensus statement].

Science.gov (United States)

Wirtz, S; Eich, C; Becke, K; Brenner, S; Callies, A; Harding, U; Höhne, C; Hoffmann, F; Kaufmann, J; Landsleitner, B; Marung, H; Nicolai, T; Reifferscheid, F; Trappe, U; Jung, P

2017-05-01

Preclinical pediatric emergencies are rare events and are therefore often associated with stress and uncertainty for emergency medical service personnel. To ensure adequate treatment of pediatric patients a variety of different cognitive aids exist (e.g. books, apps, rulers, weight-adapted bag systems). Especially the size specifications of the medical equipment and the dosage of emergency medication are individually very different in children and are dependent on parameters, such as body height and weight. Therefore, cognitive aids often enable length measurement whereby it is possible to draw conclusions on body weight for calculating the child's medication dosage. These aids may help to avoid the wrong medication dose or the wrong therapy of children but uncritical and untrained usage of these aids carries a potential risk of mistakes. This recommendation gives an overview of the general requirements and different problems of cognitive aids and should help improve the general framework and the rational basis for the use and further development of cognitive aids in emergency medicine.

Gene expression profiling for molecular classification of multiple myeloma in newly diagnosed patients

NARCIS (Netherlands)

Broyl, Annemiek; Hose, Dirk; Lokhorst, Henk; de Knegt, Yvonne; Peeters, Justine; Jauch, Anna; Bertsch, Uta; Buijs, Arjan; Stevens-Kroef, Marian; Beverloo, H. Berna; Vellenga, Edo; Zweegman, Sonja; Kersten, Marie-Josée; van der Holt, Bronno; el Jarari, Laila; Mulligan, George; Goldschmidt, Hartmut; van Duin, Mark; Sonneveld, Pieter

2010-01-01

To identify molecularly defined subgroups in multiple myeloma, gene expression profiling was performed on purified CD138(+) plasma cells of 320 newly diagnosed myeloma patients included in the Dutch-Belgian/German HOVON-65/GMMG-HD4 trial. Hierarchical clustering identified 10 subgroups; 6

Aid and AIDS: a delicate cocktail

NARCIS (Netherlands)

van Dalen, H.P.; Reuser, M.

2008-01-01

Development assistance targeting health overwhelmingly concentrates on HIV/AIDS. This column argues that that focus neglects critical demographic issues and degrades health infrastructure, particularly in Sub-Saharan Africa. The prime rule for AIDS aid should be “First, do no harm”.

Improvement of HAART in Brazil, 1998-2008: a nationwide assessment of survival times after AIDS diagnosis among men who have sex with men.

Science.gov (United States)

Malta, Monica; da Silva, Cosme M F P; Magnanini, Monica Mf; Wirtz, Andrea L; Perissé, André R S; Beyrer, Chris; Strathdee, Steffanie A; Bastos, Francisco I

2015-03-07

In 1996, Brazil became the first developing country to provide free, universal access to HAART, laboratory monitoring, and clinical care to any eligible patient. As of June 2014, approximately 400,000 patients were under treatment, making it the most comprehensive HIV treatment initiative implemented thus far in a middle-income country, worldwide. The Brazilian epidemic is highly concentrated among men who have sex with men (MSM). Four national information systems were combined and Cox regression was used to conduct retrospective cohort analysis of HAART availability/access on all-cause mortality among MSM diagnosed with AIDS reported to the information systems between 1998-2008, adjusting for demographic, clinical, and behavioral factors and controlling for spatially-correlated survival data by including a frailty effect. Multiple imputation by chained equations was used to handle missing data. Among 50,683 patients, 10,326 died during the 10 year of period. All-cause mortality rates declined following introduction of HAART, and were higher among non-white patients and those starting HAART with higher viral load and lower CD4 counts. In multivariable analysis adjusted for race, age at AIDS diagnosis, and baseline CD4 cell count, MSM diagnosed in latter periods had almost a 50% reduction in the risk of death, compared to those diagnosed between 1998-2001 (2002-2005 adjHR: 0.54, 95% CI:0.51-0.57; 2006-2008 adjHR: 0.51, 95% CI:0.48-0.55). After controlling for spatially correlated survival data, mortality remained higher among those diagnosed in the earliest diagnostic cohort and lower among non-white patients and those starting HAART with higher viral load and lower CD4 lymphocyte counts. Universal and free access to HAART has helped achieve impressive declines in AIDS mortality in Brazil. However, after a 10-years follow-up, differential AIDS-related mortality continue to exist. Efforts are needed to identify and eliminate these health disparities, therefore

Rapid Learning of Adverse Medical Event Disclosure and Apology.

Science.gov (United States)

Raemer, Daniel B; Locke, Steven; Walzer, Toni Beth; Gardner, Roxane; Baer, Lee; Simon, Robert

2016-09-01

Despite published recommended best practices for full disclosure and apology to patients and families after adverse medical events, actual practice can be inadequate. The use of "cognitive aids" to help practitioners manage complex critical events has been successful in a variety of fields and healthcare. We wished to extend this concept to disclosure and apology events. The aim of this study was to test if a brief opportunity to review a best practice guideline for disclosure and apology would improve communication performance. Thirty pairs of experienced obstetricians and labor nurses participated in a 3-part exercise with mixed-realism simulation. The first part used a standardized actor patient to meet the obstetrical team. The second part used a high-fidelity simulation leading to an adverse medical event (retained sponge), and the third part used standardized actors, patient, and husband, who systematically move through stages of grief response. The participants were randomized into 2 groups, one was provided with a cognitive aid in the form of a best practice guideline for disclosure and apology and the other was only given time to plan. Four blinded raters working in pairs scored subjects on a 7-point scale using a previously developed assessment instrument modified for this study. Pooled ratings of the disclosure and apology discussion for the intervention group (n = 167, mean = 4.9, SD = 0.92) were higher than those from the control group (n = 167, mean = 4.3, SD = 1.21) (P apology conversation after reviewing a cognitive aid in the form of a best practice guideline than a control group that was only given time to prepare.

High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.

Science.gov (United States)

Riedel, David J; Mwangi, Evelyn Ivy W; Fantry, Lori E; Alexander, Carla; Hossain, Mian B; Pauza, C David; Redfield, Robert R; Gilliam, Bruce L

2013-04-24

To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population. Retrospective cohort study. All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models. There were 470 cases of cancer among 447 patients. Patients were predominantly African-American (85%) and male (79%). Non-AIDS-defining cancers (NADCs, 69%) were more common than AIDS-defining cancers (ADCs, 31%). Cumulative cancer incidence increased significantly over the study period. The majority (55.9%) was taking antiretroviral therapy (ART) at cancer diagnosis or started afterward (26.9%); 17.2% never received ART. Stage 3 or 4 cancer was diagnosed in 67%. There were 226 deaths during 1096 person years of follow-up, yielding an overall mortality rate of 206 per 1000 person years. The cumulative mortality rate at 30 days, 1 year, and 2 years was 6.5, 32.2, and 41.4%, respectively. Mortality was similar between patients on ART whether they started before or after the cancer diagnosis but was higher in patients who never received ART. In patients with a known cause of death, 68% were related to progression of the underlying cancer. In a large cohort of urban, predominantly African-American patients with HIV and cancer, many patients presented with late-stage cancer. There was substantial 30-day and 2-year mortality, although ART had a significant mortality benefit. Deaths were most often caused by progression of cancer and not from another HIV-related or AIDS-related event.

Computer-aided diagnosis in radiological imaging: current status and future challenges

Science.gov (United States)

Doi, Kunio

2009-10-01

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different types of CAD schemes are being developed for detection and/or characterization of various lesions in medical imaging, including conventional projection radiography, CT, MRI, and ultrasound imaging. Commercial systems for detection of breast lesions on mammograms have been developed and have received FDA approval for clinical use. CAD may be defined as a diagnosis made by a physician who takes into account the computer output as a "second opinion". The purpose of CAD is to improve the quality and productivity of physicians in their interpretation of radiologic images. The quality of their work can be improved in terms of the accuracy and consistency of their radiologic diagnoses. In addition, the productivity of radiologists is expected to be improved by a reduction in the time required for their image readings. The computer output is derived from quantitative analysis of radiologic images by use of various methods and techniques in computer vision, artificial intelligence, and artificial neural networks (ANNs). The computer output may indicate a number of important parameters, for example, the locations of potential lesions such as lung cancer and breast cancer, the likelihood of malignancy of detected lesions, and the likelihood of various diseases based on differential diagnosis in a given image and clinical parameters. In this review article, the basic concept of CAD is first defined, and the current status of CAD research is then described. In addition, the potential of CAD in the future is discussed and predicted.

Crew Situation Awareness, Diagnoses, and Performance in Simulated Nuclear Power Plant Process Disturbances

International Nuclear Information System (INIS)

Sebok, Angelia; Kaarstad, Magnhild

1998-01-01

Research was conducted at the OECD Halden Reactor Project to identify issues in crew performance in complex simulated nuclear power plant scenarios. Eight crews of operators participated in five scenarios, administered over a two or three-day period. Scenarios required either rule-based or knowledge-based problem solving. Several performance parameters were collected, including Situation Awareness (SA), objective performance, rated crew performance, and crew diagnoses. The purpose of this study was to investigate differences in performance measures in knowledge-based and rule-based scenarios. Preliminary data analysis revealed a significant difference in crew SA between the two scenario types: crews in the rule-based scenarios had significantly higher SA then crews in the knowledge-based scenarios. Further investigations were initiated to determine if crews performed differently, in terms of objective performance, rated crew performance, and diagnoses, between the scenario types. Correlations between the various crew performance measurements were calculated to reveal insights into the nature of SA, performance, and diagnoses. The insights into crew performance can be used to design more effective interfaces and operator performance aids, thus contributing to enhanced crew performance and improved plant safety. (authors)

[Will AIDS overtake them?].

Science.gov (United States)

Boukhari, S

UNICEF estimates that the streets are now the home of some 5 million African children aged 7-15 who are victims of rapid population growth and urbanization as well as the disintegration of traditional family structure. These children, deprived of a home and of all parental control, are potentially very vulnerable to the threat of AIDS. Prostitution, which is almost institutionalized in the most impoverished urban areas, represents for young girls the most immediate means of survival and occasionally even of helping their families. Male prostitution is highly tabu and marginal in sub-Saharan Africa, and is only slightly developed around the tourist hotels. Homeless children are somewhat protected against contamination through the blood by their lack of access to health care. Intravenous drugs are rare in Africa, and drug use is at most an indirect risk factor for AIDS to the extent that in increases the need for money and weakens the immune system. The frequency of sexually transmitted diseases, deplorable hygienic conditions, and poor general health of homeless children increase their risk of contracting the virus. Many homeless children do not even know of the existence of condoms and in any event condoms are usually inaccessible or too costly for them. Homeless children, like the general population, have false ideas about AIDS that discourage self-protective behaviors. In addition they are cut off from the activities of existing prevention programs. In a context of permanent daily insecurity, AIDS appears as just 1 more menace among others. According to an anthropologist working with the UNESCO program to help homeless children, the only way of making such children aware of the threat of AIDS in the large African cities will be to increase the number of prevention programs targeted at them. At the same time, the children need to be educated and taught an income-generating skill; in short, they need to be given a reason to believe in the future.

Dynamic vegetation modeling of tropical biomes during Heinrich events

Science.gov (United States)

Handiani, Dian Noor; Paul, André; Dupont, Lydie M.

2010-05-01

Heinrich events are thought to be associated with a slowdown of the Atlantic Meridional Overturning Circulation (AMOC), which in turn would lead to a cooling of the North Atlantic Ocean and a warming of the South Atlantic Ocean (the "bipolar seesaw" hypothesis). The accompanying abrupt climate changes occurred not only in the ocean but also on the continents. Changes were strongest in the Northern Hemisphere but were registered in the tropics as well. Pollen data from Angola and Brazil showed that climate changes during Heinrich events affected vegetation patterns very differently in eastern South America and western Africa. To understand the differential response in the terrestrial tropics, we studied the vegetation changes during Heinrich events by using a dynamic global vegetation model (TRIFFID) as part of the University of Victoria (UVic) Earth System-Climate Model (ESCM). The model results show a bipolar seesaw pattern in temperature and precipitation during a near-collapse of the AMOC. The succession in plant-functional types (PFTs) showed changes from forest to shrubs to desert, including spreading desert in northwest Africa, retreating broadleaf trees in West Africa and northern South America, but advancing broadleaf trees in Brazil. The pattern is explained by a southward shift of the tropical rainbelt resulting in a strong decrease in precipitation over northwest and West Africa as well as in northern South America, but an increase in precipitation in eastern Brazil. To facilitate the comparison between modeled vegetation results with pollen data, we diagnosed the distribution of biomes from the PFT coverage and the simulated model climate. The biome distribution was computed for Heinrich event 1 and the Last Glacial Maximum as well as for pre-industrial conditions. We used a classification of biomes in terms of "mega-biomes", which were defined following a scheme originally proposed by BIOME 6000 (v 4.2). The biome distribution of the Sahel region

Incidence of AIDS-Defining Opportunistic Infections and Mortality during Antiretroviral Therapy in a Cohort of Adult HIV-Infected Individuals in Hanoi, 2007-2014.

Directory of Open Access Journals (Sweden)

Junko Tanuma

Full Text Available Although the prognosis for HIV-infected individuals has improved after antiretroviral therapy (ART scale-up, limited data exist on the incidence of AIDS-defining opportunistic infections (ADIs and mortality during ART in resource-limited settings.HIV-infected adults in two large hospitals in urban Hanoi were enrolled to the prospective cohort, from October 2007 through December 2013. Those who started ART less than one year before enrollment were assigned to the survival analysis. Data on ART history and ADIs were collected retrospectively at enrollment and followed-up prospectively until April 2014.Of 2,070 cohort participants, 1,197 were eligible for analysis and provided 3,446 person-years (PYs of being on ART. Overall, 161 ADIs episodes were noted at a median of 3.20 months after ART initiation (range 0.03-75.8 with an incidence 46.7/1,000 PYs (95% confidence interval [CI] 39.8-54.5. The most common ADI was tuberculosis with an incidence of 29.9/1,000 PYs. Mortality after ART initiation was 8.68/1,000 PYs and 45% (19/45 died of AIDS-related illnesses. Age over 50 years at ART initiation was significantly associated with shorter survival after controlling for baseline CD4 count, but neither having injection drug use (IDU history nor previous ADIs were associated with poor survival. Semi-competing risks analysis in 951 patients without ADIs history prior to ART showed those who developed ADIs after starting ART were at higher risk of death in the first six months than after six months.ADIs were not rare in spite of being on effective ART. Age over 50 years, but not IDU history, was associated with shorter survival in the cohort. This study provides in-depth data on the prognosis of patients on ART in Vietnam during the first decade of ART scale-up.

Variations in Upper-Level Water Vapor Transport Diagnosed from Climatological Satellite Data

Science.gov (United States)

Lerner, Jeffrey A; Jedlovee, Gary J.; Atkinson, Robert J.

1998-01-01

GOES-7 VAS measurements during the Pathfinder period (1987-88) have been analysed to reveal seasonal and interannual variations in moisture transport. Long term measurements of quality winds and humidity from satellite estimates show superior benefit in diagnosing middle and upper tropospheric large scale climate variations such as ENSO events and direct circulation systems such as the Hadley Cell. A water Vapor Transport Index (WVTI) has been developed to diagnose preferred regions of strong moisture transport and to gauge the seasonal and interannual intensities detected in the GOES viewing area. Second-order variables that may be derived from GOES winds will be also discussed on the poster.

Defining a quantitative framework for evaluation and optimisation of the environmental impacts of mega-event projects.

Science.gov (United States)

Parkes, Olga; Lettieri, Paola; Bogle, I David L

2016-02-01

This paper presents a novel quantitative methodology for the evaluation and optimisation of the environmental impacts of the whole life cycle of a mega-event project: construction and staging the event and post-event site redevelopment and operation. Within the proposed framework, a mathematical model has been developed that takes into account greenhouse gas (GHG) emissions resulting from use of transportation fuel, energy, water and construction materials used at all stages of the mega-event project. The model is applied to a case study - the London Olympic Park. Three potential post-event site design scenarios of the Park have been developed: Business as Usual (BAU), Commercial World (CW) and High Rise High Density (HRHD). A quantitative summary of results demonstrates that the highest GHG emissions associated with the actual event are almost negligible compared to those associated with the legacy phase. The highest share of emissions in the legacy phase is attributed to embodied emissions from construction materials (almost 50% for the BAU and HRHD scenarios) and emissions resulting from the transportation of residents, visitors and employees to/from the site (almost 60% for the CW scenario). The BAU scenario is the one with the lowest GHG emissions compared to the other scenarios. The results also demonstrate how post-event site design scenarios can be optimised to minimise the GHG emissions. The overall outcomes illustrate how the proposed framework can be used to support decision making process for mega-event projects planning. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

From event to impact: International Exhibition and urban mobility

Directory of Open Access Journals (Sweden)

Rosa Anna La Rocca

2008-08-01

Full Text Available The realization of a mega event mainly affects the city life. On the one hand, the exceptional event represents a factor which speeds up urban transformations, that could not be realized otherwise. This characteristic has been defined as “pulsar effect” to explicate the impulse given to normal course of urban living by the mega events. On the other hand, mega events ask for actions aimed at managing the intense displacements due to their organizations and attractive capacity. Among the different types of events, this study considers the Universal Expositions, as they have been defined by the Bureau International des Expositions (the non-governmental organization having the decision power about great exposition. Universal or International Expo’s realization affects specific urban areas, interested by important transformations, especially referred to realization of infrastructure (mobility or dedicated to the event. While the management of urban mobility requires to define specific actions aimed at traffic congestion minimization. Increasing transport demand (visitors and tourists + residents and city-users is one of mega event effects. This work deals with individuations of mega event effects on city organization by analysing some case studies of Expos cities. Particularly referred to transformations occurred in transport infrastructures this articles sketches out the contemporary Expos profile and theirs effects on city.

Matrix Analysis of Traditional Chinese Medicine Differential Diagnoses in Gulf War Illness.

Science.gov (United States)

Taylor-Swanson, Lisa; Chang, Joe; Schnyer, Rosa; Hsu, Kai-Yin; Schmitt, Beth Ann; Conboy, Lisa A

2018-03-08

To qualitatively categorize Traditional Chinese Medicine (TCM) differential diagnoses in a sample of veterans with Gulf War Illness (GWI) pre- and postacupuncture treatment. The authors randomized 104 veterans diagnosed with GWI to a 6-month acupuncture intervention that consisted of either weekly or biweekly individualized acupuncture treatments. TCM differential diagnoses were recorded at baseline and at 6 months. These TCM diagnoses were evaluated using Matrix Analysis to determine co-occurring patterns of excess, deficiency, and channel imbalances. These diagnoses were examined within and between participants to determine patterns of change and to assess stability of TCM diagnoses over time. Frequencies of diagnoses of excess, deficiency, and channel patterns were tabulated. Diagnoses of excess combined with deficiency decreased from 43% at baseline to 39% of the sample at 6 months. Excess+deficiency+channel imbalances decreased from 26% to 17%, while deficiency+channel imbalances decreased from 11% to 4% over the study duration. The authors observed a trend over time of decreased numbers of individuals presenting with all three types of differential diagnosis combinations. This may suggest that fewer people were diagnosed with concurrent excess, deficiency, and channel imbalances and perhaps a lessening in the complexity of their presentation. This is the first published article that organizes and defines TCM differential diagnoses using Matrix Analysis; currently, there are no TCM frameworks for GWI. These findings are preliminary given the sample size and the amount of missing data at 6 months. Characterization of the TCM clinical presentation of veterans suffering from GWI may help us better understand the potential role that East Asian medicine may play in managing veterans with GWI and the design of effective acupuncture treatments based on TCM. The development of a TCM manual for treating GWI is merited.

Making cytological diagnoses on digital images using the iPath network.

Science.gov (United States)

Dalquen, Peter; Savic Prince, Spasenija; Spieler, Peter; Kunze, Dietmar; Neumann, Heinrich; Eppenberger-Castori, Serenella; Adams, Heiner; Glatz, Katharina; Bubendorf, Lukas

2014-01-01

The iPath telemedicine platform Basel is mainly used for histological and cytological consultations, but also serves as a valuable learning tool. To study the level of accuracy in making diagnoses based on still images achieved by experienced cytopathologists, to identify limiting factors, and to provide a cytological image series as a learning set. Images from 167 consecutive cytological specimens of different origin were uploaded on the iPath platform and evaluated by four cytopathologists. Only wet-fixed and well-stained specimens were used. The consultants made specific diagnoses and categorized each as benign, suspicious or malignant. For all consultants, specificity and sensitivity regarding categorized diagnoses were 83-92 and 85-93%, respectively; the overall accuracy was 88-90%. The interobserver agreement was substantial (κ = 0.791). The lowest rate of concordance was achieved in urine and bladder washings and in the identification of benign lesions. Using a digital image set for diagnostic purposes implies that even under optimal conditions the accuracy rate will not exceed to 80-90%, mainly because of lacking supportive immunocytochemical or molecular tests. This limitation does not disqualify digital images for teleconsulting or as a learning aid. The series of images used for the study are open to the public at http://pathorama.wordpress.com/extragenital-cytology-2013/. © 2014 S. Karger AG, Basel.

The neglected topic: presentation of cost information in patient decision AIDS.

Science.gov (United States)

Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

2015-05-01

Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. © The Author(s) 2015.

Poverty, AIDS and child health: Identifying highest-risk children in ...

African Journals Online (AJOL)

conservative threshold of ≥3 AIDS-defining illnesses; e.g. Kaposi's sarcoma or shingles. ... and Kaposi's sarcoma, as well as a range of other chronic illnesses such as diabetes. In this study ..... de la Salpetriere, 2004. 21. Cluver L, Operario D, ...

Defining malnutrition: A plea to rethink.

Science.gov (United States)

Soeters, P; Bozzetti, F; Cynober, L; Forbes, A; Shenkin, A; Sobotka, L

2017-06-01

In a recent consensus report in Clinical Nutrition the undernourished category of malnutrition was proposed to be defined and diagnosed on the basis of a low BMI or unintentional weight loss combined with low BMI or FFMI with certain cut off points. The definition was endorsed by ESPEN despite recent endorsement of a very different definition. The approach aims to assess whether nutritional intake is sufficient but is imprecise because a low BMI does not always indicate malnutrition and individuals with increasing BMI's may have decreasing FFM's. The pathophysiology of individuals, considered to be malnourished in rich countries and in areas with endemic malnutrition, results predominantly from deficient nutrition combined with infection/inflammation. Both elements jointly determine body composition and function and consequently outcome of disease, trauma or treatment. When following the consensus statement only an imprecise estimate is acquired of nutritional intake without knowing the impact of inflammation. Most importantly, functional abilities are not assessed. Consequently it will remain uncertain how well the individual can overcome stressful events, what the causes are of dysfunction, how to set priorities for treatment and how to predict the effect of nutritional support. We therefore advise to consider the pathophysiology of malnourished individuals leading to inclusion of the following elements in the definition of malnutrition: a disordered nutritional state resulting from a combination of inflammation and a negative nutrient balance, leading to changes in body composition, function and outcome. A precise diagnosis of malnutrition should be based on assessment of these elements. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Magnetic resonance imaging features of neuroinfections in patients with AIDS. Pablo Tobon Hospital, Medellin (2008-2009)

International Nuclear Information System (INIS)

Pulgarin R, Luis G; Gomez R, Susana; Sanchez Z, Jonathan A; Abreo L, Diego F; Hernandez J, Andres F; Donado G, Jorge H.

2010-01-01

Our purpose is to describe the clinical and magnetic resonance imaging (MRI) features of the central nervous system (CNS ) most common infectious diseases in patients with human immunodeficiency virus (HIV) and / or acquired immunodeficiency syndrome (AIDS ) that consulted to the Hospital Pablo Tobon Uribe in the period 2008-2009. We included four adult patients with HIV and / or AIDS from Hospital Pablo Tobon Uribe database, who were diagnosed having central nervous system infections by MRI and diagnostic microbiological tests. The most common MRI patterns of CNS infections in AIDS patients in our institution were irregular multifocal intra-axial space-occupying lesions with heterogeneous and variable signals on T1, T2 and FLAI R, with perilesional edema and rim postcontrast enhancement.

Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

Directory of Open Access Journals (Sweden)

Anne Korir

Full Text Available Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis.The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1 documentation of positive HIV serology; 2 antiretroviral drug prescription; 3 CD4+ lymphocyte count; and 4 WHO HIV clinical stage or immune suppression syndrome (ISS, which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3% met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma and 31% (53 were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27% cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria.This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease

Isolated lung events following radiation for early stage breast cancer: incidence and predictors for primary lung vs metastatic breast cancer

International Nuclear Information System (INIS)

Van Buren, Teresa A; Harris, Jay R; Sugarbaker, David J; Schneider, Lindsey; Healey, Elizabeth A

1995-01-01

Purpose: 1) To define the incidence of isolated lung events in a cohort of women treated with conservative surgery (CS) and radiation therapy (RT) for early stage breast cancer. 2) Among such patients, to define the relative distribution of primary lung cancer, metastatic breast cancer, and indeterminate lesions; and to identify any predictors for a diagnosis of lung vs metastatic breast cancer. 3) To examine the cohort with respect to whether a higher than expected incidence of lung cancer is seen following breast irradiation. Materials and Methods: Between 1968 and 1986, 1865 patients with clinical stage I-II breast cancer were treated with CS and RT; the median follow-up for surviving patients is 129 months. The study population was limited to patients who developed a subsequent isolated lung event as the first site of distant disease. Isolated lung event was defined as disease limited to the thoracic cavity, without evidence of either uncontrolled local breast disease or metastatic disease elsewhere. Diagnosis of the lung event as a primary lung cancer, a metastatic breast lesion, or an indeterminate lesion was documented from the viewpoint of 1) the pathologic analysis and 2) the clinical impression at the time of the lung event. Results: Sixty six of the 1865 patients (3.5%) developed an isolated lung event. The relative distribution of the pathologic and clinical diagnoses is shown below: The 66 lung events were characterized either as a solitary pulmonary nodule (27), multiple nodules (23), pleural effusion alone (10), unknown (2), or miscellaneous other findings (4). Among the 47 patients for whom pathology was available, the diagnosis remained indeterminate for 24 (51%). For patients with a definitive pathologic diagnosis, 69% ((9(13))) of smokers had a new lung cancer compared to 20% ((2(10))) of non-smokers (p=0.036), and 67% ((10(15))) of patients with a solitary pulmonary nodule had lung cancer compared to 14% ((1(7))) for other lung presentations (p

A construção da AIDS-notícia The making of AIDS news

Directory of Open Access Journals (Sweden)

Mary Jane P. Spink

2001-08-01

Full Text Available O presente estudo alinha-se às pesquisas que focam a mídia como elemento imprescindível da produção de sentidos na modernidade tardia. Tendo por temática a AIDS, busca entender o contexto de produção das notícias sobre a epidemia, a partir do cruzamento das regras de construção de notícias expressas por profissionais envolvidos nesse processo e da análise das matérias publicadas em quatro jornais de maior tiragem nacional, no período de junho a dezembro de 1996. A apresentação dos resultados foi estruturada em três tópicos: (a o fluxo de construção das matérias; (b a visibilidade das notícias sobre AIDS nos jornais analisados; e (c os fatores facilitadores da produção da AIDS-notícia. O estudo permite arrolar aspectos relevantes da produção da AIDS-notícia, incluindo aí: a exclusividade e ineditismo, a noção de pauta quente ou fria e o conteúdo específico das matérias. Destaca ainda o inevitável grau de aleatoriedade decorrente de características organizacionais e do cotidiano jornalístico. Conclui apontando o impacto das transformações recentes nos contornos da epidemia, assim como na dinâmica da comunicação, à luz dos desenvolvimentos da mídia eletrônica.This study is part of the overall research effort on the role of the media in making sense of events in late modernity. The main objective is to investigate the context in which news about AIDS is produced at the interface between norms for producing news (as expressed by professional journalists and an analysis of news stories published in four mainstream Brazilian newspapers. The results are organized in three broad topics: (a the construction of news about AIDS; (b the visibility of AIDS news during the study period; and (c factors that facilitate or hinder the production of AIDS news. Important factors include exclusiveness of the story and/or novelty of the content, the notion of hot (or cold news, and the specific contents. The authors also

Multicriteria methodology for decision aiding

CERN Document Server

Roy, Bernard

1996-01-01

This is the first comprehensive book to present, in English, the multicriteria methodology for decision aiding In the foreword the distinctive features and main ideas of the European School of MCDA are outlined The twelve chapters are essentially expository in nature, but scholarly in treatment Some questions, which are too often neglected in the literature on decision theory, such as how is a decision made, who are the actors, what is a decision aiding model, how to define the set of alternatives, are discussed Examples are used throughout the book to illustrate the various concepts Ways to model the consequences of each alternative and building criteria taking into account the inevitable imprecisions, uncertainties and indeterminations are described and illustrated The three classical operational approaches of MCDA synthesis in one criterion (including MAUT), synthesis by outranking relations, interactive local judgements, are studied This methodology tries to be a theoretical or intellectual framework dire...

Serum Albumin as a Prognostic Marker for Serious Non-AIDS Endpoints in the Strategic Timing of Antiretroviral Treatment (START) Study

DEFF Research Database (Denmark)

Ronit, Andreas; Sharma, Shweta; Baker, Jason V

2018-01-01

of Antiretroviral Treatment (START) study (NCT00867048) with serum albumin as a fixed and time-updated predictor. Models with exclusion of events during initial follow-up years were built to assess the ability of serum albumin to predict beyond shorter periods of time. Secondarily, we considered hospitalizations...... of serious non-AIDS events (hazard ratio, 0.37 [95% confidence interval, .20-.71]; P = .002). Similar results were obtained in a time-updated model, after controlling for interleukin 6, and after excluding initial follow-up years. Serum albumin was independently associated with hospitalization......Background: Serum albumin may be used to stratify human immunodeficiency virus (HIV)-infected persons with high CD4 count according to their risk of serious non-AIDS endpoints. Methods: Cox proportional hazards models were used to analyze the risk of serious non-AIDS events in the Strategic Timing...

Idiopathic ulcers as an oral manifestation in pediatric patients with AIDS: multidisciplinary management.

Science.gov (United States)

Martinez-Sandoval, B; Ceballos-Hernández, H; Téllez-Rodríguez, J; Xochihua-Díaz, L; Durán-Ibarra, G; Pozos-Guillen, A J

2012-01-01

HIV infection is a major global health problem affecting developing and developed countries alike. HIV infection is associated with multiple oral lesions, some of which are of value in diagnosing the disease. The aim of this report is to describe the clinical manifestations and their multidisciplinary management, in a 6-year-old girl with AIDS. The findings of this case report indicate that, it is essential to be familiar with the early oral manifestations of AIDS in order to understand the patient's dental health needs, apply preventive methods, control caries, and understand the value of oral lesions as diagnostic markers of disease progression in children with HIV infection. A multidisciplinary management is fundamental.

Evaluation of computer-aided detection and diagnosis systems.

Science.gov (United States)

Petrick, Nicholas; Sahiner, Berkman; Armato, Samuel G; Bert, Alberto; Correale, Loredana; Delsanto, Silvia; Freedman, Matthew T; Fryd, David; Gur, David; Hadjiiski, Lubomir; Huo, Zhimin; Jiang, Yulei; Morra, Lia; Paquerault, Sophie; Raykar, Vikas; Samuelson, Frank; Summers, Ronald M; Tourassi, Georgia; Yoshida, Hiroyuki; Zheng, Bin; Zhou, Chuan; Chan, Heang-Ping

2013-08-01

Computer-aided detection and diagnosis (CAD) systems are increasingly being used as an aid by clinicians for detection and interpretation of diseases. Computer-aided detection systems mark regions of an image that may reveal specific abnormalities and are used to alert clinicians to these regions during image interpretation. Computer-aided diagnosis systems provide an assessment of a disease using image-based information alone or in combination with other relevant diagnostic data and are used by clinicians as a decision support in developing their diagnoses. While CAD systems are commercially available, standardized approaches for evaluating and reporting their performance have not yet been fully formalized in the literature or in a standardization effort. This deficiency has led to difficulty in the comparison of CAD devices and in understanding how the reported performance might translate into clinical practice. To address these important issues, the American Association of Physicists in Medicine (AAPM) formed the Computer Aided Detection in Diagnostic Imaging Subcommittee (CADSC), in part, to develop recommendations on approaches for assessing CAD system performance. The purpose of this paper is to convey the opinions of the AAPM CADSC members and to stimulate the development of consensus approaches and "best practices" for evaluating CAD systems. Both the assessment of a standalone CAD system and the evaluation of the impact of CAD on end-users are discussed. It is hoped that awareness of these important evaluation elements and the CADSC recommendations will lead to further development of structured guidelines for CAD performance assessment. Proper assessment of CAD system performance is expected to increase the understanding of a CAD system's effectiveness and limitations, which is expected to stimulate further research and development efforts on CAD technologies, reduce problems due to improper use, and eventually improve the utility and efficacy of CAD in

Cochlear Implants in Children Diagnosed with CHARGE Syndrome

Directory of Open Access Journals (Sweden)

Cardoso, Carolina Costa

2013-09-01

Full Text Available Introduction: The CHARGE association (coloboma of the eyes; heart disease; atresia of the choanae; retarded growth and development; genital hypoplasia/genitourinary anomalies; ear anomalies and/or hearing loss was first described in 1979 by Hall, and among its main features is hearing loss. This study presents a case aiming to establish relationships between performance on Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS and Meaningful Use of Speech Scales (MUSS tests and the analysis of hearing and language categories of a patient diagnosed with CHARGE syndrome, before and after cochlear implant (CI surgery. Case Report: A 7-year-old girl was diagnosed with CHARGE. She had severe sensorineural hearing loss and was a prelingual unilateral CI user. We analyzed data from the patient's medical records regarding therapies and video recordings. Results: The patient showed positive results in all evaluations after CI. IT-MAIS rose from 5 to 90% following the use of CI. MUSS also rose, from 75 to 72.5%, after use of CI. Classification of Auditory Skills changed from category 1 before use of CI to category 6 after use of CI. Classification of Language Skills changed from category 1 before use of CI to category 3 after use of CI. The CI is an aid but there are many factors in the therapeutic process, and great heterogeneity in individuals diagnosed with CHARGE should be investigated. Conclusion: The development of listening and language skills after CI use was demonstrated by IT-MAIS and MUSS tests, and categorization of speech and hearing in this child with a diagnosis of CHARGE syndrome shows that CI can be an effective technological resource to provide information on hearing as one source for language construction.

AID SELECTIVITY PRACTICE AND AID EFFECTIVENESS IN SUB-SAHARAN AFRICA

Directory of Open Access Journals (Sweden)

Adeniyi Jimmy Adedokun

2017-09-01

Full Text Available Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship in Sub-Saharan Africa (SSA and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to aid selectivity practice.

Computer-aided dispatching system design specification

Energy Technology Data Exchange (ETDEWEB)

Briggs, M.G.

1997-12-16

This document defines the performance requirements for a graphic display dispatching system to support Hanford Patrol Operations Center. This document reflects the as-built requirements for the system that was delivered by GTE Northwest, Inc. This system provided a commercial off-the-shelf computer-aided dispatching system and alarm monitoring system currently in operations at the Hanford Patrol Operations Center, Building 2721E. This system also provides alarm back-up capability for the Plutonium Finishing Plant (PFP).

Computer-aided dispatching system design specification

International Nuclear Information System (INIS)

Briggs, M.G.

1997-01-01

This document defines the performance requirements for a graphic display dispatching system to support Hanford Patrol Operations Center. This document reflects the as-built requirements for the system that was delivered by GTE Northwest, Inc. This system provided a commercial off-the-shelf computer-aided dispatching system and alarm monitoring system currently in operations at the Hanford Patrol Operations Center, Building 2721E. This system also provides alarm back-up capability for the Plutonium Finishing Plant (PFP)

Computer Aided Diagnosis for Confocal Laser Endomicroscopy in Advanced Colorectal Adenocarcinoma

DEFF Research Database (Denmark)

Ştefănescu, Daniela; Streba, Costin; Cârţână, Elena Tatiana

2016-01-01

functions, a module for fractal analysis, grey-level co-occurrence matrix (GLCM) computation module, and a feature identification module based on the Marching Squares and linear interpolation methods. A two-layer neural network was trained to automatically interpret the imaging data and diagnose...... the pathological samples based on the fractal dimension and the characteristic features of the biological tissues. RESULTS: Normal colon mucosa is characterized by regular polyhedral crypt structures whereas malignant colon mucosa is characterized by irregular and interrupted crypts, which can be diagnosed by CAD.......14, validation: 17.42, testing: 15.48. The diagnosis accuracy error was 15.5%. CONCLUSIONS: Computed aided diagnosis via fractal analysis of glandular structures can complement the traditional histological and minimally invasive imaging methods. A larger dataset from colorectal and other pathologies should...

Foreign aid

DEFF Research Database (Denmark)

Tarp, Finn

2008-01-01

Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and instituti......Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles...... and institutions of the aid system; and (c) discusses whether aid has been effective. While much of the original optimism about the impact of foreign aid needed modification, there is solid evidence that aid has indeed helped further growth and poverty reduction...

Immune Dysfunction and the Pathogenesis of AIDS-associated non-Hodgkin's Lymphoma

Directory of Open Access Journals (Sweden)

Martínez-Maza Otoniel

1998-01-01

Full Text Available Much has been learned about how HIV-induced immune dysfunction contributes to B cell hyperactivation, and potentially, to the pathogenesis of AIDS-lymphoma. However, further studies are needed to fully understand how HIV infection and immune dysfunction promote B cell hyperactivation and the development/growth of AIDS-lymphoma. In particular, studies are needed to define the role of HHV8 vIL6, IL6 receptor-expression, and lymphocyte surface stimulatory molecules, in promoting B cell hyperactivation or lymphoma cell growth.

OAE: The Ontology of Adverse Events.

Science.gov (United States)

He, Yongqun; Sarntivijai, Sirarat; Lin, Yu; Xiang, Zuoshuang; Guo, Abra; Zhang, Shelley; Jagannathan, Desikan; Toldo, Luca; Tao, Cui; Smith, Barry

2014-01-01

A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term 'adverse event' denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. For example, using the data extracted from the Vaccine Adverse Event Reporting System (VAERS), OAE was used to analyse vaccine adverse events associated with the administrations of different types of influenza vaccines. OAE has also been used to represent and classify the vaccine adverse events cited in package inserts of FDA-licensed human vaccines in the USA. OAE is a biomedical ontology that logically defines and classifies various adverse events occurring after medical interventions. OAE has successfully been applied in several adverse event studies. The OAE ontological framework provides a platform for systematic representation and analysis of adverse events and of the factors (e

Aiding Lay Decision Making Using a Cognitive Competencies Approach.

Science.gov (United States)

Maule, A J; Maule, Simon

2015-01-01

Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical procedure. We argue that the lack of an underlying prescriptive theory has limited the development and evaluation of these interventions. We draw on recent descriptive research on the cognitive competencies that underpin human decision making to suggest new ways of interpreting how and why existing decision aids may be effective and suggest a different way of evaluating their effectiveness. We also briefly outline how our approach has the potential to develop new interventions to support everyday decision making and highlight the benefits of drawing on descriptive research when developing and evaluating interventions.

Level 2 probabilistic event analyses and quantification

International Nuclear Information System (INIS)

Boneham, P.

2003-01-01

In this paper an example of quantification of a severe accident phenomenological event is given. The performed analysis for assessment of the probability that the debris released from the reactor vessel was in a coolable configuration in the lower drywell is presented. It is also analysed the assessment of the type of core/concrete attack that would occur. The coolability of the debris ex-vessel evaluation by an event in the Simplified Boiling Water Reactor (SBWR) Containment Event Tree (CET) and a detailed Decomposition Event Tree (DET) developed to aid in the quantification of this CET event are considered. The headings in the DET selected to represent plant physical states (e.g., reactor vessel pressure at the time of vessel failure) and the uncertainties associated with the occurrence of critical physical phenomena (e.g., debris configuration in the lower drywell) considered important to assessing whether the debris was coolable or not coolable ex-vessel are also discussed

Hospital-diagnosed dementia and suicide

DEFF Research Database (Denmark)

Erlangsen, Annette; Zarit, Steven H; Conwell, Yeates

2008-01-01

OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individuals...... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000. MEASUREMENTS: Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum. RESULTS: A total of 18,648,875 person-years were observed during the 11-year study period...

In-hospital Mobility Variations across Primary Diagnoses among Older Adults

Science.gov (United States)

Valiani, Vincenzo; Gao, Shiyao; Chen, Zhiguo; Swami, Sunil; Harle, Christopher A.; Lipori, Gigi; Sourdet, Sandrine; Wu, Samuel; Nayfield, Susan G.; Sabbá, Carlo; Pahor, Marco; Manini, Todd M.

2016-01-01

Objectives To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults. Design Prospective cohort study. Setting UF Health Shands Hospital, an 852-bed level I trauma center located in Gainesville, Florida. Participants 18,551 older adults (≥65 years) with 29,148 hospitalizations between 1/2009 and 4/2014. Measurements Incident and discharge mobility impairment and recovery were assessed using the Braden activity subscale score that was recorded by the nursing staff at every shift change–approximately three times per day. Primary diagnosis ICD-9 codes were used as predictors and re-categorized by using the Agency for Health Care Research and Quality Clinical Classification Software. Results Out of the 15,498 hospital records where the patient was initially observed to “walk frequently”, 3,186 (20.6%) developed incident mobility impairment (chair-fast or bedfast). Primary diagnoses with a surgical or invasive procedure were the most prevalent (77.2 %) among the hospital observations with incident mobility impairment; otherwise primary diagnoses without surgery were much more associated with discharge mobility impairment (59%). The highest incidence of mobility impairment occurred in patients with heart valve disorders and aortic and peripheral/visceral artery aneurysms (6.24 and 6.05 events per 30 person-days, respectively); septicemia showed the highest incidence rate for mobility limitation at discharge (0.94 events per 30 person-days). Mobility impairment was observed in 13,650 (46.8% of total) records at admission and 5,930 (43.44%) were observed to recover to a state of walking occasionally or frequently. Osteoarthritis and cancer of gastrointestinal organs/peritoneum had the highest incidence rate for mobility recovery (7.68 and 5.63 events per 30 person-days respectively). Conclusions Approximately 1 out of 5 patients who were mobile at admission became significantly impaired during

Educational aids

International Nuclear Information System (INIS)

Lenkeit, S.

1989-01-01

Educational aids include printed matter, aural media, visual media, audiovisual media and objects. A distinction is made between learning aids, which include blackboards, overhead projectors, flipcharts, wallcharts and pinboards, and learning aids, which include textbooks, worksheets, documentation and experimental equipment. The various aids are described and their use explained. The aids available at the School for Nuclear Technology of the Karlsruhe Nuclear Research Centre are described

[AIDS in the world: revolution, paradigm and solidarity].

Science.gov (United States)

Mann, J

1991-01-01

AIDS in a single decade has affected life and assumptions on the societal and individual level more than any other illness or epidemic in history. The most important aspect of the HIV pandemic is that it is still in an early stage of development. The pandemic will continue to be volatile and dynamic; its greatest impact has not yet been felt. There is still great potential to influence its future course. HIV infection is spreading rapidly in some already affected populations in Africa, Latin America, and the Caribbean, and is penetrating deeply into new areas such as Eastern Europe, the Middle East, and Southeast Asia. Thailand and India are symbols of its rapid spread. The more than 100 million new cases of sexually transmitted diseases diagnosed in the world each year demonstrate the potential for sexual transmission of HIV. On the global level, the foundations have been laid for preventing the spread of HIV infection. But in many countries information is still inadequate or incorrect, needed social and health services are nonexistent, and punitive and discriminatory attitudes persist toward the infected. The gap between rich and poor within and between countries is widening. 2/3 of AIDS cases and 3/4 of seropositive individuals are in developing countries. The cost of drugs and treatment implies that "early intervention" is a meaningless concept for developing countries. The developed world contributes $200 million or less to combat AIDS in developing countries. Some of the revolutionary ideas prompted by the advent of AIDS included the immediate attention given to behavior as a preventive measure, the eradication of complacency about the condition of health and social services, the insistence of AIDS patients and the HIV infected on being included in the total process of prevention, treatment, and research, and the unexpected flowering of a dialogue on dignity, human rights, and social justice. AIDS is now leading to a new vision of health promotion in which

Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report

Science.gov (United States)

Acar, Burak; Suleymanoglu, Muhammed; Burak, Cengiz; Demirkan, Burcu Mecit; Guray, Yesim; Tufekcioglu, Omac; Aydogdu, Sinan

2015-01-01

Abstract Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation. PMID:26157464

Intensity-modulated radiation therapy followed by GDP chemotherapy for newly diagnosed stage I/II extranodal natural killer/T cell lymphoma, nasal type.

Science.gov (United States)

Huang, Yu; Yang, Jianliang; Liu, Peng; Zhou, Shengyu; Gui, Lin; He, Xiaohui; Qin, Yan; Zhang, Changgong; Yang, Sheng; Xing, Puyuan; Sun, Yan; Shi, Yuankai

2017-09-01

Extranodal natural killer (NK)/T cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and the majority of ENKTL cases are diagnosed at the localized stage. Radiotherapy in combination with chemotherapy has been used for localized ENKTL, but the optimal combination treatment modality and the best first-line chemotherapy regimen have not been defined. In this retrospective study, 44 patients with newly diagnosed, stages I/II ENKTL were enrolled and received intensity-modulated radiation therapy (IMRT, 50-56 Gy) followed by GDP (gemcitabine, dexamethasone, and cisplatin) chemotherapy. The median number of chemotherapy cycles per patient was 4 (range, 2-6 cycles). At the end of treatment, the overall response rate was 95% (42/44), including 39 patients (89%) who attained complete response. Two patients developed systemic progression after IMRT. With a median follow-up of 37.5 months, the 3-year overall survival (OS) rate and progression-free survival (PFS) rate were 85% (95% CI, 74 to 96%) and 77% (95% CI, 64 to 91%), respectively. Locoregional and systemic failure rates for this treatment were 9% (4/44) and 14% (6/44), respectively. The most common grades 3 to 4 adverse events included leukopenia (37%), neutropenia (34%), and mucositis (25%). No treatment-related deaths were observed. This study suggested high efficacy and low toxicity of IMRT followed by GDP regimen chemotherapy for newly diagnosed stage I/II ENKTL patients. These results require further investigation in prospective trials.

Radionuclide cisternography: a prudent investigation in diagnosing spontaneous intracranial hypotension

International Nuclear Information System (INIS)

Sehgal, Aditi Khurana; Sethi, Ravinder Singh; Namgyal, Padma A.; Raghavan, Samudrala

2013-01-01

Spontaneous intracranial hypotension (SIH) is a cause of new persistent headache, which disappears on recumbence and reappears in sitting/standing position (orthostatic headache). We present a case of orthostatic headache, where the patient was suspected to have SIH and was subjected to radionuclide cisternography (RNC) using 99m Technetium Diethylenetriaminepenta acetic acid for confirmation of diagnosis. After due consent from the patient, the radiotracer was injected intra-thecally and serial images were acquired until 24 h. The direct and indirect evidences of Cerebrospinal fluid (CSF) leakage, which were revealed in our study, provided objective evidence to the clinical diagnosis. RNC is an important investigation in diagnosing SIH and also identifying the site of CSF leak, which may aid the management. (author)

The sanitary officer: first aid coordinator on EDF nuclear power plant

International Nuclear Information System (INIS)

Masson, A.

2000-01-01

The internal organisation for first aid to the injured in case of an accident on E.D.F. nuclear power plant calls for the immediate assistance of a first aid team, consisting of five workers, under the direction of a principal first aid officer; one of the first aid workers, the sanitary officer who instructs the first aid workers intervention awaiting the arrival of an external medical. When the 'Sanitary on-site Emergency Plan' was up' dated, twenty medical doctors and seventy members of staff from five different sites were questioned as to the function of the sanitary officer. The conclusions revealed a notable difference of training amongst the different sites, and concerning first aid organisation, difference of priority of actions, extent of their participation once the medical team arrives and their participation in case of decontamination treatment. The medical doctors and staff lay a particular stress on importance of defining on a national scale the limits of role and responsibilities of the sanitary officer and establish a more specific training in this field, consequently motivating commitment and professionalism involvement. There is a great difference between the training and coaching of the first aid assistance and fire protection teams. To conclude, we propose that the first aid officer be known as first aid coordinator and the qualification of 'Certificat de Formation aux Premiers Secours en Equipe' in compliance with the current legislation together with a specific nuclear module and they should undergo regular on-site drills. (author)

AID SELECTIVITY PRACTICE AND AID EFFECTIVENESS IN SUB-SAHARAN AFRICA

OpenAIRE

Adedokun, Adeniyi Jimmy; Abiodun O. Folawewo, Abiodun O.

2017-01-01

Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship) in Sub-Saharan Africa (SSA) and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM) technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to a...

Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients.

Science.gov (United States)

Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra; Lever, Sandra; de Bruijne, Marleen; Morana, Giovanni; Muzzio, Pier Carlo; Lequin, Maarten H; Tiddens, Harm A W M

2014-01-01

Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard for diagnosing TBM; however it has major disadvantages, such as general anaesthesia. Cine computed tomography (CT) is a noninvasive alternative used to diagnose TBM, but its use in children is restricted by ionising radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine magnetic resonance imaging (MRI) as an alternative to cine-CT in a retrospective study. 12 children with a mean age (range) of 12 years (7-17 years), suspected of having TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration covering the thorax using a three-dimensional spoiled gradient echo sequence. Three-dimensional dynamic scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter >50% at end-expiration in the static and dynamic scans. The success rate of the cine-MRI protocol was 92%. Cine-MRI was compared with bronchoscopy or chest CT in seven subjects. TBM was diagnosed by cine-MRI in seven (58%) out of 12 children and was confirmed by bronchoscopy or CT. In four patients, cine-MRI demonstrated tracheal narrowing that was not present in the static scans. Spirometer controlled cine-MRI is a promising technique to assess TBM in children and has the potential to replace bronchoscopy.

Decision aids: when 'nudging' patients to make a particular choice is more ethical than balanced, nondirective content.

Science.gov (United States)

Blumenthal-Barby, J S; Cantor, Scott B; Russell, Heidi Voelker; Naik, Aanand D; Volk, Robert J

2013-02-01

Patient decision aids, such as instructional leaflets describing treatment options for prostate cancer, are designed to help educate patients so that they can share in decisions about their care. Developers of these decision aids strive for balance, aiming to be as neutral, unbiased, and nondirective as possible. We argue that balance should not always be a goal, and we identify three situations where it should not be. For example, men diagnosed with early-stage prostate cancer frequently are not advised by their physicians that active surveillance is a reasonable alternative to immediate surgery or radiation. It may be desirable to design decision aids that promote active surveillance as an option. We recognize that the arguments put forth in this article are controversial. But they are also justified. We challenge medical decision makers and decision aid developers to determine if and when patients should be "nudged" toward one option or another.

Opportunistic esophagitis in AIDS: Radiographic diagnosis

International Nuclear Information System (INIS)

Levine, M.S.; Woldenberg, R.; Herlinger, H.; Laufer, I.

1987-01-01

Between 1983 and 1986, 35 of 90 patients with acquired immunodeficiency syndrome (AIDS) had double-contrast esophagograms to rule out opportunistic esophagitis. The radiographs were reviewed without knowledge of the clinical or endoscopic findings. Candida esophagitis was diagnosed radiographically in 17 patients who had varying degrees of plaque formation and viral esophagitis in three who had discrete ulcers without plaques. All three patients with viral esophagitis (herpes in 2 and cytomegalo virus in one) and 15 of 17 with Candida esophagitis had endoscopic and/or clinical corroboration of the radiographic diagnosis. Thus, the authors' experience suggests that fungal and viral esophagitis can often be differentiated on double-contrast esophagography, so that appropriate antifungal or antiviral therapy can be instituted without need for endoscopic intervention

Stigma Reduction in Adolescents and Young Adults Newly Diagnosed with HIV: Findings from the Project ACCEPT Intervention

OpenAIRE

Harper, Gary W.; Lemos, Diana; Hosek, Sybil G.

2014-01-01

This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of...

Estudo comparativo do LCR de pacientes com neurocriptococose sem AIDS e com AIDS Comparison between CSF samples from AIDS and non-AIDS patients with neurocryptococcosis

Directory of Open Access Journals (Sweden)

João Baptista dos Reis-Filho

1994-06-01

Full Text Available Até a década de 80, antes do surgimento da AIDS, a criptococose era relativamente rara. Verificou-se que esta doença afeta muito frequentemente os pacientes com AIDS e pode ser a primeira manifestação desta síndrome. O objetivo deste trabalho é o de comparar o resultado dos exames das amostras do LCR inicial na meningencefalite por criptococo entre pacientes com e sem AIDS. Este trabalho é baseado no estudo de 41 pacientes com neurocriptococose sem AIDS e de 23 pacientes com neurocriptococose e AIDS. Este estudo permitiu verificar que a reação inflamatória, no sistema nervoso, quando presente, foi de menor intensidade nos pacientes com AIDS; a reação inflamatória esteve presente em todos os pacientes sem AIDS e ausente em 21,7% dos pacientes com AIDS; o quadro inflamatório crônico, semelhante ao da meningencefalite tuberculosa, clássico nas meningencefalites por criptococo, ocorreu raramente nos pacientes com AIDS; em média, o número de criptococos no LCR foi maior nos pacientes com AIDS; pode ser feito diagnóstico presuntivo da AIDS quando o criptococo estiver presente no LCR que não apresenta alterações citológicas e bioquímicas.Neurocryptococcosis was a rare nervous system infection. With the rising number of patients with AIDS it became a very frequent disease. This infection is supposed to infect patients with some kind of immunodeficiency and the CSF alterations often simulate tuberculous meningitis. The purpose of this research was to compare the CSF changes in AIDS and non-AIDS patients with meningoencephalitis caused by Cr. neoformans. There were analysed 41 CSF samples from non-AIDS patients with neurocryptococcosis and 23 CSF samples from AIDS patients with neurocryptococcosis. The results of this research allowed to conclude that the inflammatory changes in the CSF from AIDS patients showed a lower intensity compared to those non-AIDS patients. These results showed as well, that the CSF samples from non-AIDS

Fungal Iron Availability during Deep Seated Candidiasis Is Defined by a Complex Interplay Involving Systemic and Local Events

Science.gov (United States)

Potrykus, Joanna; Stead, David; MacCallum, Donna M.; Urgast, Dagmar S.; Raab, Andrea; van Rooijen, Nico; Feldmann, Jörg; Brown, Alistair J. P.

2013-01-01

Nutritional immunity – the withholding of nutrients by the host – has long been recognised as an important factor that shapes bacterial-host interactions. However, the dynamics of nutrient availability within local host niches during fungal infection are poorly defined. We have combined laser ablation-inductively coupled plasma mass spectrometry (LA-ICP MS), MALDI imaging and immunohistochemistry with microtranscriptomics to examine iron homeostasis in the host and pathogen in the murine model of systemic candidiasis. Dramatic changes in the renal iron landscape occur during disease progression. The infection perturbs global iron homeostasis in the host leading to iron accumulation in the renal medulla. Paradoxically, this is accompanied by nutritional immunity in the renal cortex as iron exclusion zones emerge locally around fungal lesions. These exclusion zones correlate with immune infiltrates and haem oxygenase 1-expressing host cells. This local nutritional immunity decreases iron availability, leading to a switch in iron acquisition mechanisms within mature fungal lesions, as revealed by laser capture microdissection and qRT-PCR analyses. Therefore, a complex interplay of systemic and local events influences iron homeostasis and pathogen-host dynamics during disease progression. PMID:24146619

Aid Effectiveness

DEFF Research Database (Denmark)

Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

of the main relationships; (ii) estimating the impact of aid on a range of final and intermediate outcomes; and (iii) quantifying a simplied representation of the full structural form, where aid impacts on growth through key intermediate outcomes. A coherent picture emerges: aid stimulates growth and reduces......Controversy over the aggregate impact of foreign aid has focused on reduced form estimates of the aid-growth link. The causal chain, through which aid affects developmental outcomes including growth, has received much less attention. We address this gap by: (i) specifying a structural model...... poverty through physical capital investment and improvements in health....

Problems with diagnosing Conversion Disorder in response to variable and unusual symptoms

Directory of Open Access Journals (Sweden)

Barnum R

2014-04-01

Full Text Available Richard BarnumPrivate practice, Child and adolescent psychiatry, MA, USAAbstract: Conversion Disorder (CD is a diagnosis offered to explain signs and symptoms that do not correspond to recognized medical conditions. Pediatric patients with variable, vague, and multisystem complaints are at increased risk for being diagnosed with CD. Little is known about the impact of such a diagnosis. In making such diagnoses, it is likely that pediatric providers hope to encourage patients to access mental health care, but no basis exists to show that these diagnoses result in such access in any useful way. This article presents the case of a child with Ehlers-Danlos Syndrome, who had been previously (incorrectly diagnosed with CD and referred for mental health care. It offers commentary based on interviews with other pediatric patients with similar experiences – conducted in collaboration with the Ehlers-Danlos National Foundation. These cases indicate that CD diagnoses can seriously undermine patients’ trust in doctors, and can create such defensiveness that it may interfere with (especially patients’ abilities to engage with mental health services. Such interference is an important problem, if the diagnosis is accurate. But, in the (more likely event that it is not accurate, this defensiveness can interfere with both important mental health care and further ongoing necessary medical care.Keywords: somatoform disorders, dysautonomias, pain, collagen diseases, mitochondrial diseases, complex regional pain syndromes

Genetic variants in nuclear-encoded mitochondrial genes influence AIDS progression.

Directory of Open Access Journals (Sweden)

Sher L Hendrickson

2010-09-01

Full Text Available The human mitochondrial genome includes only 13 coding genes while nuclear-encoded genes account for 99% of proteins responsible for mitochondrial morphology, redox regulation, and energetics. Mitochondrial pathogenesis occurs in HIV patients and genetically, mitochondrial DNA haplogroups with presumed functional differences have been associated with differential AIDS progression.Here we explore whether single nucleotide polymorphisms (SNPs within 904 of the estimated 1,500 genes that specify nuclear-encoded mitochondrial proteins (NEMPs influence AIDS progression among HIV-1 infected patients. We examined NEMPs for association with the rate of AIDS progression using genotypes generated by an Affymetrix 6.0 genotyping array of 1,455 European American patients from five US AIDS cohorts. Successfully genotyped SNPs gave 50% or better haplotype coverage for 679 of known NEMP genes. With a Bonferroni adjustment for the number of genes and tests examined, multiple SNPs within two NEMP genes showed significant association with AIDS progression: acyl-CoA synthetase medium-chain family member 4 (ACSM4 on chromosome 12 and peroxisomal D3,D2-enoyl-CoA isomerase (PECI on chromosome 6.Our previous studies on mitochondrial DNA showed that European haplogroups with presumed functional differences were associated with AIDS progression and HAART mediated adverse events. The modest influences of nuclear-encoded mitochondrial genes found in the current study add support to the idea that mitochondrial function plays a role in AIDS pathogenesis.

Disaster Mental Health and Community-Based Psychological First Aid: Concepts and Education/Training.

Science.gov (United States)

Jacobs, Gerard A; Gray, Brandon L; Erickson, Sara E; Gonzalez, Elvira D; Quevillon, Randal P

2016-12-01

Any community can experience a disaster, and many traumatic events occur without warning. Psychologists can be an important resource assisting in psychological support for individuals and communities, in preparation for and in response to traumatic events. Disaster mental health and the community-based model of psychological first aid are described. The National Preparedness and Response Science Board has recommended that all mental health professionals be trained in disaster mental health, and that first responders, civic officials, emergency managers, and the general public be trained in community-based psychological first aid. Education and training resources in these two fields are described to assist psychologists and others in preparing themselves to assist their communities in difficult times and to help their communities learn to support one another. © 2016 Wiley Periodicals, Inc.

Diagnosing Tic Disorders

Science.gov (United States)

... Submit" /> Information For… Media Policy Makers Diagnosing Tic Disorders Language: English (US) Español (Spanish) Recommend on ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder To be diagnosed with a persistent tic ...

Shifting the burden: the private sector's response to the AIDS epidemic in Africa.

Science.gov (United States)

Rosen, Sydney; Simon, Jonathon L.

2003-01-01

As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include pre-employment screening, reductions in employee benefits, restructured employment contracts, outsourcing of low skilled jobs, selective retrenchments, and changes in production technologies. Between 1997 and 1999 more than two-thirds of large South African employers reduced the level of health care benefits or increased employee contributions. Most firms also have replaced defined-benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined-contribution funds, which eliminate risks to the firm but provide little for families of younger workers who die of AIDS. Contracting out previously permanent jobs is also shielding firms from benefit and turnover costs, effectively shifting the responsibility to care for affected workers and their families to households, nongovernmental organizations, and the government. Many of these changes are responses to globalization that would have occurred in the absence of AIDS, but they are devastating for the households of employees with HIV/AIDS. We argue that the shift in the economic burden of AIDS is a predictable response by business to which a deliberate public policy response is needed. Countries should make explicit decisions about each sector's responsibilities if a socially desirable allocation is to be achieved. PMID:12751421

Shifting the burden: the private sector's response to the AIDS epidemic in Africa.

Science.gov (United States)

Rosen, Sydney; Simon, Jonathon L

2003-01-01

As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include pre-employment screening, reductions in employee benefits, restructured employment contracts, outsourcing of low skilled jobs, selective retrenchments, and changes in production technologies. Between 1997 and 1999 more than two-thirds of large South African employers reduced the level of health care benefits or increased employee contributions. Most firms also have replaced defined-benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined-contribution funds, which eliminate risks to the firm but provide little for families of younger workers who die of AIDS. Contracting out previously permanent jobs is also shielding firms from benefit and turnover costs, effectively shifting the responsibility to care for affected workers and their families to households, nongovernmental organizations, and the government. Many of these changes are responses to globalization that would have occurred in the absence of AIDS, but they are devastating for the households of employees with HIV/AIDS. We argue that the shift in the economic burden of AIDS is a predictable response by business to which a deliberate public policy response is needed. Countries should make explicit decisions about each sector's responsibilities if a socially desirable allocation is to be achieved.

The Successful Diagnosis and Typing of Systemic Amyloidosis Using A Microwave-Assisted Filter-Aided Fast Sample Preparation Method and LC/MS/MS Analysis.

Directory of Open Access Journals (Sweden)

Weiyi Sun

Full Text Available Laser microdissection followed by mass spectrometry has been successfully used for amyloid typing. However, sample contamination can interfere with proteomic analysis, and overnight digestion limits the analytical throughput. Moreover, current quantitative analysis methods are based on the spectrum count, which ignores differences in protein length and may lead to misdiagnoses. Here, we developed a microwave-assisted filter-aided sample preparation (maFASP method that can efficiently remove contaminants with a 10-kDa cutoff ultrafiltration unit and can accelerate the digestion process with the assistance of a microwave. Additionally, two parameters (P- and D-scores based on the exponentially modified protein abundance index were developed to define the existence of amyloid deposits and those causative proteins with the greatest abundance. Using our protocol, twenty cases of systemic amyloidosis that were well-typed according to clinical diagnostic standards (training group and another twenty-four cases without subtype diagnoses (validation group were analyzed. Using this approach, sample preparation could be completed within four hours. We successfully subtyped 100% of the cases in the training group, and the diagnostic success rate in the validation group was 91.7%. This maFASP-aided proteomic protocol represents an efficient approach for amyloid diagnosis and subtyping, particularly for serum-contaminated samples.

The Successful Diagnosis and Typing of Systemic Amyloidosis Using A Microwave-Assisted Filter-Aided Fast Sample Preparation Method and LC/MS/MS Analysis.

Science.gov (United States)

Sun, Weiyi; Sun, Jian; Zou, Lili; Shen, Kaini; Zhong, Dingrong; Zhou, Daobin; Sun, Wei; Li, Jian

2015-01-01

Laser microdissection followed by mass spectrometry has been successfully used for amyloid typing. However, sample contamination can interfere with proteomic analysis, and overnight digestion limits the analytical throughput. Moreover, current quantitative analysis methods are based on the spectrum count, which ignores differences in protein length and may lead to misdiagnoses. Here, we developed a microwave-assisted filter-aided sample preparation (maFASP) method that can efficiently remove contaminants with a 10-kDa cutoff ultrafiltration unit and can accelerate the digestion process with the assistance of a microwave. Additionally, two parameters (P- and D-scores) based on the exponentially modified protein abundance index were developed to define the existence of amyloid deposits and those causative proteins with the greatest abundance. Using our protocol, twenty cases of systemic amyloidosis that were well-typed according to clinical diagnostic standards (training group) and another twenty-four cases without subtype diagnoses (validation group) were analyzed. Using this approach, sample preparation could be completed within four hours. We successfully subtyped 100% of the cases in the training group, and the diagnostic success rate in the validation group was 91.7%. This maFASP-aided proteomic protocol represents an efficient approach for amyloid diagnosis and subtyping, particularly for serum-contaminated samples.

The estimated magnitude of AIDS in Brazil: a delay correction applied to cases with lost dates Estimativa da magnitude da AIDS no Brasil: uma correção de atraso aplicada aos casos com data perdida

Directory of Open Access Journals (Sweden)

Maria Tereza S. Barbosa

2002-02-01

Full Text Available The number of HIV-infected people is an important measure of the magnitude of the AIDS epidemic in Brazil and allows for comparison with epidemic patterns in other countries. This quantity can be estimated from the number of reported AIDS cases, which in turn needs to be corrected for the distribution of reporting delays and under-recording of cases. These distributions are unknown and must also be estimated from the recorded dates, which were missed to the Brazilian National AIDS registry. This paper estimates the number of AIDS cases diagnosed by imputing the lost information based on an estimate of the pattern in registration delay until 1996. We first fitted a non-stationary bivariate Poisson regression model to estimate the pattern in reporting delay. In the subsequent steps these models were applied to impute new data, thus replacing the missing information, and to estimate the magnitude of the AIDS epidemic in the country. Model estimates ranged from 36,000 to 50,000 AIDS cases diagnosed in Brazil and still unreported. Therefore, the epidemic was 20 to 30% greater than known from the available information as of February 1999. To be useful to health policy-makers, the surveillance system based on officially reported AIDS cases must be continuously improved.O número de pessoas infectadas pelo HIV é uma importante medida da magnitude da epidemia de AIDS no Brasil, e permite a comparação com o padrão epidêmico de outros países. Essa quantidade pode ser estimada a partir do número de casos notificados de AIDS, que necessita ser corrigido pela distribuição do atraso da notificação e pelas sub-notificações. Essas distribuições são desconhecidas e devem ser estimadas a partir das datas registradas, que no Brasil foram perdidas. Neste artigo, estima-se o número de diagnósticos de AIDS, imputando as informações perdidas a partir da estimativa do padrão de atraso até 1996. Primeiro, ajustou-se uma regressão de Poisson

Improving the Teaching of Discrete-Event Control Systems Using a LEGO Manufacturing Prototype

Science.gov (United States)

Sanchez, A.; Bucio, J.

2012-01-01

This paper discusses the usefulness of employing LEGO as a teaching-learning aid in a post-graduate-level first course on the control of discrete-event systems (DESs). The final assignment of the course is presented, which asks students to design and implement a modular hierarchical discrete-event supervisor for the coordination layer of a…

The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study.

Science.gov (United States)

Shaffer, Victoria A; Owens, Justin; Zikmund-Fisher, Brian J

2013-12-17

Previous research has examined the impact of patient narratives on treatment choices, but to our knowledge, no study has examined the effect of narratives on information search. Further, no research has considered the relative impact of their format (text vs video) on health care decisions in a single study. Our goal was to examine the impact of video and text-based narratives on information search in a Web-based patient decision aid for early stage breast cancer. Fifty-six women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were randomly assigned to view one of four versions of a Web decision aid. Two versions of the decision aid included videos of interviews with patients and physicians or videos of interviews with physicians only. To distinguish between the effect of narratives and the effect of videos, we created two text versions of the Web decision aid by replacing the patient and physician interviews with text transcripts of the videos. Participants could freely browse the Web decision aid until they developed a treatment preference. We recorded participants' eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 24 areas of interest (AOIs) in the Web decision aid. These AOIs were either separate pages of the Web decision aid or sections within a single page covering different content. We used multilevel modeling to examine the effect of narrative presence, narrative format, and their interaction on information search. There was a significant main effect of condition, P=.02; participants viewing decision aids with patient narratives spent more time searching for information than participants viewing the decision aids without narratives. The main effect of format was not significant, P=.10. However, there was a significant condition by format interaction on

Computer aided probabilistic assessment of containment integrity

International Nuclear Information System (INIS)

Tsai, J.C.; Touchton, R.A.

1984-01-01

In the probabilistic risk assessment (PRA) of a nuclear power plant, there are three probability-based techniques which are widely used for event sequence frequency quantification (including nodal probability estimation). These three techniques are the event tree analysis, the fault tree analysis and the Bayesian approach for database development. In the barrier analysis for assessing radionuclide release to the environment in a PRA study, these techniques are employed to a greater extent in estimating conditions which could lead to failure of the fuel cladding and the reactor coolant system (RCS) pressure boundary, but to a lesser degree in the containment pressure boundary failure analysis. The main reason is that containment issues are currently still in a state of flux. In this paper, the authors describe briefly the computer programs currently used by the nuclear industry to do event tree analyses, fault tree analyses and the Bayesian update. The authors discuss how these computer aided probabilistic techniques might be adopted for failure analysis of the containment pressure boundary

Planning of aid for adolescents in Kaunas who have tried to commit suicide

OpenAIRE

Grigonytė, Daina

2006-01-01

Aim of the study: To investigate the possibilities of planning, succession and development of aid for adolescents in Kaunas city who have tried to commit suicide. Objectives: 1. to define the main stages in providing help for adolescents who have tried to commit suicide; 2. to clarify interdepartmental obstacles providing help for adolescents in crisis; 3. to formulate recommendations for the development of aid for adolescents in Kaunas who have tried to commit suicide. Methods: Qualit...

Comparison of the established definition criteria for diagnosing metabolic syndrome between overweight and obese children in Vojvodina

Directory of Open Access Journals (Sweden)

Vorgučin Ivana

2011-01-01

Full Text Available Background/Aim. Metabolic syndrome is a clinical term which encompasses obesity, insulin resistance, dyslipidemia, hypertension, as well as an increased risk of the development of diabetes mellitus type 2 and cardiovascular disorders in early adulthood. The prevalence of metabolic syndrome is increasing and directly related to the obesity rate among children. The aim of the research was to compare the established definition of the criteria for diagnosing metabolic syndrome in a sample group consisting of overweight and obese children in Vojvodina. Methods. The research was performed as a cross study analysis of 206 examinees. In terms of the sample group (25% children and 75% adolescents, 74% were obese and 26% overweight according to the body mass index (BMI. Two sets of criteria for diagnosing metabolic syndrome were applied in the sample of adolescents: the criteria for adults, specifically adapted for children, and the criteria defined by the International Diabetes Federation (IDF for children and adolescents. The research included the analysis of the following criteria: BMI, waist circumference, blood pressure, triglycerides, HDL cholesterol, glycemia and insulinemia during the oral glucose tolerance test (OGTT. Results. By applying the specific criteria for diagnosing the metabolic syndrome in children and adolescents on the whole sample, it was established that the metabolic syndrome was present in 41% of the examinees, while the application of the criteria defined by the IDF confirmed the diagnosis in 22% of the examinees. An analysis of the metabolic syndrome risk factors established that among the defined specific criteria the most frequent factors present were elevated BMI and the pathological results of the OGTT, while the least frequent was low HDL cholesterol. Among the criteria listed by the IDF, the most frequent metabolic syndrome factors were waist circumference and increased blood pressure, while the least frequent was

[Survival time of HIV/AIDS cases and related factors in Beijing, 1995-2015].

Science.gov (United States)

Li, Y; Wang, J; He, S F; Chen, J; Lu, H Y

2017-11-10

Objective: To analyze the survival time of HIV/AIDS cases and related factors in Beijing from 1995 to 2015. Methods: A retrospective cohort study was conducted to analyze the data of 12 874 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Cox proportion hazard regression model were used to identify the factors related with survival time. Results: Among 12 874 HIV/AIDS cases, 303 (2.4%) died of AIDS related diseases; 9 346 (72.6%) received antiretroviral therapy. The average survival time was 226.5 months (95 %CI : 223.0-230.1), and the survival rates of 1, 5, 10, and 15 years were 98.2%, 96.4%, 93.2%, and 91.9% respectively. Multivariate Cox proportion hazard regression model showed that AIDS phase ( HR =1.439, 95 %CI : 1.041-1.989), heterosexual transmission ( HR =1.646, 95 %CI : 1.184-2.289), being married ( HR =2.186, 95 %CI : 1.510-3.164); older age (≥60 years) at diagnosis ( HR =6.608, 95 %CI : 3.546-12.316); lower CD(4)(+)T cell counts at diagnosis (<350 cells/μl) ( HR =8.711, 95 %CI : 5.757-13.181); receiving no antiretroviral therapy (ART) ( HR =18.223, 95 %CI : 13.317-24.937) were the high risk factors influencing the survival of AIDS patients compared with HIV phase, homosexual transmission, being unmarried, younger age (≤30 years), higher CD(4)(+)T cell count (≥350 cell/μl) and receiving ART. Conclusion: The average survival time of HIV/AIDS cases was 226.5 months after diagnoses. Receiving ART, higher CD(4)(+)T cell counts at the first test, HIV phase, younger age, being unmarried and the homosexual transmission were related to the longer survival time of HIV/AIDS cases. Receiving no ART, the lower CD(4)(+)T cell counts at the first test, AIDS phase, older age, being married and heterosexual transmission indicated higher risk of death due to AIDS.

Gallium-67 scintiscanning of the lungs of AIDS patients

International Nuclear Information System (INIS)

Tatsch, K.; Knesewitsch, P.; Kirsch, C.M.; Kueffer, G.; Doerner, G.; Goebel, F.D.

1988-01-01

Thirty patients suffering from AIDS have been examined in this study. The stage of infection of the patients was defined according to the criteria of the Center for Disease Control, so that the study covered 22 patients with manifest AIDS, and 8 patients with AIDS-related complex. The lung scans have been made in all patients 48 and 72 hours after i.v. injection of 185 MBq of 67 Ga citrate, taking ventral and dorsal images with the gamma camera. In the scans recorded after 72 hours, ROI technique has been used to quantify the lung uptake and to put it in relation to uptake data of the soft neck tissue. The results show that gallium scintiscanning is far more sensitive in detecting opportunistic pneumonia in AIDS patients than is conventional chest radiography. If the latter detected any signs at all, the gallium scan did so about one to two weeks earlier in about one third of the patients. Pathologic accumulation in the scintiscan exceeding the range shown by the correlated radiograph indicate that in single cases extension of pneumonia can be underestimated when assessed by the radiograph alone. (orig./MG) [de

Genome-wide Association Study Implicates PARD3B-based AIDS Restriction

Science.gov (United States)

Nelson, George W.; Lautenberger, James A.; Chinn, Leslie; McIntosh, Carl; Johnson, Randall C.; Sezgin, Efe; Kessing, Bailey; Malasky, Michael; Hendrickson, Sher L.; Pontius, Joan; Tang, Minzhong; An, Ping; Winkler, Cheryl A.; Limou, Sophie; Le Clerc, Sigrid; Delaneau, Olivier; Zagury, Jean-François; Schuitemaker, Hanneke; van Manen, Daniëlle; Bream, Jay H.; Gomperts, Edward D.; Buchbinder, Susan; Goedert, James J.; Kirk, Gregory D.; O'Brien, Stephen J.

2011-01-01

Background. Host genetic variation influences human immunodeficiency virus (HIV) infection and progression to AIDS. Here we used clinically well-characterized subjects from 5 pretreatment HIV/AIDS cohorts for a genome-wide association study to identify gene associations with rate of AIDS progression. Methods.  European American HIV seroconverters (n = 755) were interrogated for single-nucleotide polymorphisms (SNPs) (n = 700,022) associated with progression to AIDS 1987 (Cox proportional hazards regression analysis, co-dominant model). Results.  Association with slower progression was observed for SNPs in the gene PARD3B. One of these, rs11884476, reached genome-wide significance (relative hazard = 0.3; P =3. 370 × 10−9) after statistical correction for 700,022 SNPs and contributes 4.52% of the overall variance in AIDS progression in this study. Nine of the top-ranked SNPs define a PARD3B haplotype that also displays significant association with progression to AIDS (hazard ratio, 0.3; P = 3.220 × 10−8). One of these SNPs, rs10185378, is a predicted exonic splicing enhancer; significant alteration in the expression profile of PARD3B splicing transcripts was observed in B cell lines with alternate rs10185378 genotypes. This SNP was typed in European cohorts of rapid progressors and was found to be protective for AIDS 1993 definition (odds ratio, 0.43, P = .025). Conclusions. These observations suggest a potential unsuspected pathway of host genetic influence on the dynamics of AIDS progression. PMID:21502085

AIDS Myths and Myths about AIDS Myths : A Study about AIDS-related Perceptions in South Africa

OpenAIRE

Sivelä, Jonas

2016-01-01

This doctoral thesis, consisting of four separate articles and a summarizing report, discusses so-called South African AIDS myths also called AIDS beliefs, rumours, misconceptions and legends. AIDS myths have been put forth as an outcome of and a major reason behind the severe HIV/AIDS situation in South Africa. They are proposed to flourish among black South Africans living in impoverished townships and villages. In previous studies, the reasons and mechanisms behind AIDS myths have be...

Self-defining future projections: exploring the identity function of thinking about the future.

Science.gov (United States)

D'Argembeau, Arnaud; Lardi, Claudia; Van der Linden, Martial

2012-01-01

The act of projecting oneself into meaningful future events may significantly contribute to a person's sense of self and identity. Yet if the role of memories, in particular self-defining memories (SDMs), in grounding the self is now well established, the identity function of anticipated future events has received comparatively little attention. This article introduces the construct of self-defining future projection (SDFP) to address this issue. Two studies show that people can readily identify significant future events that they frequently think about and that convey core information about who they are as individuals. Furthermore, a person's particular style of constructing SDMs is similarly manifested in SDFPs, suggesting that both types of events can be used to ground the self. Notably, people who display a stronger tendency to extract meaning from their past experiences also reflect more about the potential implications of imagined future events. The results further demonstrate that SDMs and SDFPs both give rise to a strong sense of personal continuity over time and are meaningfully related to self-esteem. Together these findings lend support to the idea that a person's sense of self and identity is in part nourished by the anticipation of significant future events.

The development of AIDS or AIDS-related conditions in a cohort of HIV antibody-positive homosexual men during a 3-year follow-up period

DEFF Research Database (Denmark)

Pedersen, C; Kolby, P; Sindrup, J

1989-01-01

One hundred and thirty-three homosexual men seropositive for the antibody against human immunodeficiency virus (HIV) were enrolled in a prospective study in 1984-85. The 3-year cumulative incidences of the acquired immunodeficiency syndrome (AIDS) and AIDS-related conditions, by life-table analyses...... with the development of AIDS. There was no association between disease progression and persistent generalized lymphadenopathy. When adjusted to the probable year of infection, these results are in accordance with previous cohort studies. It is concluded that most, or all, subjects seropositive for HIV will develop......, were 18% and 34%. The cumulative incidence of immune deficiency defined as CD4 lymphocytes less than 0.5 x 10(9) l-1 was 70% at 3 years. Absence of antibodies to p24 antigen, HIV antigenaemia, CD4 lymphocytes less than 0.3 x 10 l-1 and elevated serum level of IgA were significantly associated...

HIV/AIDS - resources

Science.gov (United States)

Resources - HIV/AIDS ... information on AIDS : AIDS.gov -- www.aids.gov AIDS Info -- aidsinfo.nih.gov The Henry J. Kaiser Family Foundation -- www.kff.org/hivaids US Centers for Disease Control and Prevention -- www.cdc.gov/hiv

[Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)].

Science.gov (United States)

López, Cristina; Masiá, Mar; Padilla, Sergio; Aquilino, Ana; Bas, Cristina; Gutiérrez, Félix

2016-04-01

The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; Pcauses of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Microseismic Event Grouping Based on PageRank Linkage at the Newberry Volcano Geothermal Site

Science.gov (United States)

Aguiar, A. C.; Myers, S. C.

2016-12-01

The Newberry Volcano DOE FORGE site in Central Oregon has been stimulated two times using high-pressure fluid injection to study the Enhanced Geothermal Systems (EGS) technology. Several hundred microseismic events were generated during the first stimulation in the fall of 2012. Initial locations of this microseismicity do not show well defined subsurface structure in part because event location uncertainties are large (Foulger and Julian, 2013). We focus on this stimulation to explore the spatial and temporal development of microseismicity, which is key to understanding how subsurface stimulation modifies stress, fractures rock, and increases permeability. We use PageRank, Google's initial search algorithm, to determine connectivity within the events (Aguiar and Beroza, 2014) and assess signal-correlation topology for the micro-earthquakes. We then use this information to create signal families and compare these to the spatial and temporal proximity of associated earthquakes. We relocate events within families (identified by PageRank linkage) using the Bayesloc approach (Myers et al., 2007). Preliminary relocations show tight spatial clustering of event families as well as evidence of events relocating to a different cluster than originally reported. We also find that signal similarity (linkage) at several stations, not just one or two, is needed in order to determine that events are in close proximity to one another. We show that indirect linkage of signals using PageRank is a reliable way to increase the number of events that are confidently determined to be similar to one another, which may lead to efficient and effective grouping of earthquakes with similar physical characteristics, such as focal mechanisms and stress drop. Our ultimate goal is to determine whether changes in the state of stress and/or changes in the generation of subsurface fracture networks can be detected using PageRank topology as well as aid in the event relocation to obtain more accurate

Radiotherapy for HIV/Aids Related Cancers: A South African Perspective. Chapter 22

International Nuclear Information System (INIS)

Sharma, V.; Kotzen, J.

2017-01-01

Cancer is a significant cause of morbidity and mortality in people infected with the human immunodeficiency virus (HIV). In fact, 30–40% of people with this condition will develop a malignancy during their lifetime. The majority of cancers affecting HIV positive people are those established as AIDS defining: Kaposi’s sarcoma (KS), non-Hodgkin’s lymphoma (NHL) and invasive cervical cancer. However, other types of cancer also appear to be more common among those infected with HIV. While not classified as AIDS defining, these malignancies are affecting the HIV/AIDS community greatly and have been referred to as ‘AIDS-associated malignancies’ or ‘opportunistic’ cancers. Two analyses have revealed a two to three fold increase in the overall risk of developing these cancers. The introduction of highly active antiretroviral therapy (HAART) has resulted in decreased mortality and morbidity, and the majority of people in developed countries infected with HIV are living with only mild to moderate immunosuppression because of wide access to antiretroviral therapy. HIV positive persons have a markedly elevated risk for two malignancies: KS and NHL, which are themselves considered sufficient to signify progression to AIDS. KS and NHL are caused by a loss of immune control of latent infection with oncogenic viruses (human herpes virus 8 (HHV-8) for KS, Epstein–Barr virus for certain NHL subtypes). Other cancers caused by viruses (e.g. cervical and anal canal cancers caused by human papillomavirus (HPV), liver cancer caused by hepatitis B and C) also occur with increased frequency in this population, although for them, the importance of immune suppression is less clear.

Computer-aided diagnosis of interictal 18F-FDG PET images for presurgical evaluation of epileptic foci in extratemporal lobe epilepsy

International Nuclear Information System (INIS)

Imabayashi, Etsuko

2003-01-01

Interictal 18 F-FDG PET is beneficial to patients with epilepsy to define the epileptic foci before operation, especially to decide the laterality of temporal lobe epilepsy (TLE). However usefulness has not been clearly established in extra TLE. We retrospectively applied Z-score analysis to interictal preoperative 18 F-FDG PET images for detection of the epileptic foci in order to achieve better performance. Seventeen epileptic patients (women/men; 8/9, age; 11-55 yrs) underwent resection of epileptic foci with good outcome (Engel's stage of I or II) even after more than a year from operation. Presurgical 18 F-FDG PET images were spatially normalized using statistical parametric mapping 99 (SPM99) with an original Japanese template for 18 F-FDG and compared with normal database constructed from 31 healthy volunteers (women/men; 14/17, age; 19-59 yrs). A software program, easy Z-score imaging system (eZIS), for analysis of patient data was developed by calculating Z-score in each voxel and visualizing the score in a standardized stereotactic space; Z-score=(normal mean-patient's value)/a standard deviation of normal data. Detectability of epileptic foci for this computer-aided analysis was compared with visual inspection of original 18 F-FDG PET images by five radiologists without any clinical information. In all cases, there was significant reduction of glucose metabolism in the operated area. The sensitivities of the detection of epileptic foci obtained from visual inspection were 47-59%. In contrast to, computer analysis by eZIS showed 71% sensitivity when we defined the highest Z-score in the cerebrum to be the focus diagnosed by eZIS. Computer-aided diagnosis with eZIS for 18 F-FDG PET study is useful for detecting epileptic foci in extra TLE. (author)

STATE AID EVOLUTION OVERVIEW IN EUROPEAN UNION CONTEXT DURING THE PERIOD 2007-2012

Directory of Open Access Journals (Sweden)

Anca D.B., DODESCU

2014-11-01

Full Text Available According to the European Union point of view, the fundamental principle of state aid is to ensure that inside the single market, competition is not distorted. In this context, by exception state aid can be justified when they contribute to achieving EU's social and economic goals. This may take place when market forces obstruct the achieving of the proposed objectives or permit their achieving on unacceptable long terms and costs. This article is structured in four parts, focusing on European Union's vision regarding state aid measures. The first part of the article refers to the general context of state aid in EU. The second part of the article tries to define this concept according to European Commission point of view and also studies the state aid information provided by the EU, through its benchmarking instrument regarding state aid expenditure called State Aid Scoreboard. The third part of the article mainly presents the EU state aid evolution during the period 2007 - 2012 and establishes a methodological point of view in order to classify and divide state aid in two main categories: non-crisis state aid and crisis state aid, with the purpose of avoiding the distortion trends regarding state aid expenditure granted for the financial sector. This part of the article also presents different types of state aid at EU27 level and granted by the selected member states (Romania, Hungary, Bulgaria and Germany between 2007 and 2012 and also analysis horizontal aid, sectorial aid and state aid during the economic crisis 2008 - 2012, referring to recapitalization and asset relief measures and guarantees and liquidity measures. The last part of the article presents the conclusions and also states certain recommendations regarding EU state aid practices, based on the results obtained.

Beta-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease

DEFF Research Database (Denmark)

Andersson, Charlotte; Shilane, David; Go, Alan S

2014-01-01

BACKGROUND: The effectiveness of beta-blockers for preventing cardiac events has been questioned for patients who have coronary heart disease (CHD) without a prior myocardial infarction (MI). OBJECTIVES: The purpose of this study was to assess the association of beta-blockers with outcomes among...... patients with new-onset CHD. METHODS: We studied consecutive patients discharged after the first CHD event (acute coronary syndrome or coronary revascularization) between 2000 and 2008 in an integrated healthcare delivery system who did not use beta-blockers in the year before entry. We used time......-varying Cox regression models to determine the hazard ratio (HR) associated with beta-blocker treatment and used treatment-by-covariate interaction tests (pint) to determine whether the association differed for patients with or without a recent MI. RESULTS: A total of 26,793 patients were included, 19...

Computer-aided approach for design of tailor-made blended products

DEFF Research Database (Denmark)

Yunus, Nor Alafiza; Gernaey, Krist; Woodley, John

2012-01-01

A computer-aided methodology has been developed for the design of blended (mixture) products. Through this methodology, it is possible to identify the most suitable chemicals for blending, and “tailor” the blend according to specified product needs (usually product attributes, e.g. performance...... as well as regulatory). The product design methodology has four tasks. First, the design problem is defined: the product needs are identified, translated into target properties and the constraints for each target property are defined. Secondly, target property models are retrieved from a property model...

Optical coherence tomography for diagnosing periodontal disease

Science.gov (United States)

Colston, Bill W., Jr.; Everett, Matthew J.; Da Silva, Luiz B.; Otis, Linda L.; Nathel, Howard

1997-05-01

We have, in this preliminary study, investigated the use of optical coherence tomography for diagnosis of periodontal disease. We took in vitro OCT images of the dental and periodontal tissues from a young pig and compared them to histological sections. These images distinguish tooth and soft tissue relationships that are important in diagnosing and assessing periodontal disease. We have imaged the attachment of gingiva to the tooth surface and located the cemento-enamel junction. This junction is an important reference point for defining attachment level in the diagnosis of periodontal disease. the boundary between enamel and dentin is also visible for most of the length of the anatomical crown, allowing quantitation of enamel thickness and character.

Collecting operational event data for statistical analysis

International Nuclear Information System (INIS)

Atwood, C.L.

1994-09-01

This report gives guidance for collecting operational data to be used for statistical analysis, especially analysis of event counts. It discusses how to define the purpose of the study, the unit (system, component, etc.) to be studied, events to be counted, and demand or exposure time. Examples are given of classification systems for events in the data sources. A checklist summarizes the essential steps in data collection for statistical analysis

Particle field diagnose using angular multiplexing volume holography

Science.gov (United States)

Zhao, Yu; Li, Zeren; Luo, Zhenxiong; Jun, Li; Zhong, Jie; Ye, Yan; Li, Shengfu; Zhu, Jianhua

2017-08-01

The problem of particle field diagnosing using holography can be met in many areas. But single frame hologram can only catch one moment of the fast event, which can't reveal the change process of an unrepeatable fast event. For events in different time-scale, different solution should be used. We did this work to record a laser induced particle field in the time-scale of tens of micron seconds. A laser of pulse sequence mode is applied to provide 10 pulses, the energy and time interval of whom is 150mJ and 1μs. Four pockels cells are employed to pick up the last four pulses for holographic recording, the other pulses are controlled to pre-expose the photopolymer based recording material, which can enhance photosensitivity of the photopolymer during the moment of holographic recording. The angular multiplexing technique and volume holography is accepted to avoid shifting the photopolymer between each shot. Another Q-switch YAG laser (pulse energy 100mJ, pulse width 10ns) is applied to produce the fast event. As a result, we successfully caught the motion process of the laser induced particle field. The time interval of each frame is 1μs, the angular range of the four references is 14°, and the diffraction efficiency of each hologram is less than 2%. After a basic analysis, this optical system could catch more holograms through a compact design.

Program For Parallel Discrete-Event Simulation

Science.gov (United States)

Beckman, Brian C.; Blume, Leo R.; Geiselman, John S.; Presley, Matthew T.; Wedel, John J., Jr.; Bellenot, Steven F.; Diloreto, Michael; Hontalas, Philip J.; Reiher, Peter L.; Weiland, Frederick P.

1991-01-01

User does not have to add any special logic to aid in synchronization. Time Warp Operating System (TWOS) computer program is special-purpose operating system designed to support parallel discrete-event simulation. Complete implementation of Time Warp mechanism. Supports only simulations and other computations designed for virtual time. Time Warp Simulator (TWSIM) subdirectory contains sequential simulation engine interface-compatible with TWOS. TWOS and TWSIM written in, and support simulations in, C programming language.

[Prenatal cerebrovascular accidents diagnosed in the early infant stage: a series of 10 patients].

Science.gov (United States)

Pina-Jover, María; Martinez-Del Villar, María; Lillo-Laguna, Lucía; Jadraque-Rodriguez, Rocío; Martinez-Pastor, Pedro; Jover-Cerda, Jenaro; Gomez-Gosalvez, Francisco

2013-07-01

INTRODUCTION. A foetal or prenatal cerebrovascular accident (CVA) is defined as an ischaemic, thrombotic or arterial or venous haemorrhagic event that occurs between the 14th week of gestation and the onset of labour. PATIENTS AND METHODS. We report a retrospective study of a series of 10 patients suffering from a, presumably foetal, stroke that went unnoticed during the pregnancy and was diagnosed in the early infant stage. The symptoms and the age at which they were identified are highlighted. RESULTS. None of the 10 patients studied presented any relevant events in the mothers' medical history, but there were four threats of a preterm birth that were solved using the usual means and without the occurrence of any alterations that later affected the foetus. The studies that led to the diagnosis were carried out between the sixth and ninth months of life, and the reason for visiting was reported by the family as being a lower degree of mobility on one side of the body with respect to the other. Two patients presented thrombophilia. With a mean follow-up time of six years, all the patients have an associated infantile cerebral palsy, a third of them have epilepsy and 75% have learning difficulties or intellectual disability. CONCLUSIONS. When CVA are not detected in the prenatal period, it is important in primary care to look for and detect the warning signs of the psychomotor development of the infant at an early stage in order to begin a study of the case and to undertake rehabilitation as early as possible.

Community senior first aid training in Western Australia: its extent and effect on knowledge and skills.

Science.gov (United States)

Lynch, Dania M; Gennat, Hanni C; Celenza, Tony; Jacobs, Ian G; O'Brien, Debra; Jelinek, George A

2006-04-01

To define the extent of Senior First Aid training in a sample of the Western Australian community, and to evaluate the effect of previous training on first aid knowledge and skills. A telephone survey of a random sample from suburban Perth and rural Western Australia; and practical assessment of first aid skills in a subsample of those surveyed. 30.4% of respondents had completed a Senior First Aid certificate. Trained individuals performed consistently better in theoretical tests (p=0.0001) and practical management of snakebite (p=0.021) than untrained. However, many volunteers, both trained and untrained, demonstrated poor skills in applying pressure immobilisation bandaging and splinting the limb adequately despite electing to do so in theory. Overall knowledge and performance of first aid skills by the community are poor, but are improved by first aid training courses.

[Try to achieve quickly the blood pressure target in newly diagnosed hypertensive patients is safe and effective].

Science.gov (United States)

Kichou, B; Henine, N; Kichou, L; Boubchir, M A; Ait Said, M A; Zatout, M; Hammouche, A; Mazeghrane, A; Madiou, A; Benbouabdellah, M

2018-05-09

To compare a so-called an "accelerated" antihypertensive strategy to a "standard" strategy, in terms of blood pressure control rates and adverse events. Prospective open-label randomized controlled trial, which included consecutive hypertensive patients, newly diagnosed, 40 to 70 years old, with no prior antihypertensive treatment. Hypertension was diagnosed if office blood pressure was≥140/90mmHg, confirmed by an increase of Home or a daytime ambulatory blood pressure. The patients were randomly assigned according to 1:1 ratio to an "accelerated" strategy or to a "standard" strategy. The primary end-point was the rate of blood pressure control at 12weeks. The secondary end-point was the rate of adverse events (a safety end-point). We recruited 268 patients (132 in the "accelerated" strategy group), with a mean age of 55 years and 62% of men. The mean office blood pressure at baseline was 168/95mmHg. The clinical characteristics were on average similar between the 2 treatment groups. At 12 weeks, the rates of blood pressure control were 63.6% in the "accelerated" strategy and 38.2% in the "standard" strategy (Pblood pressure control, without an increase in adverse events rate. This could translate into a future cardiovascular events reduction. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Statistical-techniques-based computer-aided diagnosis (CAD) using texture feature analysis: application in computed tomography (CT) imaging to fatty liver disease

Science.gov (United States)

Chung, Woon-Kwan; Park, Hyong-Hu; Im, In-Chul; Lee, Jae-Seung; Goo, Eun-Hoe; Dong, Kyung-Rae

2012-09-01

This paper proposes a computer-aided diagnosis (CAD) system based on texture feature analysis and statistical wavelet transformation technology to diagnose fatty liver disease with computed tomography (CT) imaging. In the target image, a wavelet transformation was performed for each lesion area to set the region of analysis (ROA, window size: 50 × 50 pixels) and define the texture feature of a pixel. Based on the extracted texture feature values, six parameters (average gray level, average contrast, relative smoothness, skewness, uniformity, and entropy) were determined to calculate the recognition rate for a fatty liver. In addition, a multivariate analysis of the variance (MANOVA) method was used to perform a discriminant analysis to verify the significance of the extracted texture feature values and the recognition rate for a fatty liver. According to the results, each texture feature value was significant for a comparison of the recognition rate for a fatty liver ( p fatty liver had the same scale as that for the F-value, showing 100% (average gray level) at the maximum and 80% (average contrast) at the minimum. Therefore, the recognition rate is believed to be a useful clinical value for the automatic detection and computer-aided diagnosis (CAD) using the texture feature value. Nevertheless, further study on various diseases and singular diseases will be needed in the future.

Use of waveform similarity to define planes of mining-induced seismic events

CSIR Research Space (South Africa)

Spottiswoode, SM

1998-04-15

Full Text Available can be associated with failure of previously unfractured rock (Ortlepp, 1978), geological discon- tinuities, large and small, play an important role. The largest mining-induced seismic events are usually as- sociated with faults and dykes (Gay et al... by SIMRAC under the project GAP033. We would like to thank Blyvooruitzicht Mine and R.J. Stewart for use of the seismic data. The au- thors thank N.C. Gay for his helpful review and discussions. References Deichmann, N., Garcia-Fernandez, M., 1992. Rupture...

Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

Science.gov (United States)

Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

2018-05-01

Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

Development of BWR [boiling water reactor] and PWR [pressurized water reactor] event descriptions for nuclear facility simulator training

International Nuclear Information System (INIS)

Carter, R.J.; Bovell, C.R.

1987-01-01

A number of tools that can aid nuclear facility training developers in designing realistic simulator scenarios have been developed. This paper describes each of the tools, i.e., event lists, events-by-competencies matrices, and event descriptions, and illustrates how the tools can be used to construct scenarios

[Investigation on level and influencing factors of first aid knowledge among dentists in Sichuan province].

Science.gov (United States)

Qiu, Yu; Li, Yuan-Yuan; Li, Tian-Guo; Chen, Yi-Ge; Kong, Jing-Jun; Pan, Jian

2018-04-01

The study aims to investigate the cognition degree and influencing factors of first aid knowledge among dentists in Sichuan province, and to provide suggestions for the training of oral clinician. A questionnaire was designed for this study. It included the basic situation of population, first aid knowledge level, emergency situation often encountered in stomatology clinic, first aid training situation, learning approach and attitude of first aid knowledge, etc. This questionnaire was used to investigate the dentists of medical institutions in various cities in Sichuan province. The survey results was statistical analyzed. There were 245 valid questionnaires. 1) The level of first aid knowledge of dentists was generally lower in Sichuan province. Work department and other departments work experience were the influencing factors of knowledge level of first aid knowledge among dentists. 2) 87.3% of dentists believed that it was very necessary to master the knowledge of first aid, but in the event of an emergency situation, 73.5% of dentists only can find other doctors to guide themselves to help. 3) The most common way to learn first aid knowledge was through work experience and medical school's first aid course. Dentists should strengthen the learning and training to improve the first aid skill.

Using plant clinic registers to assess the quality of diagnoses and advice given to farmers

DEFF Research Database (Denmark)

Danielsen, Solveig; Boa, Eric; Mafabi, Moses

2012-01-01

doctors. Assessment of quality of diagnoses was based on five validation criteria applied on the ten most common crops. Quality of advice was assessed for the four major problems considering efficacy and feasibility. Findings: The quality of diagnoses varied between crops, from 68% completely validated...... validated diagnoses. The majority of recommendations (82%) were assessed ‘partially effective’. ‘Best practice’ was recommended for 10% and ineffective advice was given in 8% of the cases with considerable variation between diseases. Practical implications: Plant doctors need more training in symptom...... recognition, pest management and record keeping as well as better technical backstopping to solve unknown problems. Common standards and procedures for clinic data collection and analysis should be established, and roles and responsibilities clearly defined. Originality/value: This is the first time plant...

Messages of distinction: the HIV/AIDS media campaign in Thailand.

Science.gov (United States)

Lyttleton, C

1996-03-01

In predominantly rural Thailand, television is a primary source of HIV/AIDS knowledge. Since 1990, HIV/AIDS warning messages have been aired regularly and repeatedly on television as part of the national strategy to minimize transmission of HIV. The education and prevention messages chosen do more than suggest measures to avoid infection. Within a logic of risk, these messages also define characteristics of people who are signified as threatening agents of infection. In Thailand, prostitutes and drug users are portrayed as the feared Other. Because commercial sex is so widespread, the demarcation of prostitutes as a high risk group signals a diffuse threat not easily subject to conceptual distancing. It is the pervasive and often fear-based associations born of the media material that, in large part, establish the basis for emergent practice when thoughts or actions are triggered by consideration of HIV/AIDS.

The epidemiology of HIV and AIDS reports in migrants in the 27 European Union countries, Norway and Iceland: 1999-2006.

Science.gov (United States)

Del Amo, Julia; Likatavičius, Giedrius; Pérez-Cachafeiro, Santiago; Hernando, Victoria; González, Cristina; Jarrín, Inma; Noori, Teymur; Hamers, Françoise F; Bolúmar, Francisco

2011-10-01

To describe the epidemiology of HIV and AIDS by geographical origin in the EU, 1999-2006. AIDS and HIV cases from the EU 27, Norway and Iceland reported to European Centre for Epidemiological Monitoring of AIDS were analysed. Of 75,021 AIDS reports over 1999-2006, 35% were migrants. Of 2988 heterosexual AIDS reports in 2006, 50% were migrants, largely from Sub-Saharan Africa (SSA), 20% of 1404 AIDS cases in men who have sex with men (MSM) were migrants from Latin-America and Western Europe. Of 57 mother-to-child transmission (MTCT) AIDS cases, 23% were from SSA. AIDS cases decreased from 1999 to 2006 in natives (42%), Western Europeans (40%) and North Africa and Middle East (34%), but increased in people from SSA (by 89%), Eastern Europe (by 200%) and Latin-America (50%). Of 17,646 HIV infections in men and 9066 in females in 2006, 49 and 76% were migrants, largely from SSA. Of 169 MTCT infections, 41% were from SSA. Migrants, largely from SSA, represent a considerable proportion of AIDS and HIV reports in EU, especially among heterosexual and MTCT infections. Their contribution is higher among female reports. A substantial percentage of diagnoses in MSM are migrants, largely from Western Europe and Latin-America.

Need assessment for HIV/AIDS Education: The level of knowledge about transmission in some risk groups in Turkey

International Nuclear Information System (INIS)

Ozcebe, H.

2002-01-01

Every year, the number of HIV/AIDS cases increases twice as much as the year before in Turkey. The authors anticipate that the actual numbers of HIV/AIDS cases in Turkey are higher than the number of cases diagnosed and reported. This review summarizes the results of some previous studies that were conducted among various risk groups, such as high school and university students, barbers, hair dressers, nurses, pharmacists and doctors, men and women engaged in sex trade and security workers in different regions of country. The responses of participants to similar questions of studies on the transmission of HIV/AIDS were evaluated in this review. The studies that have been conducted among different risk groups in different regions have shown that in spite of low prevalence of HIV/AIDS in Turkey, many risk groups still do not have adequate or correct information on the prevalence and transmission of disease. Effective and extensive health education on HIV/AIDS and the practice of healthy lifestyle would change the epidemiology of the disease in Turkey. (author)

Assessing traumatic event exposure: general issues and preliminary findings for the Stressful Life Events Screening Questionnaire.

Science.gov (United States)

Goodman, L A; Corcoran, C; Turner, K; Yuan, N; Green, B L

1998-07-01

This article reviews the psychometric properties of the Stressful Life Events Screening Questionnaire (SLESQ), a recently developed trauma history screening measure, and discusses the complexities involved in assessing trauma exposure. There are relatively few general measures of exposure to a variety of types of traumatic events, and most of those that exist have not been subjected to rigorous psychometric evaluation. The SLESQ showed good test-retest reliability, with a median kappa of .73, adequate convergent validity (with a lengthier interview) with a median kappa of .64, and good discrimination between Criterion A and non-Criterion A events. The discussion addresses some of the challenges of assessing traumatic event exposure along the dimensions of defining traumatic events, assessment methodologies, reporting consistency, and incident validation.

Backdating of events in electronic primary health care data: should one censor at the date of last data collection.

Science.gov (United States)

Sammon, Cormac J; Petersen, Irene

2016-04-01

Studies using primary care databases often censor follow-up at the date data are last collected from clinical computer systems (last collection date (LCD)). We explored whether this results in the selective exclusion of events entered in the electronic health records after their date of occurrence, that is, backdated events. We used data from The Health Improvement Network (THIN). Using two versions of the database, we identified events that were entered into a later (THIN14) but not an earlier version of the database (THIN13) and investigated how the number of entries changed as a function of time since LCD. Times between events and the dates they were recorded were plotted as a function of time since the LCD in an effort to determine appropriate points at which to censor follow-up. There were 356 million eligible events in THIN14 and 355 million eligible events in THIN13. When comparing the two data sets, the proportion of missing events in THIN13 was highest in the month prior to the LCD (9.6%), decreasing to 5.2% at 6 months and 3.4% at 12 months. The proportion of missing events was largest for events typically diagnosed in secondary care such as neoplasms (28% in the month prior to LCD) and negligible for events typically diagnosed in primary care such as respiratory events (2% in the month prior to LCD). Studies using primary care databases, particularly those investigating events typically diagnosed outside primary care, should censor follow-up prior to the LCD to avoid underestimation of event rates. Copyright © 2016 John Wiley & Sons, Ltd.

‘Where the action is’: events als marketingcommunicatiestrategie

NARCIS (Netherlands)

Fransen, M.; Rompay, T.; van der Plas, N.

2011-01-01

Despite the increasing use of event marketing in the field of marketing communication, the academia has paid surprisingly little empirical attention to this widely emerging phenomenon. In the present research we defined event marketing and explored consumers’ perceptions towards this relative ‘new’

Development of Training Aids for Nuclear Forensics Exercises

Energy Technology Data Exchange (ETDEWEB)

Lee, Sangjun; Lee, Seungmin; Lim, Hobin; Hyung, Sangcheol; Kim, Jaekwang [Korea Institute of Nuclear Nonproliferation and Control, Daejeon (Korea, Republic of)

2015-05-15

Current radioactive-related training has focused on the prevention of a radiation disaster. Procedures to recover nuclear and radiological materials have been simplified due to the lack of training tools to reproduce real conditions for security and staff at nuclear facilities. The process of recovering materials is crucial in order to collect evidence and secure the safety of response forces. Moreover, exercises for recovering lost or missing a low dose radiation sources, does not well match with explosive like RDD blast situations. Therefore KINAC has been developing training aids in order to closely reproduce conditions of an actual terrorist attack and enhance effectiveness of exercises. These tools will be applied to Nuclear Forensics Exercises in which evidence collection is important at the time of an incident. KINAC has been developing training aids to enhance the effectiveness of such exercises by providing simulated conditions of actual terrorist incidents. Simulated training aids, based on the beacon system, operate with electromagnetic waves. These tools are able to simulate environments close to actual conditions by supplying similar properties of radioactivity. Training aids will be helpful in giving experience to security personnel and staff in the event of a terrorist incident. This experience includes collecting evidence for nuclear forensics. KINAC also has a plan to hold drills using these tools this year with The Armed Force CBR Defense Command.

Development of Training Aids for Nuclear Forensics Exercises

International Nuclear Information System (INIS)

Lee, Sangjun; Lee, Seungmin; Lim, Hobin; Hyung, Sangcheol; Kim, Jaekwang

2015-01-01

Current radioactive-related training has focused on the prevention of a radiation disaster. Procedures to recover nuclear and radiological materials have been simplified due to the lack of training tools to reproduce real conditions for security and staff at nuclear facilities. The process of recovering materials is crucial in order to collect evidence and secure the safety of response forces. Moreover, exercises for recovering lost or missing a low dose radiation sources, does not well match with explosive like RDD blast situations. Therefore KINAC has been developing training aids in order to closely reproduce conditions of an actual terrorist attack and enhance effectiveness of exercises. These tools will be applied to Nuclear Forensics Exercises in which evidence collection is important at the time of an incident. KINAC has been developing training aids to enhance the effectiveness of such exercises by providing simulated conditions of actual terrorist incidents. Simulated training aids, based on the beacon system, operate with electromagnetic waves. These tools are able to simulate environments close to actual conditions by supplying similar properties of radioactivity. Training aids will be helpful in giving experience to security personnel and staff in the event of a terrorist incident. This experience includes collecting evidence for nuclear forensics. KINAC also has a plan to hold drills using these tools this year with The Armed Force CBR Defense Command

MadGraph/MadEvent. The new web generation

International Nuclear Information System (INIS)

Alwall, J.

2007-01-01

The new web-based version of the automatized process and event generator MadGraph/MadEvent is now available. Recent developments are: New models, notably MSSM, 2HDM and a framework for addition of user-defined models, inclusive sample generation and on-line hadronization and detector simulation. Event generation can be done on-line on any of our clusters. (author)

[The strategy and process of out-hospital emergency care of acute cardiovascular events].

Science.gov (United States)

Sun, Gang; Wu, Li-e; Li, Qian-ying; Yang, Ye; Wang, Zi-chao; Zhang, Jing-yin; Li, Shu-jun; Yan, Xu-long; Wang, Ming; Zhang, Wen-xiang; Huang, Guan-hua

2009-06-01

To study the strategy and process of out-hospital emergency care of acute cardiovascular events. One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling "120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50.0% vs. 29.2%, 83.0% vs. 60.7%, both Pemergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3+/-5.6) minutes vs. (89.6+/- 8.4) minutes, (47.3+/-7.3) minutes vs. (149.8+/-13.5) minutes, (61.7+/-8.3) minutes vs. [(149.8+/- 13.5) minutes, all P0.05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9.0%, 4.2% vs. 12.4%, both Pemergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their relatives directly affect their mode of arriving hospital and prognosis.

Aid Policy and the Macroeconomic Management of Aid

DEFF Research Database (Denmark)

Addison, Tony; Tarp, Finn

2015-01-01

This is an introduction to the UNU-WIDER special issue of World Development on aid policy and the macroeconomic management of aid. We provide an overview of the 10 studies, grouping them under three sub-themes: the aid–growth relationship; the supply-side of aid (including its level, volatility......, and coordination of donors); and the macroeconomic framework around aid. The studies in the special issue demonstrate the centrality of research methodology, the importance of disaggregation, and the need to account for country-specific situations and problems. This introduction concludes that the sometimes “over...

The effectiveness of psychological first aid as a disaster intervention tool: research analysis of peer-reviewed literature from 1990-2010.

Science.gov (United States)

Fox, Jeffrey H; Burkle, Frederick M; Bass, Judith; Pia, Francesco A; Epstein, Jonathan L; Markenson, David

2012-10-01

The Advisory Council of the American Red Cross Disaster Services requested that an independent study determine whether first-aid providers without professional mental health training, when confronted with people who have experienced a traumatic event, offer a "safe, effective and feasible intervention." Standard databases were searched by an expert panel from 1990 to September 2010 using the keyword phrase "psychological first aid." Documents were included if the process was referred to as care provided to victims, first responders, or volunteers and excluded if it was not associated with a disaster or mass casualty event, or was used after individual nondisaster traumas such as rape and murder. This search yielded 58 citations. It was determined that adequate scientific evidence for psychological first aid is lacking but widely supported by expert opinion and rational conjecture. No controlled studies were found. There is insufficient evidence supporting a treatment standard or a treatment guideline. Sufficient evidence for psychological first aid is widely supported by available objective observations and expert opinion and best fits the category of "evidence informed" but without proof of effectiveness. An intervention provided by volunteers without professional mental health training for people who have experienced a traumatic event offers an acceptable option. Further outcome research is recommended.

Aid is dead. Long live aid!

Directory of Open Access Journals (Sweden)

Jean-Michel Severino

2012-06-01

Full Text Available The concepts, targets, tools, institutions and modes of operation of official development assistance have been overtaken by the pace of change in a world marked by the combined momentum of demography, technology and economic growth.Aid can however recover, as social consequences of the globalization call for new forms of regulation. It will then be necessary to modify and diversify our target-setting processes, to update operating procedures, and to find better ways of measuring policy implementation. Aid volumes will certainly continue to grow, and we must transform the way aid is financed. Public and private aid stakeholders must recognize the importance of these transformations and be ready to support them, by questioning the methods as well as the objectives of the policies they are implementing. Otherwise, they will severely impede the emergence of the policies we need if we are to build a better world.

User-Generated Social Media Events in Tourism

OpenAIRE

Mariné Roig, Estela; Martín Fuentes, Eva; Daries Ramón, Natalia

2017-01-01

Social media and mobile technologies have revolutionised communication and particular attention has been given to user-generated content (UGC) and the formation of online communities; however, little attention has been given to tourist events entirely generated by users through social media. This paper aims to define and characterise the phenomenon of tourism user-generated events (UGEs) through social media around the user's new empowered role and to assess user-generated social media events...

Defining the complement biomarker profile of c3 glomerulopathy

DEFF Research Database (Denmark)

Zhang, Yuzhou; Nester, Carla M; Martin, Bertha

2014-01-01

BACKGROUND AND OBJECTIVES: C3 glomerulopathy (C3G) applies to a group of renal diseases defined by a specific renal biopsy finding: a dominant pattern of C3 fragment deposition on immunofluorescence. The primary pathogenic mechanism involves abnormal control of the alternative complement pathway......, although a full description of the disease spectrum remains to be determined. This study sought to validate and define the association of complement dysregulation with C3G and to determine whether specific complement pathway abnormalities could inform disease definition. DESIGN, SETTING, PARTICIPANTS......, & MEASUREMENTS: This study included 34 patients with C3G (17 with C3 glomerulonephritis [C3GN] and 17 with dense deposit disease [DDD]) diagnosed between 2008 and 2013 selected from the C3G Registry. Control samples (n=100) were recruited from regional blood drives. Nineteen complement biomarkers were assayed...

Blood, AIDS, and bureaucracy: the crisis and the tragedy.

Science.gov (United States)

Schmidt, Paul J

2011-10-01

The politics of health were never tested more than when AIDS surfaced at the beginning of the 1980s in the industrialized nations. In those countries, it became the most important medical crisis of the last half of the 20th century. Today, the significance of AIDS remains as not only an unrelenting disease but also as a disease that continues to affect social and political life throughout the entire world. The connection between blood transfusion and AIDS is now under control in the industrialized countries but only because of lessons that took too long to learn over the past 25 years. That process had different roots and effects depending on the various national blood programs and policies in different countries. That is illustrated by comparing events in France, Japan, Canada, and the United States that differed in donor and patient populations and on decisions made and secrets kept. Some of the problems persist to this day in parts of the world. Overall, the lessons learned from what happened with blood early in the AIDS epidemic apply to other aspects of human disease and could help in facing the new problems that are sure to appear in the future. Copyright © 2011 Elsevier Inc. All rights reserved.

First responders and psychological first aid.

Science.gov (United States)

Pekevski, Jordan

2013-01-01

Emergencies and disasters are common and occur on a daily basis. Although most survivors will not experience any long-term negative mental health effects, some will. First responders tend to have first contact with the survivors and, therefore, are in a position to provide needed mental health assistance to survivors. Psychological first aid (PFA) is an evidence-informed approach to providing support to survivors following a serious crisis event, and it aims to reduce the initial distress of the traumatic event and to promote adaptive functioning and coping. PFA has gained a great deal of attention lately, likely due to the fact that it is easy to provide. This article discusses the potential negative effects of emergencies and disasters on mental health, provides a description of PFA and discusses its application, and provides an overview of the research base of PFA and a discussion on the need for future research.

AIDS

Science.gov (United States)

... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

Evergreen Valley College Matriculation Aide Intervention Evaluation: Success Rates of Fall 1992 Sections Using a Matriculation Aide Compared to Non-Intervention Sections for the Same Semester and Two Previous Semesters, English 321, 322, 330, and Math 12. Research Report #408.

Science.gov (United States)

Kangas, Jon

In fall 1992, a study was performed at Evergreen Valley College, in San Jose, California, to determine whether the presence of full-time instructional aides and part-time matriculation aides in four specific courses (English 321, 322, 330, and Math 12) led to increases in student success. Success was defined as receipt of a grade of…

[A pediatric case of HIV who diagnosed by virtue of disseminated cryptococcus infection].

Science.gov (United States)

Acar, Manolya; Sütçü, Murat; Aktürk, Hacer; Hançerli Törün, Selda; Karagöz, Nurinisa; Beka, Hayati; Yekeler, Ensar; Ağaçfidan, Ali; Salman, Nuran; Somer, Ayper

2016-07-01

Cryptococcus neoformans is an important opportunistic pathogen that causes serious mortality and morbidity in AIDS patients. Although its incidence has decreased with proper antiretroviral treatment (ART), it is still a major concern in areas with low socioeconomic HIV endemic countries with poor sources of therapy. In our country, pediatric HIV infection and so, HIV-related opportunistic infections are very rare. In order to pay attention to this unusual collaboration; herein, we presented a pediatric case who was diagnosed with HIV and disseminated cryptococcus infection concomitantly. A 6.5-year-old previously healthy girl has admitted to our hospital with the complaints of prolonged fever, cough and hemoptysis. On her physical examination she had oral candidiasis, generalized lymphadenopathy and hepatosplenomegaly. Laboratory findings were as follows; white blood cell count: 3170 µL (neutrophil: 2720 µL, lymphocyte: 366 µL), hemoglobin level: 7.8 gr/dl, hematocrit: 25.5% platelets: 170.000 µL, CRP: 15.2 mg/L and serum IgG level: 1865 mg/dl. Her anti-HIV test yielde,d positive result and confirmed by Western blot assay, together with a high viral load (HIV-RNA: 3.442.000 copies/ml). She was started ART (lamivudine, zidovudine and lopinavir/ritonavir combination) with the diagnosis of stage 3 HIV infection (AIDS). Posteroanterior chest radiograph showed mediastinal extension and nodular parenchyma. Since the patient was suspected to have pulmonary tuberculosis based on the clinical and radiological findings, empirical antituberculosis therapy was started. Because of the insistance of fever, three different blood specimens, bone marrow and gastric aspirates were collected for culture, in which all of them yielded C.neoformans growth. She was then diagnosed as disseminated cryptococcosis and treated with liposomal amphotericin B and fluconazole successfully. Although pediatric HIV infection is usually diagnosed secondary to maternal disease, it can rarely be

Non-Lipschitz Dynamics Approach to Discrete Event Systems

Science.gov (United States)

Zak, M.; Meyers, R.

1995-01-01

This paper presents and discusses a mathematical formalism for simulation of discrete event dynamics (DED) - a special type of 'man- made' system designed to aid specific areas of information processing. A main objective is to demonstrate that the mathematical formalism for DED can be based upon the terminal model of Newtonian dynamics which allows one to relax Lipschitz conditions at some discrete points.

Joint two-part Tobit models for longitudinal and time-to-event data.

Science.gov (United States)

Dagne, Getachew A

2017-11-20

In this article, we show how Tobit models can address problems of identifying characteristics of subjects having left-censored outcomes in the context of developing a method for jointly analyzing time-to-event and longitudinal data. There are some methods for handling these types of data separately, but they may not be appropriate when time to event is dependent on the longitudinal outcome, and a substantial portion of values are reported to be below the limits of detection. An alternative approach is to develop a joint model for the time-to-event outcome and a two-part longitudinal outcome, linking them through random effects. This proposed approach is implemented to assess the association between the risk of decline of CD4/CD8 ratio and rates of change in viral load, along with discriminating between patients who are potentially progressors to AIDS from patients who do not. We develop a fully Bayesian approach for fitting joint two-part Tobit models and illustrate the proposed methods on simulated and real data from an AIDS clinical study. Copyright © 2017 John Wiley & Sons, Ltd.

Exploring self-defining memories in schizophrenia.

Science.gov (United States)

Raffard, Stéphane; D'Argembeau, Arnaud; Lardi, Claudia; Bayard, Sophie; Boulenger, Jean-Philippe; Van Der Linden, Martial

2009-01-01

Previous studies have shown that patients with schizophrenia are impaired in recalling specific events from their personal past. However, the relationship between autobiographical memory impairments and disturbance of the sense of identity in schizophrenia has not been investigated in detail. In this study the authors investigated schizophrenic patients' ability to recall self-defining memories; that is, memories that play an important role in building and maintaining the self-concept. Results showed that patients recalled as many specific self-defining memories as healthy participants. However, patients with schizophrenia exhibited an abnormal reminiscence bump and reported different types of thematic content (i.e., they recalled less memories about past achievements and more memories regarding hospitalisation and stigmatisation of illness). Furthermore, the findings suggest that impairments in extracting meaning from personal memories could represent a core disturbance of autobiographical memory in patients with schizophrenia.

Conservation and aid: designing more effective investments in natural resource governance reform.

Science.gov (United States)

Nelson, Fred

2009-10-01

Biodiversity conservation outcomes are closely related to the rules and institutions governing resource use. Creating local incentives for conservation through more secure resource tenure is central to conservation outcomes on private and communal lands, where the preponderance of biodiversity occurs. Conservation efforts in sub-Saharan Africa are therefore centrally concerned with governance dynamics and institutional reform processes, such as the decentralization of property rights, and how best to achieve such reforms. Traditional mechanisms for financing conservation efforts in Africa rely heavily on funds channeled through multilateral and bilateral aid agencies. The history of development aid highlights a range of constraints these aid agencies face in terms of working toward more effective resource governance arrangements and promoting reforms. Government aid agencies possess incentives for promoting large-scale and short-term projects that maximize expenditure volumes and tend to define issues in technical rather than political terms. The history of development aid suggests that these and other characteristics of aid agencies impedes their ability to influence governance reform processes and that aid funding may discourage the adoption of reforms. Greater emphasis in African conservation financing needs to be placed on flexible, small-scale investments aligned to local interests and constituencies that prioritize innovation, learning, and experimentation. Additionally, more research is required that explores the linkages between conservation funding, donor decision-making processes, and governance reforms.

Overview of the biology of extreme events

Science.gov (United States)

Gutschick, V. P.; Bassirirad, H.

2008-12-01

Extreme events have, variously, meteorological origins as in heat waves or precipitation extremes, or biological origins as in pest and disease eruptions (or tectonic, earth-orbital, or impact-body origins). Despite growing recognition that these events are changing in frequency and intensity, a universal model of ecological responses to these events is slow to emerge. Extreme events, negative and positive, contrast with normal events in terms of their effects on the physiology, ecology, and evolution of organisms, hence also on water, carbon, and nutrient cycles. They structure biogeographic ranges and biomes, almost surely more than mean values often used to define biogeography. They are challenging to study for obvious reasons of field-readiness but also because they are defined by sequences of driving variables such as temperature, not point events. As sequences, their statistics (return times, for example) are challenging to develop, as also from the involvement of multiple environmental variables. These statistics are not captured well by climate models. They are expected to change with climate and land-use change but our predictive capacity is currently limited. A number of tools for description and analysis of extreme events are available, if not widely applied to date. Extremes for organisms are defined by their fitness effects on those organisms, and are specific to genotypes, making them major agents of natural selection. There is evidence that effects of extreme events may be concentrated in an extended recovery phase. We review selected events covering ranges of time and magnitude, from Snowball Earth to leaf functional loss in weather events. A number of events, such as the 2003 European heat wave, evidence effects on water and carbon cycles over large regions. Rising CO2 is the recent extreme of note, for its climatic effects and consequences for growing seasons, transpiration, etc., but also directly in its action as a substrate of photosynthesis

Application of Key Events Dose Response Framework to defining the upper intake level of leucine in young men.

Science.gov (United States)

Pencharz, Paul B; Russell, Robert M

2012-12-01

Leucine is sold in large doses in health food stores and is ingested by weight-training athletes. The safety of ingestion of large doses of leucine is unknown. Before designing chronic high-dose leucine supplementation experiments, we decided to determine the effect of graded doses of leucine in healthy participants. The Key Events Dose Response Framework is an organizational and analytical framework that dissects the various biologic steps (key events) that occur between exposure to a substance and an eventual adverse effect. Each biologic event is looked at for its unique dose-response characteristics. For nutrients, there are a number of biologic homeostatic mechanisms that work to keep circulating/tissue levels in a safe, nontoxic range. If a response mechanism at a particular key event is especially vulnerable and easily overwhelmed, this is known as a determining event, because this event drives the overall slope or shape of the dose-response relationship. In this paper, the Key Events Dose Framework has been applied to the problem of leucine toxicity and leucine's tolerable upper level. After analyzing the experimental data vis a vis key events for leucine leading to toxicity, it became evident that the rate of leucine oxidation was the determining event. A dose-response study has been conducted to graded intakes of leucine in healthy human adult male volunteers. All participants were started at the mean requirement level of leucine [50 mg/(kg · d)] and the highest leucine intake was 1250 mg/( kg · d), which is 25 times the mean requirement. No gut intolerance was seen. Blood glucose fell progressively but remained within normal values without any changes in plasma insulin. Maximal leucine oxidation levels occurred at an intake of 550 mg leucine/( kg · d), after which plasma leucine progressively increased and plasma ammonia also increased in response to leucine intakes >500 mg/( kg · d). Thus, the "key determining event" appears to be when the

Creating Activating Events for Transformative Learning in a Prison Classroom

Science.gov (United States)

Keen, Cheryl H.; Woods, Robert

2016-01-01

In this article, we interpreted, in light of Mezirow's theory of transformative learning, interviews with 13 educators regarding their work with marginalized adult learners in prisons in the northeastern United States. Transformative learning may have been aided by the educators' response to unplanned activating events, humor, and respect, and…

Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel.

Science.gov (United States)

Parker, Cindy L; Everly, George S; Barnett, Daniel J; Links, Jonathan M

2006-01-01

A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.

Isolated Horizon, Killing Horizon and Event Horizon

OpenAIRE

Date, G.

2001-01-01

We consider space-times which in addition to admitting an isolated horizon also admit Killing horizons with or without an event horizon. We show that an isolated horizon is a Killing horizon provided either (1) it admits a stationary neighbourhood or (2) it admits a neighbourhood with two independent, commuting Killing vectors. A Killing horizon is always an isolated horizon. For the case when an event horizon is definable, all conceivable relative locations of isolated horizon and event hori...

Machine learning techniques for breast cancer computer aided diagnosis using different image modalities: A systematic review.

Science.gov (United States)

Yassin, Nisreen I R; Omran, Shaimaa; El Houby, Enas M F; Allam, Hemat

2018-03-01

The high incidence of breast cancer in women has increased significantly in the recent years. Physician experience of diagnosing and detecting breast cancer can be assisted by using some computerized features extraction and classification algorithms. This paper presents the conduction and results of a systematic review (SR) that aims to investigate the state of the art regarding the computer aided diagnosis/detection (CAD) systems for breast cancer. The SR was conducted using a comprehensive selection of scientific databases as reference sources, allowing access to diverse publications in the field. The scientific databases used are Springer Link (SL), Science Direct (SD), IEEE Xplore Digital Library, and PubMed. Inclusion and exclusion criteria were defined and applied to each retrieved work to select those of interest. From 320 studies retrieved, 154 studies were included. However, the scope of this research is limited to scientific and academic works and excludes commercial interests. This survey provides a general analysis of the current status of CAD systems according to the used image modalities and the machine learning based classifiers. Potential research studies have been discussed to create a more objective and efficient CAD systems. Copyright © 2017 Elsevier B.V. All rights reserved.

Reconstructing the AIDS epidemic among injection drug users in Brazil.

Science.gov (United States)

Hacker, Mariana A; Leite, Iuri C; Renton, Adrian; Torres, Tania Guillén de; Gracie, Renata; Bastos, Francisco I

2006-04-01

The HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.

Reconstructing the AIDS epidemic among injection drug users in Brazil

Directory of Open Access Journals (Sweden)

Mariana A. Hacker

2006-04-01

Full Text Available The HIV/AIDS epidemic among injection drug users (IDUs in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000 were used as the dependent variable, with a set of social indicators as independent variables (covariates. In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.

Aid and good governance: Examining aggregate unintended effects of aid.

Science.gov (United States)

Dijkstra, Geske

2018-06-01

Although donors generally aim to improve governance in recipient countries by various means, critics claim that the aggregate effect of large aid flows is the deterioration of governance. Aid is said to weaken domestic accountability, sustain authoritarian regimes, increase political instability, weaken government capacities, and increase corruption. Conducting a systematic search in Web of Science, this paper reviews the empirical evidence for these unintended aggregate effects of aid on the political, administrative, and judicial dimensions of good governance. It finds that the negative effects of aid on governance are much exaggerated. The aggregate effect of aid on democracy has become more positive after the Cold War, and the effect of aid on government capacity and on reducing corruption has also improved over time. Furthermore, most studies show a positive effect of aid on political stability. These findings imply that donor intentions matter: donors that are serious about their intended effects on governance are able to mitigate the possible negative unintended effects of their aid. Copyright © 2017 Elsevier Ltd. All rights reserved.

External event analysis methods for NUREG-1150

International Nuclear Information System (INIS)

Bohn, M.P.; Lambright, J.A.

1989-01-01

The US Nuclear Regulatory Commission is sponsoring probabilistic risk assessments of six operating commercial nuclear power plants as part of a major update of the understanding of risk as provided by the original WASH-1400 risk assessments. In contrast to the WASH-1400 studies, at least two of the NUREG-1150 risk assessments will include an analysis of risks due to earthquakes, fires, floods, etc., which are collectively known as eternal events. This paper summarizes the methods to be used in the external event analysis for NUREG-1150 and the results obtained to date. The two plants for which external events are being considered are Surry and Peach Bottom, a PWR and BWR respectively. The external event analyses (through core damage frequency calculations) were completed in June 1989, with final documentation available in September. In contrast to most past external event analyses, wherein rudimentary systems models were developed reflecting each external event under consideration, the simplified NUREG-1150 analyses are based on the availability of the full internal event PRA systems models (event trees and fault trees) and make use of extensive computer-aided screening to reduce them to sequence cut sets important to each external event. This provides two major advantages in that consistency and scrutability with respect to the internal event analysis is achieved, and the full gamut of random and test/maintenance unavailabilities are automatically included, while only those probabilistically important survive the screening process. Thus, full benefit of the internal event analysis is obtained by performing the internal and external event analyses sequentially

Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol.

Science.gov (United States)

Oostendorp, Linda J M; Ottevanger, Petronella B; van der Graaf, Winette T A; Stalmeier, Peep F M

2011-02-14

There is a continuing debate on the desirability of informing patients with cancer and thereby involving them in treatment decisions. On the one hand, information uptake may be hampered, and additional stress could be inflicted by involving these patients. On the other hand, even patients with advanced cancer desire information on risks and prognosis. To settle the debate, a decision aid will be developed and presented to patients with advanced disease at the point of decision making. The aid is used to assess the amount of information desired. Factors related to information desire are explored, as well as the ability of the medical oncologist to judge the patient's information desire. The effects of the information on patient well-being are assessed by comparing the decision aid group with a usual care group. This study is a randomized controlled trial of patients with advanced colorectal, breast, or ovarian cancer who have started treatment with first-line palliative chemotherapy. The trial will consist of 100 patients in the decision aid group and 70 patients in the usual care group. To collect complete data of 170 patients, 246 patients will be approached for the study. Patients will complete a baseline questionnaire on sociodemographic data, well-being measures, and psychological measures, believed to predict information desire. The medical oncologist will judge the patient's information desire. After disease progression is diagnosed, the medical oncologist offers the choice between second-line palliative chemotherapy plus best supportive care (BSC) and BSC alone. Randomization will take place to determine whether patients will receive usual care (n = 70) or usual care and the decision aid (n = 100). The aid offers information about the potential risks and benefits of both treatment options, in terms of adverse events, tumour response, and survival. Patients decide for each item whether they desire the information or not. Two follow-up questionnaires will

Neuroblastoma in Children: Just Diagnosed Information

Science.gov (United States)

... Financial Reports Watchdog Ratings Feedback Contact Select Page Neuroblastoma in Children – Just Diagnosed Home > Cancer Resources > Types ... Diagnosed Just Diagnosed In Treatment After Treatment Diagnosing Neuroblastoma Depending on the location of the tumor and ...

Impact of treatment for depression on desire for hastened death in patients with advanced AIDS.

Science.gov (United States)

Breitbart, William; Rosenfeld, Barry; Gibson, Christopher; Kramer, Michael; Li, Yuelin; Tomarken, Alexis; Nelson, Christian; Pessin, Hayley; Esch, Julie; Galietta, Michele; Garcia, Nerina; Brechtl, John; Schuster, Michael

2010-01-01

Despite the development of multi-drug regimens for HIV, palliative care and quality-of-life issues in patients with advanced AIDS remain important areas of clinical investigation. Authors assessed the impact of treatment for depression on desire for hastened death in patients with advanced AIDS. Patients with advanced AIDS (N=372) were interviewed shortly after admission to a palliative-care facility, and were reinterviewed monthly for the next 2 months. Patients diagnosed with a major depressive syndrome were provided with antidepressant treatment and reinterviewed weekly. Desire for hastened death was assessed with two questionnaire measures. Desire for death was highly associated with depression, and it decreased dramatically in patients who responded to antidepressant treatment. Little change in desire for hastened death was observed in patients whose depression did not improve. Although improved depression was not significantly associated with the use of antidepressant medication, those individuals prescribed antidepressant medication showed the largest decreases in desire for hastened death. Successful treatment for depression appears to substantially decrease desire for hastened death in patients with advanced AIDS. The authors discuss implications of these findings for palliative-care treatment and the physician-assisted suicide debate.

MR imaging in the diagnosis of intracranial infections, inflammations and AIDS

International Nuclear Information System (INIS)

Henkes, H.; Schoerner, W.; Felix, R.

1988-01-01

At present there is limited experience with MR imaging in infectious and inflammatory diseases of the brain. The purpose of this study was to compare the diagnostic sensitivity of MR imaging and CT in presumed or proved cases of cerebral infection, inflammation, or intracranial manifestation of the acquired immunodeficiency syndrome (AIDS). Third-generation CT scanners were used to obtain plain and Gd-DTPA-enhanced scans. A 0.5-T Magnetom MR imager was used to obtain plain and contrast-enhanced T1-weighted, T1/T2-weighted, and T2-weighted images with spin-echo and fast low-angle shot (FLASH) techniques. Group 1 (immunocompetent) included 35 patients (63 examinations), group 2 (AIDS), 78 (115 examinations). Diagnoses in both groups yielded a wide range of etiologies (e.g., group 1: sarcoidosis, herpes encephalitis, meningitis, neurocysticercosis, Jakob-Creutzfeldt disease, tuberculosis, virus encephalitis; group 2: toxoplasmosis, progressive diffuse leukoencephalopathia (PDL), progressive multifocal leukoencephalopathia (PML), meningitis

Defining and understanding healthy lifestyles choices for adolescents.

Science.gov (United States)

He, Ka; Kramer, Ellen; Houser, Robert F; Chomitz, Virginia R; Hacker, Karen A

2004-07-01

To: (a) establish criteria for defining positive health behaviors and lifestyle; and (b) identify characteristics of adolescents who practice a healthy lifestyle. Responses from a 1998 survey via questionnaire, of 1487 students, from a public high school, Cambridge, Massachusetts, were used to assess correlates of healthy lifestyle choices. Strict and broad assessments of healthy behaviors were defined for students: use of alcohol, tobacco, and illegal drugs; sexual behavior; attempted suicide. Whereas the "strict" criteria included only those adolescents who did not practice any of the behaviors in question, the broad criteria reflected experimentation and moderate risk-taking. The prevalence of positive behaviors was assessed by demographic and student characteristics. In addition, logistic regression models were created to predict determinants of teenagers' healthy lifestyles using both strict and broad definitions. Using strict criteria of healthy lifestyle, significant predictors were being female, born outside the United States, higher academic performance, and fewer stressful life events. Using a broad definition of a healthy lifestyle, significant predictors were being non-Caucasian, in the lower grade levels at the school, higher academic performance, and fewer stressful life events. In both models, peers' approval of risky behaviors negatively influenced teens' lifestyles, whereas parents' disapproval of risky behaviors was a positive influence. These results reinforce the importance of school, peer, and parent support of positive behaviors. It is important for public health workers and families to understand and define healthy lifestyles choices for adolescents.

Medical care at mass gatherings: emergency medical services at large-scale rave events.

Science.gov (United States)

Krul, Jan; Sanou, Björn; Swart, Eleonara L; Girbes, Armand R J

2012-02-01

The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties. Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event. During the 2006-2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs. During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for

The significant event compilation tree-sect: Theory and application

International Nuclear Information System (INIS)

Ishack, G.A.

1990-01-01

The Significant Event Compilation Tree (SECT) is a computer programme that was developed by staff of the Canadian Atomic Energy Control Board during the period 1984-86. Its primary purpose is to link seemingly unrelated events, or parts of events, that could have occurred at different points in time at various nuclear power plants. Using such a software tool aids in the identification of potential paths and/or scenarios that: a. may not have been foreseen in the accident analysis (including fault tree verification), b. could lead to a certain failure; or c. could have been caused by a certain initiating event (which may have ended or been terminated at an earlier stage). This paper describes: a. the basic idea of SECT; b. the criteria whereby events are selected and coded; c. the options available to the user; d. an example of the programme's application in Canada; and e. a demonstration of its possible use in conjunction with the NEA-IRS

The dexametazone suppression test (DST) for diagnosing of depression syndrome

International Nuclear Information System (INIS)

Rejopachi P, L.A.

1984-09-01

The dexametazone suppression test (DST) is a very valuable neuroendocrin assay as auxiliar method for diagnosing the depression. The serum cortisol levels of 20 patients of the Hospital de Salud Mental and of a control group were determined by radio-immunoassay technique. Normal concentration was defined as 5 micrograms per deciliter. Among depressed patients the average value was 9.8865 micro-grams per deciliter; having the test a 85% of positiveness. Among the control group the average value found was 1.167 micro-grams per deciliter, with a 20% of positiveness for the test. (author)

Fertility Preservation for Children Diagnosed with Cancer

Medline Plus

Full Text Available ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ...

HIV/AIDS health care challenges for cross-country migrants in low- and middle-income countries: a scoping review

Science.gov (United States)

Suphanchaimat, Rapeepong; Sommanustweechai, Angkana; Khitdee, Chiraporn; Thaichinda, Chompoonut; Kantamaturapoj, Kanang; Leelahavarong, Pattara; Jumriangrit, Pensom; Topothai, Thitikorn; Wisaijohn, Thunthita; Putthasri, Weerasak

2014-01-01

Introduction HIV/AIDS has been one of the world’s most important health challenges in recent history. The global solidarity in responding to HIV/AIDS through the provision of antiretroviral therapy (ART) and encouraging early screening has been proved successful in saving lives of infected populations in past decades. However, there remain several challenges, one of which is how HIV/AIDS policies keep pace with the growing speed and diversity of migration flows. This study therefore aimed to examine the nature and the extent of HIV/AIDS health services, barriers to care, and epidemic burdens among cross-country migrants in low-and middle-income countries. Methods A scoping review was undertaken by gathering evidence from electronic databases and gray literature from the websites of relevant international initiatives. The articles were reviewed according to the defined themes: epidemic burdens of HIV/AIDS, barriers to health services and HIV/AIDS risks, and the operational management of the current health systems for HIV/AIDS. Results Of the 437 articles selected for an initial screening, 35 were read in full and mapped with the defined research questions. A high HIV/AIDS infection rate was a major concern among cross-country migrants in many regions, in particular sub-Saharan Africa. Despite a large number of studies reported in Africa, fewer studies were found in Asia and Latin America. Barriers of access to HIV/AIDS services comprised inadequate management of guidelines and referral systems, discriminatory attitudes, language differences, unstable legal status, and financial hardship. Though health systems management varied across countries, international partners consistently played a critical role in providing support for HIV/AIDS services to uninsured migrants and refugees. Conclusion It was evident that HIV/AIDS health care problems for migrants were a major concern in many developing nations. However, there was little evidence suggesting if the current

Monitoring Natural Events Globally in Near Real-Time Using NASA's Open Web Services and Tools

Science.gov (United States)

Boller, Ryan A.; Ward, Kevin Alan; Murphy, Kevin J.

2015-01-01

Since 1960, NASA has been making global measurements of the Earth from a multitude of space-based missions, many of which can be useful for monitoring natural events. In recent years, these measurements have been made available in near real-time, making it possible to use them to also aid in managing the response to natural events. We present the challenges and ongoing solutions to using NASA satellite data for monitoring and managing these events.

A review for identification of initiating events in event tree development process on nuclear power plants

International Nuclear Information System (INIS)

Riyadi, Eko H.

2014-01-01

Initiating event is defined as any event either internal or external to the nuclear power plants (NPPs) that perturbs the steady state operation of the plant, if operating, thereby initiating an abnormal event such as transient or loss of coolant accident (LOCA) within the NPPs. These initiating events trigger sequences of events that challenge plant control and safety systems whose failure could potentially lead to core damage or large early release. Selection for initiating events consists of two steps i.e. first step, definition of possible events, such as by evaluating a comprehensive engineering, and by constructing a top level logic model. Then the second step, grouping of identified initiating event's by the safety function to be performed or combinations of systems responses. Therefore, the purpose of this paper is to discuss initiating events identification in event tree development process and to reviews other probabilistic safety assessments (PSA). The identification of initiating events also involves the past operating experience, review of other PSA, failure mode and effect analysis (FMEA), feedback from system modeling, and master logic diagram (special type of fault tree). By using the method of study for the condition of the traditional US PSA categorization in detail, could be obtained the important initiating events that are categorized into LOCA, transients and external events

Changes in the probability of co-occurring extreme climate events

Science.gov (United States)

Diffenbaugh, N. S.

2017-12-01

Extreme climate events such as floods, droughts, heatwaves, and severe storms exert acute stresses on natural and human systems. When multiple extreme events co-occur, either in space or time, the impacts can be substantially compounded. A diverse set of human interests - including supply chains, agricultural commodities markets, reinsurance, and deployment of humanitarian aid - have historically relied on the rarity of extreme events to provide a geographic hedge against the compounded impacts of co-occuring extremes. However, changes in the frequency of extreme events in recent decades imply that the probability of co-occuring extremes is also changing, and is likely to continue to change in the future in response to additional global warming. This presentation will review the evidence for historical changes in extreme climate events and the response of extreme events to continued global warming, and will provide some perspective on methods for quantifying changes in the probability of co-occurring extremes in the past and future.

A model to compare a defined benefit pension fund with a defined contribution provident fund

Directory of Open Access Journals (Sweden)

J.M. Nevin

2003-12-01

Full Text Available During 1994 universities and certain other institutions were given the option of setting up private retirement funds as an alternative to the AIPF. Because of the underfundedness of the AIPF only a substantially reduced Actuarial Reserve Value could be transferred to the new fund on behalf of each member. Employees at these institutions had to make the difficult decision of whether to remain a member of the AIPF or to join a new fund. Several institutions created defined contribution funds as an alternative to the AIPF. In such funds the member carries the investment risk and most institutions felt the need to provide some form of top-up of the Transfer Value. A simple mathematical model is formulated to aid in the comparison of expected retirement benefits under the AIPF and a private fund and to investigate the management problem of distributing additional top-up funds in a fair manner amongst the various age groups within the fund.

Human rights and access to AIDS treatment in Mozambique | Høg ...

African Journals Online (AJOL)

This article explores key issues related to the agitation for human rights in Mozambique and its weak performance power. I define human rights in the context of HIV/AIDS as well as rights-based approaches to development and health. Based on fieldwork, I describe and analyse how human rights are received and applied in ...

Generalized Detectability for Discrete Event Systems

Science.gov (United States)

Shu, Shaolong; Lin, Feng

2011-01-01

In our previous work, we investigated detectability of discrete event systems, which is defined as the ability to determine the current and subsequent states of a system based on observation. For different applications, we defined four types of detectabilities: (weak) detectability, strong detectability, (weak) periodic detectability, and strong periodic detectability. In this paper, we extend our results in three aspects. (1) We extend detectability from deterministic systems to nondeterministic systems. Such a generalization is necessary because there are many systems that need to be modeled as nondeterministic discrete event systems. (2) We develop polynomial algorithms to check strong detectability. The previous algorithms are based on observer whose construction is of exponential complexity, while the new algorithms are based on a new automaton called detector. (3) We extend detectability to D-detectability. While detectability requires determining the exact state of a system, D-detectability relaxes this requirement by asking only to distinguish certain pairs of states. With these extensions, the theory on detectability of discrete event systems becomes more applicable in solving many practical problems. PMID:21691432

Diagnosing Dementia—Positive Signs

Science.gov (United States)

... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...

Computer-aided dispatch--traffic management center field operational test final detailed test plan : WSDOT deployment

Science.gov (United States)

2003-10-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : WSDOT deployment". This document defines the objective, approach,...

Radiological aspects of nuclear accident scenarios. Volume 2 the Rade-Aid system post-Chernobyl action

International Nuclear Information System (INIS)

Sinnaeve, J.

1991-01-01

In the event of a nuclear accident, there is a need for a rapid assessment of the resulting levels of environmental contamination in order to facilitate decisions on possible countermeasures. Volume 2 describes the RADE-AID project to develop a computer system which can be used to support the formulation of decisions on countermeasures following an accidental release of radionuclides. The system is intended as an aid following an actual accident and a tool for assistance in planning and training

Being publicly diagnosed

DEFF Research Database (Denmark)

Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny

2014-01-01

a patient with TB, and finally being in medical treatment. Before being diagnosed with TB, patients were weighing between biding their time and deciding to undergo an examination. Social pressure and feelings of social responsibility tended to affect the decision. Having undergone the examination......INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting....... METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...