Assessment of psychiatric morbidity among health-care students in a teaching hospital, Telangana state: A cross-sectional questionnaire-based study

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Udai Kiran

2017-01-01

Full Text Available Introduction: Professional education can be a stressful experience for health-care students and may impact negatively on emotional well-being and academic performance which leads to psychiatric morbidity. The aim of this study is to assess the prevalence of psychiatric morbidity among the professional health-care students. Materials and Methods: A cross-sectional study was conducted among professional health-care students in a tertiary care teaching hospital of Telangana state. The information regarding demographic data, academic achievements, and positive and negative events in the recent past was collected using semi-structured pro forma, and the General Health Questionnaire (GHQ-28 is used to assess the psychiatric morbidity. Descriptive analysis and Pearson's correlation analysis were done to analyze the data. Results: A total of 836 students participated in the study, and the overall mean GHQ total score in the study population was 26.8, which is above the cutoff (24 score. The prevalence of psychiatric morbidity among study population is about 58.7%. Academic achievement and negative events in the recent past had effect on psychological morbidity and showed high GHQ scores among study population which was found to be statistically significant. Conclusion: The poor academic performance and negative events had a strong impact on psychological morbidity of students. The higher level of psychological morbidity warrants need for intervention such as social and psychological support to improve the quality of life for the health-care students. Further, a creation of positive academic environment as a teamwork of faculty, administration, educational experts, and students helps to develop psychological healthy dental and medical professionals who can perform better in a coming future.

Severe maternal morbidity in Zanzibar’s referral hospital : Measuring the impact of in-hospital care

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Herklots, Tanneke; Van Acht, Lieke; Meguid, Tarek; Franx, Arie; Jacod, Benoit

2017-01-01

Objective: to analyse the impact of in-hospital care on severe maternal morbidity using WHO’s near-miss approach in the low-resource, high mortality setting of Zanzibar’s referral hospital. Setting: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. Methods: We identified all

Administrative encounters in general practice: low value or hidden value care?

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Trevena, Lyndal J; Harrison, Christopher; Britt, Helena C

2018-02-19

To determine the frequency of general practice administrative encounters, and to determine whether they represent low value care. Secondary analysis of data from the Bettering Evaluation and Care of Health (BEACH) dataset. 1 568 100 GP-patient encounters in Australia, 2000-01 to 2015-16. An annual nationally representative random sample of about 1000 GPs, who each recorded the details of 100 consecutive encounters with patients. Proportions of general practice encounters that were potentially low value care encounters (among the patient's reasons for the encounter was at least one administrative, medication, or referral request) and potentially low value care only encounters (such reasons were the sole reason for the encounter). For 2015-16, we also examined other health care provided by GPs at these encounters. During 2015-16, 18.5% (95% CI, 17.7-19.3%) of 97 398 GP-patient encounters were potentially low value care request encounters; 7.4% (95% CI, 7.0-7.9%) were potentially low value care only encounters. Administrative work was requested at 3.8% (95% CI, 3.5-4.0%) of GP visits, 35.4% of which were for care planning and coordination, 33.5% for certification, and 31.2% for other reasons. Medication requests were made at 13.1% (95% CI, 12.4-13.7%) of encounters; other health care was provided at 57.9% of medication request encounters, counselling, advice or education at 23.4%, and pathology testing was ordered at 16.7%. Referrals were requested at 2.8% (95% CI, 1.7-3.0%) of visits, at 69.4% of which additional health care was provided. The problems managed most frequently at potentially low value care only encounters were chronic diseases. Most patients requested certificates, medications and referrals in the context of seeking help for other health needs. Additional health care, particularly for chronic diseases, was provided at most GP administrative encounters. The MBS Review should consider the hidden value of these encounters.

Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

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Wade, Dorothy M; Hankins, Matthew; Smyth, Deborah A; Rhone, Elijah E; Mythen, Michael G; Howell, David C J; Weinman, John A

2014-09-24

The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units. A validation study of IPAT was conducted in the critical care unit of a London hospital. Once un-sedated, orientated and alert, critical care patients were assessed with the IPAT and validated tools for distress, to determine the IPAT's concurrent validity. Fifty six patients took IPAT again to establish test-retest reliability. Finally, patients completed posttraumatic stress disorder (PTSD), depression and anxiety questionnaires at three months, to determine predictive validity of the IPAT. One hundred and sixty six patients completed the IPAT, and 106 completed follow-up questionnaires at 3 months. Scale analysis showed IPAT was a reliable 10-item measure of critical care-related psychological distress. Test-retest reliability was good (r =0.8). There was good concurrent validity with measures of anxiety and depression (r =0.7, P psychological morbidity was good (r =0.4, P psychological morbidity (AUC =0.7). The IPAT was found to have good reliability and validity. Sensitivity and specificity analysis suggest the IPAT could provide a way of allowing staff to assess psychological distress among critical care patients after further replication and validation. Further work is also needed to determine its utility in predicting future psychological morbidity.

Families and health-care professionals' perspectives and expectations of family-centred care: hidden expectations and unclear roles.

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Coyne, Imelda

2015-10-01

Family-centred care (FCC) is viewed as a pivotal concept in the provision of high-quality nursing care for children and their families, yet implementation continues to be problematic worldwide. This research investigated how FCC was enacted from families and nurses' perspectives. Descriptive qualitative approach using elements of analysis from grounded theory method. Data were collected though individual interviews with 18 children aged 7-16 years, their parents (n = 18) and 18 nurses from two children's hospital and one children's unit in a large general hospital in Ireland. Four key themes were identified: expectations; relying on parents' help; working out roles; and barriers to FCC. Nurses wholeheartedly endorsed FCC because of the benefits for families and their reliance on parents' contribution to the workload. There was minimal evidence of collaboration or negotiation of roles which resulted in parents feeling stressed or abandoned. Nurses cited busy workload, under-staffing and inappropriate documentation as key factors which resulted in over-reliance on parents and hindered their efforts to negotiate and work alongside parents. Families are willing to help in their child's care but they require clear guidance, information and support from nurses. Hidden expectations and unclear roles are stressful for families. Nurses need skills training, adequate resources and managerial support to meet families' needs appropriately, to establish true collaboration and to deliver optimal family-centred care. © 2013 John Wiley & Sons Ltd.

A PROSPECTIVE OBSERVATIONAL STUDY OF SHORT TERM MORBIDITY PATTERN IN PRETERM NEWBORNS DELIVERED IN A TERTIARY CARE HOSPITAL

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Harsha

2015-08-01

Full Text Available OBJECTIVE: To study the short term morbidity pattern in preterm new born babies delivered in a tertiary care hospital with level III neonatal intensive care unit (NICU. MATERIAL AND METHODS: A prospective observational study was conducted in a level III NICU betwee n November 2009 to July 2010 at Grant medical college and JJ Group of hospitals, Mumbai. All the in born preterm babies were assessed for morbidity pattern from the time of admission till discharge or death. RESULT: 156 preterm babies were included in the study. 83(54.21% were male and 73(46.79% were female. The major morbidities observed in the preterm neonates were hyperbilirubinemia in 50.54%, Respiratory distress syndrome (RDS in25.64% and severe birth asphyxia in13.46%. Other common morbidities seen were retinopathy of prematurity in 12.17%, apnoea in 11.54% and anaemia in 10.9%. Preterm neonates also had in 9.62% culture proven sepsis, in 8.33% hypoglycaemia, in 7.05% Intraventricular haemorrhage (IVH and in 6.41% various congenital anomalies. CONCL USION: Hyperbilirubinemia, respiratory distress syndrome and severe birth asphyxia are major preterm morbidity

Hypertension Control and co-morbidities in primary health care centers in Riyadh

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Al-Tuwijri, Abdulmohsin A [Dept. of Family Medicine, Ministry of Health, Riyadh (Saudi Arabia); Al-Rukban, Mohammed Othman [Dept. of Family and Community Medicine, Coll. of Medicine, King Saud Univ., Riyadh (Saudi Arabia)

2006-07-01

The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary health care (PHC) centers in Riyadh. A cross sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC-center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females, the mean age was 57.2+-11.1 years and 8.3% were smokers. The majority 204 (85.7%) had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP. The most common co-morbidity was diabetes mellitus found in 98 (38.4%), followed by dislipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrences of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in the PHC-centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels. (author)

Hypertension Control and co-morbidities in primary health care centers in Riyadh

International Nuclear Information System (INIS)

Al-Tuwijri, Abdulmohsin A.; Al-Rukban, Mohammed Othman

2006-01-01

The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary health care (PHC) centers in Riyadh. A cross sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC-center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females, the mean age was 57.2+-11.1 years and 8.3% were smokers. The majority 204 (85.7%) had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP. The most common co-morbidity was diabetes mellitus found in 98 (38.4%), followed by dislipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrences of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in the PHC-centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels. (author)

The hidden cost of 'free' maternity care in Dhaka, Bangladesh.

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Nahar, S; Costello, A

1998-12-01

We studied the cost and affordability of 'free' maternity services at government facilities in Dhaka, Bangladesh, to assess whether economic factors may contribute to low utilization. We conducted a questionnaire survey and in-depth interviews among 220 post-partum mothers and their husbands, selected from four government maternity facilities (three referral hospitals and one Mother and Child Health hospital) in Dhaka. Mothers with serious complications were excluded. Information was collected on the costs of maternity care, household income, the sources of finance used to cover the costs, and the family's willingness to pay for maternity services. The mean cost for normal delivery was 1275 taka (US$31.9) and for caesarean section 4703 taka (US$117.5). Average monthly household income was 4933 taka (US$123). Twenty-one per cent of families were spending 51-100% of monthly income, and 27% of families 2-8 times their monthly income for maternity care. Overall, 51% of the families (and 74% of those having a caesarean delivery) did not have enough money to pay; of these, 79% had to borrow from a money lender or relative. Surprisingly, 72% of the families said they were willing to pay a government-levied user charge, though this was less popular among low-income families (61%). 'Free' maternity care in Bangladesh involves considerable hidden costs which may be a major contributor to low utilization of maternity services, especially among low-income groups. To increase utilization of safer motherhood services, policy-makers might consider introducing fixed user charges with clear exemption guidelines, or greater subsidies for existing services, especially caesarean section.

Hidden Liquidity

OpenAIRE

Cebiroglu, Gökhan; Horst, Ulrich

2012-01-01

We cross-sectionally analyze the presence of aggregated hidden depth and trade volume in the S&P 500 and identify its key determinants. We find that the spread is the main predictor for a stock’s hidden dimension, both in terms of traded and posted liquidity. Our findings moreover suggest that large hidden orders are associated with larger transaction costs, higher price impact and increased volatility. In particular, as large hidden orders fail to attract (latent) liquidity to the market, hi...

Listening to women's voices: the quality of care of women experiencing severe maternal morbidity, in Accra, Ghana.

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Ozge Tunçalp

Full Text Available BACKGROUND: Women who survive severe obstetric complications can provide insight into risk factors and potential strategies for prevention of maternal morbidity as well as maternal mortality. We interviewed 32 women, in an urban facility in Ghana, who had experienced severe morbidity defined using a standardized WHO near-miss definition and identification criteria. Women provided personal accounts of their experiences of severe maternal morbidity and perceptions of the care they received. METHODS AND FINDINGS: The study took place in a referral facility in urban Accra, and semi-structured interviews were conducted with women who had either a maternal near miss (n = 17 or a potentially life-threatening complication (n = 15. The most common themes surrounding the traumatic delivery were the fear of dying and concern over the potential (or actual loss of the baby. For many women, the loss of a baby negatively influenced how they viewed and coped with this experience. Women's perceptions of the quality of the care highlighted several key factors such as the importance of information, good communication and attitudes, and availability of human (i.e., more doctors and physical resources (i.e., more beds, water at the facility. CONCLUSIONS: Our results suggest that experiences of women with severe maternal morbidity may inform different aspects of quality improvement in the facilities, which in turn have a positive impact on future health seeking behavior, service utilization and reduction in maternal morbidity and mortality.

Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

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Omar Khairani

2009-06-01

Full Text Available Abstract Background Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ. Methods This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period. Results The proportion of respondents who had at least one PHQ positive diagnosis was 24.7% and some respondents had more than one diagnosis. Diagnoses included depressive illness (n = 38, 14.4%, somatoform disorder (n = 32, 12.2%, panic and anxiety disorders (n = 17, 6.5%, binge eating disorder (n = 9, 3.4% and alcohol abuse (n = 6, 2.3%. Younger age (18 to 29 years and having a history of stressors in the previous four weeks were found to be significantly associated (p = 0.036 and p = 0.044 respectively with PHQ positive scores. Conclusion These findings are broadly similar to the findings of studies done in other countries and are a useful guide to the probable prevalence of psychiatric morbidity in primary care in other similar settings in Malaysia.

Serum biochemistry and morbidity among runners presenting for medical care after an Australian mountain ultramarathon.

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Reid, Stephen A; King, M Jonathan

2007-07-01

To determine if exercise-associated hyponatremia (EAH) was a cause of morbidity among runners requiring medical care at an Australian mountain ultramarathon. Case series. Six Foot Track mountain ultramarathon, New South Wales, Australia, March 2006. Runners presenting to the medical facility. Serum biochemistry. No cases of exercise-associated hyponatremia were identified among 9 athletes (from 775 starters) who were treated with intravenous fluid therapy. Unwell runners had a mean serum (Na) of 143 mmol/L (range 138-147 mmol/L). All runners tested had elevated serum urea and creatinine concentrations. In this setting, EAH was not a significant cause of morbidity.

Cultural competence in medical education: aligning the formal, informal and hidden curricula.

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Paul, David; Ewen, Shaun C; Jones, Rhys

2014-12-01

The concept of cultural competence has become reified by inclusion as an accreditation standard in the US and Canada, in New Zealand it is demanded through an Act of Parliament, and it pervades discussion in Australian medical education discourse. However, there is evidence that medical graduates feel poorly prepared to deliver cross-cultural care (Weissman et al. in J Am Med Assoc 294(9):1058-1067, 2005) and many commentators have questioned the effectiveness of cultural competence curricula. In this paper we apply Hafferty's taxonomy of curricula, the formal, informal and hidden curriculum (Hafferty in Acad Med 73(4):403-407, 1998), to cultural competence. Using an example across each of these curricular domains, we highlight the need for curricular congruence to support cultural competence development among learners. We argue that much of the focus on cultural competence has been in the realm of formal curricula, with existing informal and hidden curricula which may be at odds with the formal curriculum. The focus of the formal, informal and hidden curriculum, we contend, should be to address disparities in health care outcomes. In conclusion, we suggest that without congruence between formal, informal and hidden curricula, approaches to addressing disparity in health care outcomes in medical education may continue to represent reform without change.

The role of prenatal care and social risk factors in the relationship between immigrant status and neonatal morbidity: a retrospective cohort study.

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María Paz-Zulueta

Full Text Available Literature evaluating association between neonatal morbidity and immigrant status presents contradictory results. Poorer compliance with prenatal care and greater social risk factors among immigrants could play roles as major confounding variables, thus explaining contradictions. We examined whether prenatal care and social risk factors are confounding variables in the relationship between immigrant status and neonatal morbidity.Retrospective cohort study: 231 pregnant African immigrant women were recruited from 2007-2010 in northern Spain. A Spanish population sample was obtained by simple random sampling at 1:3 ratio. Immigrant status (Spanish, Sub-Saharan and Northern African, prenatal care (Kessner Index adequate, intermediate or inadequate, and social risk factors were treated as independent variables. Low birth weight (LBW < 2500 grams and preterm birth (< 37 weeks were collected as neonatal morbidity variables. Crude and adjusted odds ratios (OR were estimated by unconditional logistic regression with 95% confidence intervals (95% CI.Positive associations between immigrant women and higher risk of neonatal morbidity were obtained. Crude OR for preterm births in Northern Africans with respect to nonimmigrants was 2.28 (95% CI: 1.04-5.00, and crude OR for LBW was 1.77 (95% CI: 0.74-4.22. However, after adjusting for prenatal care and social risk factors, associations became protective: adjusted OR for preterm birth = 0.42 (95% CI: 0.14-1.32; LBW = 0.48 (95% CI: 0.15-1.52. Poor compliance with prenatal care was the main independent risk factor associated with both preterm birth (adjusted OR inadequate care = 17.05; 95% CI: 3.92-74.24 and LBW (adjusted OR inadequate care = 6.25; 95% CI: 1.28-30.46. Social risk was an important independent risk factor associated with LBW (adjusted OR = 5.42; 95% CI: 1.58-18.62.Prenatal care and social risk factors were major confounding variables in the relationship between immigrant status and neonatal

Ocular morbidity and health seeking behaviour in Kwara state, Nigeria: implications for delivery of eye care services.

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Laura Senyonjo

Full Text Available There is currently limited information as to which conditions are most prevalent in communities in developing countries. This makes effective planning of eye services difficult.3,899 eligible individuals were recruited and examined in a cross-sectional survey in Asa Local Government Area, Nigeria. Those who self-reported an ocular morbidity were also asked about their health-seeking behaviour. Health records of local facilities were reviewed to collect information on those presenting with ocular morbidities.25.2% (95% CI: 22.0-28.6 had an ocular morbidity in at least one eye. Leading causes were presbyopia and conditions affecting the lens and conjunctiva. The odds of having an ocular morbidity increased with age and lower educational attainment. 10.1% (7.7-13.0 self-reported ocular morbidity; 48.6% (40.4-56.8 of them reported seeking treatment. At the facility level, 344 patients presented with an ocular morbidity over one month, the most common conditions were red (26.3% or itchy (20.8% eyes.Ocular morbidities, including many non vision impairing conditions, were prevalent with a quarter of the population affected. The delivery of eye care services needs to be tailored in order to address this need and ensure delivery in a cost-effective and sustainable manner.

Total donor ischemic time: relationship to early hemodynamics and intensive care morbidity in pediatric cardiac transplant recipients.

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Rodrigues, Warren; Carr, Michelle; Ridout, Deborah; Carter, Katherine; Hulme, Sara Louise; Simmonds, Jacob; Elliott, Martin; Hoskote, Aparna; Burch, Michael; Brown, Kate L

2011-11-01

Single-center studies have failed to link modest increases in total donor ischemic time to mortality after pediatric orthotopic heart transplant. We aimed to investigate whether prolonged total donor ischemic time is linked to pediatric intensive care morbidity after orthotopic heart transplant. Retrospective cohort review. Tertiary pediatric transplant center in the United Kingdom. Ninety-three pediatric orthotopic heart transplants between 2002 and 2006. Total donor ischemic time was investigated for association with early post-orthotopic heart transplant hemodynamics and intensive care unit morbidities. Of 43 males and 50 females with median age 7.2 (interquartile range 2.2, 13.0) yrs, 62 (68%) had dilated cardiomyopathy, 20 (22%) had congenital heart disease, and nine (10%) had restrictive cardiomyopathy. The mean total donor ischemic time was 225.9 (sd 65.6) mins. In the first 24 hrs after orthotopic heart transplant, age-adjusted mean arterial blood pressure increased (p total donor ischemic time was significantly associated with lower mean arterial blood pressure (p care unit (p = .004), and longer post-orthotopic heart transplant stay in hospital (p = .02). Total donor ischemic time was not related to levels of mean pulmonary arterial pressure (p = .62), left atrial pressure (p = .38), or central venous pressure (p = .76) early after orthotopic heart transplant. Prolonged total donor ischemic time has an adverse effect on the donor organ, contributing to lower mean arterial blood pressure, as well as more prolonged ventilation and intensive care unit and hospital stays post-orthotopic heart transplant, reflecting increased morbidity.

[Remuneration distribution - should morbidity-dependent overall remuneration also be distributed after adjustments for morbidity?].

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Walendzik, A; Trottmann, M; Leonhardt, R; Wasem, J

2013-04-01

In the 2009 reform of the German collective remuneration system for outpatient medical care, on the level of overall remuneration, the morbidity risk was transferred to the health funds fulfilling a long-term demand of physicians. Nevertheless not transferring morbidity adjustment to the levels of physician groups and singular practices can lead to budgets not related to patient needs and to incentives for risk selection for individual doctors. The systematics of the distribution of overall remuneration in the German remuneration system for outpatient care are analysed focusing on the aspect of morbidity adjustment. Using diagnostic and pharmaceutical information of about half a million insured subjects, a risk adjustment model able to predict individual expenditures for outpatient care for different provider groups is presented. This model enables to additively split the individual care burden into several parts attributed to different physician groups. Conditions for the use of the model in the distribution of overall remuneration between physician groups are developed. A simulation of the use of diagnoses-based risk adjustment in standard service volumes then highlights the conditions for a successfull installation of standard service volumes representing a higher degree of risk adjustment. The presented estimation model is generally applicable for the distribution of overall remuneration to different physician groups. The simulation of standard service volumes using diagnosis-based risk adjustment does not provide a more accurate prediction of the expenditures on the level of physician practices than the age-related calculation currently used in the German remuneration system for outpatient medical care. Using elements of morbidity-based risk adjustment the current German collective system for outpatient medical care could be transformed towards a higher degree of distributional justice concerning medical care for patients and more appropriate incentives

Sociology of Hidden Curriculum

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Alireza Moradi

2017-06-01

Full Text Available This paper reviews the concept of hidden curriculum in the sociological theories and wants to explain sociological aspects of formation of hidden curriculum. The main question concentrates on the theoretical approaches in which hidden curriculum is explained sociologically.For this purpose it was applied qualitative research methodology. The relevant data include various sociological concepts and theories of hidden curriculum collected by the documentary method. The study showed a set of rules, procedures, relationships and social structure of education have decisive role in the formation of hidden curriculum. A hidden curriculum reinforces by existed inequalities among learners (based on their social classes or statues. There is, in fact, a balance between the learner's "knowledge receptions" with their "inequality proportion".The hidden curriculum studies from different major sociological theories such as Functionalism, Marxism and critical theory, Symbolic internationalism and Feminism. According to the functionalist perspective a hidden curriculum has a social function because it transmits social values. Marxists and critical thinkers correlate between hidden curriculum and the totality of social structure. They depicts that curriculum prepares learners for the exploitation in the work markets. Symbolic internationalism rejects absolute hegemony of hidden curriculum on education and looks to the socialization as a result of interaction between learner and instructor. Feminism theory also considers hidden curriculum as a vehicle which legitimates gender stereotypes.

Hidden measurements, hidden variables and the volume representation of transition probabilities

OpenAIRE

Oliynyk, Todd A.

2005-01-01

We construct, for any finite dimension $n$, a new hidden measurement model for quantum mechanics based on representing quantum transition probabilities by the volume of regions in projective Hilbert space. For $n=2$ our model is equivalent to the Aerts sphere model and serves as a generalization of it for dimensions $n \\geq 3$. We also show how to construct a hidden variables scheme based on hidden measurements and we discuss how joint distributions arise in our hidden variables scheme and th...

Detection of psychiatric morbidity in the primary medical care setting in Brazil Distúrbios psiquiátricos e assistência primária à saúde no Brasil

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Jair de Jesus Mari

1987-12-01

Full Text Available The aims of this study were a to assess the ability of primary care doctors to make accurate ratings of psychiatric disturbance and b to evaluate the use of a case-finding questionnaire in the detection of psychiatric morbidity. The estudy took place in three primary care clinics in the city of São Paulo, Brazil, during a six-month survey. A time sample of consecutive adult attenders were asked to complete a case-finding questionnaire for psychiatric disorders (the Self Report Questionnaire - SRQ and a subsample were selected for a semi-structured psychiatric interview (the Clinical Interview Schedule - CIS. At the end of the consultation the primary care doctors were asked to assess, in a standardized way, the presence or absence of psychiatric disorder; these assessments were then compared with that ratings obtained in the psychiatric interview. A considerable proportion of minor psychiatric morbidity remained undetected by the three primary care doctors: the hidden morbidity ranged from 22% to 79%. When these were compared to those of the case-finding questionnaire, they were consistently lower, indicating that the use of these instruments can enhance the recognition of psychiatric disorders in primary care settings. Four strategies for adopting the questionnaire are described, and some of the clinical consequences of its use are discussed.Objetivou-se avaliar a habilidade de clínicos gerais em diagnosticar distúrbios emocionais na assistência primária, e investigar a possibilidade de se introduzir um questionário de "screening" para auxiliar o diagnóstico de doenças psiquiátricas. O estudo foi realizado em dois centros de saúde e um ambulatório de clínica geral na cidade de São Paulo (Brasil, por um período de 6 meses. Uma amostra representativa de pacientes adultos (16 anos atendidos por clínico geral preencheu um questionário de "screening" para distúrbios psiquiátricos menores. Uma sub-amostra foi selecionada para

Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

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Jeevan Acharya

Full Text Available Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs.A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study.The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%, clothes (9.8% and transport (7.3%. For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007, employed house head (p = 0.011, monthly family income more than 25,000 NRs (Nepalese Rupees (p = 0.014, private hospital as a place of delivery (p = 0.0001, C-section as a mode of delivery (p = 0.0001, longer duration (>5days of stay in hospital (p = 0.0001, longer distance (>15km from house to hospital (p = 0.0001 and longer travel time (>240 minutes from house to hospital (p = 0.007 showed a significant association with the higher hidden costs (>25000 NRs.Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time were associated with hidden costs. Hidden costs can be a

Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

Science.gov (United States)

Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

2016-01-01

Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

Endovascular Interventions for the Morbidly Adherent Placenta

Directory of Open Access Journals (Sweden)

Claire Kaufman

2018-05-01

Full Text Available Morbidly adherent placentas are a spectrum of abnormalities ranging from placental invasion of the myometrium to invasion past the myometrium and muscular layers into adjacent structures. This entity is becoming more prevalent recently with increased number of cesarean deliveries. Given the high risk of morbidity and mortality, this was traditionally treated with pre-term planned cesarean hysterectomy. However, recently, uterine preservation techniques have been implemented for those women wishing to preserve future fertility or their uterus. Early identification is crucial as studies have shown better outcomes for women treated at tertiary care facilities by a dedicated multidisciplinary team. Interventional radiologists are frequently included in the care of these patients as there are several different endovascular techniques which can be implemented to decrease morbidity in these patients both in conjunction with cesarean hysterectomy and in the setting of uterine preservation. This article will review the spectrum of morbidly adherent placentas, imaging, as well as the surgical and endovascular interventions implemented in the care of these complex patients.

Morbidity and Mortality Patterns among Neurological Patients in the ...

African Journals Online (AJOL)

Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin ...

Discovering hidden sectors with monophoton Z' searches

International Nuclear Information System (INIS)

Gershtein, Yuri; Petriello, Frank; Quackenbush, Seth; Zurek, Kathryn M.

2008-01-01

In many theories of physics beyond the standard model, from extra dimensions to Hidden Valleys and models of dark matter, Z ' bosons mediate between standard model particles and hidden sector states. We study the feasibility of observing such hidden states through an invisibly decaying Z ' at the LHC. We focus on the process pp→γZ ' →γXX † , where X is any neutral, (quasi-) stable particle, whether a standard model neutrino or a new state. This complements a previous study using pp→ZZ ' →l + l - XX † . Only the Z ' mass and two effective charges are needed to describe this process. If the Z ' decays invisibly only to standard model neutrinos, then these charges are predicted by observation of the Z ' through the Drell-Yan process, allowing discrimination between Z ' decays to standard model ν's and invisible decays to new states. We carefully discuss all backgrounds and systematic errors that affect this search. We find that hidden sector decays of a 1 TeV Z ' can be observed at 5σ significance with 50 fb -1 at the LHC. Observation of a 1.5 TeV state requires super-LHC statistics of 1 ab -1 . Control of the systematic errors, in particular, the parton distribution function uncertainty of the dominant Zγ background, is crucial to maximize the LHC search reach.

Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

Science.gov (United States)

Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

2013-09-20

Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about

Mediating words, mediating worlds: interpreting as hidden care work in a South African psychiatric institution.

Science.gov (United States)

Smith, Jénine; Swartz, Leslie; Kilian, Sanja; Chiliza, Bonginkosi

2013-08-01

Many mental health clinicians in South Africa use informal interpreters, who are employed to perform other functions, such as cleaners and security guards; there are no formally trained interpreters. Drawing on qualitative semistructured interviews, this paper examines the experiences of informal interpreters working within a psychiatric setting. Furthermore, this paper explores how working in this invisible capacity affects informal interpreters' views of themselves and the contribution they feel they are making by acting as interpreters. An interpretative phenomenological approach enabled an in-depth analysis of the experiences of the ad hoc interpreters. The results of this study reveal a dilemma. On the one hand, informal interpreters interviewed jeopardize ethical principles by breaching confidentiality and reporting on patient behaviour without their consent. On the other hand, they report fulfilling an additional beneficial role in terms of the overall care of patients which goes beyond the ambit of the interpreting session. The impact and extent of the informal interpreters' involvement in care could not be ascertained solely from the data obtained in this study, but it is clear that informal interpreting may usefully be viewed as a form of hidden care work. A detailed ethnographic study aimed at exploring this further is therefore recommended.

[Morbidity observed in a health area: Impact on professionals and funding].

Science.gov (United States)

de Miguel, Pablo; Caballero, Isabel; Rivas, Francisco Javier; Manera, Jaime; de Vicente, María Auxiliadora; Gómez, Ángel

2015-05-01

To analyze morbidity, in the context of a health area, and broken down by health centre, of patients who made contact with healthcare services, in order to propose an adjustment to finance the payment per capita. A descriptive study of morbidity observed in citizens assigned a health area during year 2010. SITE: Health Area 9. Autonomous Community of Madrid. Formed by the municipalities of Fuenlabrada, Humanes, and Moraleja de Enmedio. All levels of health care included. All citizens with health card assigned to a health center in the area who has maintained contact with the public health service's own area. Coded contact of patients are grouped using the Population Grouping Clinical Risk 3M TM Software (CRG). Each patient is included in a homogeneous and exclusive group with a numerical morbidity and clinical sense. Through the health card is known primary care centre, physician, age and sex. The distribution of morbidity is obtained by primary care centre, primary care physician, age and sex analyzing differences and combinations. It was found that the average values of the population morbidity are different in each primary care centre. In order to maintain the principle of equity in health care, it is suggested that an adjustment is made to the per capita payment based on the morbidity rate of the population. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

[Multiple chronic conditions and morbidity burden: challenges and considerations for an organizational strategy].

Science.gov (United States)

Balicer, Ran; Bitterman, Haim; Shadmi, Efrat

2012-07-01

Technological advances combined with the aging of the population bring about an increasingly growing number of patients with chronic conditions and multi-morbidity. Multi-morbidity, the co-occurrence of chronic and/or non-chronic conditions in an individual, is the norm among elderly patients, and is becoming increasingly common among younger adults. The Israeli health system, like other systems worldwide, is faced with the challenges posed by the increase in complex multi-morbidity, in an era of growing fiscal constraints, a situation that can induce financial and organizational crises. To effectively cope with such circumstances, a paradigm shift is needed. Health systems need to focus on overall morbidity burden and multi-morbidity (rather than the prevailing one disease at a time approach) and on better care integration. The Israeli health system entails many of the essential elements for addressing the challenges of integrated care, including universal health coverage and advanced health information technology systems. Yet, like other health systems, there is a need for care management support mechanisms that are more effectively tailored to meet the needs of the highly multimorbid patients. This review outlines the organizational approach required to better align care for the main customers of health care in the 21st century: patients with multi-morbidity. We focus on four domains: assessment of morbidity burden according to measures that account for the interaction and synergism amongst conditions; integration across the care continuum; enhancement of primary care and self-management support approaches; and provision of uniquely tailored care management solutions for the highest risk multi-morbid patients.

Effect of Kangaroo Mother Care on Growth and Morbidity Pattern in Low Birth Weight Infants

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Keerti Swarnkar

2016-01-01

Full Text Available Background: Kangaroo Mother Care (KMC is dened as skin-to-skin contact between a mother and her newborn baby derived from practical similarities to marsupial care giving, proximately exclusive breastfeeding and early discharge from hospital. This concept was proposed as an alternative to conventional methods of care for low birth weight (LBW infants, and in replication to quandaries of earnest overcrowding in Neonatal Intensive Care Units (NICUs. KMC essentially utilizes the mother as a natural incubator Aim and Objectives: The aim was to assess the feasibility, acceptability and the effectiveness of KMC in LBW infants. It avoids agitation routinely experienced in busy ward. Material and Methods: A pilot open-labeled quasi-randomised clinical trial was conducted in Level III NICU of a teaching institution. 60 newborn infants <2500 g, meeting inclusion criteria were alternatively randomised into two groups: Kangaroo Mother Care (KMC and Conventional Methods of Care (CMC. Kangaroo mother care was practiced with minimum total period of eight hours a day intermittently for the intervention group while the controls remained in incubators or cots. Weight, head circumference, length, morbidity episodes, hospital stay, feeding patterns were monitored for all infants till postmenstrual age of 42 weeks in preterm babies or till a weight of 2500 g is achieved in term SGA babies. Results: The pilot study conrmed that trial processes were efcient, the intervention was acceptable (to mothers and nurses and that the outcome measures were appropriate; KMC babies achieved signicantly better growth at the end of the study (For preterm babies, weight, length and head circumference gain were signicantly higher in the KMC group (weight 19.28±2.9g/day, length 0.99±0.56cm/week and head circumference 0.72±0.07 cm/week than in the CMC group (P <0.001. A signicantly higher number of babies in the CMC group suffered from hypothermia, hypoglycemia, and

Children With Morbid Obesity Benefit Equally as Children With Overweight and Obesity From an Ongoing Care Program.

Science.gov (United States)

Rijks, J M; Plat, J; Mensink, R P; Dorenbos, E; Buurman, W A; Vreugdenhil, A C E

2015-09-01

Despite stabilization of childhood overweight and obesity prevalence, there is a shift toward more severe degrees of obesity, which results in an increasing prevalence of children with morbid obesity. Prior studies demonstrated that lifestyle modification without ongoing treatment has only a modest and not sustainable effect in children with morbid obesity. This suggests that a chronic care model is necessary for long-term effects on weight management and health. This study aimed to evaluate the effect of an ongoing lifestyle intervention in children with morbid obesity in comparison with children with overweight and obesity. This was a nonrandomized prospective intervention study with 12- and 24-month followup at the Centre for Overweight Adolescent and Children's Healthcare. Children and adolescents (n = 100 females and 72 males) with overweight, obesity, or morbid obesity were given long-term, outpatient, tailored lifestyle intervention. Body mass index (BMI) z score was measured. In children with morbid obesity, 12- and 24-month interventions resulted in a decrease of BMI z score of -0.13 ± 0.25 (P = .001) and -0.23 ± 0.32 (P = .01) respectively, whereas weight status category improved to obese in 21% and 25% of the children. Cardiovascular risk parameters including serum total cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), and diastolic blood pressure significantly improved after 1-year intervention in the complete group. Most important, BMI z score as well as cardiovascular risk parameters improved to a similar degree in children with overweight, obesity, and morbid obesity. Children with overweight, obesity, and morbid obesity benefit equally from an ongoing, outpatient, tailored lifestyle intervention, and demonstrate significant weight loss and improvement of cardiovascular risk parameters.

Anaesthetic and Obstetric challenges of morbid obesity in ...

African Journals Online (AJOL)

Anaesthetic and Obstetric challenges of morbid obesity in caesarean ... in morbidly obese parturient that had caesarean delivery in a Nigerian tertiary care centre. ... This mirrors a World Health Organisation report published in the World Health ...

Severe maternal morbidity in Zanzibar's referral hospital: Measuring the impact of in-hospital care.

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Tanneke Herklots

Full Text Available to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital.Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania.We identified all cases of morbidity and mortality in women admitted within 42 days after the end of pregnancy at Mnazi Mmoja Hospital in the period from April to October 2016. The severity of complications was classified using WHO's near-miss approach definitions: potentially life-threatening condition (PLTC, maternal near-miss (MNM or maternal death (MD. Quality of in-hospital care was assessed using the mortality index (MI defined as ratio between mortality and severe maternal outcome (SMO where SMO = MD + MNM, cause-specific case facility rates and comparison with predicted mortality based on the Maternal Severity Index model.5551 women were included. 569 (10.3% had a potentially life-threatening condition and 65 (1.2% a severe maternal outcome (SMO: 37 maternal near-miss cases and 28 maternal deaths. The mortality index was high at 0.43 and similar for women who developed a SMO within 12 hours of admission and women who developed a SMO after 12 hours. A standardized mortality ratio of 6.03 was found; six times higher than that expected in moderate maternal mortality settings given the same severity of cases. Obstetric haemorrhage was found to be the main cause of SMO. Ruptured uterus and admission to ICU had the highest case-fatality rates. Maternal death cases seemed to have received essential interventions less often.WHO's near-miss approach can be used in this setting. The high mortality index observed shows that in-hospital care is not preventing progression of disease adequately once a severe complication occurs. Almost one in two women experiencing life-threatening complications will die. This is six times higher than in moderate mortality settings.

Hidden gauge symmetry

International Nuclear Information System (INIS)

O'Raifeartaigh, L.

1979-01-01

This review describes the principles of hidden gauge symmetry and of its application to the fundamental interactions. The emphasis is on the structure of the theory rather than on the technical details and, in order to emphasise the structure, gauge symmetry and hidden symmetry are first treated as independent phenomena before being combined into a single (hidden gauge symmetric) theory. The main application of the theory is to the weak and electromagnetic interactions of the elementary particles, and although models are used for comparison with experiment and for illustration, emphasis is placed on those features of the application which are model-independent. (author)

Variational Infinite Hidden Conditional Random Fields

NARCIS (Netherlands)

Bousmalis, Konstantinos; Zafeiriou, Stefanos; Morency, Louis-Philippe; Pantic, Maja; Ghahramani, Zoubin

2015-01-01

Hidden conditional random fields (HCRFs) are discriminative latent variable models which have been shown to successfully learn the hidden structure of a given classification problem. An Infinite hidden conditional random field is a hidden conditional random field with a countably infinite number of

Hidden charged dark matter

International Nuclear Information System (INIS)

Feng, Jonathan L.; Kaplinghat, Manoj; Tu, Huitzu; Yu, Hai-Bo

2009-01-01

Can dark matter be stabilized by charge conservation, just as the electron is in the standard model? We examine the possibility that dark matter is hidden, that is, neutral under all standard model gauge interactions, but charged under an exact (\\rm U)(1) gauge symmetry of the hidden sector. Such candidates are predicted in WIMPless models, supersymmetric models in which hidden dark matter has the desired thermal relic density for a wide range of masses. Hidden charged dark matter has many novel properties not shared by neutral dark matter: (1) bound state formation and Sommerfeld-enhanced annihilation after chemical freeze out may reduce its relic density, (2) similar effects greatly enhance dark matter annihilation in protohalos at redshifts of z ∼ 30, (3) Compton scattering off hidden photons delays kinetic decoupling, suppressing small scale structure, and (4) Rutherford scattering makes such dark matter self-interacting and collisional, potentially impacting properties of the Bullet Cluster and the observed morphology of galactic halos. We analyze all of these effects in a WIMPless model in which the hidden sector is a simplified version of the minimal supersymmetric standard model and the dark matter is a hidden sector stau. We find that charged hidden dark matter is viable and consistent with the correct relic density for reasonable model parameters and dark matter masses in the range 1 GeV ∼ X ∼< 10 TeV. At the same time, in the preferred range of parameters, this model predicts cores in the dark matter halos of small galaxies and other halo properties that may be within the reach of future observations. These models therefore provide a viable and well-motivated framework for collisional dark matter with Sommerfeld enhancement, with novel implications for astrophysics and dark matter searches

Social differentiation and embodied dispositions: a qualitative study of maternal care-seeking behaviour for near-miss morbidity in Bolivia

Directory of Open Access Journals (Sweden)

Liljestrand Jerker

2009-07-01

Full Text Available Abstract Background Use of maternal health care in low-income countries has been associated with several socioeconomic and demographic factors, although contextual analyses of the latter have been few. A previous study showed that 75% of women with severe obstetric morbidity (near-miss identified at hospitals in La Paz, Bolivia were in critical conditions upon arrival, underscoring the significance of pre-hospital barriers also in this setting with free and accessible maternal health care. The present study explores how health care-seeking behaviour for near-miss morbidity is conditioned in La Paz, Bolivia. Methods Thematic interviews with 30 women with a near-miss event upon arrival at hospital. Near-miss was defined based on clinical and management criteria. Modified analytic induction was applied in the analysis that was further influenced by theoretical views that care-seeking behaviour is formed by predisposing characteristics, enabling factors, and perceived need, as well as by socially shaped habitual behaviours. Results The self-perception of being fundamentally separated from "others", meaning those who utilise health care, was typical for women who customarily delivered at home and who delayed seeking medical assistance for obstetric emergencies. Other explanations given by these women were distrust of authority, mistreatment by staff, such as not being kept informed about their condition or the course of their treatment, all of which reinforced their dissociation from the health-care system. Conclusion The findings illustrate health care-seeking behaviour as a practise that is substantially conditioned by social differentiation. Social marginalization and the role health institutions play in shaping care-seeking behaviour have been de-emphasised by focusing solely on endogenous cultural factors in Bolivia.

Localization of hidden Chua's attractors

International Nuclear Information System (INIS)

Leonov, G.A.; Kuznetsov, N.V.; Vagaitsev, V.I.

2011-01-01

The classical attractors of Lorenz, Rossler, Chua, Chen, and other widely-known attractors are those excited from unstable equilibria. From computational point of view this allows one to use numerical method, in which after transient process a trajectory, started from a point of unstable manifold in the neighborhood of equilibrium, reaches an attractor and identifies it. However there are attractors of another type: hidden attractors, a basin of attraction of which does not contain neighborhoods of equilibria. In the present Letter for localization of hidden attractors of Chua's circuit it is suggested to use a special analytical-numerical algorithm. -- Highlights: → There are hidden attractors: basin doesn't contain neighborhoods of equilibria. → Hidden attractors cannot be reached by trajectory from neighborhoods of equilibria. → We suggested special procedure for localization of hidden attractors. → We discovered hidden attractor in Chua's system, L. Chua in his work didn't expect this.

Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

Directory of Open Access Journals (Sweden)

Shamsa Zafar

Full Text Available For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective and psychological morbidities in two different low-income countries.Cross sectional study with assessment of morbidity in early pregnancy (34%, late pregnancy (35% and the postnatal period (31% among 3459 women from two rural communities in Pakistan (1727 and Malawi (1732. Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity.One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective. Both infective (Pakistan and non-infective morbidity (Pakistan and Malawi was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon ( 9. Complications during a previous pregnancy, infective morbidity (p <0.001, intra or postpartum haemorrhage (p <0.02 were associated with psychological morbidity in both settings.Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

Science.gov (United States)

Zafar, Shamsa; Jean-Baptiste, Rachel; Rahman, Atif; Neilson, James P; van den Broek, Nynke R

2015-01-01

For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries. Cross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity. One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings. Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

Hidden Liquidity: Determinants and Impact

OpenAIRE

Gökhan Cebiroglu; Ulrich Horst

2012-01-01

We cross-sectionally analyze the presence of aggregated hidden depth and trade volume in the S&P 500 and identify its key determinants. We find that the spread is the main predictor for a stock’s hidden dimension, both in terms of traded and posted liquidity. Our findings moreover suggest that large hidden orders are associated with larger transaction costs, higher price impact and increased volatility. In particular, as large hidden orders fail to attract (latent) liquidity to the market, ...

Health after childbirth: patterns of reported postpartum morbidity from Lebanon.

Science.gov (United States)

Kabakian-Khasholian, Tamar; Shayboub, Rawan; Ataya, Alexandra

2014-03-01

The postpartum period is under-researched in low and middle income countries. The scarce literature reveals heavy burden of ill health experienced in that period and under utilisation of health services. Understanding the postpartum morbidity burden and identifying the care-seeking behaviours is essential to improve service delivery. This paper examines reported postpartum morbidity, care seeking behaviour and whether postpartum morbidity is associated with method of birth. A cross sectional study of women delivering in 18 private hospitals from two regions in Lebanon was undertaken. Women in their second or third trimester of pregnancy, visiting private obstetric clinics affiliated with participating hospitals were interviewed for baseline information. Reported postpartum morbidity was assessed in an interview conducted at women's homes from 40 days up to six months postpartum. Of the 269 women recruited, physical postpartum health problems were reported by 93.6% and psychological health problems by 84.4% of women, with more health problems being reported beyond two months postpartum. Women were less likely to seek professional care for psychological health problems. Reporting postpartum health problems was not associated with method of birth. A heavy burden of postpartum morbidity is experienced by women with gaps in utilisation of relevant health services. Efforts should be directed towards the organisation and delivery of comprehensive maternity care services. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

[Preventable drug-related morbidity: determining valid indicators for primary care in Portugal].

Science.gov (United States)

Guerreiro, Mara Pereira; Cantrill, Judith A; Martins, Ana Paula

2007-01-01

Preventable drug-related morbidity (PDRM) indicators are operational measures of therapeutic risk management. These clinical indicators, which cover a wide range of drugs, combine process and outcome in the same instrument. They were developed in the US and have been validated for primary care settings in the US, UK and Canada. This study is part of a research programme; it aimed to determine a valid set of PDRM indicators for adult patients in primary care in Portugal. Face validity of 61 US and UK-derived indicators translated to Portuguese was preliminarily determined by means of a postal questionnaire using a purposive sample of four Portuguese pharmacists with different backgrounds. Preliminary content validity of indicators approved in the previous stage was determined by cross-checking each definition of PDRM with standard drug information sources in Portugal. Face and content validity of indicators yielded by preliminary work were then established by a 37 expert panel (20 community pharmacists and 17 general practitioners) using a two-round Delphi survey. Data were analysed using SPSS release 11.5. Nineteen indicators were ruled out in preliminary validation. Changes were made in the content of eight of the remaining 42 indicators; these were related to differences in the drugs being marketed and patterns of drug monitoring between countries. Thirty-five indicators were consensus approved as PDRM for adult patients in Portuguese primary care by the Delphi panel.

Impact of morbid obesity on medical expenditures in adults.

Science.gov (United States)

Arterburn, D E; Maciejewski, M L; Tsevat, J

2005-03-01

Morbid obesity (body mass index (BMI) > or =40 kg/m2) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly

The hidden and implicit curricula in cultural context: new insights from Doha and New York.

Science.gov (United States)

Fins, Joseph J; Rodríguez del Pozo, Pablo

2011-03-01

The authors report their longitudinal experience teaching a clerkship in clinical ethics and palliative care at the Weill Cornell Medical College campuses in New York and Doha. This course uses participant observation and reflective practice to counteract the hidden curriculum when learning about clinical ethics and end-of-life care. The authors consider how this formal element of the curriculum is influenced by the implicit and hidden curricula in different cultural contexts and how these differing venues affect communication and information exchange, using the anthropological concept of high- and low-context societies. The authors' analysis provides additional information on Weill Cornell's educational efforts in the medical humanities, bioethics, and palliative care across the curriculum and across cultural settings. By contrasting high-context Doha, where much information is culturally embedded and seemingly hidden, with low-context New York, where information is made overt, the authors theorize that in each setting, the proportion of implicit and explicit curricular elements is determined by the extramural cultural environment. They argue that there are many hidden and implicit curricula and that each is dependent on modes of communication in any given setting. They assert that these variations can be seen not only across differing societies but also, for example, among individual U.S. medical schools because of local custom, history, or mission. Because these contextual factors influence the relative importance of what is implicit and explicit in the student's educational experience, medical educators need to be aware of their local cultural contexts in order to engage in effective pedagogy.

Maternal morbidities affect tens of millions.

Science.gov (United States)

Finger, W R

1994-02-01

Various separate studies indicate maternal morbidity is more common than had been believed. A Safe Motherhood Survey was conducted in 1993 in the Philippines among 9000 women, as part of efforts to study women's language and perceptions about pregnancy and symptoms of morbidity. In El Salvador, interviews were conducted among 2000 women on morbidity issues. Preliminary results from a Family Health International (FHI) five-country survey of 16,000 women revealed that 7 out of every 10 women reported a health problem related to maternity or chronic conditions stemming from pregnancy or childbirth. Conditions ranged from obstructed labor, complications from unsafe abortions, and bacterial infections, to anemia, hemorrhage, and eclampsia. The quality of care determines whether the health problems are life threatening. Less serious morbidity cases involve fatigue or back pain, which is exacerbated by poor nutrition and hard physical labor. Other reproductive morbidities are sexually transmitted diseases, side effects from contraceptives, and general gynecological problems. The FHI results from Ghana, Indonesia, and Egypt showed 240-300 morbidities for every maternal death; maternal mortality worldwide is estimated at 500,000 annually. A study of fistula (an injury during labor to the vagina and bladder that results in urinary or fecal incontinence) found that Nigerian community norms and limited access to emergency health care were factors. The women reported costs, poor roads, and transportation problems. A study in Ethiopia found that, in an Addis Ababa hospital between 1983-88, 600 fistulas were repaired every year, of which almost 66% occurred at first delivery. A study in Cairo in 1988 found that nearly 6 out of every 10 women reported a prolapsed uterus. Women in the studies were able to talk openly and willingly about their problems, when concepts and language were appropriate and interviewers were trained. A small study in India confirmed the correlation between

Hidden Curriculum: An Analytical Definition

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Mohammad Reza Andarvazh

2018-03-01

Full Text Available Background: The concept of hidden curriculum was first used by Philip Jackson in 1968, and Hafferty brought this concept to the medical education. Many of the subjects that medical students learn are attributed to this curriculum. So far several definitions have been presented for the hidden curriculum, which on the one hand made this concept richer, and on the other hand, led to confusion and ambiguity.This paper tries to provide a clear and comprehensive definition of it.Methods: In this study, concept analysis of McKenna method was used. Using keywords and searching in the databases, 561 English and 26 Persian references related to the concept was found, then by limitingthe research scope, 125 abstracts and by finding more relevant references, 55 articles were fully studied.Results: After analyzing the definitions by McKenna method, the hidden curriculum is defined as follows: The hidden curriculum is a hidden, powerful, intrinsic in organizational structure and culture and sometimes contradictory message, conveyed implicitly and tacitly in the learning environment by structural and human factors and its contents includes cultural habits and customs, norms, values, belief systems, attitudes, skills, desires and behavioral and social expectations can have a positive or negative effect, unplanned, neither planners nor teachers, nor learners are aware of it. The ultimate consequence of the hidden curriculum includes reproducing the existing class structure, socialization, and familiarizing learners for transmission and joining the professional world.Conclusion: Based on the concept analysis, we arrived at an analytical definition of the hidden curriculum that could be useful for further studies in this area.Keywords: CONCEPT ANALYSIS, HIDDEN CURRICULUM, MCKENNA’S METHOD

Hidden particle production at the ILC

International Nuclear Information System (INIS)

Fujii, Keisuke; Itoh, Hideo; Okada, Nobuchika; Hano, Hitoshi; Yoshioka, Tamaki

2008-01-01

In a class of new physics models, the new physics sector is completely or partly hidden, namely, a singlet under the standard model (SM) gauge group. Hidden fields included in such new physics models communicate with the standard model sector through higher-dimensional operators. If a cutoff lies in the TeV range, such hidden fields can be produced at future colliders. We consider a scalar field as an example of the hidden fields. Collider phenomenology on this hidden scalar is similar to that of the SM Higgs boson, but there are several features quite different from those of the Higgs boson. We investigate productions of the hidden scalar at the International Linear Collider (ILC) and study the feasibility of its measurements, in particular, how well the ILC distinguishes the scalar from the Higgs boson, through realistic Monte Carlo simulations.

Child Health in the Peruvian Amazon: Prevalence and Factors Associated with Referred Morbidity and Health Care Access in the City of Iñapari

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Maria Gabriela Silva Guimarães

2015-01-01

Full Text Available Introduction. Children under 5 years of age are more susceptible to developing morbidities such as diarrhea, respiratory infections, anemia, and malnutrition. The objective of the study is to evaluate the prevalence of reported morbidities in this age group in the city of Iñapari (Peru and the access to health services in this municipality. Methods. Data collection using interviews that assessed socioeconomic and demographic conditions, child morbidity, and access to health services was performed in 2011. Statistical analysis was performed using SPSS 13.0. Results. Regarding morbidities that occurred during lifetime, 39.8% reported previous anemia and intestinal parasite infection. About 53.7% of the children reported any type of morbidities in the last 15 days before interview, being most frequent respiratory symptoms (38.9%, diarrhea (23,4%, and fever (23,1%. Only 63.1% of those reporting recent morbidities sought health care. These morbidities were associated with precarious sanitation and lack of infrastructure, the presence of other comorbidities, and poor access to health services. Conclusion. The main referred morbidities in Amazonian Peruvian children were diarrhea, respiratory symptoms, anemia, and vomiting. Incentives and improvements in the health and sanitation conditions would be important measures to improve the quality of life of the Amazonian child population.

Probing hidden sector photons through the Higgs window

International Nuclear Information System (INIS)

Ahlers, M.

2008-07-01

We investigate the possibility that a (light) hidden sector extra photon receives its mass via spontaneous symmetry breaking of a hidden sector Higgs boson, the so-called hidden-Higgs. The hidden-photon can mix with the ordinary photon via a gauge kinetic mixing term. The hidden-Higgs can couple to the Standard Model Higgs via a renormalizable quartic term - sometimes called the Higgs Portal. We discuss the implications of this light hidden-Higgs in the context of laser polarization and light-shining-through-the-wall experiments as well as cosmological, astrophysical, and non-Newtonian force measurements. For hidden-photons receiving their mass from a hidden-Higgs we find in the small mass regime significantly stronger bounds than the bounds on massive hidden sector photons alone. (orig.)

Probing hidden sector photons through the Higgs window

International Nuclear Information System (INIS)

Ahlers, Markus; Jaeckel, Joerg; Redondo, Javier; Ringwald, Andreas

2008-01-01

We investigate the possibility that a (light) hidden sector extra photon receives its mass via spontaneous symmetry breaking of a hidden sector Higgs boson, the so-called hidden-Higgs. The hidden-photon can mix with the ordinary photon via a gauge kinetic mixing term. The hidden-Higgs can couple to the standard model Higgs via a renormalizable quartic term - sometimes called the Higgs portal. We discuss the implications of this light hidden-Higgs in the context of laser polarization and light-shining-through-the-wall experiments as well as cosmological, astrophysical, and non-Newtonian force measurements. For hidden-photons receiving their mass from a hidden-Higgs, we find in the small mass regime significantly stronger bounds than the bounds on massive hidden sector photons alone.

Insight: Exploring Hidden Roles in Collaborative Play

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Tricia Shi

2015-06-01

Full Text Available This paper looks into interaction modes between players in co-located, collaborative games. In particular, hidden traitor games, in which one or more players is secretly working against the group mission, has the effect of increasing paranoia and distrust between players, so this paper looks into the opposite of a hidden traitor – a hidden benefactor. Rather than sabotaging the group mission, the hidden benefactor would help the group achieve the end goal while still having a reason to stay hidden. The paper explores what games with such a role can look like and how the role changes player interactions. Finally, the paper addresses the divide between video game and board game interaction modes; hidden roles are not common within video games, but they are of growing prevalence in board games. This fact, combined with the exploration of hidden benefactors, reveals that hidden roles is a mechanic that video games should develop into in order to match board games’ complexity of player interaction modes.

Hidden attractors in dynamical systems

Science.gov (United States)

Dudkowski, Dawid; Jafari, Sajad; Kapitaniak, Tomasz; Kuznetsov, Nikolay V.; Leonov, Gennady A.; Prasad, Awadhesh

2016-06-01

Complex dynamical systems, ranging from the climate, ecosystems to financial markets and engineering applications typically have many coexisting attractors. This property of the system is called multistability. The final state, i.e., the attractor on which the multistable system evolves strongly depends on the initial conditions. Additionally, such systems are very sensitive towards noise and system parameters so a sudden shift to a contrasting regime may occur. To understand the dynamics of these systems one has to identify all possible attractors and their basins of attraction. Recently, it has been shown that multistability is connected with the occurrence of unpredictable attractors which have been called hidden attractors. The basins of attraction of the hidden attractors do not touch unstable fixed points (if exists) and are located far away from such points. Numerical localization of the hidden attractors is not straightforward since there are no transient processes leading to them from the neighborhoods of unstable fixed points and one has to use the special analytical-numerical procedures. From the viewpoint of applications, the identification of hidden attractors is the major issue. The knowledge about the emergence and properties of hidden attractors can increase the likelihood that the system will remain on the most desirable attractor and reduce the risk of the sudden jump to undesired behavior. We review the most representative examples of hidden attractors, discuss their theoretical properties and experimental observations. We also describe numerical methods which allow identification of the hidden attractors.

Partially Hidden Markov Models

DEFF Research Database (Denmark)

Forchhammer, Søren Otto; Rissanen, Jorma

1996-01-01

Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression where...

Using a composite morbidity score and cultural survey to explore characteristics of high proficiency neonatal intensive care units.

Science.gov (United States)

Kaempf, Joseph W; Wang, Lian; Dunn, Michael

2018-01-03

Continuous quality improvement (CQI) collaboration has not eliminated the morbidity variability seen among neonatal intensive care units (NICUs). Factors other than inconstant application of potentially better practices (PBPs) might explain divergent proficiency. Measure a composite morbidity score and determine whether cultural, environmental and cognitive factors distinguish high proficiency from lower proficiency NICUs. Retrospective analysis using a risk-adjusted composite morbidity score (Benefit Metric) and cultural survey focusing on very low birth weight (VLBW) infants from 39 NICUs, years 2000-2014. The Benefit Metric and yearly variance from the group mean was rank-ordered by NICU. A comprehensive survey was completed by each NICU exploring whether morbidity variance correlated with CQI methodology, cultural, environmental and/or cognitive characteristics. 58 272 VLBW infants were included, mean (SD) age 28.2 (3.0) weeks, birth weight 1031 (301) g. The 39 NICU groups' Benefit Metric improved 40%, from 80 in 2000 to 112 in 2014 (Pexpectations of providers, enhanced learning opportunities, knowledge of CQI fundamentals and more generous staffing. Cultural, environmental and cognitive characteristics vary among NICUs perhaps more than traditional CQI methodology and PBPs, possibly explaining the inconstancy of VLBW infant morbidity reduction efforts. High proficiency NICUs foster spirited team work and camaraderie, sustained learning opportunities and support of favourable staffing that allows problem solving and widespread involvement in CQI activities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hidden photons in connection to dark matter

Energy Technology Data Exchange (ETDEWEB)

Andreas, Sarah; Ringwald, Andreas [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Goodsell, Mark D. [CPhT, Ecole Polytechnique, Palaiseau (France)

2013-06-15

Light extra U(1) gauge bosons, so called hidden photons, which reside in a hidden sector have attracted much attention since they are a well motivated feature of many scenarios beyond the Standard Model and furthermore could mediate the interaction with hidden sector dark matter.We review limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay. In addition, we study the possibility of having dark matter in the hidden sector. A simple toy model and different supersymmetric realisations are shown to provide viable dark matter candidates in the hidden sector that are in agreement with recent direct detection limits.

Hidden photons in connection to dark matter

International Nuclear Information System (INIS)

Andreas, Sarah; Ringwald, Andreas; Goodsell, Mark D.

2013-06-01

Light extra U(1) gauge bosons, so called hidden photons, which reside in a hidden sector have attracted much attention since they are a well motivated feature of many scenarios beyond the Standard Model and furthermore could mediate the interaction with hidden sector dark matter.We review limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay. In addition, we study the possibility of having dark matter in the hidden sector. A simple toy model and different supersymmetric realisations are shown to provide viable dark matter candidates in the hidden sector that are in agreement with recent direct detection limits.

POVMs and hidden variables

International Nuclear Information System (INIS)

Stairs, Allen

2007-01-01

Recent results by Paul Busch and Adan Cabello claim to show that by appealing to POVMs, non-contextual hidden variables can be ruled out in two dimensions. While the results of Busch and Cabello are mathematically correct, interpretive problems render them problematic as no hidden variable proofs

POSTPARTUM PHYSICAL MORBIDITIES AMONG POSTNATAL MOTHERS IN A TERTIARY CARE CENTRE

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Deepa Mohandas

2017-02-01

Full Text Available BACKGROUND Puerperium refers to the six-week period following childbirth. This is a dynamic period when the physiological changes that occur during pregnancy resolve and the body system return to their pre-pregnant state. Many of the complications leading to postpartum maternal morbidity arise during labour and delivery and in the first 1-2 weeks following delivery. The complication during immediate postpartum periods is managed in hospital itself. But, there is a risk of persisting these complications and from the postnatal checkup, the magnitude of the postpartum morbidity of these women are assessed. The aim of the study is to assess the postpartum physical morbidities among postnatal mothers and determine the association of those with selected variables. MATERIALS AND METHODS This is a descriptive study. Sample in this study consists of 406 consecutive cases of postnatal mothers after 6 weeks of postpartum period who are visiting Family Planning Outpatient Department of Sree Avittom Thirunal Hospital, Thiruvananthapuram, for postnatal checkup. Each woman was assessed by using interview schedule. The findings were presented under the following headings. Sociodemographic data, postpartum morbidities and association between selected variable and postpartum morbidities. Study Setting and Design- The design adopted is descriptive research design. 406 postnatal mothers attending the Family Planning Outpatient Department of Sree Avittom Thirunal Hospital, Thiruvananthapuram, for postnatal checkup after 6 weeks postpartum are allocated. Each woman was assessed by interview schedule. The physical postpartum morbidities among postnatal women were assessed. RESULTS Data was analysed using SPSS software using descriptive and inferential statistics based on the objective using frequency and Chi-square test. CONCLUSION In the present study, 57.6% of women had morbidities of which 29.3% had postpartum anaemia, 45.5% had backache, 15% had perineal pain, 16

Geographic Variation in Morbidity and Mortality of Cerebrovascular Diseases in Korea during 2011-2015.

Science.gov (United States)

Lee, Juyeon; Bahk, Jinwook; Kim, Ikhan; Kim, Yeon-Yong; Yun, Sung-Cheol; Kang, Hee-Yeon; Lee, Jeehye; Park, Jong Heon; Shin, Soon-Ae; Khang, Young-Ho

2018-03-01

Little is known about within-country variation in morbidity and mortality of cerebrovascular diseases (CVDs). Geographic differences in CVD morbidity and mortality have yet to be properly examined. This study examined geographic variation in morbidity and mortality of CVD, neighborhood factors for CVD morbidity and mortality, and the association between CVD morbidity and mortality across the 245 local districts in Korea during 2011-2015. District-level health care utilization and mortality data were obtained to estimate age-standardized CVD morbidity and mortality. The bivariate Pearson correlation was used to examine the linear relationship between district-level CVD morbidity and mortality Z-scores. Simple linear regression and multivariate analyses were conducted to investigate the associations of area characteristics with CVD morbidity, mortality, and discrepancies between morbidity and mortality. Substantial variation was found in CVD morbidity and mortality across the country, with 1074.9 excess CVD inpatients and 73.8 excess CVD deaths per 100,000 between the districts with the lowest and highest CVD morbidity and mortality, respectively. Higher rates of CVD admissions and deaths were clustered in the noncapital regions. A moderate geographic correlation between CVD morbidity and mortality was found (Pearson correlation coefficient = .62 for both genders). Neighborhood level indicators for socioeconomic disadvantages, undersupply of health care resources, and unhealthy behaviors were positively associated with CVD morbidity and mortality and the relative standing of CVD mortality vis-à-vis morbidity. Policy actions targeting life-course socioeconomic conditions, equitable distribution of health care resources, and behavioral risk factors may help reduce geographic differences in CVD morbidity and mortality in Korea. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern, Nigeria

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Gabriel Uche Pascal Iloh

2013-01-01

Full Text Available Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI criterion. 206 patients who had BMI ΃30kg/m 2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5% was the most common pattern; others included grade II obesity (23.3% and grade III obesity (9.2%. Hypertension (42.7% was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%, diabetes mellitus (15.1%, high triglyceride (12.6%, high total cholesterol (9.2%, and high LDL-cholesterol (6.8%. Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.

Severe maternal morbidity for 2004-2005 in the three Dublin maternity hospitals.

LENUS (Irish Health Repository)

Murphy, Cliona M

2012-02-01

OBJECTIVE: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. STUDY DESIGN: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. RESULTS: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. CONCLUSION: The prevalence of severe maternal morbidity in this population is 3.2\\/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

Helioscope bounds on hidden sector photons

International Nuclear Information System (INIS)

Redondo, J.

2008-01-01

The flux of hypothetical ''hidden photons'' from the Sun is computed under the assumption that they interact with normal matter only through kinetic mixing with the ordinary standard model photon. Requiring that the exotic luminosity is smaller than the standard photon luminosity provides limits for the mixing parameter down to χ -14 , depending on the hidden photon mass. Furthermore, it is pointed point out that helioscopes looking for solar axions are also sensitive to hidden photons. The recent results of the CAST collaboration are used to further constrain the mixing parameter χ at low masses (m γ' <1 eV) where the luminosity bound is weaker. In this regime the solar hidden photon ux has a sizable contribution of longitudinally polarized hidden photons of low energy which are invisible for current helioscopes. (orig.)

Child Morbidity and Mortality in Slum Environments along Nairobi ...

African Journals Online (AJOL)

The problem that guided this study was that child mortality and morbidity disparities continue to be observed in the era of improved expansion of the provision of health care services. Some areas have low mortality and morbidity while others such as the slums of Nairobi have high. Various factors may account for this ...

Managing Hidden Costs of Offshoring

DEFF Research Database (Denmark)

Larsen, Marcus M.; Pedersen, Torben

2014-01-01

This chapter investigates the concept of the ‘hidden costs’ of offshoring, i.e. unexpected offshoring costs exceeding the initially expected costs. Due to the highly undefined nature of these costs, we position our analysis towards the strategic responses of firms’ realisation of hidden costs....... In this regard, we argue that a major response to the hidden costs of offshoring is the identification and utilisation of strategic mechanisms in the organisational design to eventually achieving system integration in a globally dispersed and disaggregated organisation. This is heavily moderated by a learning......-by-doing process, where hidden costs motivate firms and their employees to search for new and better knowledge on how to successfully manage the organisation. We illustrate this thesis based on the case of the LEGO Group....

The Hidden Costs of Offshoring

DEFF Research Database (Denmark)

Møller Larsen, Marcus; Manning, Stephan; Pedersen, Torben

2011-01-01

of offshoring. Specifically, we propose that hidden costs can be explained by the combination of increasing structural, operational and social complexity of offshoring activities. In addition, we suggest that firm orientation towards organizational design as part of an offshoring strategy and offshoring......This study seeks to explain hidden costs of offshoring, i.e. unexpected costs resulting from the relocation of business tasks and activities outside the home country. We develop a model that highlights the role of complexity, design orientation and experience in explaining hidden costs...... experience moderate the relationship between complexity and hidden costs negatively i.e. reduces the cost generating impact of complexity. We develop three hypotheses and test them on comprehensive data from the Offshoring Research Network (ORN). In general, we find support for our hypotheses. A key result...

Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009

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Alioum Ahmadou

2011-06-01

Full Text Available Abstract Background Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children. Methods All HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation. Results 405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8 at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71 versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1 at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42. Conclusions Having benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.

Morbidity figures from general practice: sex differences in traumatology.

Science.gov (United States)

Lagro-Janssen, Toine; Grosicar, Janja

2010-08-01

Trauma prevention starts with to find out the extent of the problem and who it affects. Insight into morbidity figures is therefore necessary. To explore sex differences in traumatology and secondary medical care utilization in primary care related to age and socio-economic status (SES). Data were obtained from an academic continuous morbidity registration project in the Netherlands in the period from 1996 to 2006, in which 13,000 patients were followed in 10 successive years. Sex differences showed a male excess from childhood to 45 years and women showing almost double trauma rates in the elderly. Low SES was associated with the greatest incidence of traumas. The largest sex difference in incidence above 65 years appeared in the high SES with more traumas in women compared with men. From this age on, female morbidity in traumatology outnumbered male morbidity regardless of SES. Considering use of referrals, we found that in the age group 15-45 years men made a greater use of secondary medical care. However, the vastest gender influence in medical care utilization was noticed in the age group over 65 years, outnumbered with women. Young men and old women are the most at risk for traumatic health problems: men presenting with traumata of the skull, the tibia and ocular trauma's and women with fractures of the femur, humerus and wrist. For both men and women the greatest incidence is in the low SES. Family physicians can play a pivotal role in prevention to focus on their patients with high risks.

Hidden hunger in South Asia: a review of recent trends and persistent challenges.

Science.gov (United States)

Harding, Kassandra L; Aguayo, Víctor M; Webb, Patrick

2018-03-01

'Hidden hunger' is a term used to describe human deficiencies of key vitamins and minerals, also known as micronutrients. While global in scale, the prevalence of micronutrient deficiencies is particularly high in South Asia despite recent successes in economic growth, agricultural output and health care. The present paper reviews the most recent evidence on patterns and trends of hidden hunger across the region, with a focus on the most significant deficiencies - iodine, Fe, vitamin A and Zn - and interprets these in terms of health and economic consequences. The challenge for South Asian policy makers is to invest in actions that can cost-effectively resolve chronic nutrient gaps facing millions of households. Appropriate solutions are available today, so governments should build on evidence-based successes that combine targeted health system delivery of quality services with carefully designed multisector actions that help promote healthier diets, reduce poverty and ensure social protection simultaneously.

The perception of the hidden curriculum on medical education: an exploratory study

Directory of Open Access Journals (Sweden)

Murakami Manabu

2009-12-01

Full Text Available Abstract Background Major curriculum reform of undergraduate medical education occurred during the past decades in the United Kingdom (UK; however, the effects of the hidden curriculum, which influence the choice of primary care as a career, have not been sufficiently recognized. While Japan, where traditionally few institutions systematically foster primary care physicians and very few have truly embraced family medicine as their guiding discipline, has also experienced meaningful curriculum reform, the effect of the hidden curriculum is not well known. The aim of this study is to identify themes pertaining to the students' perceptions of the hidden curriculum affecting undergraduate medical education in bedside learning in Japan. Methods Semi-structured interviews with thematic content analysis were implemented. Undergraduate year-5 students from a Japanese medical school at a Japanese teaching hospital were recruited. Interview were planned to last between 30 to 60 minutes each, over an 8-month period in 2007. The interviewees' perceptions concerning the quality of teaching in their bedside learning and related experiences were collected and analysed thematically. Results Twenty five medical students (18 males and 7 females, mean age 25 years old consented to participate in the interviews, and seven main themes emerged: "the perception of education as having a low priority," "the prevalence of positive/negative role models," "the persistence of hierarchy and exclusivity," "the existence of gender issues," "an overburdened medical knowledge," "human relationships with colleagues and medical team members," and "first experience from the practical wards and their patients." Conclusions Both similarities and differences were found when comparing the results to those of previous studies in the UK. Some effects of the hidden curriculum in medical education likely exist in common between the UK and Japan, despite the differences in their demographic

Severe acute maternal morbidity and maternal death audit - a rapid ...

African Journals Online (AJOL)

Severe acute maternal morbidity and maternal death audit - a rapid diagnostic tool for evaluating maternal care. L Cochet, R.C. Pattinson, A.P. Macdonald. Abstract. Objective. To analyse severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria region over a 2-year period (2000 - 2001). Setting.

Post-Traumatic Stress Disorder and severe maternal morbidity: is there an association?

Science.gov (United States)

Angelini, Carina R; Pacagnella, Rodolfo C; Parpinelli, Mary A; Silveira, Carla; Andreucci, Carla B; Ferreira, Elton C; Santos, Juliana P; Zanardi, Dulce M; Souza, Renato T; Cecatti, Jose G

2018-01-01

To evaluate the occurrence of Post-Traumatic Stress Disorder among women experiencing a severe maternal morbidity event and associated factors in comparison with those without maternal morbidity. In a retrospective cohort study, 803 women with or without severe maternal morbidity were evaluated at 6 months to 5 years postpartum for the presence of Post-Traumatic Stress Disorder. Interviews were conducted by telephone and electronic data was stored. Data analysis was carried out by using χ2, Fisher's Exact test, and logistic regression analysis. There was no significant change in the prevalence of Post-Traumatic Stress Disorder related to a previous severe maternal morbidity experience. There were also no differences in diagnostic criteria for severe maternal morbidity (hypertensive syndromes, hemorrhage, surgical intervention or intensive care unit admission required, among other management criteria). Low parity (2.5-fold risk) and increasing age were factors associated with Post-Traumatic Stress Disorder. A severe maternal morbidity episode is not associated with Post-Traumatic Stress Disorder symptoms within five years of the severe maternal morbidity event and birth. However, a more advanced maternal age and primiparity increased the risk of Post-Traumatic Stress Disorder. This does not imply that women who had experienced a severe maternal morbidity event did not suffer or need differentiated care.

Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons

Directory of Open Access Journals (Sweden)

McKinnon IG

2016-09-01

Full Text Available Iain G McKinnon,1,2 Stuart DM Thomas,3–5 Heather L Noga,6 Jane Senior7 1Institute of Health and Society, Newcastle University, Academic Psychiatry, Campus for Ageing and Vitality, 2Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK; 3School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, 4Legal Intersections Research Centre, University of Wollongong, Wollongong, NSW, 5Southern Clinical School, Monash University, Clayton, VIC, Australia; 6School of Criminology, Simon Fraser University, Burnaby, BC, Canada; 7Offender Health Research Network, University of Manchester, Manchester, UK Abstract: This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention. Studies on health care in police custody identified for this review are limited to a few geographical jurisdictions, including the UK, continental Europe, North America, and Australia. There are significant health concerns among police detainees including acute injury, chronic physical health problems, mental and cognitive disorders, and the risks associated with drug and alcohol intoxication or withdrawal. There is some evidence that deaths in police custody have reduced where attention has been paid to the latter issue. Police personnel continue to experience difficulties identifying detainees with health issues relevant to their safe detention, but research shows that the use of evidence-based screening tools improves detection of such morbidities. Innovations in police custody health care mainly relate to detainees with mental disorders, including improved identification of illness

Associations between vascular co-morbidities and depression in insulin-naive diabetes patients

DEFF Research Database (Denmark)

Koopmans, B; Pouwer, F; de Bie, Rob A

2009-01-01

AIMS/HYPOTHESIS: The aim of the study was to determine the prevalence of depression in insulin-naive diabetes patients and to investigate the associations between different forms of vascular co-morbidity and depression. METHODS: Cross-sectional data were used from a primary-care sample of 1......,269 insulin-naive (i.e. not using insulin therapy) diabetes patients participating in the DIAZOB Primary Care Diabetes study. Demographics, vascular co-morbidities, clinical and lifestyle characteristics, and psychosocial factors were assessed. Depression symptoms were measured with the Edinburgh Depression.......2% vs 10.0%). Single vascular co-morbidities were not associated with increased rates of depression. The final model predicting depression included: having multiple vascular co-morbidities compared with none; having less social support; having experienced a recent stressful life event; female sex...

The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care

DEFF Research Database (Denmark)

Krag, Marlene Øhrberg; Hasselbalch, Lotte; Siersma, Volkert Dirk

2016-01-01

Aims/hypothesis: The aim of this study was to assess gender differences in mortality and morbidity during 13 follow-up years after 6 years of structured personal care in patients with type 2 diabetes mellitus. Methods: In the Diabetes Care in General Practice (DCGP) multicentre, cluster......-randomised, controlled trial (ClinicalTrials.gov registration no. NCT01074762), 1,381 patients newly diagnosed with type 2 diabetes were randomised to receive 6 years of either structured personal care or routine care. The intervention included regular follow-up, individualised goal setting and continuing medical...... = 0.005). Conclusions/interpretation: Compared with routine care, structured personal diabetes care reduced all-cause mortality and diabetes-related death in women but not in men. This gender difference was also observed for any diabetes-related outcome and stroke but was not statistically significant...

Morbidity pattern and its sociodemographic determinants among elderly population of Raichur district, Karnataka, India

Directory of Open Access Journals (Sweden)

Leyanna Susan George

2017-01-01

Full Text Available Context: India is an “aging nation” with 7.7% of its population being above 60 years of age. It has resulted in a rise of both physical and mental health morbidities. Aims: This study aimed to gather information regarding the morbidity pattern and its sociodemographic determinants among the elderly residing in the rural villages of Raichur, to understand the need for geriatric health-care facilities. Settings and Design: This community-based cross-sectional study was carried out in six rural villages of Raichur District, of which 230 elderly were selected randomly. Subjects and Methods: The data were collected using a questionnaire, clinical history, examination, and cross-checking of medical records. Statistical Analysis Used: Data were analyzed using Epi Info version-3.5.3. Results: The prevalence of morbidity was 91.7% with an average of 3/person. Females (58.9% had more morbidities than men (41.1%. The 3 most common morbidities were orthopedic (50.5%, cataract (50.4%, and respiratory (31.3%. 26.6% suffered from gastrointestinal morbidities while 23.9% had dental problems. 20.9% had hypertension with equal prevalence among both sexes. Only 17.4% were diabetics with majority being women. Central nervous system morbidities were 14.2% while 9.6% suffered from hearing loss and varicose veins. 8.2% had genitourinary-urinary morbidities and incontinence (1.7% was common among both sexes. Depression (71.1% and dermatological morbidities (4.7% were prevalent among women. Only 3.5% suffered from cardiac morbidity and 0.4% from cancer. Significant association was found between age and morbidity and also between socioeconomic class and morbidity pattern. Conclusions: Geriatric care should become an integral part of primary health care. Regular screening and Information, Education, and Communication activities need to be provided early in life for ensuring healthy aging.

Decreased chronic morbidity but elevated HIV associated cytokine levels in HIV-infected older adults receiving HIV treatment: benefit of enhanced access to care?

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Portia C Mutevedzi

Full Text Available The association of HIV with chronic morbidity and inflammatory markers (cytokines in older adults (50+years is potentially relevant for clinical care, but data from African populations is scarce.To examine levels of chronic morbidity by HIV and ART status in older adults (50+years and subsequent associations with selected pro-inflammatory cytokines and body mass index.Ordinary, ordered and generalized ordered logistic regression techniques were employed to compare chronic morbidity (heart disease (angina, arthritis, stroke, hypertension, asthma and diabetes and cytokines (Interleukins-1 and -6, C-Reactive Protein and Tumor Necrosis Factor-alpha by HIV and ART status on a cross-sectional random sample of 422 older adults nested within a defined rural South African population based demographic surveillance.Using a composite measure of all morbidities, controlling for age, gender, BMI, smoking and wealth quintile, HIV-infected individuals on ART had 51% decreased odds (95% CI:0.26-0.92 of current morbidity compared to HIV-uninfected. In adjusted regression, compared to HIV-uninfected, the proportional odds (aPOR of having elevated inflammation markers of IL6 (>1.56 pg/mL was nearly doubled in HIV-infected individuals on (aPOR 1.84; 95%CI: 1.05-3.21 and not on (aPOR 1.94; 95%CI: 1.11-3.41 ART. Compared to HIV-uninfected, HIV-infected individuals on ART had >twice partial proportional odds (apPOR=2.30;p=0.004 of having non-clinically significant raised hsCRP levels(>1 ug/mL; ART-naïve HIV-infected individuals had >double apPOR of having hsCRP levels indicative of increased heart disease risk(>3.9 ug/mL;p=0.008.Although HIV status was associated with increased inflammatory markers, our results highlight reduced morbidity in those receiving ART and underscore the need of pro-actively extending these services to HIV-uninfected older adults, beyond mere provision at fixed clinics. Providing health services through regular community chronic disease

Hidden Risk Factors for Women

Science.gov (United States)

... A.S.T. Quiz Hidden Stroke Risk Factors for Women Updated:Nov 22,2016 Excerpted from "What Women Need To Know About The Hidden Risk Factors ... 2012) This year, more than 100,000 U.S. women under 65 will have a stroke. Stroke is ...

Hidden-Sector Dynamics and the Supersymmetric Seesaw

CERN Document Server

Campbell, Bruce A; Maybury, David W

2008-01-01

In light of recent analyses that have shown that nontrivial hidden-sector dynamics in models of supersymmetry breaking can lead to a significant impact on the predicted low-energy supersymmetric spectrum, we extend these studies to consider hidden-sector effects in extensions of the MSSM to include a seesaw model for neutrino masses. A dynamical hidden sector in an interval of mass scales below the seesaw scale would yield renormalization-group running involving both the anomalous dimension from the hidden sector and the seesaw-extended MSSM renormalization group equations (RGEs). These effects interfere in general, altering the generational mixing of the sleptons, and allowing for a substantial change to the expected level of charged-lepton flavour violation in seesaw-extended MSSM models. These results provide further support for recent theoretical observations that knowledge of the hidden sector is required in order to make concrete low-energy predictions, if the hidden sector is strongly coupled. In parti...

Diabetic mothers and their newborn infants - rooming-in and neonatal morbidity

DEFF Research Database (Denmark)

Stage, E; Mathiesen, E R; Emmersen, P B

2010-01-01

As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity....

Mindfulness and eating behaviour styles in morbidly obese males and females

NARCIS (Netherlands)

Ouwens, M.A.; Schiffer, A.A.J.; Visser, L.I.; Raaijmakers, L.J.C.; Nyklicek, I.

2015-01-01

Background: Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions

Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

Science.gov (United States)

Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

2015-10-28

Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index.

Directory of Open Access Journals (Sweden)

Julie C Ruel-Bergeron

Full Text Available Deficiencies in essential vitamins and minerals-also termed hidden hunger-are pervasive and hold negative consequences for the cognitive and physical development of children.This analysis evaluates the change in hidden hunger over time in the form of one composite indicator-the Hidden Hunger Index (HHI-using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency. Net changes from 1995-2011 and population weighted regional means for various time periods are measured.Globally, hidden hunger improved (-6.7 net change in HHI from 1995-2011. Africa was the only region to see a deterioration in hidden hunger (+1.9 over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0, while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased.This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs. However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda.Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish.

Hidden variables and locality in quantum theory

International Nuclear Information System (INIS)

Shiva, Vandana.

1978-12-01

The status of hidden variables in quantum theory has been debated since the 1920s. The author examines the no-hidden-variable theories of von Neumann, Kochen, Specker and Bell, and finds that they all share one basic assumption: averaging over the hidden variables should reproduce the quantum mechanical probabilities. Von Neumann also makes a linearity assumption, Kochen and Specker require the preservation of certain functional relations between magnitudes, and Bell proposes a locality condition. It has been assumed that the extrastatistical requirements are needed to serve as criteria of success for the introduction of hidden variables because the statistical condition is trivially satisfied, and that Bell's result is based on a locality condition that is physically motivated. The author shows that the requirement of weak locality, which is not physically motivated, is enough to give Bell's result. The proof of Bell's inequality works equally well for any pair of commuting magnitudes satisfying a condition called the degeneracy principle. None of the no-hidden-variable proofs apply to a class of hidden variable theories that are not phase-space reconstructions of quantum mechanics. The author discusses one of these theories, the Bohm-Bub theory, and finds that hidden variable theories that re all the quantum statistics, for single and sequential measurements, must introduce a randomization process for the hidden variables after each measurement. The philosophical significance of this theory lies in the role it can play in solving the conceptual puzzles posed by quantum theory

Severe maternal morbidity: A population-based study of an expanded measure and associated factors.

Directory of Open Access Journals (Sweden)

Victoria Lazariu

Full Text Available Severe maternal morbidity conditions such as sepsis, embolism and cardiac arrest during the delivery hospitalization period can lead to extended length of hospital stays, life-long maternal health problems, and high medical costs. Most importantly, these conditions also contribute to the risk of maternal death. This population-based observational study proposed and evaluated the impact of expanding the Centers for Disease Control and Prevention (CDC measure of severe maternal morbidity by including additional comorbidities and intensive care admissions during delivery hospitalizations and examined associated factors. A New York State linked hospitalization and birth record database was used. Study participants included all New York State female residents, ages 10 to 55 years, who delivered a live infant in a New York acute care hospital between 2008 and 2013, inclusive. Incidence trends for both severe maternal morbidity measures were evaluated longitudinally. Associations between covariates and the two severe maternal morbidity measures were examined with logistic regression models, solved using generalized estimating equations and stratified by method of delivery. The New York expanded severe maternal morbidity measure identified 34,478 cases among 1,352,600 hospital deliveries (estimated incidence 2.55% representing a 3% increase in the number of cases compared to the CDC measure. Both estimates increased over the study period (p 1.5 included most measured comorbidities (e.g., pregnancy-induced hypertension, placentation disorder, multiple births, preterm birth, no prenatal care, hospitalization prior to delivery, higher levels of perinatal care birthing facilities and race/ethnicity. Expanding the measure for severe maternal morbidity during delivery to capture intensive care admissions provides a more sensitive estimate of disease burden. Perinatal regionalization in New York appears effective in routing high risk pregnancies to higher

Hidden care: Revelations of a case-note audit of physical health care in a community mental health service.

Science.gov (United States)

Lawn, Sharon; Zabeen, Sara; Rowlands, Nikki; Picot, Sharon

2018-05-24

People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day-to-day practice. This study involved an audit of hardcopy and electronic clinical case-notes of a random sample of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow-up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One-way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case-note records; however, because this information was 'buried' within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under-reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers. © 2018 Australian College of Mental Health Nurses Inc.

… To be hidden does not mean to be merely revealed – Part 1 Artistic research on hidden curriculum

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Annette Krause

2015-09-01

Full Text Available This text revisits the long-term project Hidden Curriculum, initiated by Annette Krauss. The project addresses unquestioned routines, hierarchies of knowledge (part 1, and the role of the body in learning processes (part 2 from the perspective of secondary/high school education (in the research on a hidden curriculum. A deeper analysis of educational studies on the phenomenon of ‘hidden curriculum’ in relation to the feminist and critical pedagogies of bell hooks, Paulo Freire, and Jacques Rancière brings forward important insights generated through the artistic research within hidden curriculum. The aim of this text is to address academic canons, corporeality, and investigate everyday norms through revisiting the framework, results, and processes of the collaborative research into hidden curriculum with secondary high school students.

Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index

Science.gov (United States)

Stevens, Gretchen A.; Ezzati, Majid; Black, Robert E.; Kraemer, Klaus

2015-01-01

Background Deficiencies in essential vitamins and minerals–also termed hidden hunger–are pervasive and hold negative consequences for the cognitive and physical development of children. Methods This analysis evaluates the change in hidden hunger over time in the form of one composite indicator–the Hidden Hunger Index (HHI)–using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency). Net changes from 1995–2011 and population weighted regional means for various time periods are measured. Findings Globally, hidden hunger improved (-6.7 net change in HHI) from 1995–2011. Africa was the only region to see a deterioration in hidden hunger (+1.9) over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0), while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased. Interpretation This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs). However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda. Funding Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish. PMID:26673631

Estimating Benzathine Penicillin Need for the Treatment of Pregnant Women Diagnosed with Syphilis during Antenatal Care in High-Morbidity Countries

Science.gov (United States)

Taylor, Melanie M.; Nurse-Findlay, Stephen; Zhang, Xiulei; Hedman, Lisa; Kamb, Mary L.; Broutet, Nathalie; Kiarie, James

2016-01-01

Background Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis. Methods Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis. Results Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women requiring treatment with at least one injection of 2.4 MU of benzathine penicillin in these 30 countries to be 351,016. Syphilis screening coverage at or above 95% for all 30 countries would increase the number of women requiring treatment with benzathine penicillin to 712,030. Based on WHO management guidelines, 351,016 doses of weight-based benzathine penicillin would also be needed for the live-born infants of mothers who test positive and are treated for syphilis in pregnancy. Assuming availability of penicillin and provision of treatment for all mothers diagnosed with syphilis, an estimated 95,938 adverse birth outcomes overall would be prevented including 37,822 stillbirths, 15,814 neonatal deaths, and 34,088 other congenital syphilis cases. Conclusion Penicillin need for maternal and infant syphilis treatment is high among this group of syphilis burdened countries. Initiatives to ensure a stable and adequate supply of benzathine penicillin for treatment

Compressing the hidden variable space of a qubit

OpenAIRE

Montina, Alberto

2010-01-01

In previously exhibited hidden variable models of quantum state preparation and measurement, the number of continuous hidden variables describing the actual state of a single realization is never smaller than the quantum state manifold dimension. We introduce a simple model for a qubit whose hidden variable space is one-dimensional, i.e., smaller than the two-dimensional Bloch sphere. The hidden variable probability distributions associated with the quantum states satisfy reasonable criteria ...

Search for Hidden Particles

CERN Multimedia

Solovev, V

The SHiP Experiment is a new general-purpose fixed target facility at the SPS to search for hidden particles as predicted by a very large number of recently elaborated models of Hidden Sectors which are capable of accommodating dark matter, neutrino oscillations, and the origin of the full baryon asymmetry in the Universe. Specifically, the experiment is aimed at searching for very weakly interacting long lived particles including Heavy Neutral Leptons - right-handed partners of the active neutrinos; light supersymmetric particles - sgoldstinos, etc.; scalar, axion and vector portals to the hidden sector. The high intensity of the SPS and in particular the large production of charm mesons with the 400 GeV beam allow accessing a wide variety of light long-lived exotic particles of such models and of SUSY. Moreover, the facility is ideally suited to study the interactions of tau neutrinos.

Higgs Portal into Hidden Sectors

CERN Multimedia

CERN. Geneva

2007-01-01

Several attractive theoretical ideas suggest the existence of one or more 'hidden sectors' consisting of standard model singlet fields, some of which may not be too heavy. There is a profound reason to think that the Higgs sector might provide the first access to these hidden sectors. This scenario could affect Higgs phenomenology in drastic ways.

Hidden in plain sight: the formal, informal, and hidden curricula of a psychiatry clerkship.

Science.gov (United States)

Wear, Delese; Skillicorn, Jodie

2009-04-01

To examine perceptions of the formal, informal, and hidden curricula in psychiatry as they are observed and experienced by (1) attending physicians who have teaching responsibilities for residents and medical students, (2) residents who are taught by those same physicians and who have teaching responsibilities for medical students, and (3) medical students who are taught by attendings and residents during their psychiatry rotation. From June to November 2007, the authors conducted focus groups with attendings, residents, and students in one midwestern academic setting. The sessions were audiotaped, transcribed, and analyzed for themes surrounding the formal, informal, and hidden curricula. All three groups offered a similar belief that the knowledge, skills, and values of the formal curriculum focused on building relationships. Similarly, all three suggested that elements of the informal and hidden curricula were expressed primarily as the values arising from attendings' role modeling, as the nature and amount of time attendings spend with patients, and as attendings' advice arising from experience and intuition versus "textbook learning." Whereas students and residents offered negative values arising from the informal and hidden curricula, attendings did not, offering instead the more positive values they intended to encourage through the informal and hidden curricula. The process described here has great potential in local settings across all disciplines. Asking teachers and learners in any setting to think about how they experience the educational environment and what sense they make of all curricular efforts can provide a reality check for educators and a values check for learners as they critically reflect on the meanings of what they are learning.

A Novel Method for Decoding Any High-Order Hidden Markov Model

Directory of Open Access Journals (Sweden)

Fei Ye

2014-01-01

Full Text Available This paper proposes a novel method for decoding any high-order hidden Markov model. First, the high-order hidden Markov model is transformed into an equivalent first-order hidden Markov model by Hadar’s transformation. Next, the optimal state sequence of the equivalent first-order hidden Markov model is recognized by the existing Viterbi algorithm of the first-order hidden Markov model. Finally, the optimal state sequence of the high-order hidden Markov model is inferred from the optimal state sequence of the equivalent first-order hidden Markov model. This method provides a unified algorithm framework for decoding hidden Markov models including the first-order hidden Markov model and any high-order hidden Markov model.

Abelian hidden sectors at a GeV

International Nuclear Information System (INIS)

Morrissey, David E.; Poland, David; Zurek, Kathryn M.

2009-01-01

We discuss mechanisms for naturally generating GeV-scale hidden sectors in the context of weak-scale supersymmetry. Such low mass scales can arise when hidden sectors are more weakly coupled to supersymmetry breaking than the visible sector, as happens when supersymmetry breaking is communicated to the visible sector by gauge interactions under which the hidden sector is uncharged, or if the hidden sector is sequestered from gravity-mediated supersymmetry breaking. We study these mechanisms in detail in the context of gauge and gaugino mediation, and present specific models of Abelian GeV-scale hidden sectors. In particular, we discuss kinetic mixing of a U(1) x gauge force with hypercharge, singlets or bi-fundamentals which couple to both sectors, and additional loop effects. Finally, we investigate the possible relevance of such sectors for dark matter phenomenology, as well as for low- and high-energy collider searches.

Stargate of the Hidden Multiverse

Directory of Open Access Journals (Sweden)

Alexander Antonov

2016-02-01

Full Text Available Concept of Monoverse, which corresponds to the existing broad interpretation of the second postulate of the special theory of relativity, is not consistent with the modern astrophysical reality — existence of the dark matter and the dark energy, the total mass-energy of which is ten times greater than the mass-energy of the visible universe (which has been considered as the entire universe until very recent . This concept does not allow to explain their rather unusual properties — invisibility and lack of baryon content — which would seem to even destroy the very modern understanding of the term ‘matter’. However, all numerous alternative concepts of Multiverses, which have been proposed until today, are unable to explain these properties of the dark matter and dark energy. This article describes a new concept: the concept of the hidden Multiverse and hidden Supermultiverse, which mutual invisibility of parallel universes is explained by the physical reality of imaginary numbers. This concept completely explains the phenomenon of the dark matter and the dark energy. Moreover, it is shown that the dark matter and the dark energy are the experimental evidence for the existence of the hidden Multiverse. Described structure of the hidden Multiverse is fully consistent with the data obtained by the space stations WMAP and Planck. An extremely important property of the hidden Multiverse is an actual possibility of its permeation through stargate located on the Earth.

Association of postpartum maternal morbidities with children's mental, psychomotor and language development in rural Bangladesh.

Science.gov (United States)

Hamadani, J D; Tofail, F; Hilaly, A; Mehrin, F; Shiraji, S; Banu, S; Huda, S N

2012-06-01

Little is known from developing countries about the effects of maternal morbidities diagnosed in the postpartum period on children's development. The study aimed to document the relationships of such morbidities with care-giving practices by mothers, children's developmental milestones and their language, mental and psychomotor development. Maternal morbidities were identified through physical examination at 6-9 weeks postpartum (n=488). Maternal care-giving practices and postnatal depression were assessed also at 6-9 weeks postpartum. Children's milestones of development were measured at six months, and their mental (MDI) and psychomotor (PDI) development, language comprehension and expression, and quality of psychosocial stimulation at home were assessed at 12 months. Several approaches were used for identifying the relationships among different maternal morbidities, diagnosed by physicians, with children's development. After controlling for the potential confounders, maternal anaemia diagnosed postpartum showed a small but significantly negative effect on children's language expression while the effects on language comprehension did not reach the significance level (p=0.085). Children's development at 12 months was related to psychosocial stimulation at home, nutritional status, education of parents, socioeconomic status, and care-giving practices of mothers at six weeks of age. Only a few mothers experienced each specific morbidity, and with the exception of anaemia, the sample-size was insufficient to make a conclusion regarding each specific morbidity. Further research with a sufficient sample-size of individual morbidities is required to determine the association of postpartum maternal morbidities with children's development.

Coding with partially hidden Markov models

DEFF Research Database (Denmark)

Forchhammer, Søren; Rissanen, J.

1995-01-01

Partially hidden Markov models (PHMM) are introduced. They are a variation of the hidden Markov models (HMM) combining the power of explicit conditioning on past observations and the power of using hidden states. (P)HMM may be combined with arithmetic coding for lossless data compression. A general...... 2-part coding scheme for given model order but unknown parameters based on PHMM is presented. A forward-backward reestimation of parameters with a redefined backward variable is given for these models and used for estimating the unknown parameters. Proof of convergence of this reestimation is given....... The PHMM structure and the conditions of the convergence proof allows for application of the PHMM to image coding. Relations between the PHMM and hidden Markov models (HMM) are treated. Results of coding bi-level images with the PHMM coding scheme is given. The results indicate that the PHMM can adapt...

Compressing the hidden variable space of a qubit

International Nuclear Information System (INIS)

Montina, Alberto

2011-01-01

In previously exhibited hidden variable models of quantum state preparation and measurement, the number of continuous hidden variables describing the actual state of single realizations is never smaller than the quantum state manifold dimension. We introduce a simple model for a qubit whose hidden variable space is one-dimensional, i.e., smaller than the two-dimensional Bloch sphere. The hidden variable probability distributions associated with quantum states satisfy reasonable criteria of regularity. Possible generalizations of this shrinking to an N-dimensional Hilbert space are discussed.

A survey of hidden-variables theories

CERN Document Server

Belinfante, F J

1973-01-01

A Survey of Hidden-Variables Theories is a three-part book on the hidden-variable theories, referred in this book as """"theories of the first kind"""". Part I reviews the motives in developing different types of hidden-variables theories. The quest for determinism led to theories of the first kind; the quest for theories that look like causal theories when applied to spatially separated systems that interacted in the past led to theories of the second kind. Parts II and III further describe the theories of the first kind and second kind, respectively. This book is written to make the literat

A classification of hidden-variable properties

International Nuclear Information System (INIS)

Brandenburger, Adam; Yanofsky, Noson

2008-01-01

Hidden variables are extra components added to try to banish counterintuitive features of quantum mechanics. We start with a quantum-mechanical model and describe various properties that can be asked of a hidden-variable model. We present six such properties and a Venn diagram of how they are related. With two existence theorems and three no-go theorems (EPR, Bell and Kochen-Specker), we show which properties of empirically equivalent hidden-variable models are possible and which are not. Formally, our treatment relies only on classical probability models, and physical phenomena are used only to motivate which models to choose

Perspective: Disclosing hidden sources of funding.

Science.gov (United States)

Resnik, David B

2009-09-01

In this article, the author discusses ethical and policy issues related to the disclosure of hidden sources of funding in research. The author argues that authors have an ethical obligation to disclose hidden sources of funding and that journals should adopt policies to enforce this obligation. Journal policies should require disclosure of hidden sources of funding that authors know about and that have a direct relation to their research. To stimulate this discussion, the author describes a recent case: investigators who conducted a lung cancer screening study had received funding from a private foundation that was supported by a tobacco company, but they did not disclose this relationship to the journal. Investigators and journal editors must be prepared to deal with these issues in a manner that promotes honesty, transparency, fairness, and accountability in research. The development of well-defined, reasonable policies pertaining to hidden sources of funding can be a step in this direction.

Randomised intervention study to assess the prevalence of subclinical vascular disease and hidden kidney disease and its impact on morbidity and mortality: The ILERVAS project

Directory of Open Access Journals (Sweden)

Àngels Betriu

2016-07-01

Conclusions: The ILERVAS project will reveal the prevalence of subclinical vascular disease and hidden kidney disease, determine whether or not their early diagnosis brings health benefits and will also allow investigation of new risk factors.

Hidden Statistics of Schroedinger Equation

Science.gov (United States)

Zak, Michail

2011-01-01

Work was carried out in determination of the mathematical origin of randomness in quantum mechanics and creating a hidden statistics of Schr dinger equation; i.e., to expose the transitional stochastic process as a "bridge" to the quantum world. The governing equations of hidden statistics would preserve such properties of quantum physics as superposition, entanglement, and direct-product decomposability while allowing one to measure its state variables using classical methods.

Association of depression and anxiety with cardiovascular co-morbidity in a primary care population in Latvia: a cross-sectional study.

Science.gov (United States)

Ivanovs, R; Kivite, A; Ziedonis, D; Mintale, I; Vrublevska, J; Rancans, E

2018-03-06

Cardiovascular (CV) diseases (CVDs) are the leading cause of mortality worldwide. Globally, there is a growing interest in understanding and addressing modifiable psychosocial risk factors, particularly depression and anxiety, to prevent CVDs and to reduce morbidity and mortality. Despite the high premature mortality rate from CVDs in Latvia, this is the first Latvian study to examine the association of depression and anxiety with CVD morbidity in a primary care population. This cross-sectional study was carried out in 2015 within the framework of the National Research Program BIOMEDICINE at 24 primary care facilities throughout Latvia. Consecutive adult patients during a one-week time period at each facility were invited to join the study. Assessments onsite included a 9-item Patient Health Questionnaire (PHQ-9) and a 7-item Generalized Anxiety Disorder scale (GAD-7) followed by a socio-demographic questionnaire and measurements of height, weight, waist circumference, blood pressure, and total cholesterol. The diagnostic Mini International Neuropsychiatric Interview (MINI) was conducted over the telephone within 2 weeks after the visit to the general practitioner. A multivariate model was developed using binary logistic regression. From the 1565 subjects (31.2% male), CVD was detected in 17.1%. Depression screening was positive (PHQ-9 ≥ 10) for 14.7%, and anxiety screening was positive (GAD-7 ≥ 10) for 10.1% of the study subjects. According to the MINI, 10.3% had current and 28.1% had lifetime depressive episode, and 16.1% had an anxiety disorder. Depression, not anxiety, was statistically significantly related to CVDs with an odds ratio (OR) of 1.52 (p = 0.04) for current depressive symptoms (PHQ-9 ≥ 10) and 2.08 (p = 0.002) for lifetime depressive episode (MINI). Current depressive symptoms (PHQ-9 ≥ 10) and a lifetime depressive episode (according to the MINI) were significantly associated with increased risk of CV morbidity

Hidden supersymmetry and Fermion number fractionalization

International Nuclear Information System (INIS)

Akhoury, R.

1985-01-01

This paper discusses how a hidden supersymmetry of the underlying field theories can be used to interpret and to calculate fermion number fractionalization in different dimensions. This is made possible by relating it to a corresponding Witten index of the hidden supersymmetry. The closely related anomalies in odd dimensions are also discussed

Changes in Morbidity and Abortion Care in Ethiopia After Legal Reform: National Results from 2008 and 2014

Science.gov (United States)

Gebrehiwot, Yirgu; Fetters, Tamara; Gebreselassie, Hailemichael; Moore, Ann; Hailemariam, Mengistu; Dibaba, Yohannes; Bankole, Akinrinola; Getachew, Yonas

2017-01-01

CONTEXT In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care—i.e., legal abortion and treatment of abortion complications—changed over time. METHODS Between December 2013 and May 2014, data were collected on symptoms, procedures and treatment from 5,604 women who sought abortion care at a sample of 439 public and private health facilities; the sample did not include lower-level private facilities—some of which provide abortion care—to maintain comparability with the sample from a 2008 study. These data were combined with monitoring data from 105,806 women treated in 74 nongovernmental organization facilities in 2013. Descriptive analyses were conducted and annual estimates were calculated to compare the numbers and types of abortion care services provided in 2008 and 2014. RESULTS The estimated annual number of women seeking a legal abortion in the types of facilities sampled increased from 158,000 in 2008 to 220,000 in 2014, and the estimated number presenting for postabortion care increased from 58,000 to 125,000. The proportion of abortion care provided in the public sector increased from 36% to 56% nationally. The proportion of women presenting for postabortion care who had severe complications rose from 7% to 11%, the share of all abortion procedures accounted for by medical abortion increased from 0% to 36%, and the proportion of abortion care provided by midlevel health workers increased from 48% to 83%. Most women received postabortion contraception. CONCLUSIONS Ethiopia has made substantial progress in expanding comprehensive abortion care; however, eradication of morbidity from unsafe abortion has not yet been achieved. PMID:28825903

The Hidden Reason Behind Children's Misbehavior.

Science.gov (United States)

Nystul, Michael S.

1986-01-01

Discusses hidden reason theory based on the assumptions that: (1) the nature of people is positive; (2) a child's most basic psychological need is involvement; and (3) a child has four possible choices in life (good somebody, good nobody, bad somebody, or severely mentally ill.) A three step approach for implementing hidden reason theory is…

Enteral Nutrition Support for Abdominal Compartment Syndrome in Morbidly Obese Patient : A Case Report from a Medical Intensive Care Unit (ICU

Directory of Open Access Journals (Sweden)

Nurul Huda Razalli

2018-01-01

Full Text Available Compartment syndrome occurs when pressure within a closed muscle or bone compartment builds to dangerous levels. This pressure can decrease blood flow to nerve and muscle cells, leading to ischemia and organ dysfunction. Challenges in providing enteral nutrition for abdominal compartment syndrome (ACS patients include the increase risk for developing gastrointestinal symptoms such as diarrhea, constipation and distention. There are limited reports available on the nutritional management of ACS patients in the ICU especially those with morbid obesity condition to guide dietitians in providing nutritional support for these patients.  Here, we report the enteral nutrition management of a mechanically ventilated, morbidly obese patient with ACS in a critical care setting by adopting postpyloric feeding, using prokinetic agents and implementing PO2/FiO2 ratio calculation for prescription of most suitable enteral formula.

Psychiatric morbidity and non-participation in breast cancer screening.

Science.gov (United States)

Jensen, Line Flytkjær; Pedersen, Anette Fischer; Bech, Bodil Hammer; Andersen, Berit; Vedsted, Peter

2016-02-01

Organised breast cancer screening is currently one of the best strategies for early-stage breast cancer detection. However, early detection has proven challenging for women with psychiatric disease. This study aims to investigate psychiatric morbidity and non-participation in breast cancer screening. We conducted an observational cohort study including women invited to the first organised screening round in the Central Denmark Region. Data on psychiatric diagnosis, psychoactive prescription medicine and consultation with private psychiatrists were obtained from Danish registries and assessed for a period of up to 10 years before the screening date. The cohort comprised 144,264 women whereof 33.0% were registered with an indication of psychiatric morbidity. We found elevated non-participation propensity among women with a psychiatric diagnosis especially for women with schizophrenia and substance abuse. Also milder psychiatric morbidity was associated with higher non-participation likelihood as women who had redeemed psychoactive prescription medicine or have had minimum one consultation with a private psychiatrist were more likely not to participate. Finally, we found that the chronicity of psychiatric morbidity was associated with non-participation and that woman who had a psychiatric morbidity defined as 'persistent' had higher likelihood of non-participation than women with recently active morbidity or inactive psychiatric morbidity. This study showed a strong association between psychiatric morbidity and an increased likelihood of non-participation in breast cancer screening in a health care system with universal and tax-funded health services. This knowledge may inform interventions targeting women with psychiatric morbidity as they have poorer breast cancer prognosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Upper gastrointestinal symptoms, psychosocial co-morbidity and health care seeking in general practice: population based case control study

Directory of Open Access Journals (Sweden)

Schellevis François G

2009-09-01

Full Text Available Abstract Background The pathophysiology of upper gastrointestinal (GI symptoms is still poorly understood. Psychological symptoms were found to be more common in patients with functional gastrointestinal complaints, but it is debated whether they are primarily linked to GI symptoms or rather represent motivations for health-care seeking. Purpose of our study was to compare co-morbidity, in particular psychological and social problems, between patients with and without upper GI symptoms. In addition, we investigated whether the prevalence of psychological and social problems is part of a broader pattern of illness related health care use. Methods Population based case control study based on the second Dutch National Survey of general practice (conducted in 2001. Cases (adults visiting their primary care physician (PCP with upper GI symptoms and controls (individuals not having any of these complaints, matched for gender, age, PCP-practice and ethnicity were compared. Main outcome measures were contact frequency, prevalence of somatic as well as psychosocial diagnoses, prescription rate of (psychopharmacological agents, and referral rates. Data were analyzed using odds ratios, the Chi square test as well as multivariable logistic regression analysis. Results Data from 13,389 patients with upper GI symptoms and 13,389 control patients were analyzed. Patients with upper GI symptoms visited their PCP twice as frequently as controls (8.6 vs 4.4 times/year. Patients with upper GI symptoms presented not only more psychological and social problems, but also more other health problems to their PCP (odds ratios (ORs ranging from 1.37 to 3.45. Patients with upper GI symptoms more frequently used drugs of any ATC-class (ORs ranging from 1.39 to 2.90, including psychotropic agents. The observed differences were less pronounced when we adjusted for non-attending control patients. In multivariate regression analysis, contact frequency and not psychological or

Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

Science.gov (United States)

Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

2013-08-07

A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

Hidden worlds in quantum physics

CERN Document Server

Gouesbet, Gérard

2014-01-01

The past decade has witnessed a resurgence in research and interest in the areas of quantum computation and entanglement. This new book addresses the hidden worlds or variables of quantum physics. Author Gérard Gouesbet studied and worked with a former student of Louis de Broglie, a pioneer of quantum physics. His presentation emphasizes the history and philosophical foundations of physics, areas that will interest lay readers as well as professionals and advanced undergraduate and graduate students of quantum physics. The introduction is succeeded by chapters offering background on relevant concepts in classical and quantum mechanics, a brief history of causal theories, and examinations of the double solution, pilot wave, and other hidden-variables theories. Additional topics include proofs of possibility and impossibility, contextuality, non-locality, classification of hidden-variables theories, and stochastic quantum mechanics. The final section discusses how to gain a genuine understanding of quantum mec...

Does BMI influence hospital stay and morbidity after fast-track hip and knee arthroplasty?

DEFF Research Database (Denmark)

Husted, Henrik; Jørgensen, Christoffer C; Gromov, Kirill

2016-01-01

Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality in such pat......Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality...... in such patients who were operated with the fast-track methodology and compared the levels with those in patients with normal BMI. Patients and methods - This was a prospective observational study involving 13,730 procedures (7,194 THA and 6,536 TKA operations) performed in a standardized fast-track setting....... Complete 90-day follow-up was achieved using national registries and review of medical records. Patients were grouped according to BMI as being underweight, of normal weight, overweight, obese, very obese, and morbidly obese. Results - Median length of stay (LOS) was 2 (IQR: 2-3) days in all BMI groups. 30...

Cholesterol testing among men and women with disability: the role of morbidity

Directory of Open Access Journals (Sweden)

Lofters AK

2016-09-01

Full Text Available Aisha K Lofters,1–3,* Sara JT Guilcher,1,3,4,* Lauren Webster,1 Richard H Glazier,1–3 Susan B Jaglal,1 Ahmed M Bayoumi,1,3 1Institute for Clinical Evaluative Sciences, 2Department of Family and Community Medicine, St Michael’s Hospital, University of Toronto, 3Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital, 4Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada *These authors contributed equally to this work Purpose: Despite more frequent use of health services by people living with disability, the quality of preventive care received may be suboptimal. In this retrospective cohort study, we used administrative data to examine the relationship between cholesterol testing and levels of disability and morbidity among women and men in Ontario, Canada. Methods: We linked multiple provincial-level databases in this study. In stratified analyses for women and men, we used multivariable logistic regression to examine differences in cholesterol testing, and we tested for an interaction effect between disability and morbidity. In a secondary analysis, we tested for a three-way interaction between sex, disability, and morbidity on the entire cohort. Results: There was an interaction between morbidity and disability for both women and men. Women and men with no chronic conditions appeared to be least likely to be up-to-date on cholesterol testing, and among this group, those with moderate disability were more likely to be up-to-date on cholesterol testing than those with no disability (adjusted odds ratio [AOR] =1.51; 95% confidence interval [CI] 1.20–1.90 for women; AOR =1.16; 95% CI 1.00–1.34 for men. Among women and men who had one chronic condition, having severe disability put them at significant disadvantage versus those with no disability. Only 58.5% of men with no disability and no chronic conditions were up-to-date on cholesterol testing. Conclusion: An intermediate level

The morbidity, mortality, and costs associated with Clostridium difficile infection.

Science.gov (United States)

Kwon, Jennie H; Olsen, Margaret A; Dubberke, Erik R

2015-03-01

Clostridium difficile infection (CDI) is the most common cause of infectious health care-associated diarrhea and is a major burden to patients and the health care system. The incidence and severity of CDI remain at historically high levels. This article reviews the morbidity, mortality, and costs associated with CDI. Copyright © 2015 Elsevier Inc. All rights reserved.

Hidden charged dark matter and chiral dark radiation

Science.gov (United States)

Ko, P.; Nagata, Natsumi; Tang, Yong

2017-10-01

In the light of recent possible tensions in the Hubble constant H0 and the structure growth rate σ8 between the Planck and other measurements, we investigate a hidden-charged dark matter (DM) model where DM interacts with hidden chiral fermions, which are charged under the hidden SU(N) and U(1) gauge interactions. The symmetries in this model assure these fermions to be massless. The DM in this model, which is a Dirac fermion and singlet under the hidden SU(N), is also assumed to be charged under the U(1) gauge symmetry, through which it can interact with the chiral fermions. Below the confinement scale of SU(N), the hidden quark condensate spontaneously breaks the U(1) gauge symmetry such that there remains a discrete symmetry, which accounts for the stability of DM. This condensate also breaks a flavor symmetry in this model and Nambu-Goldstone bosons associated with this flavor symmetry appear below the confinement scale. The hidden U(1) gauge boson and hidden quarks/Nambu-Goldstone bosons are components of dark radiation (DR) above/below the confinement scale. These light fields increase the effective number of neutrinos by δNeff ≃ 0.59 above the confinement scale for N = 2, resolving the tension in the measurements of the Hubble constant by Planck and Hubble Space Telescope if the confinement scale is ≲1 eV. DM and DR continuously scatter with each other via the hidden U(1) gauge interaction, which suppresses the matter power spectrum and results in a smaller structure growth rate. The DM sector couples to the Standard Model sector through the exchange of a real singlet scalar mixing with the Higgs boson, which makes it possible to probe our model in DM direct detection experiments. Variants of this model are also discussed, which may offer alternative ways to investigate this scenario.

Adaptive filtering for hidden node detection and tracking in networks.

Science.gov (United States)

Hamilton, Franz; Setzer, Beverly; Chavez, Sergio; Tran, Hien; Lloyd, Alun L

2017-07-01

The identification of network connectivity from noisy time series is of great interest in the study of network dynamics. This connectivity estimation problem becomes more complicated when we consider the possibility of hidden nodes within the network. These hidden nodes act as unknown drivers on our network and their presence can lead to the identification of false connections, resulting in incorrect network inference. Detecting the parts of the network they are acting on is thus critical. Here, we propose a novel method for hidden node detection based on an adaptive filtering framework with specific application to neuronal networks. We consider the hidden node as a problem of missing variables when model fitting and show that the estimated system noise covariance provided by the adaptive filter can be used to localize the influence of the hidden nodes and distinguish the effects of different hidden nodes. Additionally, we show that the sequential nature of our algorithm allows for tracking changes in the hidden node influence over time.

The Fiscal Consequences Attributed to Changes in Morbidity and Mortality Linked to Investments in Health Care: A Government Perspective Analytic Framework.

Science.gov (United States)

Connolly, Mark P; Kotsopoulos, Nikolaos; Postma, Maarten J; Bhatt, Aomesh

2017-02-01

Governments have an enormous economic and political stake in the health of their populations. Population health is not only fundamental to economic growth but also affects short-term and long-term government expenditure on health care, disability, and other social programs and influences direct and indirect tax receipts. Fiscal transfers between citizen and state are mostly ignored in conventional welfare economics analyses based on the hypothesis that there are no winners or losers through transference of wealth. However, from the government perspective, this position is flawed, as disability costs and lost taxes attributed to poor health and reduced productive output represent real costs that pose budgetary and growth implications. To address the value of health and health care investments for government, we have developed a fiscal health analytic framework that captures how changes in morbidity and mortality influence tax revenue and transfer costs (e.g., disability, allowances, ongoing health costs). The framework can be used to evaluate the marginal impact of discrete investments or a mix of interventions in health care to inform governmental budgetary consequences. In this context, the framework can be considered as a fiscal budget impact and/or cost-benefit analysis model that accounts for how morbidity and mortality linked to specific programs represent both ongoing costs and tax revenue for government. Mathematical models identical to those used in cost-effectiveness analyses can be employed in fiscal analysis to reflect how disease progression influences public accounts (e.g., tax revenue and transfers). Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The hidden universe

International Nuclear Information System (INIS)

Disney, M.

1985-01-01

Astronomer Disney has followed a somewhat different tack than that of most popular books on cosmology by concentrating on the notion of hidden (as in not directly observable by its own radiation) matter in the universe

Incremental discovery of hidden structure: Applications in theory of elementary particles

International Nuclear Information System (INIS)

Zytkow, J.M.; Fischer, P.J.

1996-01-01

Discovering hidden structure is a challenging, universal research task in Physics, Chemistry, Biology, and other disciplines. Not only must the elements of hidden structure be postulated by the discoverer, but they can only be verified by indirect evidence, at the level of observable objects. In this paper we describe a framework for hidden structure discovery, built on a constructive definition of hidden structure. This definition leads to operators that build models of hidden structure step by step, postulating hidden objects, their combinations and properties, reactions described in terms of hidden objects, and mapping between the hidden and the observed structure. We introduce the operator dependency diagram, which shows the order of operator application and model evaluation. Different observational knowledge supports different evaluation criteria, which lead to different search systems with verifiable sequences of operator applications. Isomorph-free structure generation is another issue critical for efficiency of search. We apply our framework in the system GELL-MANN, that hypothesizes hidden structure for elementary particles and we present the results of a large scale search for quark models

Use of evidence based practices to improve survival without severe morbidity for very preterm infants

DEFF Research Database (Denmark)

Zeitlin, Jennifer; Manktelow, Bradley N; Piedvache, Aurelie

2016-01-01

for which they were eligible. Infants with low gestational age, growth restriction, low Apgar scores, and who were born on the day of maternal admission to hospital were less likely to receive evidence based care. After adjustment, evidence based care was associated with lower in-hospital mortality (risk...... ratio 0.72, 95% confidence interval 0.60 to 0.87) and in-hospital mortality or severe morbidity, or both (0.82, 0.73 to 0.92), corresponding to an estimated 18% decrease in all deaths without an increase in severe morbidity if these interventions had been provided to all infants. CONCLUSIONS: More......OBJECTIVES: To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity. DESIGN: Prospective multinational...

Religious Tolerance in the Hidden Curriculum

Directory of Open Access Journals (Sweden)

Kevin Nobel Kurniawan

2018-03-01

Full Text Available Religious intolerance is spreading within the Indonesian institution of education. Previous studies have shown that the growth of intolerance is due to the state’s regulation and pedagogical apparatus. In contrast to the previous studies, I argue that the intolerance is related to hidden curriculum applied by the institution of education.  Normatively, the hidden curriculum contains the value of religious tolerance. However, factually, the author found that there are practices of intolerance, through the formal and informal spheres in the school’s structure, within the hidden curriculum. This article applies a qualitative approach with a mixed method research strategy to analyze data collected from students, teachers, and alumnis through field observation, in-depth interview, and survey.

Hidden gauge structure of supersymmetric free differential algebras

Energy Technology Data Exchange (ETDEWEB)

Andrianopoli, Laura [DISAT, Politecnico di Torino,Corso Duca degli Abruzzi 24, I-10129 Turin (Italy); INFN - Sezione di Torino,Torino (Italy); D’Auria, Riccardo [DISAT, Politecnico di Torino,Corso Duca degli Abruzzi 24, I-10129 Turin (Italy); Ravera, Lucrezia [DISAT, Politecnico di Torino,Corso Duca degli Abruzzi 24, I-10129 Turin (Italy); INFN - Sezione di Torino,Torino (Italy)

2016-08-16

The aim of this paper is to clarify the role of the nilpotent fermionic generator Q{sup ′} introduced in http://dx.doi.org/10.1016/0550-3213(82)90376-5 and appearing in the hidden supergroup underlying the free differential algebra (FDA) of D=11 supergravity. We give a physical explanation of its role by looking at the gauge properties of the theory. We find that its presence is necessary, in order that the extra 1-forms of the hidden supergroup give rise to the correct gauge transformations of the p-forms of the FDA. This interpretation is actually valid for any supergravity containing antisymmetric tensor fields, and any supersymmetric FDA can always be traded for a hidden Lie superalgebra containing extra fermionic nilpotent generators. As an interesting example we construct the hidden superalgebra associated with the FDA of N=2, D=7 supergravity. In this case we are able to parametrize the mutually non local 2- and 3-form B{sup (2)} and B{sup (3)} in terms of hidden 1-forms and find that supersymmetry and gauge invariance require in general the presence of two nilpotent fermionic generators in the hidden algebra. We propose that our approach, where all the invariances of the FDA are expressed as Lie derivatives of the p-forms in the hidden supergroup manifold, could be an appropriate framework to discuss theories defined in enlarged versions of superspace recently considered in the literature, such us double field theory and its generalizations.

Fitting Hidden Markov Models to Psychological Data

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Ingmar Visser

2002-01-01

Full Text Available Markov models have been used extensively in psychology of learning. Applications of hidden Markov models are rare however. This is partially due to the fact that comprehensive statistics for model selection and model assessment are lacking in the psychological literature. We present model selection and model assessment statistics that are particularly useful in applying hidden Markov models in psychology. These statistics are presented and evaluated by simulation studies for a toy example. We compare AIC, BIC and related criteria and introduce a prediction error measure for assessing goodness-of-fit. In a simulation study, two methods of fitting equality constraints are compared. In two illustrative examples with experimental data we apply selection criteria, fit models with constraints and assess goodness-of-fit. First, data from a concept identification task is analyzed. Hidden Markov models provide a flexible approach to analyzing such data when compared to other modeling methods. Second, a novel application of hidden Markov models in implicit learning is presented. Hidden Markov models are used in this context to quantify knowledge that subjects express in an implicit learning task. This method of analyzing implicit learning data provides a comprehensive approach for addressing important theoretical issues in the field.

Geometric phases and hidden local gauge symmetry

International Nuclear Information System (INIS)

Fujikawa, Kazuo

2005-01-01

The analysis of geometric phases associated with level crossing is reduced to the familiar diagonalization of the Hamiltonian in the second quantized formulation. A hidden local gauge symmetry, which is associated with the arbitrariness of the phase choice of a complete orthonormal basis set, becomes explicit in this formulation (in particular, in the adiabatic approximation) and specifies physical observables. The choice of a basis set which specifies the coordinate in the functional space is arbitrary in the second quantization, and a subclass of coordinate transformations, which keeps the form of the action invariant, is recognized as the gauge symmetry. We discuss the implications of this hidden local gauge symmetry in detail by analyzing geometric phases for cyclic and noncyclic evolutions. It is shown that the hidden local symmetry provides a basic concept alternative to the notion of holonomy to analyze geometric phases and that the analysis based on the hidden local gauge symmetry leads to results consistent with the general prescription of Pancharatnam. We however note an important difference between the geometric phases for cyclic and noncyclic evolutions. We also explain a basic difference between our hidden local gauge symmetry and a gauge symmetry (or equivalence class) used by Aharonov and Anandan in their definition of generalized geometric phases

Locating Hidden Servers

National Research Council Canada - National Science Library

Oeverlier, Lasse; Syverson, Paul F

2006-01-01

.... Announced properties include server resistance to distributed DoS. Both the EFF and Reporters Without Borders have issued guides that describe using hidden services via Tor to protect the safety of dissidents as well as to resist censorship...

Hidden neural networks

DEFF Research Database (Denmark)

Krogh, Anders Stærmose; Riis, Søren Kamaric

1999-01-01

A general framework for hybrids of hidden Markov models (HMMs) and neural networks (NNs) called hidden neural networks (HNNs) is described. The article begins by reviewing standard HMMs and estimation by conditional maximum likelihood, which is used by the HNN. In the HNN, the usual HMM probability...... parameters are replaced by the outputs of state-specific neural networks. As opposed to many other hybrids, the HNN is normalized globally and therefore has a valid probabilistic interpretation. All parameters in the HNN are estimated simultaneously according to the discriminative conditional maximum...... likelihood criterion. The HNN can be viewed as an undirected probabilistic independence network (a graphical model), where the neural networks provide a compact representation of the clique functions. An evaluation of the HNN on the task of recognizing broad phoneme classes in the TIMIT database shows clear...

Hidden neural networks: application to speech recognition

DEFF Research Database (Denmark)

Riis, Søren Kamaric

1998-01-01

We evaluate the hidden neural network HMM/NN hybrid on two speech recognition benchmark tasks; (1) task independent isolated word recognition on the Phonebook database, and (2) recognition of broad phoneme classes in continuous speech from the TIMIT database. It is shown how hidden neural networks...

Microwave background constraints on mixing of photons with hidden photons

International Nuclear Information System (INIS)

Mirizzi, Alessandro; Redondo, Javier; Sigl, Guenter

2008-12-01

Various extensions of the Standard Model predict the existence of hidden photons kinetically mixing with the ordinary photon. This mixing leads to oscillations between photons and hidden photons, analogous to the observed oscillations between different neutrino flavors. In this context, we derive new bounds on the photon-hidden photon mixing parameters using the high precision cosmic microwave background spectral data collected by the Far Infrared Absolute Spectrophotometer instrument on board of the Cosmic Background Explorer. Requiring the distortions of the CMB induced by the photon-hidden photon mixing to be smaller than experimental upper limits, this leads to a bound on the mixing angle χ 0 -7 - 10 -5 for hidden photon masses between 10 -14 eV and 10 -7 eV. This low-mass and low-mixing region of the hidden photon parameter space was previously unconstrained. (orig.)

Hidden Crises and Communication: An Interactional Analysis of Hidden Crises

NARCIS (Netherlands)

dr. Annette Klarenbeek

2011-01-01

In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in

Hidden Crises and Communication : An Interactional Analysis of Hidden Crises

NARCIS (Netherlands)

dr. Annette Klarenbeek

2011-01-01

In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in

Hidden treasures - 50 km points of interests

Science.gov (United States)

Lommi, Matias; Kortelainen, Jaana

2015-04-01

Tampere is third largest city in Finland and a regional centre. During 70's there occurred several communal mergers. Nowadays this local area has both strong and diversed identity - from wilderness and agricultural fields to high density city living. Outside the city center there are interesting geological points unknown for modern city settlers. There is even a local proverb, "Go abroad to Teisko!". That is the area the Hidden Treasures -student project is focused on. Our school Tammerkoski Upper Secondary School (or Gymnasium) has emphasis on visual arts. We are going to offer our art students scientific and artistic experiences and knowledge about the hidden treasures of Teisko area and involve the Teisko inhabitants into this project. Hidden treasures - Precambrian subduction zone and a volcanism belt with dense bed of gold (Au) and arsenic (As), operating goldmines and quarries of minerals and metamorphic slates. - North of subduction zone a homogenic precambrian magmastone area with quarries, products known as Kuru Grey. - Former ashores of post-glasial Lake Näsijärvi and it's sediments enabled the developing agriculture and sustained settlement. Nowadays these ashores have both scenery and biodiversity values. - Old cattle sheds and dairy buildings made of local granite stones related to cultural stonebuilding inheritance. - Local active community of Kapee, about 100 inhabitants. Students will discover information of these "hidden" phenomena, and rendering this information trough Enviromental Art Method. Final form of this project will be published in several artistic and informative geocaches. These caches are achieved by a GPS-based special Hidden Treasures Cycling Route and by a website guiding people to find these hidden points of interests.

Estimating morbidity rates from electronic medical records in general practice: evaluation of a grouping system.

NARCIS (Netherlands)

Biermans, M.C.J.; Verheij, R.A.; Bakker, D.H. de; Zielhuis, G.A.; Vries Robbé, P.F. de

2008-01-01

Objectives: In this study, we evaluated the internal validity of EPICON, an application for grouping ICPCcoded diagnoses from electronic medical records into episodes of care. These episodes are used to estimate morbidity rates in general practice. Methods: Morbidity rates based on EPICON were

Hidden Markov Model Application to Transfer The Trader Online Forex Brokers

Directory of Open Access Journals (Sweden)

Farida Suharleni

2012-05-01

Full Text Available Hidden Markov Model is elaboration of Markov chain, which is applicable to cases that can’t directly observe. In this research, Hidden Markov Model is used to know trader’s transition to broker forex online. In Hidden Markov Model, observed state is observable part and hidden state is hidden part. Hidden Markov Model allows modeling system that contains interrelated observed state and hidden state. As observed state in trader’s transition to broker forex online is category 1, category 2, category 3, category 4, category 5 by condition of every broker forex online, whereas as hidden state is broker forex online Marketiva, Masterforex, Instaforex, FBS and Others. First step on application of Hidden Markov Model in this research is making construction model by making a probability of transition matrix (A from every broker forex online. Next step is making a probability of observation matrix (B by making conditional probability of five categories, that is category 1, category 2, category 3, category 4, category 5 by condition of every broker forex online and also need to determine an initial state probability (π from every broker forex online. The last step is using Viterbi algorithm to find hidden state sequences that is broker forex online sequences which is the most possible based on model and observed state that is the five categories. Application of Hidden Markov Model is done by making program with Viterbi algorithm using Delphi 7.0 software with observed state based on simulation data. Example: By the number of observation T = 5 and observed state sequences O = (2,4,3,5,1 is found hidden state sequences which the most possible with observed state O as following : where X1 = FBS, X2 = Masterforex, X3 = Marketiva, X4 = Others, and X5 = Instaforex.

Microwave background constraints on mixing of photons with hidden photons

Energy Technology Data Exchange (ETDEWEB)

Mirizzi, Alessandro [Max-Planck-Institut fuer Physik, Muenchen (Germany); Redondo, Javier [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Sigl, Guenter [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik

2008-12-15

Various extensions of the Standard Model predict the existence of hidden photons kinetically mixing with the ordinary photon. This mixing leads to oscillations between photons and hidden photons, analogous to the observed oscillations between different neutrino flavors. In this context, we derive new bounds on the photon-hidden photon mixing parameters using the high precision cosmic microwave background spectral data collected by the Far Infrared Absolute Spectrophotometer instrument on board of the Cosmic Background Explorer. Requiring the distortions of the CMB induced by the photon-hidden photon mixing to be smaller than experimental upper limits, this leads to a bound on the mixing angle {chi}{sub 0} hidden photon masses between 10{sup -14} eV and 10{sup -7} eV. This low-mass and low-mixing region of the hidden photon parameter space was previously unconstrained. (orig.)

Hidden symmetries in minimal five-dimensional supergravity

International Nuclear Information System (INIS)

Poessel, Markus; Silva, Sebastian

2004-01-01

We study the hidden symmetries arising in the dimensional reduction of d=5, N=2 supergravity to three dimensions. Extending previous partial results for the bosonic part, we give a derivation that includes fermionic terms, shedding light on the appearance of the local hidden symmetry SO(4) in the reduction

The Use of a Bayesian Hierarchy to Develop and Validate a Co-Morbidity Score to Predict Mortality for Linked Primary and Secondary Care Data from the NHS in England.

Science.gov (United States)

Crooks, Colin J; Card, Tim R; West, Joe

2016-01-01

We have assessed whether the linkage between routine primary and secondary care records provided an opportunity to develop an improved population based co-morbidity score with the combined information on co-morbidities from both health care settings. We extracted all people older than 20 years at the start of 2005 within the linkage between the Hospital Episodes Statistics, Clinical Practice Research Datalink, and Office for National Statistics death register in England. A random 50% sample was used to identify relevant diagnostic codes using a Bayesian hierarchy to share information between similar Read and ICD 10 code groupings. Internal validation of the score was performed in the remaining 50% and discrimination was assessed using Harrell's C statistic. Comparisons were made over time, age, and consultation rate with the Charlson and Elixhauser indexes. 657,264 people were followed up from the 1st January 2005. 98 groupings of codes were derived from the Bayesian hierarchy, and 37 had an adjusted weighting of greater than zero in the Cox proportional hazards model. 11 of these groupings had a different weighting dependent on whether they were coded from hospital or primary care. The C statistic reduced from 0.88 (95% confidence interval 0.88-0.88) in the first year of follow up, to 0.85 (0.85-0.85) including all 5 years. When we stratified the linked score by consultation rate the association with mortality remained consistent, but there was a significant interaction with age, with improved discrimination and fit in those under 50 years old (C = 0.85, 0.83-0.87) compared to the Charlson (C = 0.79, 0.77-0.82) or Elixhauser index (C = 0.81, 0.79-0.83). The use of linked population based primary and secondary care data developed a co-morbidity score that had improved discrimination, particularly in younger age groups, and had a greater effect when adjusting for co-morbidity than existing scores.

Influence of educational attainments on long term glucose control and morbid events in patients with type 2 diabetes receiving integrated care from 15 China urban communities: The Beijing Community Diabetes Study 11.

Science.gov (United States)

Yang, Guang-Ran; Yuan, Shen-Yuan; Fu, Han-Jing; Wan, Gang; Zhu, Liang-Xiang; Yuan, Ming-Xia; Lv, Yu-Jie; Zhang, Jian-Dong; Du, Xue-Ping; Li, Yu-Ling; Ji, Yu; Zhou, Li; Li, Yue

2015-12-01

To investigate the effects of educational attainment on glucose control and morbid events in patients with type 2 diabetes in Beijing communities. In this prospective multi-center study, 2866 type 2 diabetes patients receiving integrated care from 15 Beijing urban communities were investigated. Educational attainment was categorized into three levels: low, medium, and high. After a 42-month management, glucose control parameters and morbid events were analyzed. At baseline, the percentages of patients with good glucose control (HbA1c ≤ 7.0%) in the low, medium and high educational groups were 49.09%, 54.82% and 62.59%, respectively (Peducational group (7.51 ± 2.05 mmol/l and 7.20 ± 1.27%, respectively). Percentages of patients with good glucose control in the three groups were 49.6%, 55.83% and 67.23%, respectively, and the incidences of combined morbid events were 4.5%, 2.4% and 1.5%, respectively. Cox regression analysis showed that educational level was related to the incidence of combined morbid events (medium level, HR=0.572; high level, HR=0.351; PEducational level was associated with long-term glucose control, and seemed to be related to the incidence of combined morbid events in people with type 2 diabetes. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Emergency Medical Technician Training During Medical School: Benefits for the Hidden Curriculum.

Science.gov (United States)

Russ-Sellers, Rebecca; Blackwell, Thomas H

2017-07-01

Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery. To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared. Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness. The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.

Local models and hidden nonlocality in Quantum Theory

OpenAIRE

Guerini, Leonardo

2014-01-01

This Master's thesis has two central subjects: the simulation of correlations generated by local measurements on entangled quantum states by local hidden-variables models and the revelation of hidden nonlocality. We present and detail the Werner's local model and the hidden nonlocality of some Werner states of dimension $d\\geq5$, the Gisin-Degorre's local model for a Werner state of dimension $d=2$ and the local model of Hirsch et al. for mixtures of the singlet state and noise, all of them f...

Searching for hidden-charm baryonium signals in QCD sum rules

Energy Technology Data Exchange (ETDEWEB)

Chen, Hua-Xing; Zhou, Dan [Beihang University, School of Physics, Beijing Key Laboratory of Advanced Nuclear Materials and Physics, Beijing (China); Chen, Wei [University of Saskatchewan, Department of Physics and Engineering Physics, Saskatoon, SK (Canada); Liu, Xiang [Lanzhou University, School of Physical Science and Technology, Lanzhou (China); Lanzhou University, Research Center for Hadron and CSR Physics, Institute of Modern Physics of CAS, Lanzhou (China); Zhu, Shi-Lin [Peking University, School of Physics, State Key Laboratory of Nuclear Physics and Technology, Beijing (China); Collaborative Innovation Center of Quantum Matter, Beijing (China); Peking University, Center of High Energy Physics, Beijing (China)

2016-11-15

We give an explicit QCD sum rule investigation for hidden-charm baryonium states with the quark content u anti ud anti dc anti c, spin J = 0/1/2/3, and of both positive and negative parities. We systematically construct the relevant local hidden-charm baryonium interpolating currents, which can actually couple to various structures, including hidden-charm baryonium states, charmonium states plus two pions, and hidden-charm tetraquark states plus one pion, etc. We do not know which structure these currents couple to at the beginning, but after sum rule analyses we can obtain some information. We find some of them can couple to hidden-charm baryonium states, using which we evaluate the masses of the lowest-lying hidden-charm baryonium states with quantum numbers J{sup P} = 2{sup -}/3{sup -}/0{sup +}/1{sup +}/2{sup +} to be around 5.0 GeV. We suggest to search for hidden-charm baryonium states, especially the one of J = 3{sup -}, in the D-wave J/ψππ and P-wave J/ψρ and J/ψω channels in this energy region. (orig.)

Hidden symmetries in five-dimensional supergravity

International Nuclear Information System (INIS)

Poessel, M.

2003-05-01

This thesis is concerned with the study of hidden symmetries in supergravity, which play an important role in the present picture of supergravity and string theory. Concretely, the appearance of a hidden G 2(+2) /SO(4) symmetry is studied in the dimensional reduction of d=5, N=2 supergravity to three dimensions - a parallel model to the more famous E 8(+8) /SO(16) case in eleven-dimensional supergravity. Extending previous partial results for the bosonic part, I give a derivation that includes fermionic terms. This sheds new light on the appearance of the local hidden symmetry SO(4) in the reduction, and shows up an unusual feature which follows from an analysis of the R-symmetry associated with N=4 supergravity and of the supersymmetry variations, and which has no parallel in the eleven-dimensional case: The emergence of an additional SO(3) as part of the enhanced local symmetry, invisible in the dimensional reduction of the gravitino, and corresponding to the fact that, of the SO(4) used in the coset model, only the diagonal SO(3) is visible immediately upon dimensional reduction. The uncovering of the hidden symmetries proceeds via the construction of the proper coset gravity in three dimensions, and matching it with the Lagrangian obtained from the reduction. (orig.)

The Hidden Poor: Over Three-Quarters of a Million Older Californians Overlooked by Official Poverty Line.

Science.gov (United States)

Padilla-Frausto, Imelda D; Wallace, Steven P

2015-08-01

More than three-quarters of a million (772,000) older Californians are among the "hidden poor"--older adults with incomes above the federal poverty line (FPL) but below a minimally decent standard of living as determined by the Elder Economic Security Standard™ Index (Elder Index) in 2011. This policy brief uses the most recent Elder Index calculations to document the wide discrepancy that exists between the FPL and the Elder Index. This study finds that the FPL significantly underestimates the number of economically insecure older adults who are unable to make ends meet. Yet, because many public assistance programs are aligned with the FPL, potentially hundreds of thousands of economically insecure older Californians are denied aid. The highest rates of the hidden poor among older adults are found among renters, Latinos, women, those who are raising grandchildren, and people in the oldest age groups. Raising the income and asset eligibility requirement thresholds for social support programs such as Supplemental Security Income (SSI), housing, health care, and food assistance would help California's older hidden poor make ends meet.

QCD sum rule study of hidden-charm pentaquarks

Energy Technology Data Exchange (ETDEWEB)

Chen, Hua-Xing; Cui, Er-Liang [Beihang University, School of Physics and Beijing Key Laboratory of Advanced Nuclear Materials and Physics, Beijing (China); Chen, Wei; Steele, T.G. [University of Saskatchewan, Department of Physics and Engineering Physics, Saskatoon, Saskatchewan (Canada); Liu, Xiang [Lanzhou University, School of Physical Science and Technology, Lanzhou (China); Lanzhou University and Institute of Modern Physics of CAS, Research Center for Hadron and CSR Physics, Lanzhou (China); Zhu, Shi-Lin [Peking University, School of Physics and State Key Laboratory of Nuclear Physics and Technology, Beijing (China); Collaborative Innovation Center of Quantum Matter, Beijing (China); Peking University, Center of High Energy Physics, Beijing (China)

2016-10-15

We study the mass spectra of hidden-charm pentaquarks having spin J = (1)/(2)/(3)/(2)/(5)/(2) and quark contents uudc anti c. We systematically construct all the relevant local hidden-charm pentaquark currents, and we select some of them to perform QCD sum rule analyses. We find that the P{sub c}(4380) and P{sub c}(4450) can be identified as hidden-charm pentaquark states composed of an anti-charmed meson and a charmed baryon. Besides them, we also find (a) the lowest-lying hidden-charm pentaquark state of J{sup P} = 1/2{sup -} has the mass 4.33{sup +0.17}{sub -0.13} GeV, while the one of J{sup P} = 1/2{sup +} is significantly higher, that is, around 4.7-4.9 GeV; (b) the lowest-lying hidden-charm pentaquark state of J{sup P} = 3/2{sup -} has the mass 4.37{sup +0.18}{sub -0.13} GeV, consistent with the P{sub c}(4380) of J{sup P} = 3/2{sup -}, while the one of J{sup P} = 3/2{sup +} is also significantly higher, that is, above 4.6 GeV; (c) the hidden-charm pentaquark state of J{sup P} = 5/2{sup -} has a mass around 4.5-4.6 GeV, slightly larger than the P{sub c}(4450) of J{sup P} = 5/2{sup +}. (orig.)

FACTORS PREDICTING MORBIDITY IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL

Directory of Open Access Journals (Sweden)

Muhammad Imran Hasan Khan

2013-02-01

Full Text Available Introduction: Dengue virus (DENV affects over half the world’s population in 112 countries, and dengue fever (DF is the second largest arthropod borne infectious global hazard after malaria with complications like Dengue Hemorrhagic Fever (DHF and Dengue Shock Syndrome (DSS accounting for significant morbidity and mortality world over. Pakistan is significantly affected with DENV infection and to-date no study identifying risk factors associated with complications of DF has been done. Methods: 997 confirmed cases of DF were collected in a tertiary care hospital in Lahore, Pakistan and their clinical and biochemical data were collected. Univariate, multivariate and logistics regression analysis was performed to identify risk factors associated with development of DHF and DSS. Results: Bleeding OR 70.7 (CI 38.4-129.9, deranged liver function test OR 1.9 (CI 0.97-0.99, platelet count on admission less than 50,000 x109/L OR 0.16 (CI 0.13-0.19, presence of urinary red blood cells OR 1.4 (CI 0.179-0.900 and presence of urinary protein OR 1.1 (CI 0.191-0.974 were related to development of DHF and DSS.

Hidden sources of grapefruit in beverages: potential interactions with immunosuppressant medications.

Science.gov (United States)

Auten, Ashley A; Beauchamp, Lauren N; Joshua Taylor; Hardinger, Karen L

2013-06-01

The interaction between grapefruit-containing beverages and immunosuppressants is not well defined in the literature. This study was conducted to investigate possible sources of grapefruit juice or grapefruit extract in common US-manufactured beverages. The goal was to identify those products that might serve as hidden sources of dietary grapefruit intake, increasing a transplant patient's risk for drug interactions. A careful review of the ingredients of the 3 largest US beverage manufacturer's product lines was conducted through manufacturer correspondence, product labeling examination, and online nutrition database research. Focus was placed on citrus-flavored soft drinks, teas, and juice products and their impact on a patient's immunosuppressant regimens. Twenty-three beverages were identified that contained grapefruit. Five did not contain the word "grapefruit" in the product name. In addition to the confirmed grapefruit-containing products, 17 products were identified as possibly containing grapefruit juice or grapefruit extract. A greater emphasis should be placed upon properly educating patients regarding hidden sources of grapefruit in popular US beverages and the potential for food-drug interactions.

Sociocultural Dimension of Hidden Content in a Professional Language Curriculum

Directory of Open Access Journals (Sweden)

Ekaterina E. Shishlova

2017-12-01

Full Text Available Introduction: studying curriculum as a pedagogical problem has traditionally been reduced to the analysis of its explicit content, set in official educational documents. However, a much less studied hidden content plays a significant role in education. So, what is the role of the hidden curriculum during professional language training? The purpose of the article is to determine the potential impact of hidden curriculum on students’ conceptual worldview. Comparing the worldview presented in textbooks with students’ one has allowed us to estimate the rate of influence of hidden curr iculum. Materials and Methods: the methodological basis of the work is the cultural concept of personalityoriented education. The methodology for studying the role of hidden curriculum includes four stages: at the first stage, the authors set the criteria for selecting textbooks for analysis and do the selection; at the second stage, the authors select sociocultural concepts for analysis; at the third stage, the scheme of analysis is designed and the analysis of textbooks is done; at the fourth stage, the authors identify the potential influence of hidden curriculum on students’ conceptual worldview. Results: the structure of hidden curriculum has been determined and the scheme for analysing its subject component has been developed. The authors have identified a significant influence of hidden curriculum on students’ worldview, which represents the scientific novelty of the article. Discussion and Conclusions: the article gives the definition of a hidden curriculum which is new for Russian pedagogy and presents a methodology for its analysis in EFL textbooks. That analysis is recommended to be conducted when selecting teaching materials both i n languages and other humanities.

Establishing a National Maternal Morbidity Outcome Indicator in England: A Population-Based Study Using Routine Hospital Data.

Directory of Open Access Journals (Sweden)

Manisha Nair

Full Text Available As maternal deaths become rarer, monitoring near-miss or severe maternal morbidity becomes important as a tool to measure changes in care quality. Many calls have been made to use routinely available hospital administration data to monitor the quality of maternity care. We investigated 1 the feasibility of developing an English Maternal Morbidity Outcome Indicator (EMMOI by reproducing an Australian indicator using routinely available hospital data, 2 the impact of modifications to the indicator to address potential data quality issues, 3 the reliability of the indicator.We used data from 6,389,066 women giving birth in England from April 2003 to March 2013 available in the Hospital Episode Statistics (HES database of the Health and Social care Information centre (HSCIC. A composite indicator, EMMOI, was generated from the diagnoses and procedure codes. Rates of individual morbid events included in the EMMOI were compared with the rates in the UK reported by population-based studies.EMMOI included 26 morbid events (17 diagnosis and 9 procedures. Selection of the individual morbid events was guided by the Australian indicator and published literature for conditions associated with maternal morbidity and mortality in the UK, but was mainly driven by the quality of the routine hospital data. Comparing the rates of individual morbid events of the indicator with figures from population-based studies showed that the possibility of false positive and false negative cases cannot be ruled out.While routine English hospital data can be used to generate a composite indicator to monitor trends in maternal morbidity during childbirth, the quality and reliability of this monitoring indicator depends on the quality of the hospital data, which is currently inadequate.

Infinite hidden conditional random fields for human behavior analysis.

Science.gov (United States)

Bousmalis, Konstantinos; Zafeiriou, Stefanos; Morency, Louis-Philippe; Pantic, Maja

2013-01-01

Hidden conditional random fields (HCRFs) are discriminative latent variable models that have been shown to successfully learn the hidden structure of a given classification problem (provided an appropriate validation of the number of hidden states). In this brief, we present the infinite HCRF (iHCRF), which is a nonparametric model based on hierarchical Dirichlet processes and is capable of automatically learning the optimal number of hidden states for a classification task. We show how we learn the model hyperparameters with an effective Markov-chain Monte Carlo sampling technique, and we explain the process that underlines our iHCRF model with the Restaurant Franchise Rating Agencies analogy. We show that the iHCRF is able to converge to a correct number of represented hidden states, and outperforms the best finite HCRFs--chosen via cross-validation--for the difficult tasks of recognizing instances of agreement, disagreement, and pain. Moreover, the iHCRF manages to achieve this performance in significantly less total training, validation, and testing time.

Detecting hidden particles with MATHUSLA

Science.gov (United States)

Evans, Jared A.

2018-03-01

A hidden sector containing light long-lived particles provides a well-motivated place to find new physics. The recently proposed MATHUSLA experiment has the potential to be extremely sensitive to light particles originating from rare meson decays in the very long lifetime region. In this work, we illustrate this strength with the specific example of a light scalar mixed with the standard model-like Higgs boson, a model where MATHUSLA can further probe unexplored parameter space from exotic Higgs decays. Design augmentations should be considered in order to maximize the ability of MATHUSLA to discover very light hidden sector particles.

Zipf exponent of trajectory distribution in the hidden Markov model

Science.gov (United States)

Bochkarev, V. V.; Lerner, E. Yu

2014-03-01

This paper is the first step of generalization of the previously obtained full classification of the asymptotic behavior of the probability for Markov chain trajectories for the case of hidden Markov models. The main goal is to study the power (Zipf) and nonpower asymptotics of the frequency list of trajectories of hidden Markov frequencys and to obtain explicit formulae for the exponent of the power asymptotics. We consider several simple classes of hidden Markov models. We prove that the asymptotics for a hidden Markov model and for the corresponding Markov chain can be essentially different.

Zipf exponent of trajectory distribution in the hidden Markov model

International Nuclear Information System (INIS)

Bochkarev, V V; Lerner, E Yu

2014-01-01

This paper is the first step of generalization of the previously obtained full classification of the asymptotic behavior of the probability for Markov chain trajectories for the case of hidden Markov models. The main goal is to study the power (Zipf) and nonpower asymptotics of the frequency list of trajectories of hidden Markov frequencys and to obtain explicit formulae for the exponent of the power asymptotics. We consider several simple classes of hidden Markov models. We prove that the asymptotics for a hidden Markov model and for the corresponding Markov chain can be essentially different

Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) - Smoking-Attributable Expenditures (SAE)

Data.gov (United States)

U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable expenditures (SAEs) are excess health care expenditures...

SHIFT: server for hidden stops analysis in frame-shifted translation.

Science.gov (United States)

Gupta, Arun; Singh, Tiratha Raj

2013-02-23

Frameshift is one of the three classes of recoding. Frame-shifts lead to waste of energy, resources and activity of the biosynthetic machinery. In addition, some peptides synthesized after frame-shifts are probably cytotoxic which serve as plausible cause for innumerable number of diseases and disorders such as muscular dystrophies, lysosomal storage disorders, and cancer. Hidden stop codons occur naturally in coding sequences among all organisms. These codons are associated with the early termination of translation for incorrect reading frame selection and help to reduce the metabolic cost related to the frameshift events. Researchers have identified several consequences of hidden stop codons and their association with myriad disorders. However the wealth of information available is speckled and not effortlessly acquiescent to data-mining. To reduce this gap, this work describes an algorithmic web based tool to study hidden stops in frameshifted translation for all the lineages through respective genetic code systems. This paper describes SHIFT, an algorithmic web application tool that provides a user-friendly interface for identifying and analyzing hidden stops in frameshifted translation of genomic sequences for all available genetic code systems. We have calculated the correlation between codon usage frequencies and the plausible contribution of codons towards hidden stops in an off-frame context. Markovian chains of various order have been used to model hidden stops in frameshifted peptides and their evolutionary association with naturally occurring hidden stops. In order to obtain reliable and persuasive estimates for the naturally occurring and predicted hidden stops statistical measures have been implemented. This paper presented SHIFT, an algorithmic tool that allows user-friendly exploration, analysis, and visualization of hidden stop codons in frameshifted translations. It is expected that this web based tool would serve as a useful complement for

[Case-control study on effect of rivaroxaban on the risk of hidden bleeding after total hip arthroplasty].

Science.gov (United States)

Li, Jun; Jing, Jue-Hua; Shi, Zhan-Jun; Zhou, Yun

2014-01-01

To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty. From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula. The mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups. Rivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

Asymptotics for Estimating Equations in Hidden Markov Models

DEFF Research Database (Denmark)

Hansen, Jørgen Vinsløv; Jensen, Jens Ledet

Results on asymptotic normality for the maximum likelihood estimate in hidden Markov models are extended in two directions. The stationarity assumption is relaxed, which allows for a covariate process influencing the hidden Markov process. Furthermore a class of estimating equations is considered...

A hidden service model based on HS-HS anonymous network

Science.gov (United States)

Meng, Yitong; Zhao, Xing; Fei, Jinlong; Zhu, Yuefei

2017-10-01

The Hidden Service provided by Tor anonymous network can effectively protect the anonymity and security of the Hidden server, this article through the analysis of the data packet structure of Tor, three jump transmission mechanism and link establishment protocol and Hidden Service communication process, in view of the Hidden node number too much, link building Service for too long and too redundant link problem. An improved hidden service model HS-HS is proposed that incorporating multiple transmission link and reuse, and at the same time will be important transit point for reuse protection link anonymity, through the ExperimenTor simulation environment test, verify the improved model of HS-HS can be more effective in guarantee anonymity and security, improve the overall efficiency of data transmission, to meet the needs of today's anonymous service.

Management of co-morbidity of depression and chronic non ...

African Journals Online (AJOL)

Methods: The study used an action research design involving a research team of 14 health care professionals to collaboratively identify existing protocols or interventions for managing co-morbidity of depression and NCDs in Rwanda. Focus group discussion using a structured interview guide was used to collect qualitative ...

VISIBLE COSTS AND HIDDEN COSTS IN THE BAKING INDUSTRY

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Criveanu Maria

2013-04-01

Full Text Available Hidden costs are present in the activity of any company, hardly identified in the traditional administrative accounting. The high levels of the hidden costs and their unknown presence have serious consequences on the decisions made by the managers. This paper aims at presenting some aspects related to the hidden costs that occur in the activity of the companies in the baking industry and the possibilities to reduce their level.

Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

Science.gov (United States)

Baird, Suzanne McMurtry; Troiano, Nan H; Kennedy, Margaret Betsy Babb

"Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

The hidden values

DEFF Research Database (Denmark)

Rasmussen, Birgitte; Jensen, Karsten Klint

“The Hidden Values - Transparency in Decision-Making Processes Dealing with Hazardous Activities”. The report seeks to shed light on what is needed to create a transparent framework for political and administrative decisions on the use of GMOs and chemical products. It is our hope that the report...

A systematic review of the burden of neonatal mortality and morbidity in the ASEAN Region.

Science.gov (United States)

Tran, Hoang T; Doyle, Lex W; Lee, Katherine J; Graham, Stephen M

2012-01-01

Neonatal morbidity and mortality are major global public health challenges representing an increasing proportion of overall under-5 child mortality, with the vast majority of neonatal deaths occurring in resource-limited settings. In the Association of Southeast Asian Nations (ASEAN) region, it is estimated that approximately 200 000 neonatal deaths occur annually with reported estimates of the neonatal mortality rate ranging from 1 to over 30 per 1000 live-births, depending on the setting. The aim of this study is to conduct a systematic review of published data on neonatal morbidity and mortality from the ASEAN region over the last 10 years. Very few published studies reporting neonatal morbidity and mortality in this region were found. Importantly, data are available from just a few countries, with an underrepresentation of the most resource-limited settings. The majority of the studies describing mortality and morbidity were retrospective surveys or focussed on a specific cause of neonatal morbidity. Studies included findings from a range of settings, from neonatal intensive care to community settings utilizing verbal autopsy. Therefore, comprehensive and prospective data are needed to inform priorities and potential interventions to improve neonatal care and reduce neonatal mortality in this region.

Psychiatric morbidity in perimenopausal women

Directory of Open Access Journals (Sweden)

Biswajit L Jagtap

2016-01-01

Full Text Available Background: Women in the perimenopausal period are reported to be vulnerable to psychiatric disorders. Aim: To assess the psychiatric morbidity in perimenopausal women aged 45–55 years. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the Department of Psychiatry in a tertiary care hospital attached to a medical college. The study sample consisted of consecutive women in perimenopause as diagnosed by a gynecologist and written informed consent for inclusion in the study. Women with a previous history of psychiatric illnesses, with a major medical illness, or who had undergone surgical menopause were excluded from the study. All women were evaluated with a brief questionnaire for collecting demographic and clinical information and the Mini International Neuropsychiatric Interview for assessing psychiatric disorders. Results: Of the 108 women in perimenopause included in the study, 31% had depressive disorder, 7% had anxiety, while 5% had depressive disorder with anxiety features. Psychiatric morbidity was significantly more in women having lesser education, from rural background, with a history of psychiatric illness in the family, a later age of menarche, and in the late stage of perimenopause. Conclusions: Women in the perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. As perimenopause is a time of vulnerability in women, attention to signs and symptoms of depression may be required so that they may lead a more productive life.

Suppressing the QCD axion abundance by hidden monopoles

International Nuclear Information System (INIS)

Kawasaki, Masahiro

2015-11-01

We study the Witten effect of hidden monopoles on the QCD axion dynamics, and show that its abundance as well as isocurvature perturbations can be significantly suppressed if there is a sufficient amount of hidden monopoles. When the hidden monopoles make up a significant fraction of dark matter, the Witten effect suppresses the abundance of axion with the decay constant smaller than 10 12 GeV. The cosmological domain wall problem of the QCD axion can also be avoided, relaxing the upper bound on the decay constant when the Peccei-Quinn symmetry is spontaneously broken after inflation.

Lower mortality but higher neonatal morbidity over a decade in very preterm infants

NARCIS (Netherlands)

Kleine, M.J.K. de; Ouden, A.L. den; Kollée, L.A.A.; Ilsen, A.; Wassenaer, A.G. van; Brand, R.; Verloove-Vanhorick, S.P.

2007-01-01

Better perinatal care has led to better survival of very preterm children, but may or may not have increased the number of children with cerebral and pulmonary morbidity. We therefore investigated the relationship between changes in perinatal care during one decade, and short-term outcome in very

Social exclusion, health and hidden homelessness.

Science.gov (United States)

Watson, J; Crawley, J; Kane, D

2016-10-01

Homelessness and poverty are extreme forms of social exclusion which extend beyond the lack of physical or material needs. The purpose of this study was to explore and expand the concept of social exclusion within the social determinants of health perspective - to understand how the social environment, health behaviours and health status are associated with material and social deprivation. Fundamental qualitative description with tones of focused ethnography. Participants who identified as hidden homeless described their everyday living conditions and how these everyday conditions were impacted and influenced by their social environments, coping/health behaviours and current health status. Research Ethics Board approval was granted and informed consents were obtained from 21 participants prior to the completion of individual interviews. Qualitative content analysis examined the descriptions of men and women experiencing hidden homelessness. Participants described the 'lack of quality social interactions and supports' and their 'daily struggles of street life'. They also shared the 'pain of addiction' and how coping strategies influenced health. Participants were hopeful that their insights would 'better the health of homeless people' by helping shape public policy and funding of community resources that would reduce barriers and improve overall health. Health professionals who understand health behaviours as coping mechanisms for poor quality social environments can provide more comprehensive and holistic care. The findings of this study can be used to support the importance of housing as a key factor in the health and well-being of people experiencing poverty, homelessness and social exclusion; and consequently, reinforces the need for a national housing strategy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands.

Science.gov (United States)

Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

2010-02-01

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified in 115 pharmacies and a questionnaire was sent to their stimulant prescribing physician. Of 773 questionnaires sent out, 556 were returned and were suitable for analysis (72%). The results are based on 510 questionnaires concerning stimulant-treated children for whom a diagnosis of ADHD was reported. Of the 510 children diagnosed with ADHD, 31% had also received one or more other psychiatric diagnoses, mainly pervasive developmental disorder or oppositional defiant disorder/conduct disorder. We found an association between the presence of co-morbidity and the use of psychosocial interventions for the child (P parents (P receive any form of additional interventions, while psychosocial interventions varied from 8 to 18% in children with ADHD and psychiatric co-morbidity. The presence of diagnostic co-morbidity was also associated with the use of psychotropic co-medication (overall, P = 0.012) and antipsychotics (P received more psychosocial interventions and psychotropic co-medication than children with ADHD-only. The type of psychosocial interventions and psychotropic co-medication received by the children and their parents, depended on the specific co-morbid psychiatric disorder being present.

Context Tree Estimation in Variable Length Hidden Markov Models

OpenAIRE

Dumont, Thierry

2011-01-01

We address the issue of context tree estimation in variable length hidden Markov models. We propose an estimator of the context tree of the hidden Markov process which needs no prior upper bound on the depth of the context tree. We prove that the estimator is strongly consistent. This uses information-theoretic mixture inequalities in the spirit of Finesso and Lorenzo(Consistent estimation of the order for Markov and hidden Markov chains(1990)) and E.Gassiat and S.Boucheron (Optimal error exp...

Extracting hidden-photon dark matter from an LC-circuit

International Nuclear Information System (INIS)

Arias, Paola; Arza, Ariel; Gamboa, Jorge; Mendez, Fernando

2014-11-01

We point out that a cold dark matter condensate made of gauge bosons from an extra hidden U(1) sector - dubbed hidden-photons - can create a small, oscillating electric density current. Thus, they could also be searched for in the recently proposed LC-circuit setup conceived for axion cold dark matter search by Sikivie, Sullivan and Tanner. We estimate the sensitivity of this setup for hidden-photon cold dark matter and we find it could cover a sizable, so far unexplored parameter space.

Extracting Hidden-Photon Dark Matter From an LC-Circuit

CERN Document Server

Arias, Paola; Döbrich, Babette; Gamboa, Jorge; Méndez, Fernando

2015-01-01

We point out that a cold dark matter condensate made of gauge bosons from an extra hidden U(1) sector - dubbed hidden- photons - can create a small, oscillating electric density current. Thus, they could also be searched for in the recently proposed LC-circuit setup conceived for axion cold dark matter search by Sikivie, Sullivan and Tanner. We estimate the sensitivity of this setup for hidden-photon cold dark matter and we find it could cover a sizable, so far unexplored parameter space.

Early postpartum maternal morbidity among rural women of Rajasthan, India: a community-based study.

Science.gov (United States)

Iyengar, Kirti

2012-06-01

The first postpartum week is a high-risk period for mothers and newborns. Very few community-based studies have been conducted on patterns of maternal morbidity in resource-poor countries in that first week. An intervention on postpartum care for women within the first week after delivery was initiated in a rural area of Rajasthan, India. The intervention included a rigorous system of receiving reports of all deliveries in a defined population and providing home-level postpartum care to all women, irrespective of the place of delivery. Trained nurse-midwives used a structured checklist for detecting and managing maternal and neonatal conditions during postpartum-care visits. A total of 4,975 women, representing 87.1% of all expected deliveries in a population of 58,000, were examined in their first postpartum week during January 2007-December 2010. Haemoglobin was tested for 77.1% of women (n=3,836) who had a postnatal visit. The most common morbidity was postpartum anaemia--7.4% of women suffered from severe anaemia and 46% from moderate anaemia. Other common morbidities were fever (4%), breast conditions (4.9%), and perineal conditions (4.5%). Life-threatening postpartum morbidities were detected in 7.6% of women--9.7% among those who had deliveries at home and 6.6% among those who had institutional deliveries. None had a fistula. Severe anaemia had a strong correlation with perinatal death [pcaste or tribe [p<0.000, AOR=2.47 (95% CI 1.83-3.33)], and parity of three or more [p<0.000, AOR=1.52 (95% CI 1.18-1.97)]. The correlation with antenatal care was not significant. Perineal conditions were more frequent among women who had institutional deliveries while breast conditions were more common among those who had a perinatal death. This study adds valuable knowledge on postpartum morbidity affecting women in the first few days after delivery in a low-resource setting. Health programmes should invest to ensure that all women receive early postpartum visits after

Neonatal morbidity associated with shoulder dystocia maneuvers.

Science.gov (United States)

Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

2015-03-01

We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

Hidden photons in beam dump experiments and in connection with dark matter

Energy Technology Data Exchange (ETDEWEB)

Andreas, Sarah

2012-12-15

Hidden sectors with light extra U(1) gauge bosons, so-called hidden photons, recently received much interest as natural feature of beyond standard model scenarios like string theory and SUSY and because of their possible connection to dark matter. This paper presents limits on hidden photons from past electron beam dump experiments including two new limits from experiments at KEK and Orsay. Additionally, various hidden sector models containing both a hidden photon and a dark matter candidate are discussed with respect to their viability and potential signatures in direct detection.

Hidden photons in beam dump experiments and in connection with dark matter

International Nuclear Information System (INIS)

Andreas, Sarah

2012-12-01

Hidden sectors with light extra U(1) gauge bosons, so-called hidden photons, recently received much interest as natural feature of beyond standard model scenarios like string theory and SUSY and because of their possible connection to dark matter. This paper presents limits on hidden photons from past electron beam dump experiments including two new limits from experiments at KEK and Orsay. Additionally, various hidden sector models containing both a hidden photon and a dark matter candidate are discussed with respect to their viability and potential signatures in direct detection.

Search for hidden particles with the SHiP experiment

Energy Technology Data Exchange (ETDEWEB)

Hagner, Caren; Bick, Daniel; Bieschke, Stefan; Ebert, Joachim; Schmidt-Parzefall, Walter [Universitaet Hamburg, Institut fuer Experimentalphysik, Luruper Chaussee 149, 22761 Hamburg (Germany)

2016-07-01

Many theories beyond the standard model predict long lived neutral (hidden) particles. There might be a whole Hidden Sector (HS) of weakly interacting particles, which cannot be detected in existing high energy experiments. The SHiP experiment (Search for Hidden Particles) requires a high intensity beam dump, which could be realized by a new facility at the CERN SPS accelerator. New superweakly interacting particles with masses below O(10) GeV could be produced in the beam dump and detected in a general purpose Hidden Sector (HS) detector. In addition there will be a dedicated tau neutrino subdetector. I present the major requirements and technical challenges for the HS detector and discuss how the HS can be accessed through several portals: neutrino portal, scalar portal, vector portal and many more.

Multilayer Neural Networks with Extensively Many Hidden Units

International Nuclear Information System (INIS)

Rosen-Zvi, Michal; Engel, Andreas; Kanter, Ido

2001-01-01

The information processing abilities of a multilayer neural network with a number of hidden units scaling as the input dimension are studied using statistical mechanics methods. The mapping from the input layer to the hidden units is performed by general symmetric Boolean functions, whereas the hidden layer is connected to the output by either discrete or continuous couplings. Introducing an overlap in the space of Boolean functions as order parameter, the storage capacity is found to scale with the logarithm of the number of implementable Boolean functions. The generalization behavior is smooth for continuous couplings and shows a discontinuous transition to perfect generalization for discrete ones

Hidden Area and Mechanical Nonlinearities in Freestanding Graphene

Science.gov (United States)

Nicholl, Ryan J. T.; Lavrik, Nickolay V.; Vlassiouk, Ivan; Srijanto, Bernadeta R.; Bolotin, Kirill I.

2017-06-01

We investigated the effect of out-of-plane crumpling on the mechanical response of graphene membranes. In our experiments, stress was applied to graphene membranes using pressurized gas while the strain state was monitored through two complementary techniques: interferometric profilometry and Raman spectroscopy. By comparing the data obtained through these two techniques, we determined the geometric hidden area which quantifies the crumpling strength. While the devices with hidden area ˜0 % obeyed linear mechanics with biaxial stiffness 428 ±10 N /m , specimens with hidden area in the range 0.5%-1.0% were found to obey an anomalous nonlinear Hooke's law with an exponent ˜0.1 .

Extracting hidden-photon dark matter from an LC-circuit

International Nuclear Information System (INIS)

Arias, Paola; Arza, Ariel; Gamboa, Jorge; Mendez, Fernando; Doebrich, Babette

2015-01-01

We point out that a cold dark matter condensate made of gauge bosons from an extra hidden U(1) sector - dubbed hidden photons - can create a small, oscillating electric density current. Thus, they could also be searched for in the recently proposed LC-circuit setup conceived for axion cold dark matter search by Sikivie, Sullivan and Tanner. We estimate the sensitivity of this setup for hidden-photon cold dark matter and we find it could cover a sizable, so far unexplored parameter space. (orig.)

Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study.

Science.gov (United States)

Toft, Tomas; Fink, Per; Oernboel, Eva; Christensen, Kaj; Frostholm, Lisbeth; Olesen, Frede

2005-08-01

Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.

Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India.

Science.gov (United States)

Jacob, P; Srinath, S; Girimaji, S; Seshadri, S; Sagar, J V

2016-12-01

To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

Petro Rents, Political Institutions, and Hidden Wealth

DEFF Research Database (Denmark)

Andersen, Jørgen Juel; Johannesen, Niels; Lassen, David Dreyer

2017-01-01

Do political institutions limit rent seeking by politicians? We study the transformation of petroleum rents, almost universally under direct government control, into hidden wealth using unique data on bank deposits in offshore financial centers that specialize in secrecy and asset protection. Our...... rulers is diverted to secret accounts. We find very limited evidence that shocks to other types of income not directly controlled by governments affect hidden wealth....

Hidden charm molecules in a finite volume

International Nuclear Information System (INIS)

Albaladejo, M.; Hidalgo-Duque, C.; Nieves, J.; Oset, E.

2014-01-01

In the present paper we address the interaction of charmed mesons in hidden charm channels in a finite box. We use the interaction from a recent model based on heavy quark spin symmetry that predicts molecules of hidden charm in the infinite volume. The energy levels in the box are generated within this model, and several methods for the analysis of these levels ("inverse problem") are investigated. (author)

B-graph sampling to estimate the size of a hidden population

NARCIS (Netherlands)

Spreen, M.; Bogaerts, S.

2015-01-01

Link-tracing designs are often used to estimate the size of hidden populations by utilizing the relational links between their members. A major problem in studies of hidden populations is the lack of a convenient sampling frame. The most frequently applied design in studies of hidden populations is

Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.

Science.gov (United States)

Sivaram, P; Sreekumar, A

2018-04-01

Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a substantial health problem with significant postoperative morbidity and mortality. This study aimed to find out the association between various preoperative and intraoperative factors with the postoperative mortality and morbidity in patients operated for peptic ulcer perforation. This prospective observational study had a time based sample of 101 perforation peritonitis cases admitted to the surgical wards of a tertiary care center from February 2015 to January 2016 who underwent laparotomy, diagnosed to have peptic ulcer perforation and underwent simple closure with an omental patch. Data regarding age, gender, presenting complaints, time elapsed from the onset of symptoms to surgery, physical examination findings, comorbid diseases, laboratory and imaging findings, intraoperative findings, length of hospital stay, postoperative morbidity, and mortality were recorded and analyzed. Female gender, older age group, perforation surgery interval more than 36 h, and size of perforation more than 1 cm 2 were found to be significant factors influencing postoperative mortality and morbidity. Postoperative morbidity was also associated with comorbid diseases. Abnormal renal function on presentation was identified as an additional risk factor for postoperative morbidity and longer hospital stay. An understanding of these factors, identification of patients at risk and early intervention can help in reducing the postoperative morbidity and mortality in peptic ulcer perforation.

Hidden Agendas in Marriage: Affective and Longitudinal Dimensions.

Science.gov (United States)

Krokoff, Lowell J.

1990-01-01

Examines how couples' discussions of troublesome problems reveal hidden agendas (issues not directly discussed or explored). Finds disgust and contempt are at the core of both love and respect agendas for husbands and wives. Finds that wives' more than husbands' hidden agendas are directly predictive of how negatively they argue at home. (SR)

Vocal cord paralysis post patent ductus arteriosus ligation surgery: risks and co-morbidities.

Science.gov (United States)

Rukholm, Gavin; Farrokhyar, Forough; Reid, Diane

2012-11-01

1. To determine the prevalence of left vocal cord paralysis (LVCP) post patent ductus arteriosus (PDA) ligation at a Tertiary Care Centre. 2. To identify risk factors associated with LVCP. 3. To identify co-morbidities associated with LVCP. 4. To determine the frequency of pre- and post-operative nasopharyngolaryngoscopic (NPL) examination in this patient population. Retrospective chart review of all infants who underwent PDA ligation surgery at a tertiary care academic hospital between July 2003 and July 2010. Data on patient age, gender, weight, method of PDA ligation, and results of NPL scoping were collected, as well as patient co-morbidities post PDA ligation. One hundred and fifteen patients underwent PDA ligation surgery. Four patients were excluded due to bilateral vocal cord paralysis. Of the remaining 111 patients, nineteen patients (17.1%) were found to have LVCP. Low birth weight was identified as a significant risk factor for LVCP (p=0.002). Gastroesophageal reflux was identified as a significant co-morbidity associated with LVCP post PDA ligation (p=0.002). Only 0.9% of patients were scoped pre-operatively, and 27.9% were scoped postoperatively. LVCP is associated with multiple morbidities. The authors strongly recommend routine post-operative scoping of all patients post PDA ligation surgery, and preoperative scoping when possible. A prospective study is warranted, in order to confirm the prevalence of LVCP as well as risk factors and associated co-morbidities. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Observable Effects of Atmospheric Pollution on Outpatient and Inpatient Morbidity in Bulgaria.

Science.gov (United States)

Platikanova, Magdalena; Penkova-Radicheva, Mariana

2016-04-01

One of Europe's most well-developed industrial regions is found in the Republic of Bulgaria. The industrialization of the region has a big impact on air pollution. Thermal power plant "Maritza East" (the largest of its kind in southeastern Europe), the army training range, machine manufacturers, household heating and high volume of automobile traffic are all major sources of pollution in the region. A five year study (2009-2013) followed yearly concentrations of principal atmospheric pollutants such as sulfur dioxide, dust, nitrogen dioxide, lead aerosols and hydrogen sulfide, and the way in which those levels had an effect on morbidity (outpatient and inpatient medical care) in the area. Statistical processing of data has been completed to represent and analyze the collected data in nonparametric and alternative format. Atmospheric pollution affects human health directly through pathological changes in the human organism. The registered outpatient care provided for the period 2009-2013 is highest for diseases of the cardiovascular system (11.85%), the respiratory system (17.34%) and the genitourinary system (9.76%). The registered rate of hospitalization for the same period is for diseases of the digestive system (11.90%), the cardiovascular system (11.85%), respiratory system (10.86%) and the genitourinary system (8.88%). The observed period shows a decrease in average yearly concentrations of the principal atmospheric pollutants in the industrial region (Bulgaria) and reflects a decrease in morbidity based on outpatient care and an increase in morbidity by inpatient care (hospitalization). Our findings should be corroborated in future longitudinal studies.

A study of geriatric depression and co- morbidities among primary ...

African Journals Online (AJOL)

Depression in the elderly is very common but diagnostic rates among primary care physicians is poor. This is attributed to both patient and physician related factors. The patient factors include co-morbidities, aging and psychological mindedness which is culture related. Generally, there's paucity of psychological complaints ...

Morbidity of curative cancer surgery and suicide risk.

Science.gov (United States)

Jayakrishnan, Thejus T; Sekigami, Yurie; Rajeev, Rahul; Gamblin, T Clark; Turaga, Kiran K

2017-11-01

Curative cancer operations lead to debility and loss of autonomy in a population vulnerable to suicide death. The extent to which operative intervention impacts suicide risk is not well studied. To examine the effects of morbidity of curative cancer surgeries and prognosis of disease on the risk of suicide in patients with solid tumors. Retrospective cohort study using Surveillance, Epidemiology, and End Results data from 2004 to 2011; multilevel systematic review. General US population. Participants were 482 781 patients diagnosed with malignant neoplasm between 2004 and 2011 who underwent curative cancer surgeries. Death by suicide or self-inflicted injury. Among 482 781 patients that underwent curative cancer surgery, 231 committed suicide (16.58/100 000 person-years [95% confidence interval, CI, 14.54-18.82]). Factors significantly associated with suicide risk included male sex (incidence rate [IR], 27.62; 95% CI, 23.82-31.86) and age >65 years (IR, 22.54; 95% CI, 18.84-26.76). When stratified by 30-day overall postoperative morbidity, a significantly higher incidence of suicide was found for high-morbidity surgeries (IR, 33.30; 95% CI, 26.50-41.33) vs moderate morbidity (IR, 24.27; 95% CI, 18.92-30.69) and low morbidity (IR, 9.81; 95% CI, 7.90-12.04). Unit increase in morbidity was significantly associated with death by suicide (odds ratio, 1.01; 95% CI, 1.00-1.03; P = .02) and decreased suicide-specific survival (hazards ratio, 1.02; 95% CI, 1.00-1.03, P = .01) in prognosis-adjusted models. In this sample of cancer patients in the Surveillance, Epidemiology, and End Results database, patients that undergo high-morbidity surgeries appear most vulnerable to death by suicide. The identification of this high-risk cohort should motivate health care providers and particularly surgeons to adopt screening measures during the postoperative follow-up period for these patients. Copyright © 2016 John Wiley & Sons, Ltd.

On the LHC sensitivity for non-thermalised hidden sectors

Science.gov (United States)

Kahlhoefer, Felix

2018-04-01

We show under rather general assumptions that hidden sectors that never reach thermal equilibrium in the early Universe are also inaccessible for the LHC. In other words, any particle that can be produced at the LHC must either have been in thermal equilibrium with the Standard Model at some point or must be produced via the decays of another hidden sector particle that has been in thermal equilibrium. To reach this conclusion, we parametrise the cross section connecting the Standard Model to the hidden sector in a very general way and use methods from linear programming to calculate the largest possible number of LHC events compatible with the requirement of non-thermalisation. We find that even the HL-LHC cannot possibly produce more than a few events with energy above 10 GeV involving states from a non-thermalised hidden sector.

Massive hidden photons as lukewarm dark matter

International Nuclear Information System (INIS)

Redondo, Javier; Postma, Marieke

2008-11-01

We study the possibility that a keV-MeV mass hidden photon (HP), i.e. a hidden sector U(1) gauge boson, accounts for the observed amount of dark matter. We focus on the case where the HP interacts with the standard model sector only through kinetic mixing with the photon. The relic abundance is computed including all relevant plasma effects into the photon's self-energy, which leads to a resonant yield almost independent of the HP mass. The HP can decay into three photons. Moreover, if light enough it can be copiously produced in stars. Including bounds from cosmic photon backgrounds and stellar evolution, we find that the hidden photon can only give a subdominant contribution to the dark matter. This negative conclusion may be avoided if another production mechanism besides kinetic mixing is operative. (orig.)

Massive hidden photons as lukewarm dark matter

Energy Technology Data Exchange (ETDEWEB)

Redondo, Javier [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Postma, Marieke [Nationaal Inst. voor Kernfysica en Hoge-Energiefysica (NIKHEF), Amsterdam (Netherlands)

2008-11-15

We study the possibility that a keV-MeV mass hidden photon (HP), i.e. a hidden sector U(1) gauge boson, accounts for the observed amount of dark matter. We focus on the case where the HP interacts with the standard model sector only through kinetic mixing with the photon. The relic abundance is computed including all relevant plasma effects into the photon's self-energy, which leads to a resonant yield almost independent of the HP mass. The HP can decay into three photons. Moreover, if light enough it can be copiously produced in stars. Including bounds from cosmic photon backgrounds and stellar evolution, we find that the hidden photon can only give a subdominant contribution to the dark matter. This negative conclusion may be avoided if another production mechanism besides kinetic mixing is operative. (orig.)

New limits on hidden photons from past electron beam dumps

International Nuclear Information System (INIS)

Andreas, Sarah; Niebuhr, Carsten; Ringwald, Andreas

2012-09-01

Hidden sectors with light extra U(1) gauge bosons, so called hidden photons, have recently attracted some attention because they are a common feature of physics beyond the Standard Model like string theory and SUSY and additionally are phenomenologically of great interest regarding recent astrophysical observations. The hidden photon is already constrained by various laboratory experiments and presently searched for in running as well as upcoming experiments. We summarize the current status of limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay that have so far not been considered. All our limits take into account the experimental acceptances obtained from Monte Carlo simulations.

New limits on hidden photons from past electron beam dumps

Energy Technology Data Exchange (ETDEWEB)

Andreas, Sarah; Niebuhr, Carsten; Ringwald, Andreas

2012-09-15

Hidden sectors with light extra U(1) gauge bosons, so called hidden photons, have recently attracted some attention because they are a common feature of physics beyond the Standard Model like string theory and SUSY and additionally are phenomenologically of great interest regarding recent astrophysical observations. The hidden photon is already constrained by various laboratory experiments and presently searched for in running as well as upcoming experiments. We summarize the current status of limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay that have so far not been considered. All our limits take into account the experimental acceptances obtained from Monte Carlo simulations.

Time trends in primary-care morbidity, hospitalization and mortality due to pneumonia.

NARCIS (Netherlands)

Gageldonk-Lafeber, A.B. van; Bogaerts, M.A.H.; Verheij, R.; Sande, M.A.B. van der

2009-01-01

Most studies reporting pneumonia morbidity are restricted to hospitalized patients, although only a minority of pneumonia patients are admitted to hospital. To get a better understanding of the burden of disease in the general population, we conducted a population-based retrospective study to

Incidence of the acute renal failure in the intensive care unit at the General Hospital of Mexico: Risk factors and associated morbidity and mortality

OpenAIRE

Herrera-Méndez, J.; Sánchez-Velázquez, L.D.; González-Chávez, A.; Rodríguez-Terán, G.

2015-01-01

Background: The acute renal failure (ARF) contributes to a longer hospital stay, morbidity, mortality and use of resources in critical patients. The estimate of its incidence was difficult, mainly due to the lack of a generally accepted definition. Objective: To determine the incidence, risk factors and effects of the ARF in critical patients. Material and methods: Study of prospective cohort. Patients hospitalised in the Intensive Care Unit (ICU) were included. The population was di...

Patterns and expenditures of multi-morbidity in an insured working population in the United States: insights for a sustainable health care system and building healthier lives.

Science.gov (United States)

Greene, Robert; Dasso, Edwin; Ho, Sam; Frank, Jerry; Scandrett, Graeme; Genaidy, Ash

2013-12-01

The U.S. health care system is currently heading toward unsustainable health care expenditures and increased dissatisfaction with health outcomes. The objective of this population-based study is to uncover practical insights regarding patients with 1 or more chronic illnesses. A cross-sectional investigation was designed to gather data from health records drawn from diverse US geographic markets. A database of 9.74 million fully-insured, working individuals was used, together with members in the same households. Among nearly 3.43 million patients with claims, 2.22 million had chronic conditions. About 24.3% had 1 chronic condition and 40.4% had multi-morbidity. Health care expenditures for chronic conditions accounted for 92% of all costs (52% for chronic costs and 40% for nonchronic costs). Psychiatry, orthopedics-rheumatology, endocrinology, and cardiology areas accounted for two thirds of these chronic condition costs; nonchronic condition costs were dominated by otolaryngology, gastroenterology, dermatology, orthopedics-rheumatology conditions, and preventive services. About 50.1% of all households had 2 or more members with chronic conditions. In summary, multi-morbidity is prevalent not only among those older than age 65 years but also in younger and working individuals, and commonly occurs among several members of a household. The authors suggest that the disease-focused model of medicine should change to a more holistic illness-wellness model, emphasizing not only the physical but also the mental and social elements that can influence individual health. In that way the chronic care model could be broadened in context and content to improve the health of patients and households.

Invisible axion in the hidden sector of no-scale supergravity

International Nuclear Information System (INIS)

Sato, Hikaru

1987-01-01

We propose a new axion model which incorporates the U(1) PQ symmetry into a hidden sector, as well as an observable sector, of no-scale supergravity models. The axion is a spin-zero field in the hidden sector. The U(1) PQ symmetry is naturally embedded in the family symmetry of the no-scale models. Invisible axions live in the gravity hidden sector without conflict with the cosmological and astrophysical constraints. (orig.)

Increased taxon sampling reveals thousands of hidden orthologs in flatworms

Science.gov (United States)

2017-01-01

Gains and losses shape the gene complement of animal lineages and are a fundamental aspect of genomic evolution. Acquiring a comprehensive view of the evolution of gene repertoires is limited by the intrinsic limitations of common sequence similarity searches and available databases. Thus, a subset of the gene complement of an organism consists of hidden orthologs, i.e., those with no apparent homology to sequenced animal lineages—mistakenly considered new genes—but actually representing rapidly evolving orthologs or undetected paralogs. Here, we describe Leapfrog, a simple automated BLAST pipeline that leverages increased taxon sampling to overcome long evolutionary distances and identify putative hidden orthologs in large transcriptomic databases by transitive homology. As a case study, we used 35 transcriptomes of 29 flatworm lineages to recover 3427 putative hidden orthologs, some unidentified by OrthoFinder and HaMStR, two common orthogroup inference algorithms. Unexpectedly, we do not observe a correlation between the number of putative hidden orthologs in a lineage and its “average” evolutionary rate. Hidden orthologs do not show unusual sequence composition biases that might account for systematic errors in sequence similarity searches. Instead, gene duplication with divergence of one paralog and weak positive selection appear to underlie hidden orthology in Platyhelminthes. By using Leapfrog, we identify key centrosome-related genes and homeodomain classes previously reported as absent in free-living flatworms, e.g., planarians. Altogether, our findings demonstrate that hidden orthologs comprise a significant proportion of the gene repertoire in flatworms, qualifying the impact of gene losses and gains in gene complement evolution. PMID:28400424

Searching for hidden sector in multiparticle production at LHC

Directory of Open Access Journals (Sweden)

Miguel-Angel Sanchis-Lozano

2016-03-01

Full Text Available We study the impact of a hidden sector beyond the Standard Model, e.g. a Hidden Valley model, on factorial moments and cumulants of multiplicity distributions in multiparticle production with a special emphasis on the prospects for LHC results.

An introduction to hidden Markov models for biological sequences

DEFF Research Database (Denmark)

Krogh, Anders Stærmose

1998-01-01

A non-matematical tutorial on hidden Markov models (HMMs) plus a description of one of the applications of HMMs: gene finding.......A non-matematical tutorial on hidden Markov models (HMMs) plus a description of one of the applications of HMMs: gene finding....

Beyond the hidden curriculum: The challenging search for authentic values in medical ethics education

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Gerald Ssebunnya

2013-11-01

Full Text Available Since the practice of medicine is a moral enterprise, medical ethics education aims to produce ‘good’ doctors who are capable of self-reflective discernment of the many values at play in the clinical encounter, and of re-affirming the patient’s human dignity. However, the caring and compassionate physician envisaged as the end-product of medical ethics curricula evidently remains elusive. I argue that this apparent failure of medical ethics education is traceable to a systematic de-emphasis of humanistic values since the pioneering stages of formal medical ethics curricula. The idea of ‘the hidden curriculum’ connotes a distinctive value-laden medical morality that is transmissible through socialisation and role-modelling in the medical school moral ecosystem. Further, the hidden curriculum is hampered by the challenging medical school workload, bad role models, and lack of appropriate evaluation and assessment methods, as well as the lack of consensus in bioethics on the key concept of human dignity. Properly conceived, the dignity of the human person is the ultimate source of human values. Optimising the hidden curriculum, therefore, demands an authentic and comprehensive enquiry into the concept of human dignity, as well as the nature of the human person, the true human good and what constitutes the unitary good of the patient.

The origin of the hidden supersymmetry

International Nuclear Information System (INIS)

Jakubsky, Vit; Nieto, Luis-Miguel; Plyushchay, Mikhail S.

2010-01-01

The hidden supersymmetry and related tri-supersymmetric structure of the free particle system, the Dirac delta potential problem and the Aharonov-Bohm effect (planar, bound state, and tubule models) are explained by a special nonlocal unitary transformation, which for the usual N=2 supercharges has a nature of Foldy-Wouthuysen transformation. We show that in general case, the bosonized supersymmetry of nonlocal, parity even systems emerges in the same construction, and explain the origin of the unusual N=2 supersymmetry of electron in three-dimensional parity even magnetic field. The observation extends to include the hidden superconformal symmetry.

Naturally light hidden photons in LARGE volume string compactifications

International Nuclear Information System (INIS)

Goodsell, M.; Jaeckel, J.; Redondo, J.; Ringwald, A.

2009-09-01

Extra ''hidden'' U(1) gauge factors are a generic feature of string theory that is of particular phenomenological interest. They can kinetically mix with the Standard Model photon and are thereby accessible to a wide variety of astrophysical and cosmological observations and laboratory experiments. In this paper we investigate the masses and the kinetic mixing of hidden U(1)s in LARGE volume compactifications of string theory. We find that in these scenarios the hidden photons can be naturally light and that their kinetic mixing with the ordinary electromagnetic photon can be of a size interesting for near future experiments and observations. (orig.)

Hidden photon dark matter search with large metallic mirror

International Nuclear Information System (INIS)

Doebrich, Babette; Lindner, Axel; Daumiller, Kai; Engel, Ralph; Roth, Markus; Kowalski, Marek

2014-10-01

If Dark Matter is composed of hidden-sector photons that kinetically mix with photons of the visible sector, then Dark Matter has a tiny oscillating electric field component. Its presence would lead to a small amount of visible radiation being emitted from a conducting surface, with the photon frequency given approximately by the mass of the hidden photon. Here, we report on experimental efforts that have started recently to search for such hidden photon Dark Matter in the (sub-)eV regime with a prototype mirror for the Auger fluorescence detector at the Karlsruhe Institute for Technology.

Supersymmetry, p-brane duality, and hidden spacetime dimensions

International Nuclear Information System (INIS)

Bars, I.

1996-01-01

A global superalgebra with 32 supercharges and all possible central extensions is studied in order to extract some general properties of duality and hidden dimensions in a theory that treats p-branes democratically. The maximal number of dimensions is 12, with signature (10,2), containing one space and one time dimension that are hidden from the point of view of perturbative ten-dimensional string theory or its compactifications. When the theory is compactified on R d-1,1 circle-times T c+1,1 with d+c+2=12, there are isometry groups that relate to the hidden dimensions as well as to duality. Their combined intersecting classification schemes provide some properties of nonperturbative states and their couplings. copyright 1996 The American Physical Society

Morbidity and injury recurrence in victims of firearm injuries.

Science.gov (United States)

Ponzer, S; Bergman, B; Brismar, B

1996-01-01

Civilian violence has become an increasing problem in the industrial world. Gunshot wounds, fatal or non-fatal, are often considered as acute trauma episodes. However, our previous study, based on 820 firearm injuries, showed that this group of patients was characterized by a high mortality rate and a pronounced involvement in criminality when compared to a control group. The aim of this study was to determine the general morbidity in the same group of firearm victims. Our hypotheses were that these patients consume a considerable amount of hospital care due to recurring trauma episodes and that their general morbidity is raised. Information was collected concerning all episodes of in-patient care for victims of firearm injuries from 1972-1992 in Stockholm, Sweden. The victims were compared with a sex- and age-matched control group. During the study period, 69.9% of the 820 firearm victims were treated for other reasons than gunshot injuries, compared to 45.5% of the 820 controls. The former group was hospitalized 3,703 times and the latter on 1,512 occasions. The firearm injury group showed an higher morbidity in almost all diagnostic subgroups according to ICD-9. The trauma recurrence rate was high and suicide, homicide and assault were relatively more common in this group. We suggest that the gunshot episode may be regarded as one expression of a "chronic trauma syndrome'. Patients exhibiting this "syndrome' are characterized by recurrent episodes of trauma, a risk-taking and destructive behavior, high morbidity and mortality as well as anti-social traits. Medical, social and legal complications are common making these patients extremely costly for society and their identification a matter of concern. It is probable that this "syndrome' also exists in other groups of trauma patients. Since hospitalization affords a unique opportunity of reaching patients who have a "chronic trauma syndrome' risk profile, we believe, that these patients should not only be treated

A single hidden layer feedforward network with only one neuron in the hidden layer can approximate any univariate function

OpenAIRE

Guliyev , Namig; Ismailov , Vugar

2016-01-01

The possibility of approximating a continuous function on a compact subset of the real line by a feedforward single hidden layer neural network with a sigmoidal activation function has been studied in many papers. Such networks can approximate an arbitrary continuous function provided that an unlimited number of neurons in a hidden layer is permitted. In this paper, we consider constructive approximation on any finite interval of $\\mathbb{R}$ by neural networks with only one neuron in the hid...

Prevalence and causes of ocular morbidity in Mbeere District, Kenya. Results of a population-based survey.

Directory of Open Access Journals (Sweden)

Kahaki Kimani

Full Text Available PURPOSE: Ocular morbidity (OM describes any eye disease regardless of resultant visual loss. Ocular morbidity may affect large numbers of people in low income countries and could lead to many episodes of care. However there is limited evidence about the prevalence of ocular morbidity or resulting health-seeking behavior. This study in Mbeere District, Kenya, set out to explore both these issues. METHODS: A cross-sectional household survey was conducted in 2011. Trained teams moved from house to house examining and questioning residents on ocular morbidity and health-seeking behavior. Data were collected on standardized proformas and entered into a database for analysis. RESULTS: 3,691 people were examined (response rate 91.7%. 15.52% (95% CI 13.86-16.92 had at least one ocular morbidity in at least one eye. The leading cause was presbyopia which affected 25.11% (95% CI 22.05-28.45 of participants over 35 and increased with age. Other leading causes of OM were conditions that affected the lens (32.58% and the conjunctiva (31.31%. No association was found between educational attainment or employment and OM. 9.63% (7.87-11.74 self-reported an ocular morbidity in the previous six months and 45.94% (95% CI 37.1-55.04 stated that they had sought treatment for the condition. CONCLUSION: A large number of people were affected by an ocular morbidity in this survey. Most of these people could potentially be managed in their own communities through primary care services (e.g. those with presbyopia. Further work is required to understand the best way of providing an effective, equitable service for ocular morbidity.

Nutritional profile of the morbidly obese patients attending a bariatric clinic in a South Indian tertiary care centre

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Mini Joseph

2017-09-01

Full Text Available Background: Obesity is sweeping across continents and is a major public health concern of the modern society. Aims: The main objective of this study was to study the demographic, anthropometric and dietary patterns of the morbidly obese and study region wise variation in their nutrient intake. Materials and Methods: The study was conducted on 101 morbidly obese individuals from different regions of India who attended the Bariatric clinic of a tertiary care hospital in India. Their socio-demographic details, anthropometric measurements were collected. The dietary assessment was done using a 24 hour dietary recall and a food frequency questionnaire. The study was approved by the Institutional review board and informed consent was obtained from them. Results: More than 3/4th of the patients were females and 61 per cent had Type 2 diabetes mellitus. The mean age of the male and female population was 41.3 + 15.5 years and 36.7 + 11.9 years respectively. Their mean BMI was 41kg/m2. The mean daily intake of calories was more than 2200kcal/day with a gross deficit in the intake of micronutrients. Bonferroni Test showed that there was region wise variation in dietary intake, South Indian female population had the lowest intake of the micronutrients and those from East India had the highest intake. In the male population, there was a significant regional difference in intake of Proteins (p=0.039 and Energy (p=0.024. Independent Sample T test showed that South Indian had the highest intake of Energy and proteins. Anthropometric measures showed positive relation with various macronutrient intakes. Conclusion: The obese patients require intense counselling by a dedicated team of an endocrinologist, psychiatrist, dietician, bariatric surgeon and a social worker to make achievable changes in the quality of life of the morbidly obese patients. Regional influences must be considered when counselling the patient.

Child Abuse: The Hidden Bruises

Science.gov (United States)

... for Families - Vietnamese Spanish Facts for Families Guide Child Abuse - The Hidden Bruises No. 5; Updated November 2014 The statistics on physical child abuse are alarming. It is estimated hundreds of thousands ...

Learning and inference in a nonequilibrium Ising model with hidden nodes.

Science.gov (United States)

Dunn, Benjamin; Roudi, Yasser

2013-02-01

We study inference and reconstruction of couplings in a partially observed kinetic Ising model. With hidden spins, calculating the likelihood of a sequence of observed spin configurations requires performing a trace over the configurations of the hidden ones. This, as we show, can be represented as a path integral. Using this representation, we demonstrate that systematic approximate inference and learning rules can be derived using dynamical mean-field theory. Although naive mean-field theory leads to an unstable learning rule, taking into account Gaussian corrections allows learning the couplings involving hidden nodes. It also improves learning of the couplings between the observed nodes compared to when hidden nodes are ignored.

Effects of reproductive morbidity on women's lives and costs of accessing treatment in Yemen.

Science.gov (United States)

Dejong, Jocelyn; Bahubaishi, Najia; Attal, Bothaina

2012-12-01

Research on the consequences of reproductive morbidity for women's lives and their economic and social roles is relatively under-developed. There is also a lack of consensus on appropriate conceptual frameworks to understand the social determinants of reproductive morbidity as well as their social and economic implications. We report here on an exploratory study in Yemen using quantitative (n=72 women) and qualitative methods (n=35 women), in 2005 and 2007 respectively, with women suffering from uterine prolapse, infertility or pelvic inflammatory disease (PID). It explored women's views on how reproductive morbidity affected their lives, marital security and their households, and the burden of paying for treatment. We also interviewed six health professionals about women's health care-seeking for these conditions. Sixty per cent of women reported that treatment was not affordable, and 43% had to sell assets or take out a loan to pay for care. Prolapse and PID interfered particularly in subsistence and household activities while infertility created social pressure. Reproductive morbidity is not a priority in Yemen, given its multiple public health needs and low resources, but by failing to provide comprehensive and affordable services for women, the country incurs developmental losses. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Analysing the hidden curriculum: use of a cultural web.

Science.gov (United States)

Mossop, Liz; Dennick, Reg; Hammond, Richard; Robbé, Iain

2013-02-01

Major influences on learning about medical professionalism come from the hidden curriculum. These influences can contribute positively or negatively towards the professional enculturation of clinical students. The fact that there is no validated method for identifying the components of the hidden curriculum poses problems for educators considering professionalism. The aim of this study was to analyse whether a cultural web, adapted from a business context, might assist in the identification of elements of the hidden curriculum at a UK veterinary school. A qualitative approach was used. Seven focus groups consisting of three staff groups and four student groups were organised. Questioning was framed using the cultural web, which is a model used by business owners to assess their environment and consider how it affects their employees and customers. The focus group discussions were recorded, transcribed and analysed thematically using a combination of a priori and emergent themes. The cultural web identified elements of the hidden curriculum for both students and staff. These included: core assumptions; routines; rituals; control systems; organisational factors; power structures, and symbols. Discussions occurred about how and where these issues may affect students' professional identity development. The cultural web framework functioned well to help participants identify elements of the hidden curriculum. These aspects aligned broadly with previously described factors such as role models and institutional slang. The influence of these issues on a student's development of a professional identity requires discussion amongst faculty staff, and could be used to develop learning opportunities for students. The framework is promising for the analysis of the hidden curriculum and could be developed as an instrument for implementation in other clinical teaching environments. © Blackwell Publishing Ltd 2013.

Anticipating hidden text salting in emails (extended abstract)

OpenAIRE

Lioma, Christina; Moens, Marie-Francine; Gomez, Juan Carlos; De Beer, Jan; Bergholz, Andre; Paass, Gerhard; Horkan, Patrick

2008-01-01

Salting is the intentional addition or distortion of content, aimed to evade automatic filtering. Salting is usually found in spam emails. Salting can also be hidden in phishing emails, which aim to steal personal information from users. We present a novel method that detects hidden salting tricks as visual anomalies in text. We solely use these salting tricks to successfully classify emails as phishing (F-measure >90%).

Complicated basins and the phenomenon of amplitude death in coupled hidden attractors

Energy Technology Data Exchange (ETDEWEB)

Chaudhuri, Ushnish [Department of Physics, Sri Venkateswara College, University of Delhi, New Delhi 110021 (India); Department of Physics, National University of Singapore, Singapore 117551 (Singapore); Prasad, Awadhesh, E-mail: awadhesh@physics.du.ac.in [Department of Physics and Astrophysics, University of Delhi, Delhi 110007 (India)

2014-02-07

Understanding hidden attractors, whose basins of attraction do not contain the neighborhood of equilibrium of the system, are important in many physical applications. We observe riddled-like complicated basins of coexisting hidden attractors both in coupled and uncoupled systems. Amplitude death is observed in coupled hidden attractors with no fixed point using nonlinear interaction. A new route to amplitude death is observed in time-delay coupled hidden attractors. Numerical results are presented for systems with no or one stable fixed point. The applications are highlighted.

Gauge mediation scenario with hidden sector renormalization in MSSM

International Nuclear Information System (INIS)

Arai, Masato; Kawai, Shinsuke; Okada, Nobuchika

2010-01-01

We study the hidden sector effects on the mass renormalization of a simplest gauge-mediated supersymmetry breaking scenario. We point out that possible hidden sector contributions render the soft scalar masses smaller, resulting in drastically different sparticle mass spectrum at low energy. In particular, in the 5+5 minimal gauge-mediated supersymmetry breaking with high messenger scale (that is favored by the gravitino cold dark matter scenario), we show that a stau can be the next lightest superparticle for moderate values of hidden sector self-coupling. This provides a very simple theoretical model of long-lived charged next lightest superparticles, which imply distinctive signals in ongoing and upcoming collider experiments.

Gauge mediation scenario with hidden sector renormalization in MSSM

Science.gov (United States)

Arai, Masato; Kawai, Shinsuke; Okada, Nobuchika

2010-02-01

We study the hidden sector effects on the mass renormalization of a simplest gauge-mediated supersymmetry breaking scenario. We point out that possible hidden sector contributions render the soft scalar masses smaller, resulting in drastically different sparticle mass spectrum at low energy. In particular, in the 5+5¯ minimal gauge-mediated supersymmetry breaking with high messenger scale (that is favored by the gravitino cold dark matter scenario), we show that a stau can be the next lightest superparticle for moderate values of hidden sector self-coupling. This provides a very simple theoretical model of long-lived charged next lightest superparticles, which imply distinctive signals in ongoing and upcoming collider experiments.

Morbidity, including fatal morbidity, throughout life in men entering adult life as obese

DEFF Research Database (Denmark)

Zimmermann, Esther; Holst, Claus; Sørensen, Thorkild I A

2011-01-01

The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult...... life as obese....

Quantum mechanics and hidden superconformal symmetry

Science.gov (United States)

Bonezzi, R.; Corradini, O.; Latini, E.; Waldron, A.

2017-12-01

Solvability of the ubiquitous quantum harmonic oscillator relies on a spectrum generating osp (1 |2 ) superconformal symmetry. We study the problem of constructing all quantum mechanical models with a hidden osp (1 |2 ) symmetry on a given space of states. This problem stems from interacting higher spin models coupled to gravity. In one dimension, we show that the solution to this problem is the Vasiliev-Plyushchay family of quantum mechanical models with hidden superconformal symmetry obtained by viewing the harmonic oscillator as a one dimensional Dirac system, so that Grassmann parity equals wave function parity. These models—both oscillator and particlelike—realize all possible unitary irreducible representations of osp (1 |2 ).

Hidden simplicity of gauge theory amplitudes

Energy Technology Data Exchange (ETDEWEB)

Drummond, J M, E-mail: drummond@lapp.in2p3.f [LAPTH, Universite de Savoie, CNRS, B.P. 110, F-74941 Annecy-le-Vieux, Cedex (France)

2010-11-07

These notes were given as lectures at the CERN Winter School on Supergravity, Strings and Gauge Theory 2010. We describe the structure of scattering amplitudes in gauge theories, focussing on the maximally supersymmetric theory to highlight the hidden symmetries which appear. Using the Britto, Cachzo, Feng and Witten (BCFW) recursion relations we solve the tree-level S-matrix in N=4 super Yang-Mills theory and describe how it produces a sum of invariants of a large symmetry algebra. We review amplitudes in the planar theory beyond tree level, describing the connection between amplitudes and Wilson loops, and discuss the implications of the hidden symmetries.

[Frailty, disability and multi-morbidity: the relationship with quality of life and healthcare costs in elderly people].

Science.gov (United States)

Lutomski, Jennifer E; Baars, Maria A E; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

2014-01-01

To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people. Cross-sectional, descriptive study. Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models. A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation. Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.

Evidence of hidden leprosy in a supposedly low endemic area of Brazil.

Science.gov (United States)

Bernardes, Fred; Paula, Natália Aparecida de; Leite, Marcel Nani; Abi-Rached, Thania Loyola Cordeiro; Vernal, Sebastian; Silva, Moises Batista da; Barreto, Josafá Gonçalves; Spencer, John Stewart; Frade, Marco Andrey Cipriani

2017-12-01

Show that hidden endemic leprosy exists in a municipality of inner São Paulo state (Brazil) with active surveillance actions based on clinical and immunological evaluations. The study sample was composed by people randomly selected by a dermatologist during medical care in the public emergency department and by active surveillance carried out during two days at a mobile clinic. All subjects received a dermato-neurological examination and blood sampling to determine anti-PGL-I antibody titers by enzyme-linked immunosorbent assay (ELISA). From July to December 2015, 24 new cases of leprosy were diagnosed; all were classified as multibacillary (MB) leprosy, one with severe Lucio's phenomenon. Seventeen (75%) were found with grade-1 or 2 disability at the moment of diagnosis. Anti-PGL-I titer was positive in 31/133 (23.3%) individuals, only 6/24 (25%) were positive in newly diagnosed leprosy cases. During the last ten years before this study, the average new case detection rate (NCDR) in this town was 2.62/100,000 population. After our work, the NCDR was raised to 42.8/100,000. These results indicate a very high number of hidden leprosy cases in this supposedly low endemic area of Brazil.

Update on hidden sectors with dark forces and dark matter

Energy Technology Data Exchange (ETDEWEB)

Andreas, Sarah

2012-11-15

Recently there has been much interest in hidden sectors, especially in the context of dark matter and ''dark forces'', since they are a common feature of beyond standard model scenarios like string theory and SUSY and additionally exhibit interesting phenomenological aspects. Various laboratory experiments place limits on the so-called hidden photon and continuously further probe and constrain the parameter space; an updated overview is presented here. Furthermore, for several hidden sector models with light dark matter we study the viability with respect to the relic abundance and direct detection experiments.

Searching for hidden sectors in multiparticle production at the LHC

CERN Document Server

Sanchis-Lozano, Miguel-Angel; Moreno-Picot, Salvador

2016-01-01

We study the impact of a hidden sector beyond the Standard Model, e.g. a Hidden Valley model, on factorial moments and cumulants of multiplicity distributions in multiparticle production with a special emphasis on the prospects for LHC results.

Morbidity profile of elderly outpatients attending selected sub-district Siddha health facilities in Tamil Nadu, India

Science.gov (United States)

Selvaraj, Kalaiselvi; Srinivasan, Manikandan; Duraisamy, Venkatachalam; Ramaswamy, Gomathi; Venugopal, Vinayagamurthy; Chinnakali, Palanivel

2016-01-01

Background: Recently, under National Health Mission alternate systems of Medicine are mainstreamed in public health care system. Effective action plan generation, logistic arrangement and roll out of these alternate systems of Medicine needs understanding on profile of morbidities among attendees who come to these facilities. Objectives: This study was planned to report profile of morbidities, age and sex differentials in specific morbidities among geriatric attendees in secondary level siddha health facilities. Materials and Methods: A facility based cross sectional study was conducted among elderly person (60 years and above) attending Siddha outpatient department (OPD) from two of the randomly selected sub district level siddha facilities in Erode district, Tamil Nadu, India. Information on socio-demographic variables like age, gender, education and clinical profile (diagnosis) were collected from records already maintained in the siddha OPD. Morbidities were summarized in terms of proportions based on age and gender. Age and sex specific differentials on specific morbidities were compared using ‘z’ test. Results: Of 2710 patients who visited these two siddha facilities during the reference period, 763 (28.1%) patients were elderly. Arthritis (45.2%), neuritis (8.8%), diabetes (6.6%), bronchial asthma (5.2%), hemiplegia (3.7%) were the top five morbidities diagnosed and treated among elderly attending the siddha OPD. There was a predilection towards elderly male for morbidities such as bronchial asthma and hemiplegia compared to elderly female. Similarly, higher proportions of lumbar spondylosis, hypertension and fungal skin diseases were reported among aged 80 years or more compared to elderly aged 60-79 years. Conclusion: Elderly constitute more than one fourth of outpatients load from siddha health facilities. Degenerative diseases like arthritis and non-communicable diseases were the common morbidities in this age group. Geriatric clinics and mobile

Pain Catastrophizing in Borderline Morbidly Obese and Morbidly Obese Individuals with Osteoarthritic Knee Pain

Directory of Open Access Journals (Sweden)

Tamara J Somers

2008-01-01

Full Text Available OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m2 or greater OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m2 and 34 kg/m2. Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients.

Resident-Specific Morbidity Reduced Following ACS NSQIP Data-Driven Quality Program.

Science.gov (United States)

Turrentine, Florence E; Hanks, John B; Tracci, Megan C; Jones, R Scott; Schirmer, Bruce D; Smith, Philip W

2018-04-16

The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. A 22-month interactive, educational program based on resident-specific surgical outcomes data culminated in a quality improvement project for postgraduate year 4 surgery residents. Self- assessment, quality knowledge test, and resident-specific American College of Surgeons National Surgical Quality Improvement Program Quality In-Training Initiative morbidity were compared before and after the intervention. Quality in-training initiative morbidity decreased from 25% (82/325) to 18% (93/517), p = 0.015 despite residents performing more complex cases. All participants achieved level 4 competency (4/4) within the general surgery milestones improvement of care, practice-based learning and improvement competency. Institutional American College of Surgeons National Surgical Quality Improvement Program general surgery morbidity improved from the ninth to the sixth decile. Quality assessment and improvement self-assessment postintervention scores (M = 23.80, SD = 4.97) were not significantly higher than preintervention scores (M = 19.20, SD = 5.26), p = 0.061. Quality Improvement Knowledge Application Tool postintervention test scores (M = 17.4, SD = 4.88), were not significantly higher than pretest scores (M = 13.2, SD = 1.92), p = 0.12. Sharing validated resident-specific clinical data with participants was associated with improved surgical outcomes. Participating fourth year surgical residents achieved the highest score, a level 4, in the practice based learning and improvement competency of the improvement of care practice domain and observed significantly reduced surgical morbidity for cases in which they participated. Copyright © 2018. Published by Elsevier Inc.

Secret Codes: The Hidden Curriculum of Semantic Web Technologies

Science.gov (United States)

Edwards, Richard; Carmichael, Patrick

2012-01-01

There is a long tradition in education of examination of the hidden curriculum, those elements which are implicit or tacit to the formal goals of education. This article draws upon that tradition to open up for investigation the hidden curriculum and assumptions about students and knowledge that are embedded in the coding undertaken to facilitate…

State-space dimensionality in short-memory hidden-variable theories

International Nuclear Information System (INIS)

Montina, Alberto

2011-01-01

Recently we have presented a hidden-variable model of measurements for a qubit where the hidden-variable state-space dimension is one-half the quantum-state manifold dimension. The absence of a short memory (Markov) dynamics is the price paid for this dimensional reduction. The conflict between having the Markov property and achieving the dimensional reduction was proved by Montina [A. Montina, Phys. Rev. A 77, 022104 (2008)] using an additional hypothesis of trajectory relaxation. Here we analyze in more detail this hypothesis introducing the concept of invertible process and report a proof that makes clearer the role played by the topology of the hidden-variable space. This is accomplished by requiring suitable properties of regularity of the conditional probability governing the dynamics. In the case of minimal dimension the set of continuous hidden variables is identified with an object living an N-dimensional Hilbert space whose dynamics is described by the Schroedinger equation. A method for generating the economical non-Markovian model for the qubit is also presented.

Maternal mortality and serious maternal morbidity in Jehovah's witnesses in The Netherlands

NARCIS (Netherlands)

van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; van Roosmalen, J.

2009-01-01

To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in The Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in The Netherlands. All

Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the Netherlands

NARCIS (Netherlands)

Van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; Van Roosmalen, J.

To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. All

Dopamine reward prediction errors reflect hidden state inference across time

Science.gov (United States)

Starkweather, Clara Kwon; Babayan, Benedicte M.; Uchida, Naoshige; Gershman, Samuel J.

2017-01-01

Midbrain dopamine neurons signal reward prediction error (RPE), or actual minus expected reward. The temporal difference (TD) learning model has been a cornerstone in understanding how dopamine RPEs could drive associative learning. Classically, TD learning imparts value to features that serially track elapsed time relative to observable stimuli. In the real world, however, sensory stimuli provide ambiguous information about the hidden state of the environment, leading to the proposal that TD learning might instead compute a value signal based on an inferred distribution of hidden states (a ‘belief state’). In this work, we asked whether dopaminergic signaling supports a TD learning framework that operates over hidden states. We found that dopamine signaling exhibited a striking difference between two tasks that differed only with respect to whether reward was delivered deterministically. Our results favor an associative learning rule that combines cached values with hidden state inference. PMID:28263301

Higher-dimensional black holes: hidden symmetries and separation of variables

International Nuclear Information System (INIS)

Frolov, Valeri P; Kubiznak, David

2008-01-01

In this paper, we discuss hidden symmetries in rotating black hole spacetimes. We start with an extended introduction which mainly summarizes results on hidden symmetries in four dimensions and introduces Killing and Killing-Yano tensors, objects responsible for hidden symmetries. We also demonstrate how starting with a principal CKY tensor (that is a closed non-degenerate conformal Killing-Yano 2-form) in 4D flat spacetime one can 'generate' the 4D Kerr-NUT-(A)dS solution and its hidden symmetries. After this we consider higher-dimensional Kerr-NUT-(A)dS metrics and demonstrate that they possess a principal CKY tensor which allows one to generate the whole tower of Killing-Yano and Killing tensors. These symmetries imply complete integrability of geodesic equations and complete separation of variables for the Hamilton-Jacobi, Klein-Gordon and Dirac equations in the general Kerr-NUT-(A)dS metrics

Site of delivery contribution to black-white severe maternal morbidity disparity.

Science.gov (United States)

Howell, Elizabeth A; Egorova, Natalia N; Balbierz, Amy; Zeitlin, Jennifer; Hebert, Paul L

2016-08-01

The black-white maternal mortality disparity is the largest disparity among all conventional population perinatal health measures, and the mortality gap between black and white women in New York City has nearly doubled in recent years. For every maternal death, 100 women experience severe maternal morbidity, a life-threatening diagnosis, or undergo a life-saving procedure during their delivery hospitalization. Like maternal mortality, severe maternal morbidity is more common among black than white women. A significant portion of maternal morbidity and mortality is preventable, making quality of care in hospitals a critical lever for improving outcomes. Hospital variation in risk-adjusted severe maternal morbidity rates exists. The extent to which variation in hospital performance on severe maternal morbidity rates contributes to black-white disparities in New York City hospitals has not been studied. We examined the extent to which black-white differences in severe maternal morbidity rates in New York City hospitals can be explained by differences in the hospitals in which black and white women deliver. We conducted a population-based study using linked 2011-2013 New York City discharge and birth certificate datasets (n = 353,773 deliveries) to examine black-white differences in severe maternal morbidity rates in New York City hospitals. A mixed-effects logistic regression with a random hospital-specific intercept was used to generate risk-standardized severe maternal morbidity rates for each hospital (n = 40). We then assessed differences in the distributions of black and white deliveries among these hospitals. Severe maternal morbidity occurred in 8882 deliveries (2.5%) and was higher among black than white women (4.2% vs 1.5%, P rates among New York City hospitals ranged from 0.8 to 5.7 per 100 deliveries. White deliveries were more likely to be delivered in low-morbidity hospitals: 65% of white vs 23% of black deliveries occurred in hospitals in the lowest

Extended abstract of a hidden agenda

Energy Technology Data Exchange (ETDEWEB)

Goguen, J.; Malcolm, G. [Oxford Univ. (United Kingdom)

1996-12-31

The initial goal of our hidden research programme was both straightforward and ambitious: give a semantics for software engineering, and in particular for the object paradigm, supporting correctness proofs that are as simple and mechanical as possible. This emphasizes proofs rather than models, and thus suggests an equational approach, rather than one based on higher order logic, denotational semantics, or any kind of model, because equational proofs achieve maximal simplicity and mechanization, and yet are fully expressive. We introduce powerful coinduction techniques for proving behavioral properties of complex systems. We make the no doubt outrageous claim that our hidden approach gives simpler proofs than other formalisms; this is because we exploit algebraic structure that most other approaches discard.

Morbidity and mortality associated with obstetric hysterectomy

International Nuclear Information System (INIS)

Shaikh, N.B.; Shaikh, S.; Shaikh, J.M.

2010-01-01

Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

Science.gov (United States)

Ray, Pradip K; Ray Bhattacharya, Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

2015-01-01

Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1(st) November 2013 to 30(th) April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

Photoacoustic imaging of hidden dental caries by using a fiber-based probing system

Science.gov (United States)

Koyama, Takuya; Kakino, Satoko; Matsuura, Yuji

2017-04-01

Photoacoustic method to detect hidden dental caries is proposed. It was found that high frequency ultrasonic waves are generated from hidden carious part when radiating laser light to occlusal surface of model tooth. By making a map of intensity of these high frequency components, photoacoustic images of hidden caries were successfully obtained. A photoacoustic imaging system using a bundle of hollow optical fiber was fabricated for using clinical application, and clear photoacoustic image of hidden caries was also obtained by this system.

Maternal Smoking During Pregnancy and the Risk of Psychiatric Morbidity in Singleton Sibling Pairs

Science.gov (United States)

Lehtonen, Liisa; Korkeila, Jyrki; Gissler, Mika

2017-01-01

Abstract Introduction: Maternal smoking during pregnancy has been associated with an increased risk for psychiatric morbidity. We further studied this with Finnish siblings to control for genetic/familial factors. Methods: From the Finnish Medical Birth Register, sibling pairs were selected as the first two children born 1987–1995 to the same mother (n = 150 168 pairs), along with information on maternal smoking (no smoking/smoking). Information on the children’s psychiatric diagnoses related to outpatient care visits (1998–2013) and inpatient care (1987–2013), and the mothers’ psychiatric morbidity (1969–2013) was derived from the Finnish Hospital Discharge Register. The first pair analysis compared siblings of mothers who only smoked in the first pregnancy (Quitters, 4.7%) and mothers who smoked in both pregnancies (Smokers, 9.6%); the second analysis included mothers who smoked only in the second pregnancy (Starters, 3.3%) and mothers who did not smoke in either pregnancy (Nonsmokers, 77.5%). Smoking information was missing for 5.0% of pairs. Psychiatric morbidity of the siblings and mother was included in the statistical analyses. Results: The risk of psychiatric diagnoses was significantly lower for the second child of quitters (adjusted OR 0.77, 95% CI 0.72–0.83) compared to the risk among smokers. A higher risk for psychiatric diagnoses was found for the second child of starters (1.39, 1.30–1.49) compared to the risk among nonsmokers. The effect of smoking was more robust for externalizing diagnoses. Conclusions: Maternal smoking was independently associated with a higher risk for psychiatric morbidity in children, even when controlling thoroughly for genetic and familial factors. Implications: Maternal smoking during pregnancy has an independent effect on the risk of psychiatric morbidity in children, even after controlling for non-measurable genetic/familial factors by using a sibling pair design. The effect of maternal smoking was robust

A hidden history

OpenAIRE

Peppers, Emily

2008-01-01

The Cultural Collections Audit project began at the University of Edinburgh in 2004, searching for hidden treasures in its 'distributed heritage collections' across the university. The objects and collections recorded in the Audit ranged widely from fine art and furniture to historical scientific and teaching equipment and personalia relating to key figures in the university's long tradition of academic excellence. This information was gathered in order to create a central database of informa...

Life imitating art: depictions of the hidden curriculum in medical television programs.

Science.gov (United States)

Stanek, Agatha; Clarkin, Chantalle; Bould, M Dylan; Writer, Hilary; Doja, Asif

2015-09-26

The hidden curriculum represents influences occurring within the culture of medicine that indirectly alter medical professionals' interactions, beliefs and clinical practices throughout their training. One approach to increase medical student awareness of the hidden curriculum is to provide them with readily available examples of how it is enacted in medicine; as such the purpose of this study was to examine depictions of the hidden curriculum in popular medical television programs. One full season of ER, Grey's Anatomy and Scrubs were selected for review. A summative content analysis was performed to ascertain the presence of depictions of the hidden curriculum, as well as to record the type, frequency and quality of examples. A second reviewer also viewed a random selection of episodes from each series to establish coding reliability. The most prevalent themes across all television programs were: the hierarchical nature of medicine; challenges during transitional stages in medicine; the importance of role modeling; patient dehumanization; faking or overstating one's capabilities; unprofessionalism; the loss of idealism; and difficulties with work-life balance. The hidden curriculum is frequently depicted in popular medical television shows. These examples of the hidden curriculum could serve as a valuable teaching resource in undergraduate medical programs.

Rare Z boson decays to a hidden sector

Science.gov (United States)

Blinov, Nikita; Izaguirre, Eder; Shuve, Brian

2018-01-01

We demonstrate that rare decays of the Standard Model Z boson can be used to discover and characterize the nature of new hidden-sector particles. We propose new searches for these particles in soft, high-multiplicity leptonic final states at the Large Hadron Collider. The proposed searches are sensitive to low-mass particles produced in Z decays, and we argue that these striking signatures can shed light on the hidden-sector couplings and mechanism for mass generation.

The Consensus String Problem and the Complexity of Comparing Hidden Markov Models

DEFF Research Database (Denmark)

Lyngsø, Rune Bang; Pedersen, Christian Nørgaard Storm

2002-01-01

The basic theory of hidden Markov models was developed and applied to problems in speech recognition in the late 1960s, and has since then been applied to numerous problems, e.g. biological sequence analysis. Most applications of hidden Markov models are based on efficient algorithms for computing...... the probability of generating a given string, or computing the most likely path generating a given string. In this paper we consider the problem of computing the most likely string, or consensus string, generated by a given model, and its implications on the complexity of comparing hidden Markov models. We show...... that computing the consensus string, and approximating its probability within any constant factor, is NP-hard, and that the same holds for the closely related labeling problem for class hidden Markov models. Furthermore, we establish the NP-hardness of comparing two hidden Markov models under the L∞- and L1...

Cosmological abundance of the QCD axion coupled to hidden photons

Science.gov (United States)

Kitajima, Naoya; Sekiguchi, Toyokazu; Takahashi, Fuminobu

2018-06-01

We study the cosmological evolution of the QCD axion coupled to hidden photons. For a moderately strong coupling, the motion of the axion field leads to an explosive production of hidden photons by tachyonic instability. We use lattice simulations to evaluate the cosmological abundance of the QCD axion. In doing so, we incorporate the backreaction of the produced hidden photons on the axion dynamics, which becomes significant in the non-linear regime. We find that the axion abundance is suppressed by at most O (102) for the decay constant fa =1016GeV, compared to the case without the coupling. For a sufficiently large coupling, the motion of the QCD axion becomes strongly damped, and as a result, the axion abundance is enhanced. Our results show that the cosmological upper bound on the axion decay constant can be relaxed by a few hundred for a certain range of the coupling to hidden photons.

Low-scale gravity mediation in warped extra dimension and collider phenomenology on hidden sector

International Nuclear Information System (INIS)

Itoh, H.; Okada, N.; Yamashita, T.

2007-01-01

We propose a new scenario of gravity-mediated supersymmetry breaking (gravity mediation) in a supersymmetric Randall-Sundrum model, where the gravity mediation takes place at a low scale due to the warped metric. We investigate collider phenomenology involving the hidden sector field, and find a possibility that the hidden sector field can be produced at the LHC and the ILC. The hidden sector may no longer be hidden. (author)

An impossibility theorem for parameter independent hidden variable theories

Science.gov (United States)

Leegwater, Gijs

2016-05-01

Recently, Roger Colbeck and Renato Renner (C&R) have claimed that '[n]o extension of quantum theory can have improved predictive power' (Colbeck & Renner, 2011, 2012b). If correct, this is a spectacular impossibility theorem for hidden variable theories, which is more general than the theorems of Bell (1964) and Leggett (2003). Also, C&R have used their claim in attempt to prove that a system's quantum-mechanical wave function is in a one-to-one correspondence with its 'ontic' state (Colbeck & Renner, 2012a). C&R's claim essentially means that in any hidden variable theory that is compatible with quantum-mechanical predictions, probabilities of measurement outcomes are independent of these hidden variables. This makes such variables otiose. On closer inspection, however, the generality and validity of the claim can be contested. First, it is based on an assumption called 'Freedom of Choice'. As the name suggests, this assumption involves the independence of an experimenter's choice of measurement settings. But in the way C&R define this assumption, a no-signalling condition is surreptitiously presupposed, making the assumption less innocent than it sounds. When using this definition, any hidden variable theory violating parameter independence, such as Bohmian Mechanics, is immediately shown to be incompatible with quantum-mechanical predictions. Also, the argument of C&R is hard to follow and their mathematical derivation contains several gaps, some of which cannot be closed in the way they suggest. We shall show that these gaps can be filled. The issue with the 'Freedom of Choice' assumption can be circumvented by explicitly assuming parameter independence. This makes the result less general, but better founded. We then obtain an impossibility theorem for hidden variable theories satisfying parameter independence only. As stated above, such hidden variable theories are impossible in the sense that any supplemental variables have no bearing on outcome probabilities

Special report on taxation and reimbursement. Recovering excess funds from a defined-benefit pension plan: don't forget the hidden costs!

Science.gov (United States)

Renas, D A; Hoffman, S F

1989-10-01

In light of the pitfalls and hidden costs associated with recovering excess pension plan funds, providers may consider examining more conventional sources of raising capital before proceeding. In any event, the process should always be initiated by a careful cost-benefit analysis conducted by the employer, with the help of pension consultants and counsel.

Entry deterrence and hidden competition

NARCIS (Netherlands)

Lavrutich, Maria; Huisman, Kuno; Kort, Peter

This paper studies strategic investment behavior of firms facing an uncertain demand in a duopoly setting. Firms choose both investment timing and the capacity level while facing additional uncertainty about market participants, which is introduced via the concept of hidden competition. We focus on

Adaptive Partially Hidden Markov Models

DEFF Research Database (Denmark)

Forchhammer, Søren Otto; Rasmussen, Tage

1996-01-01

Partially Hidden Markov Models (PHMM) have recently been introduced. The transition and emission probabilities are conditioned on the past. In this report, the PHMM is extended with a multiple token version. The different versions of the PHMM are applied to bi-level image coding....

Applications of hidden symmetries to black hole physics

International Nuclear Information System (INIS)

Frolov, Valeri

2011-01-01

This work is a brief review of applications of hidden symmetries to black hole physics. Symmetry is one of the most important concepts of the science. In physics and mathematics the symmetry allows one to simplify a problem, and often to make it solvable. According to the Noether theorem symmetries are responsible for conservation laws. Besides evident (explicit) spacetime symmetries, responsible for conservation of energy, momentum, and angular momentum of a system, there also exist what is called hidden symmetries, which are connected with higher order in momentum integrals of motion. A remarkable fact is that black holes in four and higher dimensions always possess a set ('tower') of explicit and hidden symmetries which make the equations of motion of particles and light completely integrable. The paper gives a general review of the recently obtained results. The main focus is on understanding why at all black holes have something (symmetry) to hide.

Hidden Markov model analysis of maternal behavior patterns in inbred and reciprocal hybrid mice.

Directory of Open Access Journals (Sweden)

Valeria Carola

Full Text Available Individual variation in maternal care in mammals shows a significant heritable component, with the maternal behavior of daughters resembling that of their mothers. In laboratory mice, genetically distinct inbred strains show stable differences in maternal care during the first postnatal week. Moreover, cross fostering and reciprocal breeding studies demonstrate that differences in maternal care between inbred strains persist in the absence of genetic differences, demonstrating a non-genetic or epigenetic contribution to maternal behavior. In this study we applied a mathematical tool, called hidden Markov model (HMM, to analyze the behavior of female mice in the presence of their young. The frequency of several maternal behaviors in mice has been previously described, including nursing/grooming pups and tending to the nest. However, the ordering, clustering, and transitions between these behaviors have not been systematically described and thus a global description of maternal behavior is lacking. Here we used HMM to describe maternal behavior patterns in two genetically distinct mouse strains, C57BL/6 and BALB/c, and their genetically identical reciprocal hybrid female offspring. HMM analysis is a powerful tool to identify patterns of events that cluster in time and to determine transitions between these clusters, or hidden states. For the HMM analysis we defined seven states: arched-backed nursing, blanket nursing, licking/grooming pups, grooming, activity, eating, and sleeping. By quantifying the frequency, duration, composition, and transition probabilities of these states we were able to describe the pattern of maternal behavior in mouse and identify aspects of these patterns that are under genetic and nongenetic inheritance. Differences in these patterns observed in the experimental groups (inbred and hybrid females were detected only after the application of HMM analysis whereas classical statistical methods and analyses were not able to

[Mortality and morbidity in surgery for abdominal aortic aneurysm

DEFF Research Database (Denmark)

Banke, A.B.; Andersen, Jakob Steen; Heslet, L.

2008-01-01

Care Unit's (ICU) Critical Information System, a blood bank and the database of a vascular surgery unit. RESULTS: The perioperative mortality was 8%, ICU mortality 22%, postoperative mortality 33% and 30-day mortality 39%. The ICU mortality for patients with renal failure and septic shock...... was significantly higher than the overall ICU mortality. The ICU mortality and morbidity increased with the amount of postoperative blood loss. Patients with an initial serum creatinine concentration of

Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

Science.gov (United States)

Hsu, Joy; Chen, Jessica; Mirabelli, Maria C

Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described. The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to asthma control. Data were obtained from 14,076 older adults ≥65 years with active asthma participating in the 2006-2010 Behavioral Risk Factor Surveillance System Asthma Call-back Survey (a random-digit dialed survey) in 40 US states, the District of Columbia, and Puerto Rico, representative of >2.6 million persons. Weighted, adjusted logistic regression was conducted. One or more asthma-related hospitalizations in the past year were reported by 5.7% (95% confidence interval [95% CI] = 5.0% to 6.4%) of participants; 10.6% (95% CI = 9.7% to 11.5%) reported ≥1 asthma-related ED/UCV. Compared with older adults without asthma-related hospitalizations, adjusted odds were higher among those with ≥1 asthma-related hospitalization for chronic obstructive pulmonary disease (COPD), coronary artery disease, depression, cockroaches or mold in the home, and cost barriers to asthma-related health care or medication. All these factors, except for cockroaches, were associated with asthma-related ED/UCV. Compared with males, adjusted odds were higher among females for COPD, depression, obesity, and cost barriers to asthma-related health care or medication. Among older adults, asthma-related hospitalizations and ED/UCV were associated with clinical comorbidities, mold in the home, and financial barriers to asthma-related health care. Interventions addressing modifiable factors could reduce asthma morbidity among older adults. Published by Elsevier Inc.

Detecting Hidden Hierarchy of Non Hierarchical Terrorist Networks

DEFF Research Database (Denmark)

Memon, Nasrullah

measures (and combinations of them) to identify key players (important nodes) in terrorist networks. Our recently introduced techniques and algorithms (which are also implemented in the investigative data mining toolkit known as iMiner) will be particularly useful for law enforcement agencies that need...... to analyze terrorist networks and prioritize their targets. Applying recently introduced mathematical methods for constructing the hidden hierarchy of "nonhierarchical" terrorist networks; we present case studies of the terrorist attacks occurred / planned in the past, in order to identify hidden hierarchy...

Conscientious objection in health care

Directory of Open Access Journals (Sweden)

Kuře Josef

2016-12-01

Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.

Small children´s movements across residential care and day-care

DEFF Research Database (Denmark)

Schwartz, Ida

2018-01-01

is then seen as closely connected with the ways in which their caregivers coordinate and involve one another across different locations. Viewed from the children's perspectives, their parental support also plays a major role, but due to the conflicts in inter-professional cooperation, parents may find...... in very different ways. Parents, child-welfare workers in residential care and day-care teachers in kindergartens may assess problems in children's everyday lives differently. These different perspectives on the common work of childcare are analysed and the challenges and conflicts inherently hidden...

Signatures of a hidden cosmic microwave background.

Science.gov (United States)

Jaeckel, Joerg; Redondo, Javier; Ringwald, Andreas

2008-09-26

If there is a light Abelian gauge boson gamma' in the hidden sector its kinetic mixing with the photon can produce a hidden cosmic microwave background (HCMB). For meV masses, resonant oscillations gammagamma' happen after big bang nucleosynthesis (BBN) but before CMB decoupling, increasing the effective number of neutrinos Nnu(eff) and the baryon to photon ratio, and distorting the CMB blackbody spectrum. The agreement between BBN and CMB data provides new constraints. However, including Lyman-alpha data, Nnu(eff) > 3 is preferred. It is tempting to attribute this effect to the HCMB. The interesting parameter range will be tested in upcoming laboratory experiments.

Hidden inventory and safety considerations

International Nuclear Information System (INIS)

Anderson, A.R.; James, R.H.; Morgan, F.

1976-01-01

Preliminary results are described of the evaluation of residual plutonium in a process line used for the production of experimental fast reactor fuel. Initial attention has been focussed on a selection of work boxes used for processing powders and solutions. Amounts of material measured as ''hidden inventory'' are generally less than 0.1 percent of throughput but in one box containing very complex equipment the amount was exceptionally about 0.5 percent. The total surface area of the box and the installed equipment appears to be the most significant factor in determining the amount of plutonium held-up as ''hidden inventory,'' representing an average of about 4 x 10 -4 g cm -2 . Present results are based on gamma spectrometer measurements but neutron techniques are being developed to overcome some of the inherent uncertainties in the gamma method. It is suggested that the routine use of sample plates of known surface area would be valuable in monitoring the deposition of plutonium in work boxes

Hidden School Dropout among Immigrant Students: A Cross-Sectional Study

Science.gov (United States)

Makarova, Elena; Herzog, Walter

2013-01-01

Actual school dropout among immigrant youth has been addressed in a number of studies, but research on hidden school dropout among immigrant students is rare. Thus, the objective of this paper is to analyze hidden school dropout among primary school students with an immigrant background. The analyses were performed using survey data of 1186…

WIMPless dark matter from non-Abelian hidden sectors with anomaly-mediated supersymmetry breaking

International Nuclear Information System (INIS)

Feng, Jonathan L.; Shadmi, Yael

2011-01-01

In anomaly-mediated supersymmetry breaking models, superpartner masses are proportional to couplings squared. Their hidden sectors therefore naturally contain WIMPless dark matter, particles whose thermal relic abundance is guaranteed to be of the correct size, even though they are not weakly interacting massive particles. We study viable dark matter candidates in WIMPless anomaly-mediated supersymmetry breaking models with non-Abelian hidden sectors and highlight unusual possibilities that emerge in even the simplest models. In one example with a pure SU(N) hidden sector, stable hidden gluinos freeze out with the correct relic density, but have an extremely low, but natural, confinement scale, providing a framework for self-interacting dark matter. In another simple scenario, hidden gluinos freeze out and decay to visible Winos with the correct relic density, and hidden glueballs may either be stable, providing a natural framework for mixed cold-hot dark matter, or may decay, yielding astrophysical signals. Last, we present a model with light hidden pions that may be tested with improved constraints on the number of nonrelativistic degrees of freedom. All of these scenarios are defined by a small number of parameters, are consistent with gauge coupling unification, preserve the beautiful connection between the weak scale and the observed dark matter relic density, and are natural, with relatively light visible superpartners. We conclude with comments on interesting future directions.

Taking it one day at a time: African American women aging with HIV and co-morbidities.

Science.gov (United States)

Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

2014-07-01

Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52-65. Topics included HIV and co-morbidity self-management, social support needs, medication adherence, and future plans for old age. A constant comparison approach was applied during data analysis. Co-morbidities, including diabetes and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was not attributed to aging but to daily struggles such as lack of income and/or health insurance, an inflexible work schedule, and loneliness. Social responsibilities, including caring for family, positively impacted participants' ability to self-manage HIV by serving as motivation to stay healthy in order to continue to help family members. In contrast, inflexible work schedules negatively impacted women's ability to sustain medication adherence. Overall, this study demonstrates that HIV and co-morbidity self-management are inextricably linked. We can no longer afford to view engagement in HIV care as a single-disease issue and hope to attain optimal health and well-being in our HIV-affected populations. Optimal HIV self-management must be framed within a larger context that simultaneously addresses HIV and co-morbidities, while considering how social and cultural factors uniquely intersect to influence older African American women's self-management strategies.

Mindfulness and eating behaviour styles in morbidly obese males and females.

Science.gov (United States)

Ouwens, M A; Schiffer, A A; Visser, L I; Raeijmaekers, N J C; Nyklíček, I

2015-04-01

Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions aimed at changing eating behaviour after bariatric surgery. Dispositional mindfulness seems promising as one such potential determinant. Therefore, the association between mindfulness and eating behaviour was examined in females and males with morbid obesity. Outpatients with morbid obesity who were candidates for bariatric surgery (N = 335; 78.8% female) completed the Dutch Eating Behaviour Questionnaire (DEBQ), the Freiburg Mindfulness Inventory (FMI) and the Hospital Anxiety and Depression Scale (HADS), in addition to the collection of relevant demographic and medical data. Three separate multiple regression analyses with three eating behaviour styles (restrained, emotional, external) as dependent variables showed that mindfulness was positively associated with restrained eating behaviour (Beta = .28, p ≤ .001), and negatively associated with emotional (Beta = -.22, p ≤ .001) and external (Beta = -.32, p ≤ .001) eating behaviours, independent of sex, age, educational level, Body Mass Index and affective symptoms. Dispositional mindfulness was associated with more restrained, and less emotional and external eating behaviour in morbidly obese outpatients, above and beyond affective symptoms. Future studies, establishing the causal direction of the associations, are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Morbidity and mortality of low birth weight infants in the New Born ...

African Journals Online (AJOL)

Background: Morbidity and mortality of low birth weight (LBW) infants at Kenyatta National Hospital (KNH) has previously been found to be high. Other centres have shown that even with lack of neonatal intensive care facilities, selective interventions can be implemented that improve neonatal survival rates. It is important to ...

On the hidden maxwell superalgebra underlying D = 4 supergravity

Energy Technology Data Exchange (ETDEWEB)

Penafiel, D.M. [Departamento de Fisica, Universidad de Concepcion (Chile); DISAT, Politecnico di Torino (Italy); Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Torino (Italy); Ravera, L. [DISAT, Politecnico di Torino (Italy); Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Torino (Italy)

2017-09-15

In this work, we expand the hidden AdS-Lorentz superalgebra underlying D = 4 supergravity, reaching a (hidden) Maxwell superalgebra. The latter can be viewed as an extension involving cosmological constant of the superalgebra underlying D = 4 supergravity in flat spacetime. We write the Maurer-Cartan equations in this context and we find some interesting extensions of the antisymmetric 3-form A{sup (3)} appearing in the Free Differential Algebra in Minkowski space. The structure of Free Differential Algebras is obtained by considering the zero curvature equations. We write the parametrization of A{sup (3)} in terms of 1-forms and we rend the topological features of its extensions manifest. We interestingly find out that the structure of these extensions, and consequently the structure of the corresponding boundary contribution dA{sup (3)}, strongly depends on the form of the extra fermionic generator appearing in the hidden Maxwell superalgebra. The model we develop in this work is defined in an enlarged superspace with respect to the ordinary one, and the extra bosonic and fermionic 1-forms required for the closure of the hidden Maxwell superalgebra must be considered as physical fields in this enlarged superspace. (copyright 2017 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

The Hidden Dimensions of Databases.

Science.gov (United States)

Jacso, Peter

1994-01-01

Discusses methods of evaluating commercial online databases and provides examples that illustrate their hidden dimensions. Topics addressed include size, including the number of records or the number of titles; the number of years covered; and the frequency of updates. Comparisons of Readers' Guide Abstracts and Magazine Article Summaries are…

Low-intensity interference effects and hidden-variable theories

Energy Technology Data Exchange (ETDEWEB)

Buonomano, V [Universidade Estadual de Campinas (Brazil). Inst. de Matematica

1978-05-11

The double-slit interference experiment and other similar experiments in the low-intensity limit (that is, one photon in the apparatus at a time) are examined in the spirit of Bell's work from the point of view of hidden-variable theories. It is found that there exists a class of hidden-variable theories which disagrees with quantum mechanics for a certain type of interference experiment. A manufactured conceptualization of this class, which is a particle view of interference, is described. An experiment, which appears to be feasible, is proposed to examine this disagreement.

Application of Hidden Markov Models in Biomolecular Simulations.

Science.gov (United States)

Shukla, Saurabh; Shamsi, Zahra; Moffett, Alexander S; Selvam, Balaji; Shukla, Diwakar

2017-01-01

Hidden Markov models (HMMs) provide a framework to analyze large trajectories of biomolecular simulation datasets. HMMs decompose the conformational space of a biological molecule into finite number of states that interconvert among each other with certain rates. HMMs simplify long timescale trajectories for human comprehension, and allow comparison of simulations with experimental data. In this chapter, we provide an overview of building HMMs for analyzing bimolecular simulation datasets. We demonstrate the procedure for building a Hidden Markov model for Met-enkephalin peptide simulation dataset and compare the timescales of the process.

Detecting Faults By Use Of Hidden Markov Models

Science.gov (United States)

Smyth, Padhraic J.

1995-01-01

Frequency of false alarms reduced. Faults in complicated dynamic system (e.g., antenna-aiming system, telecommunication network, or human heart) detected automatically by method of automated, continuous monitoring. Obtains time-series data by sampling multiple sensor outputs at discrete intervals of t and processes data via algorithm determining whether system in normal or faulty state. Algorithm implements, among other things, hidden first-order temporal Markov model of states of system. Mathematical model of dynamics of system not needed. Present method is "prior" method mentioned in "Improved Hidden-Markov-Model Method of Detecting Faults" (NPO-18982).

From the solar system fo hidden cosmic structures

Energy Technology Data Exchange (ETDEWEB)

Benes, K

1987-01-01

The development of experimental astrophysics showed that in the evolution of planets, natural processes of a common nature take place. They include, e.g., radiogenic heat, the production of magmas, volcanic activity, degassing, etc. The solar system is a cosmic formation in an advanced stage of development and it is a realistic assumption that in the Galaxy other hidden planetary systems in various stages of development exist. The views on the possibility of the origination of life in other systems differ; life, however, is seen as a hidden property of cosmic matter. (M.D.).

Search for hidden Higgs decay in ATLAS detector

International Nuclear Information System (INIS)

Gabrielli, A.

2013-01-01

In this paper, a brief overview of the search for the Higgs boson in Hidden Valley models is given. Hidden Valley models predict Higgs decays to neutral particles, which can be also long lived with decay paths comparable to the LHC detectors dimensions. Decay final states consist of collimated leptons (Lepton Jets). Results are presented of a search for Higgs decays to long lived particles in the ATLAS detector at the LHC, based on 1.92 fb −1 data collected during 2011 at a 7TeV center-of-mass energy.

Dissipative hidden sector dark matter

Science.gov (United States)

Foot, R.; Vagnozzi, S.

2015-01-01

A simple way of explaining dark matter without modifying known Standard Model physics is to require the existence of a hidden (dark) sector, which interacts with the visible one predominantly via gravity. We consider a hidden sector containing two stable particles charged under an unbroken U (1 )' gauge symmetry, hence featuring dissipative interactions. The massless gauge field associated with this symmetry, the dark photon, can interact via kinetic mixing with the ordinary photon. In fact, such an interaction of strength ε ˜10-9 appears to be necessary in order to explain galactic structure. We calculate the effect of this new physics on big bang nucleosynthesis and its contribution to the relativistic energy density at hydrogen recombination. We then examine the process of dark recombination, during which neutral dark states are formed, which is important for large-scale structure formation. Galactic structure is considered next, focusing on spiral and irregular galaxies. For these galaxies we modeled the dark matter halo (at the current epoch) as a dissipative plasma of dark matter particles, where the energy lost due to dissipation is compensated by the energy produced from ordinary supernovae (the core-collapse energy is transferred to the hidden sector via kinetic mixing induced processes in the supernova core). We find that such a dynamical halo model can reproduce several observed features of disk galaxies, including the cored density profile and the Tully-Fisher relation. We also discuss how elliptical and dwarf spheroidal galaxies could fit into this picture. Finally, these analyses are combined to set bounds on the parameter space of our model, which can serve as a guideline for future experimental searches.

Morbidity, including fatal morbidity, throughout life in men entering adult life as obese.

Directory of Open Access Journals (Sweden)

Esther Zimmermann

Full Text Available BACKGROUND: The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult life as obese. METHODS: Among 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (defined as BMI≥31.0 kg/m(2, and, as controls, a random 1% sample of the others was identified. In the age range of 18-25 years, there were 1,862 obese, which encompass the men above the 99.5 percentile, and 3,476 controls. Information on morbidity was obtained via national registers. Cox regression models were used to estimate the relative morbidity assessed as first incidence of disease, occurrence of disease in the year preceding death and prevalent disease at time of death. RESULTS: From age 18 through 80 years the obese had an increased risk of becoming diseased by or die from a broad range of diseases. Generally, the incidence of first event, occurrence in the year prior to death, and prevalence at time of death showed the same pattern. As an example, the relative hazard of type 2 diabetes was constant throughout life at 4.9 (95% confidence intervals [CI]: 4.1-5.9, 5.2 (95% CI: 3.6-7.5, and 6.8 (95% CI: 4.6-10.1, respectively. CONCLUSIONS: Our findings strongly support the continued need to avoid beginning adult life as obese, as obese young men experience an increased morbidity, including fatal morbidity, from many diseases throughout life.

Hidden twelve-dimensional super Poincare symmetry in eleven dimensions

International Nuclear Information System (INIS)

Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

2004-01-01

First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional super Poincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven-dimensional superparticle, taken off-shell, we discover a hidden twelve-dimensional super Poincare symmetry that governs the theory

Electroweak-charged bound states as LHC probes of hidden forces

Science.gov (United States)

Li, Lingfeng; Salvioni, Ennio; Tsai, Yuhsin; Zheng, Rui

2018-01-01

We explore the LHC reach on beyond-the-standard model (BSM) particles X associated with a new strong force in a hidden sector. We focus on the motivated scenario where the SM and hidden sectors are connected by fermionic mediators ψ+,0 that carry SM electroweak charges. The most promising signal is the Drell-Yan production of a ψ±ψ¯ 0 pair, which forms an electrically charged vector bound state ϒ± due to the hidden force and later undergoes resonant annihilation into W±X . We analyze this final state in detail in the cases where X is a real scalar ϕ that decays to b b ¯, or a dark photon γd that decays to dileptons. For prompt X decays, we show that the corresponding signatures can be efficiently probed by extending the existing ATLAS and CMS diboson searches to include heavy resonance decays into BSM particles. For long-lived X , we propose new searches where the requirement of a prompt hard lepton originating from the W boson ensures triggering and essentially removes any SM backgrounds. To illustrate the potential of our results, we interpret them within two explicit models that contain strong hidden forces and electroweak-charged mediators, namely λ -supersymmetry (SUSY) and non-SUSY ultraviolet extensions of the twin Higgs model. The resonant nature of the signals allows for the reconstruction of the mass of both ϒ± and X , thus providing a wealth of information about the hidden sector.

Maternal health care initiatives: Causes of morbidities and mortalities in two rural districts of Upper West Region, Ghana.

Directory of Open Access Journals (Sweden)

Joshua Sumankuuro

Full Text Available Maternal and neonatal morbidities and mortalities have received much attention over the years in sub-Saharan Africa; yet addressing them remains a profound challenge, no more so than in the nation of Ghana. This study focuses on finding explanations to the conditions which lead to maternal and neonatal morbidities and mortalities in rural Ghana, particularly the Upper West Region.Mixed methods approach was adopted to investigate the medical and non-medical causes of maternal and neonatal morbidities and mortalities in two rural districts of the Upper West Region of Ghana. Survey questionnaires, in-depth interviews and focus group discussions were employed to collect data from: a 80 expectant mothers (who were in their second and third trimesters, excluding those in their ninth month, b 240 community residents and c 13 healthcare providers (2 district directors of health services, 8 heads of health facilities and 3 nurses.Morbidity and mortality during pregnancy is attributed to direct causes such urinary tract infection (48%, hypertensive disorders (4%, mental health conditions (7%, nausea (4% and indirect related sicknesses such as anaemia (11%, malaria, HIV/AIDS, oedema and hepatitis B (26%. Socioeconomic and cultural factors are identified as significant underlying causes of these complications and to morbidity and mortality during labour and the postnatal period. Birth asphyxia and traditional beliefs and practices were major causes of neonatal deaths.These findings provide focused targets and open a window of opportunity for the community-based health services run by Ghana Health Service to intensify health education and promotion programmes directed at reducing risky economic activities and other cultural beliefs and practices affecting maternal and neonatal morbidity and mortality.

A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder.

Science.gov (United States)

Furuta, Marie; Sandall, Jane; Bick, Debra

2012-11-10

The incidence of severe maternal morbidity is increasing in high-income countries as a consequence, in part, of increased obstetric intervention and increasingly complex medical needs of women who become pregnant. Access to emergency obstetric care means that for the majority of women in these countries, an experience of severe maternal morbidity is unlikely to result in loss of life. However, little is known about the subsequent impact on postnatal psychological health resulting in an evidence gap to support provision of appropriate care for these women. There has recently been increasing recognition that childbirth can be a cause of post-traumatic stress disorder (PTSD). The combination of experiencing a life-threatening complication and its management may culminate in psychological trauma. This systematic review examined the association between women's experience of severe maternal morbidity during labour, at the time of giving birth or within the first week following birth, and PTSD and its symptoms. Relevant literature was identified through multiple databases, including MEDLINE, PsycINFO, EMBASE, CINAHL, British Nursing Index, Web of Science, Cochrane library and the British Library, using predetermined search strategies. The search terms included "post-traumatic stress disorder", "PTSD", "stress disorders, post-traumatic", "maternal morbidity", "pregnancy complications" "puerperal disorders", "obstetric labo(u)r complication", "postpartum h(a)emorrhage", "eclampsia". Studies identified were categorised according to pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the relevant CASP appraisal tools. Eleven primary studies met review criteria. Evidence of a relationship between severe maternal morbidity and PTSD/PTSD symptoms was inconsistent and findings varied between studies. Nevertheless, there is some evidence that severe pre-eclampsia is a risk factor for PTSD and its symptoms, an association possibly

Application of ANNS in tube CHF prediction: effect on neuron number in hidden layer

International Nuclear Information System (INIS)

Han, L.; Shan, J.; Zhang, B.

2004-01-01

Prediction of the Critical Heat Flux (CHF) for upward flow of water in uniformly heated vertical round tube is studied with Artificial Neuron Networks (ANNs) method utilizing different neuron number in hidden layers. This study is based on thermal equilibrium conditions. The neuron number in hidden layers is chosen to vary from 5 to 30 with the step of 5. The effect due to the variety of the neuron number in hidden layers is analyzed. The analysis shows that the neuron number in hidden layers should be appropriate, too less will affect the prediction accuracy and too much may result in abnormal parametric trends. It is concluded that the appropriate neuron number in two hidden layers should be [15 15]. (authors)

UV Photography Shows Hidden Sun Damage

Science.gov (United States)

... mcat1=de12", ]; for (var c = 0; c UV photography shows hidden sun damage A UV photograph gives ... developing skin cancer and prematurely aged skin. Normal photography UV photography 18 months of age: This boy's ...

Anomalies of hidden local chiral symmetries in sigma-models and extended supergravities

International Nuclear Information System (INIS)

Vecchia, P. di; Ferrara, S.; Girardello, L.

1985-01-01

Non-linear sigma-models with hidden gauge symmetries are anomalous, at the quantum level, when coupled to chiral fermions in not anomaly free representations of the hidden chiral symmetry. These considerations generally apply to supersymmetric kaehlerian sigma-models on coset spaces with hidden chiral symmetries as well as to extended supergravities in four dimensions with local SU(N) symmetry. The presence of the anomaly implies that the scenario of dynamical generation of gauge vector bosons has to be reconsidered in these theories. (orig.)

Co-morbidities of COPD in primary care : frequency, relation to COPD, and treatment consequences

NARCIS (Netherlands)

van der Molena, Thys

2010-01-01

Introduction: In the Western world, chronic obstructive pulmonary disease (COPD) is predominantly caused by long-term smoking, which results in pulmonary inflammation that is often associated with systemic inflammation. A number of co-morbid conditions, such as cardiovascular disease, muscle

Cushing's Syndrome in a Morbidly Obese Patient Undergoing Evaluation before Bariatric Surgery

Directory of Open Access Journals (Sweden)

Livia Borsoi

2014-06-01

Full Text Available Objective: Cushing's syndrome (CS is extremely rare in morbidly obese patients. To date, no occurrences in obese patients with BMI above 60 kg/m2 have been reported in the literature. Case Report: This case report describes a patient who was admitted to the ward of the Clinical Division of Endocrinology and Metabolism of the Medical University of Vienna in preparation for bariatric surgery. The patient was a 49-year-old female who showed morbid obesity (BMI 61.6 kg/m2, hypertension, and substituted hypothyroidism. Preoperative work-up revealed CS due to an adrenal adenoma. Therefore, the patient underwent unilateral adrenalectomy followed by bariatric surgery 6 months later. Conclusion: Since undiagnosed CS might result in severe perioperative complications in a population already at increased risk, this case report underlines the importance of careful endocrine evaluation of morbidly obese patients. After all, even rare endocrine causes should be excluded.

Review of hidden carbon emissions, trade, and labor income share in China, 2001–2011

International Nuclear Information System (INIS)

Wang, Shu-Hong; Song, Ma-Lin

2014-01-01

Coordinated development between the economy and the environment is currently one of the most important issues in China. By establishing models concerning labor income share and hidden carbon emissions, and taking trade as the link in their relationship, this study puts forward the scale effects, technological effects, and structural effects that relate to labor income share under the function of trade. We then establish multi-index and multi-indicator constitutive (MIMIC) equation to measure the ratio of hidden carbon emissions to total emissions, which is further considered the basis of the measurement model. Results of regression analysis carried out on labor income share show that hidden carbon emissions do have a positive effect on labor income share. In the meantime, we also prove that under scale effects, technological effects, and the structural effects of trade, hidden carbon emissions affect labor income shares in different directions. Our conclusions and policy implications are obtained from the calculated results. - Highlights: • This study establishes models concerning labor income share and hidden carbon emissions. • MIMIC is established to measure the ratio of hidden carbon emissions to total discharge. • Hidden carbon emissions have a positive effect on labor income share. • Hidden carbon emissions have various effects on the labor income share

A Multidisciplinary Clinical Pathway Decreases Rib Fracture-Associated Infectious Morbidity and Mortality in High-Risk Trauma Patients

Science.gov (United States)

2006-01-01

RT respiratory therapy ; PT physical therapy ; OT occupational therapy ; GCS Glasgow Coma Scale. 808 S.R. Todd et al. / The American Journal of...Morbidity form rib fractures increases after age 45. J Am Coll Surg 2003;196:549–55. [14] Pierson DJ, Kacmarek R. Foundations of Respiratory Care. New...Papers presented A multidisciplinary clinical pathway decreases rib fracture –associated infectious morbidity and mortality in high-risk trauma

The selection and implementation of hidden line algorithms

International Nuclear Information System (INIS)

Schneider, A.

1983-06-01

One of the most challenging problems in the field of computer graphics is the elimination of hidden lines in images of nontransparent bodies. In the real world the nontransparent material hinders the light ray coming from hidden regions to the observer. In the computer based image formation process there is no automatic visibility regulation of this kind. So many lines are created which result in a poor quality of the spacial representation. Therefore a three-dimensional representation on the screen is only meaningfull if the hidden lines are eliminated. For this process many algorithms have been developed in the past. A common feature of these codes is the large amount of computer time needed. In the first generation of algorithms, which are commonly used today, the bodies are modeled by plane polygons. More recently, however, also algorithms are in use, which are able to treat curved surfaces without discretisation by plane surfaces. In this paper the first group of algorithms is reviewed, and the most important codes are described. The experience obtained during the implementation of two algorithms is presented. (orig.) [de

Strategies to reduce disparities in maternal morbidity and mortality: Patient and provider education.

Science.gov (United States)

Jain, Joses; Moroz, Leslie

2017-08-01

A reduction in racial disparities in maternal morbidity and mortality requires effective education of both patients and providers. Although providers seem to recognize that disparities exist, there is a widespread need for improving our understanding differences in health care and outcomes and the factors that contribute to them. There are increasingly more educational materials available for the purpose of augmenting disparities education among patients and providers. However, it is important to incorporate contemporary learning methodologies and technologies to address our current knowledge deficit. Collaborative educational models with a multi-disciplinary approach to patient education will be essential. Ultimately, the comprehensive education of providers and patients will require efforts on the part of numerous stakeholders within patient care delivery models. Further investigation will be necessary to determine how best to disseminate this information to maximize the impact of patient and provider educations with the goal of eliminating disparities in maternal morbidity and mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

Hidden sector behind the CKM matrix

Science.gov (United States)

Okawa, Shohei; Omura, Yuji

2017-08-01

The small quark mixing, described by the Cabibbo-Kobayashi-Maskawa (CKM) matrix in the standard model, may be a clue to reveal new physics around the TeV scale. We consider a simple scenario that extra particles in a hidden sector radiatively mediate the flavor violation to the quark sector around the TeV scale and effectively realize the observed CKM matrix. The lightest particle in the hidden sector, whose contribution to the CKM matrix is expected to be dominant, is a good dark matter (DM) candidate. There are many possible setups to describe this scenario, so that we investigate some universal predictions of this kind of model, focusing on the contribution of DM to the quark mixing and flavor physics. In this scenario, there is an explicit relation between the CKM matrix and flavor violating couplings, such as four-quark couplings, because both are radiatively induced by the particles in the hidden sector. Then, we can explicitly find the DM mass region and the size of Yukawa couplings between the DM and quarks, based on the study of flavor physics and DM physics. In conclusion, we show that DM mass in our scenario is around the TeV scale, and the Yukawa couplings are between O (0.01 ) and O (1 ). The spin-independent DM scattering cross section is estimated as O (10-9) [pb]. An extra colored particle is also predicted at the O (10 ) TeV scale.

Laser experiments explore the hidden sector

International Nuclear Information System (INIS)

Ahlers, M.

2007-11-01

Recently, the laser experiments BMV and GammeV, searching for light shining through walls, have published data and calculated new limits on the allowed masses and couplings for axion-like particles. In this note we point out that these experiments can serve to constrain a much wider variety of hidden-sector particles such as, e.g., minicharged particles and hidden-sector photons. The new experiments improve the existing bounds from the older BFRT experiment by a factor of two. Moreover, we use the new PVLAS constraints on a possible rotation and ellipticity of light after it has passed through a strong magnetic field to constrain pure minicharged particle models. For masses -7 times the electron electric charge. This is the best laboratory bound and comparable to bounds inferred from the energy spectrum of the cosmic microwave background. (orig.)

Increased detection of co-morbidities with evaluation at a dedicated adult Turner syndrome clinic.

Science.gov (United States)

Vincent, A J; Nguyen, H H; Ranasinha, S; Vollenhoven, B

2017-10-01

Turner syndrome (TS), resulting from complete/partial X chromosomal monosomy, is associated with multiple co-morbidities and increased mortality. Although multidisciplinary management is recommended, TS women's health care is sub-optimal. This study evaluates a multidisciplinary adult TS service. Retrospective cohort study of 82 patients attending the quarterly TS clinic from December 2003 to December 2014. Evaluation included (1) demographics, (2) TS standardized co-morbidity screening, and (3) estrogen therapy use. Data analysis involved frequency statistics, T tests and polychoric correlation analysis. Median age at TS diagnosis was 14 years (range 0-65 years), with 12% of women aged >18 years. Median age at initial consultation was 31 years (range 16-65 years). Only 14% of patients were transition program referrals. XO karyotype occurred in 30%. Primary amenorrhea predominated; however, 37% of TS women were not taking estrogen therapy. The proportion of patients not previously screened (44-76%) and those with positive screening diagnoses (5-53%) varied according to co-morbidity. The mean (± standard deviation) number of co-morbidities identified increased following TS clinic screening (7.0 ± 2.6 post-screening vs. 4.4 ± 2.3 pre-screening; p < 0.0001). Polychoric correlation analysis identified particular co-morbidity groupings (including metabolism-related) and increased co-morbidities with primary amenorrhea. A multidisciplinary adult TS clinic improves health surveillance with increased identification of co-morbidities and initiation of estrogen therapy.

438 Optimal Number of States in Hidden Markov Models and its ...

African Journals Online (AJOL)

In this paper, Hidden Markov Model is applied to model human movements as to .... emit either discrete information or a continuous data derived from a Probability .... For each hidden state in the test set, the probability = ... by applying the Kullback-Leibler distance (Juang & Rabiner, 1985) which ..... One Size Does Not Fit.

Co-morbid disorders in Tourette syndrome

DEFF Research Database (Denmark)

Debes, Nanette Marinette Monique

2013-01-01

in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co......-morbid disorders, like rage, anxiety, and conduct disorders. The symptoms of a co-morbid disorder might appear prior to the time that tics reach clinical attention. The TS phenotype probably changes during the course of the disease. The exact aetiology of the co-occurrence of co-morbid disorders and TS...

The hidden and informal curriculum across the continuum of training: A cross-sectional qualitative study.

Science.gov (United States)

Doja, Asif; Bould, M Dylan; Clarkin, Chantalle; Eady, Kaylee; Sutherland, Stephanie; Writer, Hilary

2016-04-01

The hidden and informal curricula refer to learning in response to unarticulated processes and constraints, falling outside the formal medical curriculum. The hidden curriculum has been identified as requiring attention across all levels of learning. We sought to assess the knowledge and perceptions of the hidden and informal curricula across the continuum of learning at a single institution. Focus groups were held with undergraduate and postgraduate learners and faculty to explore knowledge and perceptions relating to the hidden and informal curricula. Thematic analysis was conducted both inductively by research team members and deductively using questions structured by the existing literature. Participants highlighted several themes related to the presence of the hidden and informal curricula in medical training and practice, including: the privileging of some specialties over others; the reinforcement of hierarchies within medicine; and a culture of tolerance towards unprofessional behaviors. Participants acknowledged the importance of role modeling in the development of professional identities and discussed the deterioration in idealism that occurs. Common issues pertaining to the hidden curriculum exist across all levels of learners, including faculty. Increased awareness of these issues could allow for the further development of methods to address learning within the hidden curriculum.

Low scale gravity mediation with warped extra dimension and collider phenomenology on the hidden sector

International Nuclear Information System (INIS)

Itoh, Hideo; Okada, Nobuchika; Yamashita, Toshifumi

2006-01-01

We propose a scenario of gravity mediated supersymmetry breaking (gravity mediation) in a supersymmetric Randall-Sundrum model. In our setup, both the visible sector and the hidden sector coexist on the infrared (IR) brane. We introduce the Polonyi model as a simple hidden sector. Because of the warped metric, the effective cutoff scale on the IR brane is 'warped down', so that the gravity mediation occurs at a low scale. As a result, the gravitino is naturally the lightest superpartner (LSP) and contact interactions between the hidden and the visible sector fields become stronger. We address phenomenologies for various IR cutoff scales. In particular, we investigate collider phenomenology involving a scalar field (Polonyi field) in the hidden sector for the case with the IR cutoff around 10 TeV. We find a possibility that the hidden sector scalar can be produced at the LHC and the international linear collider (ILC). Interestingly, the scalar behaves like the Higgs boson of the standard model in the production process, while its decay process is quite different and, once produced, it will provide us with a very clean signature. The hidden sector may be no longer hidden

In Brief: Hidden environment and health costs of energy

Science.gov (United States)

Showstack, Randy

2009-10-01

The hidden costs of energy production and use in the United States amounted to an estimated $120 billion in 2005, according to a 19 October report by the U.S. National Research Council. The report, “Hidden Costs of Energy: Unpriced Consequences of Energy Production and Use,” examines hidden costs, including the cost of air pollution damage to human health, which are not reflected in market prices of energy sources, electricity, or gasoline. The report found that in 2005, the total annual external damages from sulfur dioxide, nitrogen oxides, and particulate matter created by coal-burning power plants that produced 95% of the nation's coal-generated electricity were about $62 billion, with nonclimate damages averaging about 3.2 cents for every kilowatt-hour of energy produced. It is estimated that by 2030, nonclimate damages will fall to 1.7 cents per kilowatt-hour. The 2030 figure assumes that new policies already slated for implementation are put in place.

Distinguishing Hidden Markov Chains

OpenAIRE

Kiefer, Stefan; Sistla, A. Prasad

2015-01-01

Hidden Markov Chains (HMCs) are commonly used mathematical models of probabilistic systems. They are employed in various fields such as speech recognition, signal processing, and biological sequence analysis. We consider the problem of distinguishing two given HMCs based on an observation sequence that one of the HMCs generates. More precisely, given two HMCs and an observation sequence, a distinguishing algorithm is expected to identify the HMC that generates the observation sequence. Two HM...

Coupling of Hidden Sector

OpenAIRE

Królikowski, Wojciech

2016-01-01

A hypothetic Hidden Sector of the Universe, consisting of sterile fer\\-mions (``sterinos'') and sterile mediating bosons (``sterons'') of mass dimension 1 (not 2!) --- the last described by an antisymmetric tensor field --- requires to exist also a scalar isovector and scalar isoscalar in order to be able to construct electroweak invariant coupling (before spontaneously breaking its symmetry). The introduced scalar isoscalar might be a resonant source for the diphoton excess of 750 GeV, sugge...

Improving perinatal outcome: towards individualized care

OpenAIRE

Kazemier, B.M.

2015-01-01

Unfortunately not all pregnancies and deliveries take place without complications. Complications during pregnancy or delivery can lead to maternal morbidity and poor perinatal outcomes such as perinatal mortality or (severe) neonatal morbidity. First assessment in antenatal care is to distinguish women who require standard care from those requiring special attention. At the moment, we can make some global risk assessments, but are not able to give a women a risk assessment that is adapted for...

Ethnic disparity in severe acute maternal morbidity: A nationwide cohort study in the Netherlands

NARCIS (Netherlands)

Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; Roosmalen, J. van

2011-01-01

Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

Ethnic disparity in severe acute maternal morbidity: a nationwide cohort study in the Netherlands

NARCIS (Netherlands)

Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; van Roosmalen, J.

2011-01-01

Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

Co-morbidity in psoriasis

DEFF Research Database (Denmark)

Lønnberg, Ann Sophie; Skov, Lone

2017-01-01

for the clinic to be able to recognize such co-morbidities. Areas covered: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

Co-morbidities of vertiginous diseases

OpenAIRE

Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

2009-01-01

Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes ...

Co-existing hidden attractors in a radio-physical oscillator system

DEFF Research Database (Denmark)

Kuznetsov, A. P.; Kuznetsov, S. P.; Mosekilde, Erik

2015-01-01

The term `hidden attractor' relates to a stable periodic, quasiperiodic or chaotic state whose basin of attraction does not overlap with the neighborhood of an unstable equilibrium point. Considering a three-dimensional oscillator system that does not allow for the existence of an equilibrium point...... frequency, describe the bifurcations through which hidden attractors of different type arise and disappear, and illustrate the form of the basins of attraction....

A two particle hidden sector and the oscillations with photons

Energy Technology Data Exchange (ETDEWEB)

Alvarez, Pedro D. [Universidad de Antofagasta, Departamento de Fisica, Antofagasta (Chile); Arias, Paola; Maldonado, Carlos [Universidad de Santiago de Chile, Departmento de Fisica, Santiago (Chile)

2018-01-15

We present a detailed study of the oscillations and optical properties for vacuum, in a model for the dark sector that contains axion-like particles and hidden photons. We provide bounds for the couplings versus the mass, using current results from ALPS-I and PVLAS. We also discuss the challenges for the detection of models with more than one hidden particle in light shining trough wall-like experiments. (orig.)

Preoperative alcoholism and postoperative morbidity

DEFF Research Database (Denmark)

Tonnesen, H; Kehlet, H

1999-01-01

BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

Optimal no-go theorem on hidden-variable predictions of effect expectations

Science.gov (United States)

Blass, Andreas; Gurevich, Yuri

2018-03-01

No-go theorems prove that, under reasonable assumptions, classical hidden-variable theories cannot reproduce the predictions of quantum mechanics. Traditional no-go theorems proved that hidden-variable theories cannot predict correctly the values of observables. Recent expectation no-go theorems prove that hidden-variable theories cannot predict the expectations of observables. We prove the strongest expectation-focused no-go theorem to date. It is optimal in the sense that the natural weakenings of the assumptions and the natural strengthenings of the conclusion make the theorem fail. The literature on expectation no-go theorems strongly suggests that the expectation-focused approach is more general than the value-focused one. We establish that the expectation approach is not more general.

The financial burden of morbidity in HIV-infected adults on antiretroviral therapy in Cote d'Ivoire.

Directory of Open Access Journals (Sweden)

Arnousse Beaulière

Full Text Available BACKGROUND: Large HIV care programs frequently subsidize antiretroviral (ARV drugs and CD4 tests, but patients must often pay for other health-related drugs and services. We estimated the financial burden of health care for households with HIV-infected adults taking antiretroviral therapy (ART in Côte d'Ivoire. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cross-sectional survey. After obtaining informed consent, we interviewed HIV-infected adults taking ART who had consecutively attended one of 18 HIV care facilities in Abidjan. We collected information on socioeconomic and medical characteristics. The main economic indicators were household capacity-to-pay (overall expenses minus food expenses, and health care expenditures. The primary outcome was the percentage of households confronted with catastrophic health expenditures (health expenditures were defined as catastrophic if they were greater than or equal to 40% of the capacity-to-pay. We recruited 1,190 adults. Median CD4 count was 187/mm(3, median time on ART was 14 months, and 72% of subjects were women. Mean household capacity-to-pay was $213.7/month, mean health expenditures were $24.3/month, and 12.3% of households faced catastrophic health expenditures. Of the health expenditures, 75.3% were for the study subject (ARV drugs and CD4 tests, 24.6%; morbidity events diagnosis and treatment, 50.1%; transportation to HIV care centres, 25.3% and 24.7% were for other household members. When we stratified by most recent CD4 count, morbidity events related expenses were significantly lower when subjects had higher CD4 counts. CONCLUSIONS/SIGNIFICANCE: Many households in Côte d'Ivoire face catastrophic health expenditures that are not attributable to ARV drugs or routine follow-up tests. Innovative schemes should be developed to help HIV-infected patients on ART face the cost of morbidity events.

Improving perinatal outcome: towards individualized care

NARCIS (Netherlands)

Kazemier, B.M.

2015-01-01

Unfortunately not all pregnancies and deliveries take place without complications. Complications during pregnancy or delivery can lead to maternal morbidity and poor perinatal outcomes such as perinatal mortality or (severe) neonatal morbidity. First assessment in antenatal care is to distinguish

Raising awareness of the hidden curriculum in veterinary medical education: a review and call for research.

Science.gov (United States)

Whitcomb, Tiffany L

2014-01-01

The hidden curriculum is characterized by information that is tacitly conveyed to and among students about the cultural and moral environment in which they find themselves. Although the hidden curriculum is often defined as a distinct entity, tacit information is conveyed to students throughout all aspects of formal and informal curricula. This unconsciously communicated knowledge has been identified across a wide spectrum of educational environments and is known to have lasting and powerful impacts, both positive and negative. Recently, medical education research on the hidden curriculum of becoming a doctor has come to the forefront as institutions struggle with inconsistencies between formal and hidden curricula that hinder the practice of patient-centered medicine. Similarly, the complex ethical questions that arise during the practice and teaching of veterinary medicine have the potential to cause disagreement between what the institution sets out to teach and what is actually learned. However, the hidden curriculum remains largely unexplored for this field. Because the hidden curriculum is retained effectively by students, elucidating its underlying messages can be a key component of program refinement. A review of recent literature about the hidden curriculum in a variety of fields, including medical education, will be used to explore potential hidden curricula in veterinary medicine and draw attention to the need for further investigation.

Maternal morbidity in emergency versus elective caesarean section at tertiary care hospital

International Nuclear Information System (INIS)

Ghazi, A.; Karim, F.; Hussain, M.; Ali, T.; Jabbar, S.

2012-01-01

Background: In the past 30 years the rate of caesarean section (C/S) has steadily increased from 5% to more than 20% for many avoidable and unavoidable indications. The objective of this study was to compare maternal morbidity and determine its cause in elective and emergency caesarean section. Method: It was a cross-sectional comparative study conducted in Civil Hospital Karachi at Obs/Gyn Unit III. All mothers admitted through OPD or emergency during the study period, of any age or parity undergoing C/S were recruited in the study. Patients having previous myomectomy, hysterotomy or classical C/S were excluded from the study. Patients undergoing emergency C/S were placed in group A, and those delivered by elective C/S were included in group B. Study variables were general and obstetric parameters and complications observed intra-operatively. Any postoperative complications were recorded from recovery room till patient was discharged from the ward. Results: There were 50 patients in each group. In group A, 11 (22%) were booked and 33 (66%) were referred cases. In group B, 48 (96%) were booked. The mean age in both groups was 28 years. In both groups, multigravida compared to primigravida were 78% vs 22% in group A, and 92% vs 8% in group B. Indication for C/S was previous C/S in 10 (20%) patients in group A, and 39 (78%) patients in group B, placenta previa, chorioamionitis, obstructed labour (6, 12% each); pregnancy induced hypertension and eclampsia in 5 (10%) cases in group A only. Intra-operative complications in group A were 48 (96%) vs 15 (30%) in group B (p=0.000). Postoperative morbidity in group A was 50 (100%) and 26 (52%) in group B (p=0.000). Intra-operative complication was haemorrhage in 46 (92%) cases in group A and 11 (22%) in group B. Anaesthetic complications were 40 (80%); prolonged intubation 25 (50%), aspiration of gastric contents 8 (16%), and difficult intubation 7 (14%) in group A. Ten (20%) cases had anaesthetic complications in group B

Nonparametric model validations for hidden Markov models with applications in financial econometrics.

Science.gov (United States)

Zhao, Zhibiao

2011-06-01

We address the nonparametric model validation problem for hidden Markov models with partially observable variables and hidden states. We achieve this goal by constructing a nonparametric simultaneous confidence envelope for transition density function of the observable variables and checking whether the parametric density estimate is contained within such an envelope. Our specification test procedure is motivated by a functional connection between the transition density of the observable variables and the Markov transition kernel of the hidden states. Our approach is applicable for continuous time diffusion models, stochastic volatility models, nonlinear time series models, and models with market microstructure noise.

The Consensus String Problem and the Complexity of Comparing Hidden Markov Models

DEFF Research Database (Denmark)

Lyngsø, Rune Bang; Pedersen, Christian Nørgaard Storm

2002-01-01

The basic theory of hidden Markov models was developed and applied to problems in speech recognition in the late 1960s, and has since then been applied to numerous problems, e.g. biological sequence analysis. Most applications of hidden Markov models are based on efficient algorithms for computing......-norms. We discuss the applicability of the technique used for proving the hardness of comparing two hidden Markov models under the L1-norm to other measures of distance between probability distributions. In particular, we show that it cannot be used for proving NP-hardness of determining the Kullback...

Inference with constrained hidden Markov models in PRISM

DEFF Research Database (Denmark)

Christiansen, Henning; Have, Christian Theil; Lassen, Ole Torp

2010-01-01

A Hidden Markov Model (HMM) is a common statistical model which is widely used for analysis of biological sequence data and other sequential phenomena. In the present paper we show how HMMs can be extended with side-constraints and present constraint solving techniques for efficient inference. De......_different are integrated. We experimentally validate our approach on the biologically motivated problem of global pairwise alignment.......A Hidden Markov Model (HMM) is a common statistical model which is widely used for analysis of biological sequence data and other sequential phenomena. In the present paper we show how HMMs can be extended with side-constraints and present constraint solving techniques for efficient inference...

EVALUASI HIDDEN CURRICULUM DI SMP NEGERI BOJA, KABUPATEN KENDAL

Directory of Open Access Journals (Sweden)

Neni Lestari

2015-12-01

Full Text Available This study aimed to evaluate the implementation and impact of Hidden Curriculum, as well as the determinant factors of success and sustainability in SMPN 2 Boja Kendal. This study was an evaluative research using qualitative approach. The data collected by using observation, interviews, and documentation. Data analyzed by collecting and selecting to be deduce. Validity used triangulation data that combined the result of observation, interviews, and documentation. The results of the study were: 1 The activities of hidden curriculum development at SMPN 2 Boja Kendal, namely: flag ceremony, school environmental management, establishing and enforcing discipline, special religious worship, smiles, greetings and courtesies, exemplary, relationship among students and principal, teachers, and staff, school canteen services. 2 The impact of the hidden curriculum development was the changing of school community’s behavior being better, created clean and beautiful school environment, the improvement of public trust to the school toward their kids’ education. Development of the hidden curriculum could establish students good character and an optimal achievement as well as a good school culture. 3 Internal supporting factors including: qualified human resources, the availability of school facilities, school environment was clean and beautiful. External supporting factors occur in the form of endorsement of the parents, school committees and communities in establishing good and virtuous character for the students.

Hidden and generalized conformal symmetry of Kerr–Sen spacetimes

International Nuclear Information System (INIS)

Ghezelbash, A M; Siahaan, H M

2013-01-01

It is recently conjectured that generic non-extremal Kerr black hole could be holographically dual to a hidden conformal field theory (CFT) in two dimensions. Moreover, it is known that there are two CFT duals (pictures) to describe the charged rotating black holes which correspond to angular momentum J and electric charge Q of the black hole. Furthermore these two pictures can be incorporated by the CFT duals (general picture) that are generated by SL(2,Z) modular group. The general conformal structure can be revealed by looking at charged scalar wave equation in some appropriate values of frequency and charge. In this regard, we consider the wave equation of a charged massless scalar field in the background of Kerr–Sen black hole and show that in the ‘near region’, the wave equation can be reproduced by the Casimir operator of a local SL(2,R) L ×SL(2,R) R hidden conformal symmetry. We find the exact agreement between macroscopic and microscopic physical quantities like entropy and absorption cross section of scalars for Kerr–Sen black hole. We then find an extension of vector fields that in turn yields an extended local family of SL(2,R) L ×SL(2,R) R hidden conformal symmetry, parameterized by one parameter. For some special values of the parameter, we find a copy of SL(2,R) hidden conformal algebra for the charged Gibbons–Maeda–Garfinkle–Horowitz–Strominger black hole in the strong deflection limit. (paper)

A model for morbidity after lung resection in octogenarians.

Science.gov (United States)

Berry, Mark F; Onaitis, Mark W; Tong, Betty C; Harpole, David H; D'Amico, Thomas A

2011-06-01

Age is an important risk factor for morbidity after lung resection. This study was performed to identify specific risk factors for complications after lung resection in octogenarians. A prospective database containing patients aged 80 years or older, who underwent lung resection at a single institution between January 2000 and June 2009, was reviewed. Preoperative, histopathologic, perioperative, and outcome variables were assessed. Morbidity was measured as a patient having any perioperative event as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. A multivariable risk model for morbidity was developed using a panel of established preoperative and operative variables. Survival was calculated using the Kaplan-Meier method. During the study period, 193 patients aged 80 years or older (median age 82 years) underwent lung resection: wedge resection in 77, segmentectomy in 13, lobectomy in 96, bilobectomy in four, and pneumonectomy in three. Resection was accomplished via thoracoscopy in 149 patients (77%). Operative mortality was 3.6% (seven patients) and morbidity was 46% (89 patients). A total of 181 (94%) patients were discharged directly home. Postoperative events included atrial arrhythmia in 38 patients (20%), prolonged air leak in 24 patients (12%), postoperative transfusion in 22 patients (11%), delirium in 16 patients (8%), need for bronchoscopy in 14 patients (7%), and pneumonia in 10 patients (5%). Significant predictors of morbidity by multivariable analysis included resection greater than wedge (odds ratio 2.98, p=0.006), thoracotomy as operative approach (odds ratio 2.6, p=0.03), and % predicted forced expiratory volume in 1s (odds ratio 1.28 for each 10% decrement, p=0.01). Octogenarians can undergo lung resection with low mortality. Extent of resection, use of a thoracotomy, and impaired lung function increase the risk of complications. Careful evaluation is necessary to select the most appropriate approach in

Hidden solution to the μ/Bμ problem in gauge mediation

International Nuclear Information System (INIS)

Roy, Tuhin S.; Schmaltz, Martin

2008-01-01

We propose a solution to the μ/B μ problem in gauge mediation. The novel feature of our solution is that it uses dynamics of the hidden sector, which is often present in models with dynamical supersymmetry breaking. We give an explicit example model of gauge mediation where a very simple messenger sector generates both μ and B μ at one loop. The usual problem, that B μ is then too large, is solved by strong renormalization effects from the hidden sector which suppress B μ relative to μ. Our mechanism relies on an assumption about the signs of certain incalculable anomalous dimensions in the hidden sector. Making these assumptions not only allows us to solve the μ/B μ problem but also leads to a characteristic superpartner spectrum which would be a smoking gun signal for our mechanism.

Multitask TSK fuzzy system modeling by mining intertask common hidden structure.

Science.gov (United States)

Jiang, Yizhang; Chung, Fu-Lai; Ishibuchi, Hisao; Deng, Zhaohong; Wang, Shitong

2015-03-01

The classical fuzzy system modeling methods implicitly assume data generated from a single task, which is essentially not in accordance with many practical scenarios where data can be acquired from the perspective of multiple tasks. Although one can build an individual fuzzy system model for each task, the result indeed tells us that the individual modeling approach will get poor generalization ability due to ignoring the intertask hidden correlation. In order to circumvent this shortcoming, we consider a general framework for preserving the independent information among different tasks and mining hidden correlation information among all tasks in multitask fuzzy modeling. In this framework, a low-dimensional subspace (structure) is assumed to be shared among all tasks and hence be the hidden correlation information among all tasks. Under this framework, a multitask Takagi-Sugeno-Kang (TSK) fuzzy system model called MTCS-TSK-FS (TSK-FS for multiple tasks with common hidden structure), based on the classical L2-norm TSK fuzzy system, is proposed in this paper. The proposed model can not only take advantage of independent sample information from the original space for each task, but also effectively use the intertask common hidden structure among multiple tasks to enhance the generalization performance of the built fuzzy systems. Experiments on synthetic and real-world datasets demonstrate the applicability and distinctive performance of the proposed multitask fuzzy system model in multitask regression learning scenarios.

Hidden-sector Spectroscopy with Gravitational Waves from Binary Neutron Stars

Science.gov (United States)

Croon, Djuna; Nelson, Ann E.; Sun, Chen; Walker, Devin G. E.; Xianyu, Zhong-Zhi

2018-05-01

We show that neutron star (NS) binaries can be ideal laboratories to probe hidden sectors with a long-range force. In particular, it is possible for gravitational wave (GW) detectors such as LIGO and Virgo to resolve the correction of waveforms from ultralight dark gauge bosons coupled to NSs. We observe that the interaction of the hidden sector affects both the GW frequency and amplitude in a way that cannot be fitted by pure gravity.

A Hidden Twelve-Dimensional SuperPoincare Symmetry In Eleven Dimensions

Energy Technology Data Exchange (ETDEWEB)

Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

2003-12-13

First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional superPoincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven dimensional superparticle, taken off-shell, we discover a hidden twelve dimensional superPoincare symmetry that governs the theory.

Postoperative ileus-related morbidity profile in patients treated with alvimopan after bowel resection.

Science.gov (United States)

Wolff, Bruce G; Weese, James L; Ludwig, Kirk A; Delaney, Conor P; Stamos, Michael J; Michelassi, Fabrizio; Du, Wei; Techner, Lee

2007-04-01

Postoperative ileus (POI), an interruption of coordinated bowel motility after operation, is exacerbated by opioids used to manage pain. Alvimopan, a peripherally acting mu-opioid receptor antagonist, accelerated gastrointestinal (GI) recovery after bowel resection in randomized, double-blind, placebo-controlled, multicenter phase III POI trials. The effect of alvimopan on POI-related morbidity for patients who underwent bowel resection was evaluated in a post-hoc analysis. Incidence of POI-related postoperative morbidity (postoperative nasogastric tube insertion or POI-related prolonged hospital stay or readmission) was analyzed in four North American trials for placebo or alvimopan 12 mg administered 30 minutes or more preoperatively and twice daily postoperatively until hospital discharge (7 or fewer postoperative days). GI-related adverse events and opioid consumption were summarized for each treatment. Estimations of odds ratios of alvimopan to placebo and number needed to treat (NNT) to prevent one patient from experiencing an event of POI-related morbidity were derived from the analysis. Patients receiving alvimopan 12 mg were less likely to experience POI-related morbidity than patients receiving placebo (odds ratio = 0.44, p POI-related morbidity. There was a lower incidence of postoperative nasogastric tube insertion, and other GI-related adverse events on postoperative days 3 to 6 in the alvimopan group than the placebo group. Opioid consumption was comparable between groups. Alvimopan 12 mg was associated with reduced POI-related morbidity compared with placebo, without compromising opioid-based analgesia in patients undergoing bowel resection. Relatively low NNTs are clinically meaningful and reinforce the potential benefits of alvimopan for the patient and health care system.

Hidden Neural Networks: A Framework for HMM/NN Hybrids

DEFF Research Database (Denmark)

Riis, Søren Kamaric; Krogh, Anders Stærmose

1997-01-01

This paper presents a general framework for hybrids of hidden Markov models (HMM) and neural networks (NN). In the new framework called hidden neural networks (HNN) the usual HMM probability parameters are replaced by neural network outputs. To ensure a probabilistic interpretation the HNN is nor...... HMMs on TIMIT continuous speech recognition benchmarks. On the task of recognizing five broad phoneme classes an accuracy of 84% is obtained compared to 76% for a standard HMM. Additionally, we report a preliminary result of 69% accuracy on the TIMIT 39 phoneme task...

Privatisation & marketisation of post-birth care: the hidden costs for new mothers

Directory of Open Access Journals (Sweden)

Benoit Cecilia

2012-10-01

Full Text Available Abstract Retrenchment of government services has occurred across a wide range of sectors and regions. Care services, in particular, have been clawed away in the wake of fiscal policies of cost containment and neoliberal policies centred on individual responsibility and market autonomy. Such policies have included the deinstitutionalisation of care from hospitals and clinics, and early discharge from hospital, both of which are predicated on the notion that care can be provided informally within families and communities. In this paper we examine the post-birth "care crisis" that new mothers face in one region of Canada. Method The data are drawn from a larger study of social determinants of pregnant and new mothers' health in Victoria, Canada. Mixed methods interviews were conducted among a purposive sample of women at three points in time. This paper reports data on sample characteristics, length of stay in hospital and health service gaps. This data is contextualised via a more in-depth analysis of qualitative responses from Wave 2 (4-6 weeks postpartum. Results Out results show a significant portion of participants desired services that were not publically available to them during the post-birth period. Among those who reported a gap in care, the two most common barriers were: cost and unavailability of home care supports. Participants' open-ended responses revealed many positive features of the public health care system but also gaps in services, and economic barriers to receiving the care they wanted. The implications of these findings are discussed in relation to recent neoliberal reforms. Discussion & conclusions While Canada may be praised for its public provision of maternity care, mothers' reports of gaps in care during the early postpartum period and increasing use of private doulas is a worrying trend. To the extent that individual mothers or families rely on the market for care provision, issues of equity and quality of care are

Maternal morbid obesity and obstetric outcomes.

LENUS (Irish Health Repository)

Farah, Nadine

2012-02-01

OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

Hidden costs, value lost: uninsurance in America

National Research Council Canada - National Science Library

Committee on the Consequences of Uninsurance

2003-01-01

Hidden Cost, Value Lost , the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country of maintaining...

Hidden Markov Models for Human Genes

DEFF Research Database (Denmark)

Baldi, Pierre; Brunak, Søren; Chauvin, Yves

1997-01-01

We analyse the sequential structure of human genomic DNA by hidden Markov models. We apply models of widely different design: conventional left-right constructs and models with a built-in periodic architecture. The models are trained on segments of DNA sequences extracted such that they cover com...

Psychiatric morbidities in postpartum females: a prospective follow-up during puerperium

Directory of Open Access Journals (Sweden)

Adya Shanker Srivastava

2015-07-01

Full Text Available Aims and objectives: Postpartum psychiatric disturbances pose a significant mental health problem in community because of their impact on parent-infant and couple relationship. This study was carried out with the aim to find out psychiatric morbidities in postpartum females during puerperium so that a proper assessment of mental health and comprehensive management can be planned. Methodology: Hundred females who had delivered in maternity ward of obstetrics and gynaecology department of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi were evaluated for mental status on day one (i.e. day of delivery, and followed-up till four weeks postpartum period. Psychiatric evaluation was done on the basis of structured proforma containing socio-demographic details and the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR diagnostic criteria for diagnosis. Brief Psychiatric Rating Scale (BPRS, Hamilton Anxiety Rating Scale (HARS, and Hamilton Rating Scale for Depression (HDRS were used to assess the severity of the respective conditions. Result: Psychiatric evaluation during postpartum puerperal stage revealed that 16 (16% females had developed psychiatric morbidity. Twelve (12% cases fulfilled the criteria for major depressive disorder and four (four per cent patients had features of anxiety disorder. In 84 (84% cases, postpartum period was uneventful and no psychiatric disturbance was found.Seventy five per cent females had joint family and good family support. Conclusion: Major depressive disorder is the most common psychiatric morbidity observed in postpartum females during puerperium. The careful observation of females during postpartum puerperal stage may help in identification and proper management of mental state of such females, and also proper care of newborn.perspective.

What Lies Within: Using Radiopharmaceuticals to Reveal and Target Diseases Hidden Inside the Human Body

International Nuclear Information System (INIS)

Jawerth, Nicole

2014-01-01

The ability to pinpoint the location and size of a cancerous mass hidden inside of a patient’s body was unthinkable less than 100 years ago. Today, with the help of special scanning machines, doctors are able to use radioactive drugs known as radiopharmaceuticals to get a glimpse inside the human body, and these pharmaceuticals can even be used in treating many health conditions. In nuclear medicine, radiopharmaceuticals play an essential role for minimally invasive diagnostic, treatment and care management procedures for many diseases, especially cancer, as well as for relieving pain associated with certain cancers

Resource allocation and the burden of co-morbidities among patients diagnosed with chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Ahnfeldt-Mollerup, Peder; Lykkegaard, Jesper; Halling, Anders

2016-01-01

Background Chronic obstructive pulmonary disease is a leading cause of mortality, and associated with increased healthcare utilization and healthcare expenditure. In several countries, morbidity-based systems have changed the way resources are allocated in general practice. In primary care, fee......-for-services tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated expenditures for patients with chronic obstructive pulmonary disease has not previously been examined. The aim of this study...... is to analyze fee-for-service expenditure of patients diagnosed with chronic obstructive pulmonary disease visiting Danish general practice clinics and further to assess what proportion of fee-for-service expenditure variation was explained by patient morbidity and general practice clinic characteristics...

The hidden costs of self-management services in the accounting activity of a company

Directory of Open Access Journals (Sweden)

Dan Ioan TOPOR

2017-05-01

Full Text Available This article addresses relevant aspects regarding the hidden costs of self-management services in the accounting area, within the accounting department of a company. With this aim, the authors conducted a study using a questionnaire, whose results were analyzed and interpreted. The hidden costs of the self-management of business accounting services observed in the accounting department of the company have been assessed and the causes of their generating sources were identified and analyzed. The debate of these hidden costs involved the treating of notions that exist in the accounting language, but are still not sufficiently explored by the specialists in the area. We also presented and analyzed the causes of the hidden costs of self-management in the accounting activity, as well as a reporting document for failures, arising from the case study. The article ends with the authors' conclusions regarding the hidden costs of self-management services in the accounting area.

Hidden Costs and the Role of Modularity

DEFF Research Database (Denmark)

Larsen, Marcus M.

2013-01-01

that the inability to effectively estimate the costs of implementing an activity in a foreign location has a negative impact on the process performance of that activity. Performance is deterred as operations are likely to be disrupted by opportunity costs and managerial responses. However, this relationship......This paper addresses estimation errors in strategic decision-making processes due to hidden costs. While previous research has investigated the antecedents of hidden costs, this paper investigates performance consequences. Using unique data on 221 offshoring implementations, it is argued...... is mitigated by the degree of modularity in the activity as it reduces the need for costly coordination in offshoring. This paper contributes to research on offshoring and strategic decision-making by emphasizing the importance of organizational design and of estimating the costs of internal organizational...

Risk factors for morbidity in infants undergoing tetralogy of fallot repair

Directory of Open Access Journals (Sweden)

Alexander C Egbe

2014-01-01

Full Text Available Background: Primary repair of tetralogy of Fallot (TOF has low surgical mortality, but some patients still experience significant postoperative morbidity. Aim: To review our institutional experience with primary TOF repair, and identify predictors of intensive care unit (ICU morbidity. Settings and Design: Medium-sized pediatric cardiology program. Retrospective study. Subjects and Methods: We retrospectively reviewed all the patients with TOF and pulmonic stenosis who underwent primary repair in infancy at our institution from January 2001 to December 2012. Preoperative, operative, and postoperative demographic and morphologic data were analyzed. ICU morbidity was defined as prolonged ICU stay (≥7 days, and/or prolonged duration of mechanical ventilation (≥48 h. Statistical Analysis Used: Multiple logistic regression analysis. Results: Ninety-seven patients underwent primary surgical repair during the study period. The median age was 4.9 months (1-9 months and the median weight was 5.3 kg (3.1-9.8 kg. There was no early surgical mortality. Incidence of junctional ectopic tachycardia (JET and persistent complete heart block was 2 and 1%, respectively. The median length of ICU stay was 6 days (2-21 days and median duration of mechanical ventilation was 19 h (0-136 h. By multiple regression analysis, age and weight were independent predictors of length of ICU stay, while surgical era was an independent predictor of duration of mechanical ventilation. Conclusion: Primary TOF repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery remain significant predictors of morbidity.

Use of evidence based practices to improve survival without severe morbidity for very preterm infants

DEFF Research Database (Denmark)

Zeitlin, Jennifer; Manktelow, Bradley N; Piedvache, Aurelie

2016-01-01

OBJECTIVES: To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity. DESIGN: Prospective multinational populat...

Segmentation of laser range radar images using hidden Markov field models

International Nuclear Information System (INIS)

Pucar, P.

1993-01-01

Segmentation of images in the context of model based stochastic techniques is connected with high, very often unpracticle computational complexity. The objective with this thesis is to take the models used in model based image processing, simplify and use them in suboptimal, but not computationally demanding algorithms. Algorithms that are essentially one-dimensional, and their extensions to two dimensions are given. The model used in this thesis is the well known hidden Markov model. Estimation of the number of hidden states from observed data is a problem that is addressed. The state order estimation problem is of general interest and is not specifically connected to image processing. An investigation of three state order estimation techniques for hidden Markov models is given. 76 refs

A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery – Part I: model planning

Directory of Open Access Journals (Sweden)

Biagioli Bonizella

2007-11-01

Full Text Available Abstract Background Different methods have recently been proposed for predicting morbidity in intensive care units (ICU. The aim of the present study was to critically review a number of approaches for developing models capable of estimating the probability of morbidity in ICU after heart surgery. The study is divided into two parts. In this first part, popular models used to estimate the probability of class membership are grouped into distinct categories according to their underlying mathematical principles. Modelling techniques and intrinsic strengths and weaknesses of each model are analysed and discussed from a theoretical point of view, in consideration of clinical applications. Methods Models based on Bayes rule, k-nearest neighbour algorithm, logistic regression, scoring systems and artificial neural networks are investigated. Key issues for model design are described. The mathematical treatment of some aspects of model structure is also included for readers interested in developing models, though a full understanding of mathematical relationships is not necessary if the reader is only interested in perceiving the practical meaning of model assumptions, weaknesses and strengths from a user point of view. Results Scoring systems are very attractive due to their simplicity of use, although this may undermine their predictive capacity. Logistic regression models are trustworthy tools, although they suffer from the principal limitations of most regression procedures. Bayesian models seem to be a good compromise between complexity and predictive performance, but model recalibration is generally necessary. k-nearest neighbour may be a valid non parametric technique, though computational cost and the need for large data storage are major weaknesses of this approach. Artificial neural networks have intrinsic advantages with respect to common statistical models, though the training process may be problematical. Conclusion Knowledge of model

Parkinson's disease: the reliability of morbidity and mortality statistics in the Russian Federation

Directory of Open Access Journals (Sweden)

Krivonos O.V.

2013-12-01

Full Text Available The aim of the research was to study the significance of morbidity of Parkinson's disease (PD and mortality in Russian Federation in international comparisons. Material and Methods: In accordance with the purpose of the study the morbidity and mortality were analyzed in the Russian Federation on the basis of volumes "Morbidity in Russia" of the Ministry of Health of the Russian Federation in 2009-2012, "Human resources for health care institutions" of the Ministry of Health of the Russian Federation in 2012, tables С 51 about the mortality of subjects of the Russian Federation in 2012, data of mortality from Parkinson's disease in different countries in 2011, published by WHO. Results. The analysis of data on the morbidity patterns showed that in the Russian Federation in 2009-2012 there was an increase in general morbidity of adult patients with PD from 75.1 to 87.7 per thousand of populations. The data of primary morbidity in the adult population of the Russian Federation from PD also tend to increase from 8.0 to 8.5 per thousand of populations. The sharp fluctuations of mortality's data were revealed in subject of Russian Federation that was related of unreliable data. Mortality from PD in Russian Federation in 2012 was 0.31 per thousand of populations. Conclusion. The values in the study of general and primary PD's morbidity in the Russian Federation were lower than performance in international comparisons. PD's mortality in Russia was also lower than in other developed countries. Abidance by rules of selecting the primary cause of death (PCOD, confirmed by an automated system, where one of the causes is PD will make mortality statistics of PD reliable and internationally comparable.

Hidden Markov models for labeled sequences

DEFF Research Database (Denmark)

Krogh, Anders Stærmose

1994-01-01

A hidden Markov model for labeled observations, called a class HMM, is introduced and a maximum likelihood method is developed for estimating the parameters of the model. Instead of training it to model the statistics of the training sequences it is trained to optimize recognition. It resembles MMI...

Hidden costs of nuclear power

International Nuclear Information System (INIS)

England, R.W.

1979-01-01

Mr. England contends that these hidden costs add up to a figure much higher than those that appear in the electric utilities' profit and loss account - costs that are borne by Federal taxpayers, by nuclear industry workers, and by all those people who must share their environment with nuclear facilities. Costs he details are additional deaths and illnesses resulting from exposure to radiation, and the use of tax dollars to clean up the lethal garbage produced by those activities. He asserts that careless handling of uranium ore and mill tailings in past years has apparently resulted in serious public health problems in those mining communities. In another example, Mr. England states that the failure to isolate uranium tailings physically from their environment has probably contributed to an acute leukemia rate in Mesa County, Colorado. He mentions much of the technology development for power reactors being done by the Federal government, not by private reactor manufacturers - thus, again, hidden costs that do not show up in electric bills of customers. The back end of the nuclear fuel cycle as a place for Federally subsidized research and development is discussed briefly. 1 figure, 2 tables

Depressive morbidity among elderly individuals who are hospitalized, reside at long-term care facilities, and are under outpatient care in Brazil: a meta-analysis

Directory of Open Access Journals (Sweden)

Luís Fernando S. Castro-de-Araújo

2013-06-01

Full Text Available Objectives: i To investigate studies published between 1991 and 2010 on the prevalence of depressive morbidity (major depressive disorder [MDD], dysthymia and clinically significant depressive symptoms [CSDS] among elderly Brazilians assisted at healthcare facilities; ii to establish the prevalence of depression and identify its related factors; and iii to conduct a meta-analysis to assess the prevalence of depressive syndrome among elderly individuals assisted or hospitalized at healthcare facilities. Methods: Studies were selected from articles dated between January 1991 and June 2010 and extracted from the MEDLINE, LILACS, and SciELO databases. Results: The final analysis consisted of 15 studies, distributed as follows: i four sampled hospitalized patients, totaling 299 individuals, and found a prevalence of CSDS varying between 20 and 56%; ii four sampled outpatients, totaling 1,454 individuals; the prevalence of CSDS varied between 11 and 65%, and the prevalence of MDD varied between 23 and 42%; and iii seven sampled elderly individuals residing in long-term care facilities (LTCF, totaling 839 individuals, and the prevalence of CSDS varied between 11 and 65%. Conclusion: The present review indicated a higher prevalence of both MDD and CSDS among elderly Brazilians assisted at healthcare facilities.

ORIGINAL ARTICLES Primary care morbidity in Eastern Cape ...

African Journals Online (AJOL)

Research Department of Primary Care and Population Health, Royal Free and Uni- .... S - Skin. 842. (12.28) 147 (17.78). 563. (15.04). 132. (5.78). A - General unspecified. 823. (12). 108 (13.6). 428. (11.43). 287. (12.56). N - Neurological. 801. (11.68). 90 (10.58) .... absence of longitudinal follow-up data to monitor trends in.

Multivariate longitudinal data analysis with mixed effects hidden Markov models.

Science.gov (United States)

Raffa, Jesse D; Dubin, Joel A

2015-09-01

Multiple longitudinal responses are often collected as a means to capture relevant features of the true outcome of interest, which is often hidden and not directly measurable. We outline an approach which models these multivariate longitudinal responses as generated from a hidden disease process. We propose a class of models which uses a hidden Markov model with separate but correlated random effects between multiple longitudinal responses. This approach was motivated by a smoking cessation clinical trial, where a bivariate longitudinal response involving both a continuous and a binomial response was collected for each participant to monitor smoking behavior. A Bayesian method using Markov chain Monte Carlo is used. Comparison of separate univariate response models to the bivariate response models was undertaken. Our methods are demonstrated on the smoking cessation clinical trial dataset, and properties of our approach are examined through extensive simulation studies. © 2015, The International Biometric Society.

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

NARCIS (Netherlands)

Faber, Adrianne; Kalverdijk, Luuk J.; de Jong-van den Berg, Lolkje T. W.; Hugtenburg, Jacqueline G.; Minderaa, Ruud B.; Tobi, Hilde

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

NARCIS (Netherlands)

Faber, A.; Kalverdijk, L.J.; de Jong-van den Berg, L.T.W.; Hugtenburg, J.G.; Minderaa, R.B.; Tobi, H.

2010-01-01

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

Limits of performance for the model reduction problem of hidden Markov models

KAUST Repository

Kotsalis, Georgios

2015-12-15

We introduce system theoretic notions of a Hankel operator, and Hankel norm for hidden Markov models. We show how the related Hankel singular values provide lower bounds on the norm of the difference between a hidden Markov model of order n and any lower order approximant of order n̂ < n.

Limits of performance for the model reduction problem of hidden Markov models

KAUST Repository

Kotsalis, Georgios; Shamma, Jeff S.

2015-01-01

We introduce system theoretic notions of a Hankel operator, and Hankel norm for hidden Markov models. We show how the related Hankel singular values provide lower bounds on the norm of the difference between a hidden Markov model of order n and any lower order approximant of order n̂ < n.

Hidden Valley Higgs Decays in the ATLAS detector

CERN Document Server

Ciapetti, G

2009-01-01

A number of extensions of the Standard Model result in particles that are neutral, weakly-coupled and have macroscopic decay lengths that can be comparable with LHC detector dimensions. These particles represent, from an experimental point of view, a challenge both for the trigger and for the reconstruction capabilities of the ATLAS apparatus. For the purpose of exploring the challenges to the trigger posed by long-lived particles, the Hidden Valley scenario serves as an excellent setting. In this note we present the results of a first study of ATLAS detector performance for some Hidden Valley processes with long-lived, neutral states that decay throughout the detector volume to multi heavy-flavor jets, mainly b-bbar.

The hidden epidemic: confronting sexually transmitted diseases

National Research Council Canada - National Science Library

Eng, Thomas R; Butler, William T

.... In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis...

Self-reported skin morbidity in Denmark

DEFF Research Database (Denmark)

Miller, Iben Marie; Zarchi, Kian; Ellervik, Christina

2016-01-01

Skin diseases are thought to be common in the general population. In 2004, a cross-sectional study in Norway, using a validated questionnaire for 18,770 individuals, revealed a high prevalence of skin diseases in the general population. To describe the prevalence of self-reported skin morbidities...... questionnaire. In total, 17.2% self-reported skin complaints. The most prominent self-reported skin complaint was itch with an overall prevalence of 6.5%. The skin morbidity most influenced by age was pimples. There was a uniform pattern showing fewer skin complaints with increasing education. Women reported...... skin morbidities more frequently than men. Participants in employment reported fewer skin morbidities compared to unemployed participants. Skin morbidities in Denmark are common, and the distribution of prevalence estimates in the Danish population parallel those of the Norwegian population, although...

Dimensional reduction in field theory and hidden symmetries in extended supergravity

International Nuclear Information System (INIS)

Kremmer, E.

1985-01-01

Dimensional reduction in field theories is discussed both in theories which do not include gravity and in gravity theories. In particular, 11-dimensional supergravity and its reduction to 4 dimensions is considered. Hidden symmetries of supergravity with N=8 in 4 dimensions, global E 7 and local SU(8)-invariances in particular are detected. The hidden symmmetries permit to interpret geometrically the scalar fields

Effect of Antenatal Steroids on Respiratory Morbidity of Late Preterm Newborns: A Randomized Controlled Trial.

Science.gov (United States)

Ontela, Vijaya; Dorairajan, Gowri; Bhat, Vishnu B; Chinnakali, Palanivel

2018-01-22

The objective of this article was to study the effect of antenatal dexamethasone on the respiratory morbidity of late preterm newborns. A randomized controlled trial, conducted in Obstetrics and Gynecology Department in collaboration with Neonatology department at JIPMER, India. In total, 155 women were studied in each group. Intention to treat analysis and per protocol analysis were done. Overall 31 (10%) newborns were admitted to intensive care unit. The composite respiratory morbidity (defined as respiratory distress syndrome and/or transient tachypnea of newborn) was observed in 64 (41.6%) infants in the study and 56 (36.2%) infants in the control group. On multivariable-adjusted analysis, use of steroids was not found to be associated with decrease in composite respiratory morbidity [adjusted relative risk 0.91 (95% confidence interval: 0.7-1.2)]. Antenatal dexamethasone does not reduce the composite respiratory morbidity of babies born vaginally or by emergency cesarean to women with late preterm labor. © The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Survival and morbidity of very low birth weight infant in a South American neonatal network.

Science.gov (United States)

Fernández, Rocío; D'Apremont, Ivonne; Domínguez, Angélica; Tapia, José L

2014-10-01

To analyze survival and relevant morbidity by gestational age (GA) in very low birth weight (VLBW) infants (Neonatal Network (Red Neonatal Neocosur) between January 2001 and December 2011. Data on 8234 VLBW with a GA between 24+0 and 31+6 weeks were analyzed. Overall mortality was 26% (95% CI: 25.0-26.9), including 2.6% of deaths in the delivery room. Fact sheets for survival and morbidity for each week of gestation were developed based on collected data. Survival at discharge increased from 29% at 24 weeks of GA to 91% at 31 weeks of GA (p neonatal morbidity was inversely related to GA (p hemorrhage, and 4.6% periventricular leukomalacia. Among survivors, 47.3% had none of these five conditions. A tool for use in a clinical setting was developed based on updated regional data for establishing week-to-week survival and morbidity of newborn infants born between 24+0 and 31+6 weeks of GA. This information could be used to make decisions related to perinatal care and for counseling parents.

The Hidden Roles That Management Partners Play In Accountable Care Organizations.

Science.gov (United States)

Lewis, Valerie A; D'Aunno, Thomas; Murray, Genevra F; Shortell, Stephen M; Colla, Carrie H

2018-02-01

Accountable care organizations (ACOs) are often discussed and promoted as driven by physicians, hospitals, and other health care providers. However, because of the flexible nature of ACO contracts, management organizations may also become partners in ACOs. We used data from 2013-15 on 276 ACOs from the National Survey of Accountable Care Organizations to understand the prevalence of nonprovider management partners' involvement in ACOs, the services these partners provide, and the structure of ACOs that have such partners. We found that 37 percent of ACOs reported having a management partner, and two-thirds of these ACOs reported that the partner shared in the financial risks or rewards. Among ACOs with partners, 94 percent had data services provided by the partner, 87 percent received administrative services, 68 percent received educational services, and 66 percent received care coordination services. Half received all four of these services from their partner. ACOs with partners were more heavily primary care than other ACOs. ACOs with and without partners had similar performance on costs and quality in Medicare ACO programs. Our findings suggest that management partners play a central role in many ACOs, perhaps supplying smaller and physician-run ACOs with services or expertise perceived as necessary for ACO success.

Co-morbidities of vertiginous diseases.

Science.gov (United States)

Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

2009-07-07

Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index), migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

Co-morbidities of vertiginous diseases

Directory of Open Access Journals (Sweden)

Ferrari Uta

2009-07-01

Full Text Available Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD, vestibular migraine and phobic vertigo (PPV have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index, migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. Results We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. Conclusion In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

Experimental search for solar hidden photons in the eV energy range using kinetic mixing with photons

International Nuclear Information System (INIS)

Mizumoto, T.; Ohta, R.; Horie, T.; Suzuki, J.; Minowa, M.; Inoue, Y.

2013-01-01

We have searched for solar hidden photons in the eV energy range using a dedicated hidden photon detector. The detector consisted of a parabolic mirror with a diameter of 500 mm and a focal length of 1007 mm installed in a vacuum chamber, and a photomultiplier tube at its focal point. The detector was attached to the Tokyo axion helioscope, Sumico which has a mechanism to track the sun. From the result of the measurement, we found no evidence for the existence of hidden photons and set a limit on the photon-hidden photon mixing parameter χ depending on the hidden photon mass m γ'

A model for abnormal activity recognition and alert generation system for elderly care by hidden conditional random fields using R-transform and generalized discriminant analysis features.

Science.gov (United States)

Khan, Zafar Ali; Sohn, Won

2012-10-01

The growing population of elderly people living alone increases the need for automatic healthcare monitoring systems for elderly care. Automatic vision sensor-based systems are increasingly used for human activity recognition (HAR) in recent years. This study presents an improved model, tested using actors, of a sensor-based HAR system to recognize daily life activities of elderly people at home and generate an alert in case of abnormal HAR. Datasets consisting of six abnormal activities (falling backward, falling forward, falling rightward, falling leftward, chest pain, and fainting) and four normal activities (walking, rushing, sitting down, and standing up) are generated from different view angles (90°, -90°, 45°, -45°). Feature extraction and dimensions reduction are performed by R-transform followed by generalized discriminant analysis (GDA) methods. R-transform extracts symmetric, scale, and translation-invariant features from the sequences of activities. GDA increases the discrimination between different classes of highly similar activities. Silhouette sequences are quantified by the Linde-Buzo-Gray algorithm and recognized by hidden conditional random fields. Experimental results provide an average recognition rate of 94.2% for abnormal activities and 92.7% for normal activities. The recognition rate for the highly similar activities from different view angles shows the flexibility and efficacy of the proposed abnormal HAR and alert generation system for elderly care.

Morbidity in extreme low birth weight newborns hospitalized in a high risk public maternity

Directory of Open Access Journals (Sweden)

Derijulie Siqueira Sousa

Full Text Available Abstract Objectives: to determine the prevalence of the most common morbidities in extremely low birth weight (ELBW infants hospitalized in a newborn intensive care unit (NICU and to evaluate the influence of these morbidities through the length of in-hospital stay. Methods: observational, longitudinal, prospective and analytical study in a high risk reference maternity NICU from Sergipe, realized with 158 ELBW infants admitted between March 2014 and April 2015. The analysis of the hospitalization time was realized through the Kaplan-Meier method. Results: the average weight of premature was 785,2g ± 138,2g. The gestational age vary from 22 to 35 weeks and the average was 26,8 weeks. Of those admitted at NICU, sixty three (39,9% were discharged and 95 (60,1% died. The time of hospitalization was influenced for morbidities as: patent ductus arteriosus (PDA, intraventricular hemorrhage and sepsis. Acute respiratory distress syndrome was the most common complication (157 - 99,4%. The incidence of persistent arterial duct, intraventricular hemorrhage, sepsis, hypothermia, hypoglycemia and retinopathy of prematurity was 39,2%, 17,1%, 32,3%,50,3%, 52,3% e 16,6% respectively. Conclusions: the morbidities from respiratory tract, cardiac, neurological and infectious were the most prevalent, whilst PDA, intraventricular hemorrhage and sepsis were the morbidities that significantly influenced the time of hospitalization.

Sharp Contradiction for Local-Hidden-State Model in Quantum Steering

Science.gov (United States)

Chen, Jing-Ling; Su, Hong-Yi; Xu, Zhen-Peng; Pati, Arun Kumar

2016-08-01

In quantum theory, no-go theorems are important as they rule out the existence of a particular physical model under consideration. For instance, the Greenberger-Horne-Zeilinger (GHZ) theorem serves as a no-go theorem for the nonexistence of local hidden variable models by presenting a full contradiction for the multipartite GHZ states. However, the elegant GHZ argument for Bell’s nonlocality does not go through for bipartite Einstein-Podolsky-Rosen (EPR) state. Recent study on quantum nonlocality has shown that the more precise description of EPR’s original scenario is “steering”, i.e., the nonexistence of local hidden state models. Here, we present a simple GHZ-like contradiction for any bipartite pure entangled state, thus proving a no-go theorem for the nonexistence of local hidden state models in the EPR paradox. This also indicates that the very simple steering paradox presented here is indeed the closest form to the original spirit of the EPR paradox.

Discovering Hidden Controlling Parameters using Data Analytics and Dimensional Analysis

Science.gov (United States)

Del Rosario, Zachary; Lee, Minyong; Iaccarino, Gianluca

2017-11-01

Dimensional Analysis is a powerful tool, one which takes a priori information and produces important simplifications. However, if this a priori information - the list of relevant parameters - is missing a relevant quantity, then the conclusions from Dimensional Analysis will be incorrect. In this work, we present novel conclusions in Dimensional Analysis, which provide a means to detect this failure mode of missing or hidden parameters. These results are based on a restated form of the Buckingham Pi theorem that reveals a ridge function structure underlying all dimensionless physical laws. We leverage this structure by constructing a hypothesis test based on sufficient dimension reduction, allowing for an experimental data-driven detection of hidden parameters. Both theory and examples will be presented, using classical turbulent pipe flow as the working example. Keywords: experimental techniques, dimensional analysis, lurking variables, hidden parameters, buckingham pi, data analysis. First author supported by the NSF GRFP under Grant Number DGE-114747.

Searching for confining hidden valleys at LHCb, ATLAS, and CMS

Science.gov (United States)

Pierce, Aaron; Shakya, Bibhushan; Tsai, Yuhsin; Zhao, Yue

2018-05-01

We explore strategies for probing hidden valley scenarios exhibiting confinement. Such scenarios lead to a moderate multiplicity of light hidden hadrons for generic showering and hadronization similar to QCD. Their decays are typically soft and displaced, making them challenging to probe with traditional LHC searches. We show that the low trigger requirements and excellent track and vertex reconstruction at LHCb provide a favorable environment to search for such signals. We propose novel search strategies in both muonic and hadronic channels. We also study existing ATLAS and CMS searches and compare them with our proposals at LHCb. We find that the reach at LHCb is generically better in the parameter space we consider here, even with optimistic background estimations for ATLAS and CMS searches. We discuss potential modifications at ATLAS and CMS that might make these experiments competitive with the LHCb reach. Our proposed searches can be applied to general hidden valley models as well as exotic Higgs boson decays, such as in twin Higgs models.

Single-hidden-layer feed-forward quantum neural network based on Grover learning.

Science.gov (United States)

Liu, Cheng-Yi; Chen, Chein; Chang, Ching-Ter; Shih, Lun-Min

2013-09-01

In this paper, a novel single-hidden-layer feed-forward quantum neural network model is proposed based on some concepts and principles in the quantum theory. By combining the quantum mechanism with the feed-forward neural network, we defined quantum hidden neurons and connected quantum weights, and used them as the fundamental information processing unit in a single-hidden-layer feed-forward neural network. The quantum neurons make a wide range of nonlinear functions serve as the activation functions in the hidden layer of the network, and the Grover searching algorithm outstands the optimal parameter setting iteratively and thus makes very efficient neural network learning possible. The quantum neuron and weights, along with a Grover searching algorithm based learning, result in a novel and efficient neural network characteristic of reduced network, high efficient training and prospect application in future. Some simulations are taken to investigate the performance of the proposed quantum network and the result show that it can achieve accurate learning. Copyright © 2013 Elsevier Ltd. All rights reserved.

Severe maternal morbidity due to sepsis: The burden and preventability of disease in New Zealand.

Science.gov (United States)

Lepine, Sam; Lawton, Beverley; Geller, Stacie; Abels, Peter; MacDonald, Evelyn J

2018-02-20

Sepsis is a life-threatening systemic condition that appears to be increasing in the obstetric population. Clinical detection can be difficult and may result in increased morbidity via delays in the continuum of patient care. To describe the burden of severe maternal morbidity (SMM) caused by sepsis in New Zealand and investigate the potential preventability. A multidisciplinary expert review panel was established to review cases of obstetric sepsis admitted to intensive care or high-dependency units over an 18 month span in New Zealand. Cases were then analysed for the characteristics of infection and their preventability. Fifty cases met the inclusion criteria, most commonly due to uterine, respiratory or kidney infection. Fifty per cent (25) of these cases were deemed potentially preventable, predominantly due to delays in diagnosis and treatment. A high index of suspicion, development of early recognition systems and multi-disciplinary training are recommended to decrease preventable cases of maternal sepsis. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Nurture Hidden Talents: Transform School Culture into One That Values Teacher Expertise

Science.gov (United States)

Zimmerman, Diane P.

2014-01-01

This article looks into the school culture where teacher expertise is often hidden and underused. While the media-rich culture places a high value on talent, the irony is that talent is underrated in most schools, and educators often remain silent about their hidden talents. Many school cultures are not conducive to dialogue that supports displays…

Long memory of financial time series and hidden Markov models with time-varying parameters

DEFF Research Database (Denmark)

Nystrup, Peter; Madsen, Henrik; Lindström, Erik

Hidden Markov models are often used to capture stylized facts of daily returns and to infer the hidden state of financial markets. Previous studies have found that the estimated models change over time, but the implications of the time-varying behavior for the ability to reproduce the stylized...... facts have not been thoroughly examined. This paper presents an adaptive estimation approach that allows for the parameters of the estimated models to be time-varying. It is shown that a two-state Gaussian hidden Markov model with time-varying parameters is able to reproduce the long memory of squared...... daily returns that was previously believed to be the most difficult fact to reproduce with a hidden Markov model. Capturing the time-varying behavior of the parameters also leads to improved one-step predictions....

Photoacoustic imaging of hidden dental caries by using a bundle of hollow optical fibers

Science.gov (United States)

Koyama, Takuya; Kakino, Satoko; Matsuura, Yuji

2018-02-01

Photoacoustic imaging system using a bundle of hollow-optical fibers to detect hidden dental caries is proposed. Firstly, we fabricated a hidden caries model with a brown pigment simulating a common color of caries lesion. It was found that high frequency ultrasonic waves are generated from hidden carious part when radiating Nd:YAG laser light with a 532 nm wavelength to occlusal surface of model tooth. We calculated by Fourier transform and found that the waveform from the carious part provides frequency components of approximately from 0.5 to 1.2 MHz. Then a photoacoustic imaging system using a bundle of hollow optical fiber was fabricated for clinical applications. From intensity map of frequency components in 0.5-1.2 MHz, photoacoustic images of hidden caries in the simulated samples were successfully obtained.

Spatially Interpolated Disease Prevalence Estimation Using Collateral Indicators of Morbidity and Ecological Risk

Science.gov (United States)

Congdon, Peter

2013-01-01

This paper considers estimation of disease prevalence for small areas (neighbourhoods) when the available observations on prevalence are for an alternative partition of a region, such as service areas. Interpolation to neighbourhoods uses a kernel method extended to take account of two types of collateral information. The first is morbidity and service use data, such as hospital admissions, observed for neighbourhoods. Variations in morbidity and service use are expected to reflect prevalence. The second type of collateral information is ecological risk factors (e.g., pollution indices) that are expected to explain variability in prevalence in service areas, but are typically observed only for neighbourhoods. An application involves estimating neighbourhood asthma prevalence in a London health region involving 562 neighbourhoods and 189 service (primary care) areas. PMID:24129116

Spatially interpolated disease prevalence estimation using collateral indicators of morbidity and ecological risk.

Science.gov (United States)

Congdon, Peter

2013-10-14

This paper considers estimation of disease prevalence for small areas (neighbourhoods) when the available observations on prevalence are for an alternative partition of a region, such as service areas. Interpolation to neighbourhoods uses a kernel method extended to take account of two types of collateral information. The first is morbidity and service use data, such as hospital admissions, observed for neighbourhoods. Variations in morbidity and service use are expected to reflect prevalence. The second type of collateral information is ecological risk factors (e.g., pollution indices) that are expected to explain variability in prevalence in service areas, but are typically observed only for neighbourhoods. An application involves estimating neighbourhood asthma prevalence in a London health region involving 562 neighbourhoods and 189 service (primary care) areas.

Primary care and communication in shared cancer care: A Qualitative Study

Science.gov (United States)

Sada, Yvonne; Street, Richard L.; Singh, Hardeep; Shada, Rachel; Naik, Aanand D.

2013-01-01

Objective To explore perceptions of primary care physicians’ (PCPs) and oncologists’ roles, responsibilities, and patterns of communication related to shared cancer care in three integrated health systems that used electronic health records (EHRs). Study design Qualitative study. Methods We conducted semi-structured interviews with ten early stage colorectal cancer patients and fourteen oncologists and PCPs. Sample sizes were determined by thematic saturation. Dominant themes and codes were identified and subsequently applied to all transcripts. Results Physicians reported that EHRs improved communication within integrated systems, but communication with physicians outside their system was still difficult. PCPs expressed uncertainty about their role during cancer care, even though medical oncologists emphasized the importance of co-morbidity control during cancer treatment. Both patients and physicians described additional roles for PCPs, including psychological distress support and behavior modification. Conclusions Integrated systems that use EHRs likely facilitate shared cancer care through improved PCP-oncologist communication. However, strategies to facilitate a more active role for PCPs in managing co-morbidities, psychological distress and behavior modification, as well as to overcome communication challenges between physicians not practicing within the same integrated system, are still needed to improve shared cancer care. PMID:21615196

Hidden loss

DEFF Research Database (Denmark)

Kieffer-Kristensen, Rikke; Johansen, Karen Lise Gaardsvig

2013-01-01

to participate. RESULTS: All children were affected by their parents' ABI and the altered family situation. The children's expressions led the authors to identify six themes, including fear of losing the parent, distress and estrangement, chores and responsibilities, hidden loss, coping and support. The main......PRIMARY OBJECTIVE: The purpose of this study was to listen to and learn from children showing high levels of post-traumatic stress symptoms after parental acquired brain injury (ABI), in order to achieve an in-depth understanding of the difficulties the children face in their everyday lives...... finding indicates that the children experienced numerous losses, many of which were often suppressed or neglected by the children to protect the ill parents. CONCLUSIONS: The findings indicated that the children seemed to make a special effort to hide their feelings of loss and grief in order to protect...

Hidden Markov models: the best models for forager movements?

Science.gov (United States)

Joo, Rocio; Bertrand, Sophie; Tam, Jorge; Fablet, Ronan

2013-01-01

One major challenge in the emerging field of movement ecology is the inference of behavioural modes from movement patterns. This has been mainly addressed through Hidden Markov models (HMMs). We propose here to evaluate two sets of alternative and state-of-the-art modelling approaches. First, we consider hidden semi-Markov models (HSMMs). They may better represent the behavioural dynamics of foragers since they explicitly model the duration of the behavioural modes. Second, we consider discriminative models which state the inference of behavioural modes as a classification issue, and may take better advantage of multivariate and non linear combinations of movement pattern descriptors. For this work, we use a dataset of >200 trips from human foragers, Peruvian fishermen targeting anchovy. Their movements were recorded through a Vessel Monitoring System (∼1 record per hour), while their behavioural modes (fishing, searching and cruising) were reported by on-board observers. We compare the efficiency of hidden Markov, hidden semi-Markov, and three discriminative models (random forests, artificial neural networks and support vector machines) for inferring the fishermen behavioural modes, using a cross-validation procedure. HSMMs show the highest accuracy (80%), significantly outperforming HMMs and discriminative models. Simulations show that data with higher temporal resolution, HSMMs reach nearly 100% of accuracy. Our results demonstrate to what extent the sequential nature of movement is critical for accurately inferring behavioural modes from a trajectory and we strongly recommend the use of HSMMs for such purpose. In addition, this work opens perspectives on the use of hybrid HSMM-discriminative models, where a discriminative setting for the observation process of HSMMs could greatly improve inference performance.

Hidden Markov models: the best models for forager movements?

Directory of Open Access Journals (Sweden)

Rocio Joo

Full Text Available One major challenge in the emerging field of movement ecology is the inference of behavioural modes from movement patterns. This has been mainly addressed through Hidden Markov models (HMMs. We propose here to evaluate two sets of alternative and state-of-the-art modelling approaches. First, we consider hidden semi-Markov models (HSMMs. They may better represent the behavioural dynamics of foragers since they explicitly model the duration of the behavioural modes. Second, we consider discriminative models which state the inference of behavioural modes as a classification issue, and may take better advantage of multivariate and non linear combinations of movement pattern descriptors. For this work, we use a dataset of >200 trips from human foragers, Peruvian fishermen targeting anchovy. Their movements were recorded through a Vessel Monitoring System (∼1 record per hour, while their behavioural modes (fishing, searching and cruising were reported by on-board observers. We compare the efficiency of hidden Markov, hidden semi-Markov, and three discriminative models (random forests, artificial neural networks and support vector machines for inferring the fishermen behavioural modes, using a cross-validation procedure. HSMMs show the highest accuracy (80%, significantly outperforming HMMs and discriminative models. Simulations show that data with higher temporal resolution, HSMMs reach nearly 100% of accuracy. Our results demonstrate to what extent the sequential nature of movement is critical for accurately inferring behavioural modes from a trajectory and we strongly recommend the use of HSMMs for such purpose. In addition, this work opens perspectives on the use of hybrid HSMM-discriminative models, where a discriminative setting for the observation process of HSMMs could greatly improve inference performance.

Chimpanzees (Pan troglodytes) use markers to monitor the movement of a hidden item.

Science.gov (United States)

Beran, Michael J; Beran, Mary M; Menzel, Charles R

2005-10-01

Four chimpanzees (Pan troglodytes) monitored the movement of hidden items in arrays of opaque cups. A chocolate candy was hidden in an array of four cups and temporarily presented paper markers indicated the location of the candy (which otherwise was not visible). These markers were either non-symbolic or symbolic (lexigram) stimuli that in other contexts acted as a label for the hidden candy, and the array was either rotated 180 degrees after the marker was removed or the array remained in the same location. For three of four chimpanzees, performance was better than chance in all conditions and there was no effect of the type of marker. These experiments indicate that chimpanzees can track the movement of a hidden item in an array of identical cups even when they never see the item itself, but only see a temporarily presented marker for the location of that item. However, there was no benefit to the use of symbolic as opposed to non-symbolic stimuli in this performance.

Reducing maternal morbidity and mortality in the developing world: a simple, cost-effective example

Directory of Open Access Journals (Sweden)

Browning A

2015-02-01

Full Text Available Andrew Browning,1,2 Birhanu Menber21Maternity Africa, Arusha, Tanzania; 2Vision Maternity Care, Barhirdar, Ethiopia Objectives: To determine the impact of volunteer obstetricians and midwife teams on obstetric services in a rural hospital in Ethiopia.Methods: The intervention was undertaken in Mota district hospital, a rural hospital in the Amhara region of Ethiopia, which is the only hospital for 1.2 million people. Before the placement of volunteer teams it had a rudimentary basic obstetric service, no blood transfusion service, and no operative delivery. The study prospectively analyzed delivery data before, during, and after the placement of volunteer obstetrician and midwife teams. The volunteers established emergency obstetric care, and trained and supervised local staff over a 3-year period. Measurable outcomes consisted of the number of women delivering, the number of referrals of pregnant women, the number of maternal deaths, and the number of referrals of obstetric fistula patients.Results: With the establishment of the service the number of women attending hospital for delivery increased by 40%. In the hospital maternal mortality decreased from 7.1% to <0.5%, and morbidity, as measured by number of obstetric fistulae, decreased from 1.5% deliveries to 0.5% over the 3-year intervention period. The improvements were sustained after handing the project back to the government.Conclusion: The placement of volunteer teams was an effective method of decreasing maternal mortality and morbidity. Keywords: emergency obstetric care, volunteers, obstetric fistula, emergency obstetric care

Hidden State Conditional Random Field for Abnormal Activity Recognition in Smart Homes

Directory of Open Access Journals (Sweden)

Yu Tong

2015-03-01

Full Text Available As the number of elderly people has increased worldwide, there has been a surge of research into assistive technologies to provide them with better care by recognizing their normal and abnormal activities. However, existing abnormal activity recognition (AAR algorithms rarely consider sub-activity relations when recognizing abnormal activities. This paper presents an application of the Hidden State Conditional Random Field (HCRF method to detect and assess abnormal activities that often occur in elderly persons’ homes. Based on HCRF, this paper designs two AAR algorithms, and validates them by comparing them with a feature vector distance based algorithm in two experiments. The results demonstrate that the proposed algorithms favorably outperform the competitor, especially when abnormal activities have same sensor type and sensor number as normal activities.

Significance of hidden advertising of the media business models in Latvia

OpenAIRE

Rožukalne, Anda

2012-01-01

Since 2002 parliamentary and municipal elections in Latvia, media content researches have shown a considerable amount of hidden advertising: media publish information that is paid-for, yet not identified as advertising, assigning this information with the qualities of independent content, therefore misleading its audience. In order to analyze this practice, a research was commissioned to find out why Latvian media publish hidden advertising, what is the force behind this practice, who are com...

Enhanced axion-photon coupling in GUT with hidden photon

Science.gov (United States)

Daido, Ryuji; Takahashi, Fuminobu; Yokozaki, Norimi

2018-05-01

We show that the axion coupling to photons can be enhanced in simple models with a single Peccei-Quinn field, if the gauge coupling unification is realized by a large kinetic mixing χ = O (0.1) between hypercharge and unbroken hidden U(1)H. The key observation is that the U(1)H gauge coupling should be rather strong to induce such large kinetic mixing, leading to enhanced contributions of hidden matter fields to the electromagnetic anomaly. We find that the axion-photon coupling is enhanced by about a factor of 10-100 with respect to the GUT-axion models with E / N = 8 / 3.

Multistability and hidden attractors in a multilevel DC/DC converter

DEFF Research Database (Denmark)

Zhusubaliyev, Zhanybai T.; Mosekilde, Erik

2015-01-01

An attracting periodic, quasiperiodic or chaotic set of a smooth, autonomous system may be referred to as a "hidden attractor" if its basin of attraction does not overlap with the neighborhood of an unstable equilibrium point. Historically, this condition has implied that the basin of attraction...... produce complicated structures of attracting and repelling states organized around the basic switching cycle. This leads us to suggest the existence of hidden attractors in such systems as well. In this case, the condition will be that the basin of attraction does not overlap with the fixed point...

Exploring inequality violations by classical hidden variables numerically

International Nuclear Information System (INIS)

Vongehr, Sascha

2013-01-01

There are increasingly suggestions for computer simulations of quantum statistics which try to violate Bell type inequalities via classical, common cause correlations. The Clauser–Horne–Shimony–Holt (CHSH) inequality is very robust. However, we argue that with the Einstein–Podolsky–Rosen setup, the CHSH is inferior to the Bell inequality, although and because the latter must assume anti-correlation of entangled photon singlet states. We simulate how often quantum behavior violates both inequalities, depending on the number of photons. Violating Bell 99% of the time is argued to be an ideal benchmark. We present hidden variables that violate the Bell and CHSH inequalities with 50% probability, and ones which violate Bell 85% of the time when missing 13% anti-correlation. We discuss how to present the quantum correlations to a wide audience and conclude that, when defending against claims of hidden classicality, one should demand numerical simulations and insist on anti-correlation and the full amount of Bell violation. -- Highlights: •The widely assumed superiority of the CHSH fails in the EPR problem. •We simulate Bell type inequalities behavior depending on the number of photons. •The core of Bell’s theorem in the EPR setup is introduced in a simple way understandable to a wide audience. •We present hidden variables that violate both inequalities with 50% probability. •Algorithms have been supplied in form of Mathematica programs

Mass spectra of hidden-charm molecular pentaquarks states

International Nuclear Information System (INIS)

Patel, Smruti; Vinodkumar, P.C.

2016-01-01

Very recently, the LHCb Collaboration has reported two hidden-charmed resonances P_c(4380) and P_c(4450) consistent with pentaquark states in the Λ_b"0 → K"-J/Ψp process with masses (widths) (4380 ±8 ± 29) MeV ((205 ±18 ± 86) MeV) and (4449.8 ±1.7 ± 2.5) MeV ((39 ±5 ±19) MeV), respectively. The observation of the P_c states has aroused the theorist's strong interest in the hidden-charm pentaquark states. They have been studied in various frameworks, such as the molecule-like pentaquark states, the diquark-diquark-antiquark type pentaquark states, the diquark-triquark type pentaquark states, re-scattering effects, etc. An identification of pentaquark states as exotic hadron has been one of the long standing problems in the physics of strong interaction and quantum chromodynamics (QCD). A decade ago lots of discussion were made about pentaquarks states but due to lack of further experimental evidences the study of pentaquarks have been almost gone in the darkness. But, recent remarkable observation of two resonances i.e. P_c(4380) and P_c(4450) with hidden charm and the minimal quark content cc-baruud provided new impact for studies of pentaquark states and opens a new window to study the exotic hadronic matter

Morbidity profile of elderly outpatients attending selected sub-district Siddha health facilities in Tamil Nadu, India

Directory of Open Access Journals (Sweden)

Kalaiselvi Selvaraj

2016-01-01

Conclusion: Elderly constitute more than one fourth of outpatients load from siddha health facilities. Degenerative diseases like arthritis and non-communicable diseases were the common morbidities in this age group. Geriatric clinics and mobile clinics under siddha system may help in improving health care services.

Estimation of morbidity effects

International Nuclear Information System (INIS)

Ostro, B.

1994-01-01

Many researchers have related exposure to ambient air pollution to respiratory morbidity. To be included in this review and analysis, however, several criteria had to be met. First, a careful study design and a methodology that generated quantitative dose-response estimates were required. Therefore, there was a focus on time-series regression analyses relating daily incidence of morbidity to air pollution in a single city or metropolitan area. Studies that used weekly or monthly average concentrations or that involved particulate measurements in poorly characterized metropolitan areas (e.g., one monitor representing a large region) were not included in this review. Second, studies that minimized confounding ad omitted variables were included. For example, research that compared two cities or regions and characterized them as 'high' and 'low' pollution area were not included because of potential confounding by other factors in the respective areas. Third, concern for the effects of seasonality and weather had to be demonstrated. This could be accomplished by either stratifying and analyzing the data by season, by examining the independent effects of temperature and humidity, and/or by correcting the model for possible autocorrelation. A fourth criterion for study inclusion was that the study had to include a reasonably complete analysis of the data. Such analysis would include an careful exploration of the primary hypothesis as well as possible examination of te robustness and sensitivity of the results to alternative functional forms, specifications, and influential data points. When studies reported the results of these alternative analyses, the quantitative estimates that were judged as most representative of the overall findings were those that were summarized in this paper. Finally, for inclusion in the review of particulate matter, the study had to provide a measure of particle concentration that could be converted into PM10, particulate matter below 10

Hidden supersymmetry and large N

International Nuclear Information System (INIS)

Alfaro, J.

1988-01-01

In this paper we present a new method to deal with the leading order in the large-N expansion of a quantum field theory. The method uses explicitly the hidden supersymmetry that is present in the path-integral formulation of a stochastic process. In addition to this we derive a new relation that is valid in the leading order of the large-N expansion of the hermitian-matrix model for any spacetime dimension. (orig.)

Morbidity pattern and health-seeking behavior of aged population residing in Shimla hills of north India: A cross-sectional study

Directory of Open Access Journals (Sweden)

Deepak Sharma

2013-01-01

Full Text Available Background: Population aging is a global phenomenon. In India, the size of the elderly population is growing fast. Many older adults have multiple medical conditions. Understanding elderly health problems and health-seeking behavior is prerequisite for proving comprehensive geriatric care to them. Objectives: To assess the morbidity pattern and study the health-seeking behavior of the elderly people of Shimla district in Himachal Pradesh. Materials and Methods: A total of 400 elderly people aged 60 years and above were selected from urban and rural areas of Shimla hills in North India by simple random sampling. Statistical software Epi info software version 3.2 was used for analyzing data. Descriptive statistics were used to describe sociodemographic and morbidity variables. Results: The most common morbidity identified among them were musculoskeletal problems (55.0% followed by hypertension (40.5%. Two third were seeking treatment for their health problems. Among older persons not seeking treatment for their medical condition, most considered these morbidities as an age-related phenomenon. Many perceived that the health services were too far. Conclusion: The high morbidity load among elderly in the present study stresses for efforts to provide better health care to them and thus ensure that they remain active members of our society. Residence emerged out to be most significant determinant of healthcare-seeking behavior. Policy makers must focus on rural elderly and their beliefs which prevent them from seeking healthcare.

Long Memory of Financial Time Series and Hidden Markov Models with Time-Varying Parameters

DEFF Research Database (Denmark)

Nystrup, Peter; Madsen, Henrik; Lindström, Erik

2016-01-01

Hidden Markov models are often used to model daily returns and to infer the hidden state of financial markets. Previous studies have found that the estimated models change over time, but the implications of the time-varying behavior have not been thoroughly examined. This paper presents an adaptive...... to reproduce with a hidden Markov model. Capturing the time-varying behavior of the parameters also leads to improved one-step density forecasts. Finally, it is shown that the forecasting performance of the estimated models can be further improved using local smoothing to forecast the parameter variations....

Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

NARCIS (Netherlands)

van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

2004-01-01

Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

Ethnic variations in severe maternal morbidity in the UK- a case control study.

Directory of Open Access Journals (Sweden)

Manisha Nair

Full Text Available Previous studies showed a higher risk of maternal morbidity amongst black and other minority ethnic (BME groups, but were unable to investigate whether this excess risk was concentrated within specific BME groups in the UK. Our aim was to analyse the specific risks and to investigate reasons for any disparity.Unmatched case-control analysis using data from the United Kingdom Obstetric Surveillance System (UKOSS, February 2005-January 2013. Cases were 1,753 women who experienced severe morbidity during the peripartum period. Controls were 3,310 women who delivered immediately before the cases in the same hospital. Multivariable logistic regression modelling was used to adjust for known confounders and to understand their effects.Compared with white European women, the odds of severe maternal morbidity were 83% higher among black African women (adjusted odds ratio (aOR = 1.83; 95% Confidence Interval (CI = 1.39-2.40, 80% higher among black Caribbean (aOR = 1.80; 95% CI = 1.14-2.82, 74% higher in Bangladeshi (aOR = 1.74; 95% CI = 1.05-2.88, 56% higher in other non-whites (non-Asian (aOR = 1.56; 95% CI = 1.05-2.33 and 43% higher among Pakistani women (aOR = 1.43; 95% CI = 1.07-1.92. There was no evidence of substantial confounding. Anaemia in current pregnancy, previous pregnancy problems, inadequate utilisation of antenatal care, pre-existing medical conditions, parity>3, and being younger and older were independent risk factors but, the odds of severe maternal morbidity did not differ by socioeconomic status, between smokers and non-smokers or by BMI.This national study demonstrates an increased risk of severe maternal morbidity among women of ethnic minority backgrounds which could not be explained by known risk factors for severe maternal morbidity.

Hidden Broad-line Regions in Seyfert 2 Galaxies: From the Spectropolarimetric Perspective

International Nuclear Information System (INIS)

Du, Pu; Wang, Jian-Min; Zhang, Zhi-Xiang

2017-01-01

The hidden broad-line regions (BLRs) in Seyfert 2 galaxies, which display broad emission lines (BELs) in their polarized spectra, are a key piece of evidence in support of the unified model for active galactic nuclei (AGNs). However, the detailed kinematics and geometry of hidden BLRs are still not fully understood. The virial factor obtained from reverberation mapping of type 1 AGNs may be a useful diagnostic of the nature of hidden BLRs in type 2 objects. In order to understand the hidden BLRs, we compile six type 2 objects from the literature with polarized BELs and dynamical measurements of black hole masses. All of them contain pseudobulges. We estimate their virial factors, and find the average value is 0.60 and the standard deviation is 0.69, which agree well with the value of type 1 AGNs with pseudobulges. This study demonstrates that (1) the geometry and kinematics of BLR are similar in type 1 and type 2 AGNs of the same bulge type (pseudobulges), and (2) the small values of virial factors in Seyfert 2 galaxies suggest that, similar to type 1 AGNs, BLRs tend to be very thick disks in type 2 objects.

Finite-time Lyapunov dimension and hidden attractor of the Rabinovich system

OpenAIRE

Kuznetsov, N. V.; Leonov, G. A.; Mokaev, T. N.; Prasad, A.; Shrimali, M. D.

2015-01-01

The Rabinovich system, describing the process of interaction between waves in plasma, is considered. It is shown that the Rabinovich system can exhibit a hidden attractor in the case of multistability as well as a classical self-excited attractor. The hidden attractor in this system can be localized by analytical/numerical methods based on the continuation and perpetual points. The concept of finite-time Lyapunov dimension is developed for numerical study of the dimension of attractors. A con...

Women's experience of maternal morbidity: a qualitative analysis.

LENUS (Irish Health Repository)

Meaney, S

2016-07-01

Maternal morbidity refers to pregnancy-related complications, ranging in severity from acute to chronic. In Ireland one in 210 maternities will experience a severe morbidity. Yet, how women internalize their experience of morbidity has gone largely unexplored. This study aimed to explore women\\'s experiences of maternal morbidity.

The hidden challenges in role transitions and how leadership coaching can help new leaders find solid ground.

Science.gov (United States)

Weinstock, Beth

2011-01-01

Leadership coaching is becoming an increasingly important intervention that helps individual nurse executives and managers develop and use the best of their strengths, gifts, and talents. As the need for leadership in nursing becomes urgent and brave souls move into the positions of greater authority and potential impact, they will face challenges as they move up in rank. This article identifies the hidden and often-overlooked challenges that are faced by new leaders as they transition into roles of increased responsibility, and it demonstrates how leadership coaching can help new leaders make successful transitions. As the current health care crisis creates opportunity for new leaders, those who opt for promotions and lateral shifts encounter both expected and surprising challenges. The expected challenges include mastering new content skills, learning new organizational structures, and getting to know new teams. The less obvious stressors include issues of self-esteem, assertiveness, self-consciousness, self-criticism, perfectionism, new boundaries, changing identities, and finding one's own leadership style. These important issues are often kept out of conscious awareness and overlooked at great cost to the individual leader and her institution. Leadership coaching can provide support and practical strategies for managing and overcoming these hidden challenges.

Intense gamma-ray lines from hidden vector dark matter decay

International Nuclear Information System (INIS)

Arina, Chiara; Hambye, Thomas

2009-12-01

Scenarios with hidden, spontaneously broken, non-abelian gauge groups contain a natural dark matter candidate, the hidden vector, whose longevity is due to an accidental custodial symmetry in the renormalizable Lagrangian. Nevertheless, non-renormalizable dimension six operators break the custodial symmetry and induce the decay of the dark matter particle at cosmological times. We discuss in this paper the cosmic ray signatures of this scenario and we show that the decay of hidden vector dark matter particles generically produce an intense gamma ray line which could be observed by the Fermi-LAT experiment, if the scale of custodial symmetry breaking is close to the Grand Unification scale. This gamma line proceeds directly from a tree level dark matter 2-body decay in association with a Higgs boson. Within this model we also perform a determination of the relic density constraints taking into account the dark matter annihilation processes with one dark matter particle in the final state. The corresponding direct detection rates can be easily of order the current experimental sensitivities. (orig.)

Intense gamma-ray lines from hidden vector dark matter decay

Energy Technology Data Exchange (ETDEWEB)

Arina, Chiara; Hambye, Thomas [Universite Libre de Bruxelles (Belgium). Service de Physique Theorique; Ibarra, Alejandro [Technische Univ. Muenchen, Garching (Germany). Physik-Department; Weniger, Christoph [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

2009-12-15

Scenarios with hidden, spontaneously broken, non-abelian gauge groups contain a natural dark matter candidate, the hidden vector, whose longevity is due to an accidental custodial symmetry in the renormalizable Lagrangian. Nevertheless, non-renormalizable dimension six operators break the custodial symmetry and induce the decay of the dark matter particle at cosmological times. We discuss in this paper the cosmic ray signatures of this scenario and we show that the decay of hidden vector dark matter particles generically produce an intense gamma ray line which could be observed by the Fermi-LAT experiment, if the scale of custodial symmetry breaking is close to the Grand Unification scale. This gamma line proceeds directly from a tree level dark matter 2-body decay in association with a Higgs boson. Within this model we also perform a determination of the relic density constraints taking into account the dark matter annihilation processes with one dark matter particle in the final state. The corresponding direct detection rates can be easily of order the current experimental sensitivities. (orig.)

Intense gamma-ray lines from hidden vector dark matter decay

International Nuclear Information System (INIS)

Arina, Chiara; Hambye, Thomas; Ibarra, Alejandro; Weniger, Christoph

2010-01-01

Scenarios with hidden, spontaneously broken, non-abelian gauge groups contain a natural dark matter candidate, the hidden vector, whose longevity is due to an accidental custodial symmetry in the renormalizable Lagrangian. Nevertheless, non-renormalizable dimension six operators break the custodial symmetry and induce the decay of the dark matter particle at cosmological times. We discuss in this paper the cosmic ray signatures of this scenario and we show that the decay of hidden vector dark matter particles generically produce an intense gamma ray line which could be observed by the Fermi-LAT experiment, if the scale of custodial symmetry breaking is close to the Grand Unification scale. This gamma line proceeds directly from a tree level dark matter 2-body decay in association with a Higgs boson. Within this model we also perform a determination of the relic density constraints taking into account the dark matter annihilation processes with one dark matter particle in the final state. The corresponding direct detection rates can be easily of order the current experimental sensitivities

The Hidden Cost of Buying a Computer.

Science.gov (United States)

Johnson, Michael

1983-01-01

In order to process data in a computer, application software must be either developed or purchased. Costs for modifications of the software package and maintenance are often hidden. The decision to buy or develop software packages should be based upon factors of time and maintenance. (MLF)

The association between gender and pediatric respiratory morbidity.

Science.gov (United States)

Ben-Shmuel, Atar; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Vaknin, Flear; Walfisch, Asnat

2018-06-26

To evaluate the association between newborn gender and the risk for later pediatric respiratory morbidity. A population based cohort analysis was performed by comparing the risk of long-term respiratory morbidity (until 18 years of age) according to gender. Respiratory morbidity included hospitalizations involving pneumonia, asthma, bronchitis, bronchiolitis, upper respiratory tract infection (URTI), influenza, and bronchiectasis. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center. Kaplan-Meier survival curves were constructed to compare cumulative respiratory morbidity. A Cox proportional hazards model controlled for confounders. During the study period 240 953 newborns met the inclusion criteria. Among them, 118 113 were females (49.0%) and 122 840 were males (51.0%). During the 18 years of follow-up, 13 719 (5.7%) different newborns were hospitalized with respiratory related morbidity. Males had significantly higher rates of respiratory morbidity as compared with females (6.4% vs 4.9% respectively, P respiratory morbidity (log rank P respiratory morbidity while adjusting for gestational age, birthweight, and other confounders (HR 1.29, 95% CI 1.25-1.34, P respiratory morbidity, independent of obstetrical characteristics such as gestational age and birthweight. © 2018 Wiley Periodicals, Inc.

Theoretical analysis of hidden photon searches in high-precision experiments

International Nuclear Information System (INIS)

Beranek, Tobias

2014-01-01

Although the Standard Model of particle physics (SM) provides an extremely successful description of the ordinary matter, one knows from astronomical observations that it accounts only for around 5% of the total energy density of the Universe, whereas around 30% are contributed by the dark matter. Motivated by anomalies in cosmic ray observations and by attempts to solve questions of the SM like the (g-2) μ discrepancy, proposed U(1) extensions of the Standard Model gauge group SU(3) x SU(2) x U(1) have raised attention in recent years. In the considered U(1) extensions a new, light messenger particle γ', the hidden photon, couples to the hidden sector as well as to the electromagnetic current of the SM by kinetic mixing. This allows for a search for this particle in laboratory experiments exploring the electromagnetic interaction. Various experimental programs have been started to search for the γ' boson, such as in electron-scattering experiments, which are a versatile tool to explore various physics phenomena. One approach is the dedicated search in fixed-target experiments at modest energies as performed at MAMI or at JLAB. In these experiments the scattering of an electron beam off a hadronic target e→e(A,Z)l + l - is investigated and a search for a very narrow resonance in the invariant mass distribution of the l + l - pair is performed. This requires an accurate understanding of the theoretical basis of the underlying processes. For this purpose it is demonstrated in the first part of this work, in which way the hidden photon can be motivated from existing puzzles encountered at the precision frontier of the SM. The main part of this thesis deals with the analysis of the theoretical framework for electron scattering fixed-target experiments searching for hidden photons. As a first step, the cross section for the bremsstrahlung emission of hidden photons in such experiments is studied. Based on these results, the applicability of the Weizsaecker

The association between inadequate prenatal care and future healthcare use among offspring in the Bedouin population.

Science.gov (United States)

Estis-Deaton, Asia; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Walfisch, Asnat

2017-12-01

To evaluate the impact of inadequate prenatal care on long-term morbidity among the offspring of an ethnic minority population. A retrospective population-based cohort analysis was performed among all Bedouin women with singleton pregnancies who delivered in a tertiary medical center in Israel between January 1, 1991, and January 1, 2014. Morbidity was defined as pediatric hospitalization across six distinct disease categories before 18 years of age. The cumulative morbidity rates were compared for offspring born following pregnancies with either inadequate (prenatal care facility) or adequate prenatal care. Overall, 127 396 neonates were included; 19 173 (15.0%) were born following inadequate prenatal care. Pediatric hospitalizations for all morbidities other than cardiovascular ones were less frequent among the inadequate prenatal care group than the adequate prenatal care group (Pprenatal care group, with the exception of cardiovascular disease. Inadequate prenatal care correlated with reduced pediatric hospitalization rates among offspring, possibly owing to a lack of child healthcare service utilization within the Bedouin population. © 2017 International Federation of Gynecology and Obstetrics.

NEONATAL MORBIDITY AND EARLY OUTCOME OF VERY PRETERM INFANTS

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Heljić Suada

2013-01-01

Full Text Available Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions.The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s < 30 weeks’ gestation, who were admitted to the NICU. Patients and methods: This study enrolled 102 infants with gestational age less than 30 weeks’ gestation, hospitalized in Neonatal Intensive Care Unit, Pediatric Hospital, Clinical University Center Sarajevo, from Jan. 2010 to Dec. 2010. Parameters taken at admission were: birth weight, gestational age, Apgar score, excess base and CRIB score. Early outcome is considered as a survival at discharge or common preterm morbidities presented during hospitalizationResults: The mean BW of evaluated preterm infants was 1086 ± 250 g, the mean GA27.89 ± 1.97, Apgar score 5.41 ± 1.76, excess base at admission 6.39 ± 1.74 and mean CRIB score 3.72 ± 3.16. The overall survival rate was 70.5%. Selected outcomes at discharge were: RDS with 70.5% infants treated with natural surfactant, PDA treated with NSAIDS (23.5%, brain injury ( ≥ grade 3 IVH or PVL 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3% of infants who survived to 36 weeks postmenstrual age. In 38 (37.2% infants, episodes of infections were noticed (one or more episodes in 25 infants, half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the mostfrequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9% early onset of sepsis was documented. Conclusion: Very preterm

Sterile neutrino, hidden dark matter and their cosmological signatures

International Nuclear Information System (INIS)

Das, Subinoy

2012-01-01

Though thermal dark matter has been the central idea behind the dark matter candidates, it is highly possible that dark matter of the universe is non-thermal in origin or it might be in thermal contact with some hidden or dark sector but not with standard model. Here we explore the cosmological bounds as well as the signatures on two types of non-thermal dark matter candidates. First we discuss a hidden dark matter with almost no interaction (or very feeble) with standard model particles so that it is not in thermal contact with visible sector but we assume it is thermalized with in a hidden sector due to some interaction. While encompassing the standard cold WIMP scenario, we do not require the freeze-out process to be non-relativistic. Rather, freeze-out may also occur when dark matter particles are semi-relativistic or relativistic. Especially we focus on the warm dark matter scenario in this set up and find the constraints on the warm dark matter mass, cross-section and hidden to visible sector temperature ratio which accounts for the observed dark-matter density, satisfies the Tremaine-Gunn bound on dark-matter phase space density and has a free-streaming length consistent with cosmological constraints on the matter power spectrum. Our method can also be applied to keV sterile neutrino dark matter which is not thermalized with standard model but is thermalized with in a dark sector. The second part of this proceeding focuses on an exotic dark matter candidate which arises from the existence of eV mass sterile neutrino through a late phase transition. Due to existence of a strong scalar force the light sterile states get trapped into stable degenerate micro nuggets. We find that its signature in matter power spectra is close to a warm dark matter candidate.

Hyperthyroidism and psychiatric morbidity

DEFF Research Database (Denmark)

Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

2014-01-01

Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

Psychological co-morbidity in children with specific learning disorders

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Manoj K Sahoo

2015-01-01

Full Text Available Children under 19 years of age constitute over 40% of India′s population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common to depression, anxiety, suicide etc., to substance abuse (least common. Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

Psychological Co-morbidity in Children with Specific Learning Disorders.

Science.gov (United States)

Sahoo, Manoj K; Biswas, Haritha; Padhy, Susanta Kumar

2015-01-01

Children under 19 years of age constitute over 40% of India's population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs) exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder) is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common) to depression, anxiety, suicide etc., to substance abuse (least common). Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most) given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

Spatially Interpolated Disease Prevalence Estimation Using Collateral Indicators of Morbidity and Ecological Risk

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Peter Congdon

2013-10-01

Full Text Available This paper considers estimation of disease prevalence for small areas (neighbourhoods when the available observations on prevalence are for an alternative partition of a region, such as service areas. Interpolation to neighbourhoods uses a kernel method extended to take account of two types of collateral information. The first is morbidity and service use data, such as hospital admissions, observed for neighbourhoods. Variations in morbidity and service use are expected to reflect prevalence. The second type of collateral information is ecological risk factors (e.g., pollution indices that are expected to explain variability in prevalence in service areas, but are typically observed only for neighbourhoods. An application involves estimating neighbourhood asthma prevalence in a London health region involving 562 neighbourhoods and 189 service (primary care areas.

Exposing the Hidden-Web Induced by Ajax

NARCIS (Netherlands)

Mesbah, A.; Van Deursen, A.

2008-01-01

AJAX is a very promising approach for improving rich interactivity and responsiveness of web applications. At the same time, AJAX techniques increase the totality of the hidden web by shattering the metaphor of a web ‘page’ upon which general search engines are based. This paper describes a

K­MEANS CLUSTERING FOR HIDDEN MARKOV MODEL

NARCIS (Netherlands)

Perrone, M.P.; Connell, S.D.

2004-01-01

An unsupervised k­means clustering algorithm for hidden Markov models is described and applied to the task of generating subclass models for individual handwritten character classes. The algorithm is compared to a related clustering method and shown to give a relative change in the error rate of as

Algorithms for a parallel implementation of Hidden Markov Models with a small state space

DEFF Research Database (Denmark)

Nielsen, Jesper; Sand, Andreas

2011-01-01

Two of the most important algorithms for Hidden Markov Models are the forward and the Viterbi algorithms. We show how formulating these using linear algebra naturally lends itself to parallelization. Although the obtained algorithms are slow for Hidden Markov Models with large state spaces...

Testing string vacua in the lab. From a hidden CMB to dark forces in flux compactifications

Energy Technology Data Exchange (ETDEWEB)

Cicoli, Michele; Goodsell, Mark; Ringwald, Andreas [Deutsches Elektronen-Synchrotron DESY, Hamburg (Germany). Theory Group; Jaeckel, Joerg [Durham Univ. (United Kingdom). Inst. for Particle Physics Phenomenolgy

2011-03-15

We perform a detailed analysis of the phenomenological properties of hidden Abelian gauge bosons with a kinetic mixing with the ordinary photon within type IIB flux compactifications. We study the interplay between moduli stabilisation and the Green-Schwarz mechanism that gives mass to the hidden photon paying particular attention to the role of D-terms. We present two generic classes of explicit Calabi-Yau examples with an isotropic and an anisotropic shape of the extra dimensions showing how the last case turns out to be very promising to make contact with current experiments. In fact, anisotropic compactifications lead naturally to a GeV-scale hidden photon (''dark forces'' that can be searched for in beam dump experiments) for an intermediate string scale; or even to an meV-scale hidden photon (which could lead to a ''hidden CMB'' and can be tested by light-shining-through-a-wall experiments) in the case of TeV-scale strings. (orig.)

Has Bell's inequality a general meaning for hidden-variable theories

International Nuclear Information System (INIS)

Lochak, G.

1976-01-01

The proof given by J. S. Bell of an inequality between mean values of measurement results which, according to him, would be characteristic of any local hidden-parameter theory, is analyzed. It is shown that Bell's proof is based upon a hypothesis already contained in von Neumann's famous theorem: It consists in the admission that hidden values of parameters must obey the same statistical laws as observed values. This hypothesis contradicts in advance well known and certainly correct statistical relations in measurement results: one must therefore reject the type of theory considered by Bell, and his inequality has no general meaning

Morbidity and mortality in reptiles presented to a wildlife care facility in Central Illinois

OpenAIRE

Rivas, Anne E.; Allender, Matthew C.; Mitchell, Mark; Whittington, Julia K.

2014-01-01

We examined morbidity and mortality of 200 reptiles, representing 13 different species that were presented to the University of Illinois Wildlife Medical Clinic (WMC) from 2003 to 2010. Snapping turtles (Chelydra serpentine; n = 46), box turtles (Terrapene sp.; n = 43), painted turtles (Chrysemys picta; n = 37), and red-eared slider turtles (Trachemys scripta elegans; n = 33) were the most frequently seen species. Turtles were significantly more likely to be presented to the WMC following col...

Clustering Multivariate Time Series Using Hidden Markov Models

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Shima Ghassempour

2014-03-01

Full Text Available In this paper we describe an algorithm for clustering multivariate time series with variables taking both categorical and continuous values. Time series of this type are frequent in health care, where they represent the health trajectories of individuals. The problem is challenging because categorical variables make it difficult to define a meaningful distance between trajectories. We propose an approach based on Hidden Markov Models (HMMs, where we first map each trajectory into an HMM, then define a suitable distance between HMMs and finally proceed to cluster the HMMs with a method based on a distance matrix. We test our approach on a simulated, but realistic, data set of 1,255 trajectories of individuals of age 45 and over, on a synthetic validation set with known clustering structure, and on a smaller set of 268 trajectories extracted from the longitudinal Health and Retirement Survey. The proposed method can be implemented quite simply using standard packages in R and Matlab and may be a good candidate for solving the difficult problem of clustering multivariate time series with categorical variables using tools that do not require advanced statistic knowledge, and therefore are accessible to a wide range of researchers.

Study of Morbidity Profile of a Rural Population in Tamil Nadu

Science.gov (United States)

Ganeshkumar, P.; Katta, Ajitha

2015-01-01

Objective: To identify the reported morbidity profile of people according to age, gender and organ system affected using International Classification of Diseases (ICD) coding, in a demographically defined area in Tamil Nadu in order to identify their health care needs and to plan appropriate interventions strategies. Materials and Methods: This is a-cross sectional study using a convenience sample of 12308 persons sceened from the 41 panchayat units of the Kattankulathur block, comprising 90 villages with a population of about 2,00,890, over a period of one year. Diagnosis made were coded using ICD 10 version and data collected was analysed by appropriate statistical methods to explain the distribution of morbidity profile among the study population. Result: Out of total, 38.1% screened were males and 61.9% were females. Underfives were 5.3%, school going children 43.3%, adults 39.2% and elderly 12.3%. Majority had illness affecting respiratory system (20%), ‘symptoms and signs’ (19%), musculo-skeletal system (16.1%) and digestive system(11.9%). ‘Symptoms and signs’ classification, is a group of conditions which is of nonspecific diseases, signs, symptoms, abnormal findings and complaints, apart from the system specific conditions diagnosed properly and not elsewhere classified, More males were affeced with respiratory, digestive and illnesses with ‘symptoms and signs’ while more women were affected with musculo-skeletal problems. Only 9.7 % of patients reported with non-communicable diseases. Among them, 55 % women and 42.3 % men had osteoarthritis and 15.7 % women and 21.3 % men had cataract. About 15.8 % women and 18.1 % men had hypertension and other heart diseases while 9.7 % women and 8.4 % men had diabetes and 10.0 % men and 3.9 % women had chronic respiratory diseases. Conclusion: School going children and adults have higher levels of morbidity when compared to elderly and under five children. More females reported with illness but morbidity was

Swallowing sound detection using hidden markov modeling of recurrence plot features

International Nuclear Information System (INIS)

Aboofazeli, Mohammad; Moussavi, Zahra

2009-01-01

Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

Swallowing sound detection using hidden markov modeling of recurrence plot features

Energy Technology Data Exchange (ETDEWEB)

Aboofazeli, Mohammad [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: umaboofa@cc.umanitoba.ca; Moussavi, Zahra [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: mousavi@ee.umanitoba.ca

2009-01-30

Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

Hidden conformal symmetry of a rotating black hole with four charges

International Nuclear Information System (INIS)

Shao Kainan; Zhang Zhibai

2011-01-01

Kerr/CFT correspondence exhibits many remarkable connections between the near-horizon Kerr black hole and a conformal field theory (CFT). Recently, Castro, Maloney, and Strominger showed that a hidden conformal symmetry exists in the solution space of a Kerr black hole. In this paper we investigate a rotating black hole with four independent U(1) charges derived from string theory which is known as the four-dimensional Cvetic-Youm solution, and we prove that the same hidden conformal symmetry also holds. We obtain the exact black hole entropy using the temperatures derived. The entropy and absorption cross section agree with the previous results [M. Cvetic and F. Larsen, Nucl. Phys. B506, 107 (1997).] and [M. Cvetic and F. Larsen, J. High Energy Phys. 09 (2009) 088.]. In addition, we clarify a previous explanation on the temperatures of the Cvetic-Youm solution's dual CFT. This work provides more robust derivation of the hidden conformal symmetry of Kerr-like black holes and as well as Kerr/CFT correspondence.

Physician styles of decision-making for a complex condition: Type 2 diabetes with co-morbid mental illness.

Science.gov (United States)

Trachtenberg, Felicia L; Pober, David M; Welch, Lisa C; McKinlay, John B

Variation in physician decisions may reflect personal styles of decision-making, as opposed to singular clinical actions and these styles may be applied differently depending on patient complexity. The objective of this study is to examine clusters of physician decision-making for type 2 diabetes, overall and in the presence of a mental health co-morbidity. This randomized balanced factorial experiment presented video vignettes of a "patient" with diagnosed, but uncontrolled type 2 diabetes. "Patients" were systematically varied by age, sex, race and co-morbidity (depression, schizophrenia with normal or bizarre affect, eczema as control). Two hundred and fifty-six primary care physicians, balanced by gender and experience level, completed a structured interview about clinical management. Cluster analysis identified 3 styles of diabetes management. "Minimalists" (n=84) performed fewer exams or tests compared to "middle of the road" physicians (n=84). "Interventionists" (n=88) suggested more medications and referrals. A second cluster analysis, without control for co-morbidities, identified an additional cluster of "information seekers" (n=15) who requested more additional information and referrals. Physicians ranking schizophrenia higher than diabetes on their problem list were more likely "minimalists" and none were "interventionists" or "information seekers". Variations in clinical management encompass multiple clinical actions and physicians subtly shift these decision-making styles depending on patient co-morbidities. Physicians' practice styles may help explain persistent differences in patient care. Training and continuing education efforts to encourage physicians to implement evidence-based clinical practice should account for general styles of decision-making and for how physicians process complicating comorbidities.

Prevalence and Morbidity of Late Preterm Infants: Current Status in a Medical Center of Northern Taiwan

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Ming-Luen Tsai

2012-06-01

Conclusion: Late-preterm infants have increased risk of neonatal morbidities associated with organ immaturity. The results of this study emphasize the importance of judicious obstetrical decision-making when considering late preterm delivery, and the need to set up anticipatory clinical guidelines for the care of late preterm infants.

Implications of the measured angular anisotropy at the hidden order transition of URu2Si2

Science.gov (United States)

Chandra, P.; Coleman, P.; Flint, R.; Trinh, J.; Ramirez, A. P.

2018-05-01

The heavy fermion compound URu2Si2 continues to attract great interest due to the long-unidentified nature of the hidden order that develops below 17.5 K. Here we discuss the implications of an angular survey of the linear and nonlinear susceptibility of URu2Si2 in the vicinity of the hidden order transition [1]. While the anisotropic nature of spin fluctuations and low-temperature quasiparticles was previously established, our recent results suggest that the order parameter itself has intrinsic Ising anisotropy, and that moreover this anisotropy extends far above the hidden order transition. Consistency checks and subsequent questions for future experimental and theoretical studies of hidden order are discussed.

Synergistic effect of age and body mass index on mortality and morbidity in general surgery.

Science.gov (United States)

Yanquez, Federico J; Clements, John M; Grauf, Dawn; Merchant, Aziz M

2013-09-01

, respectively) subgroup may have an increased morbidity and mortality after general surgery. This information, along with patient-specific factors and their comorbidities, may allow us to better take care of our patients perioperatively and better inform our patients about their risk of surgical procedures. Copyright © 2013 Elsevier Inc. All rights reserved.

Male gender preference, female gender disadvantage as risk factors for psychological morbidity in Pakistani women of childbearing age - a life course perspective

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Medhin Girmay

2011-09-01

Full Text Available Abstract Background In Pakistan, preference for boys over girls is deeply culturally embedded. From birth, many women experience gendered disadvantages; less access to scarce resources, poorer health care, higher child mortality, limited education, less employment outside of the home and circumscribed autonomy. The prevalence of psychological morbidity is exceptionally high among women. We hypothesise that, among women of childbearing age, gender disadvantage is an independent risk factor for psychological morbidity Methods A cross-sectional catchment area survey of 525 women aged 18 to 35 years living in Islamabad and Rawalpindi. The effect of gender disadvantage was assessed as a latent variable using structural equation modelling. Indicators were parental gender preference, low parental care, parental overprotection, limited education, early age at marriage, marital dissatisfaction and low autonomy. Psychological morbidity was assessed using the 20 item Self Reporting Questionnaire (SRQ. Results Gender disadvantage was independently predictive of psychological morbidity. Among married women, socio-economic status did not predict psychological morbidity, and the effect of education was mediated through gender disadvantage rather than socioeconomic status (SES. The women's own preference for a male child was strongly predicted by their perceptions of having been disadvantaged by their gender in their families of origin. Conclusions The high prevalence of psychological morbidity among women in Pakistan is concerning given recently reported strong associations with low birth weight and infant stunting. Social action, public policies and legislation are indicated to reduce culturally embedded preferences. Neglect of these fundamentals will entrench consequent inequities including gender bias in access to education, a key millennium development goal.

A Depth Video-based Human Detection and Activity Recognition using Multi-features and Embedded Hidden Markov Models for Health Care Monitoring Systems

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Ahmad Jalal

2017-08-01

Full Text Available Increase in number of elderly people who are living independently needs especial care in the form of healthcare monitoring systems. Recent advancements in depth video technologies have made human activity recognition (HAR realizable for elderly healthcare applications. In this paper, a depth video-based novel method for HAR is presented using robust multi-features and embedded Hidden Markov Models (HMMs to recognize daily life activities of elderly people living alone in indoor environment such as smart homes. In the proposed HAR framework, initially, depth maps are analyzed by temporal motion identification method to segment human silhouettes from noisy background and compute depth silhouette area for each activity to track human movements in a scene. Several representative features, including invariant, multi-view differentiation and spatiotemporal body joints features were fused together to explore gradient orientation change, intensity differentiation, temporal variation and local motion of specific body parts. Then, these features are processed by the dynamics of their respective class and learned, modeled, trained and recognized with specific embedded HMM having active feature values. Furthermore, we construct a new online human activity dataset by a depth sensor to evaluate the proposed features. Our experiments on three depth datasets demonstrated that the proposed multi-features are efficient and robust over the state of the art features for human action and activity recognition.

Morbidity among Israeli paediatric travellers.

Science.gov (United States)

Rabinowicz, Shira; Schwartz, Eli

2017-09-01

International travel, particularly to developing countries, is becoming increasingly common among the Israeli population, including an increase in the number of travelling children. Since children are a distinct travellers' population, data about their post-travel morbidity are needed. A retrospective study which examined all children (0-19 years old) who presented to our centre after international travel from 1999 to 2015. About 314 children were seen. The mean age was 10 years (SD ± 5.8). Most of the patients (80.6%) were tourists, and the rest were expatriates. The main destinations visited were South-Asia (46.5%), Sub-Saharan Africa (33.4%), Latin-America (7%) and Europe (6.4%). Overall, the most common diagnoses were gastrointestinal (GI) (mainly chronic) disorders (30.6%), followed by febrile diseases (26.4%), among which 18.1% of patients were diagnosed with dengue fever and 12% with malaria. Dermatologic conditions accounted for 25.2%. Additional diagnoses were schistosomiasis (6.4%) and neuropsychiatric symptoms (2.2%). A substantial part, 10.8%, had eosinophilia, either symptomatic or asymptomatic. Travellers to Asia, compared to travellers to Africa, presented more commonly with GI illness (OR 2.02, 95% confidence interval 1.13-3.61), and dermatologic conditions (OR 1.94, 95% confidence interval 1.05-3.61). Morbidity was associated with a variety of transmission modes, such as food-borne illnesses (30.9%), bite and sting wounds (10.2%), mosquito-borne infections (8%), freshwater contact (6.7%) and tick-borne infections (2.2%). The main conditions seen in paediatric returning travellers were GI, febrile and dermatologic illnesses, some may be rare in their country of origin. Targeting care for the suspected pathogens based on updated knowledge of epidemiology and thorough travel history is essential. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Hidden sector dark matter and the Galactic Center gamma-ray excess: a closer look

Science.gov (United States)

Escudero, Miguel; Witte, Samuel J.; Hooper, Dan

2017-11-01

Stringent constraints from direct detection experiments and the Large Hadron Collider motivate us to consider models in which the dark matter does not directly couple to the Standard Model, but that instead annihilates into hidden sector particles which ultimately decay through small couplings to the Standard Model. We calculate the gamma-ray emission generated within the context of several such hidden sector models, including those in which the hidden sector couples to the Standard Model through the vector portal (kinetic mixing with Standard Model hypercharge), through the Higgs portal (mixing with the Standard Model Higgs boson), or both. In each case, we identify broad regions of parameter space in which the observed spectrum and intensity of the Galactic Center gamma-ray excess can easily be accommodated, while providing an acceptable thermal relic abundance and remaining consistent with all current constraints. We also point out that cosmic-ray antiproton measurements could potentially discriminate some hidden sector models from more conventional dark matter scenarios.

Hidden Sector Dark Matter and the Galactic Center Gamma-Ray Excess: A Closer Look

Energy Technology Data Exchange (ETDEWEB)

Escudero, Miguel; Witte, Samuel J.; Hooper, Dan

2017-09-20

Stringent constraints from direct detection experiments and the Large Hadron Collider motivate us to consider models in which the dark matter does not directly couple to the Standard Model, but that instead annihilates into hidden sector particles which ultimately decay through small couplings to the Standard Model. We calculate the gamma-ray emission generated within the context of several such hidden sector models, including those in which the hidden sector couples to the Standard Model through the vector portal (kinetic mixing with Standard Model hypercharge), through the Higgs portal (mixing with the Standard Model Higgs boson), or both. In each case, we identify broad regions of parameter space in which the observed spectrum and intensity of the Galactic Center gamma-ray excess can easily be accommodated, while providing an acceptable thermal relic abundance and remaining consistent with all current constraints. We also point out that cosmic-ray antiproton measurements could potentially discriminate some hidden sector models from more conventional dark matter scenarios.

ESO's Hidden Treasures Brought to Light

Science.gov (United States)

2011-01-01

ESO's Hidden Treasures 2010 astrophotography competition attracted nearly 100 entries, and ESO is delighted to announce the winners. Hidden Treasures gave amateur astronomers the opportunity to search ESO's vast archives of astronomical data for a well-hidden cosmic gem. Astronomy enthusiast Igor Chekalin from Russia won the first prize in this difficult but rewarding challenge - the trip of a lifetime to ESO's Very Large Telescope at Paranal, Chile. The pictures of the Universe that can be seen in ESO's releases are impressive. However, many hours of skilful work are required to assemble the raw greyscale data captured by the telescopes into these colourful images, correcting them for distortions and unwanted signatures of the instrument, and enhancing them so as to bring out the details contained in the astronomical data. ESO has a team of professional image processors, but for the ESO's Hidden Treasures 2010 competition, the experts decided to give astronomy and photography enthusiasts the opportunity to show the world what they could do with the mammoth amount of data contained in ESO's archives. The enthusiasts who responded to the call submitted nearly 100 entries in total - far exceeding initial expectations, given the difficult nature of the challenge. "We were completely taken aback both by the quantity and the quality of the images that were submitted. This was not a challenge for the faint-hearted, requiring both an advanced knowledge of data processing and an artistic eye. We are thrilled to have discovered so many talented people," said Lars Lindberg Christensen, Head of ESO's education and Public Outreach Department. Digging through many terabytes of professional astronomical data, the entrants had to identify a series of greyscale images of a celestial object that would reveal the hidden beauty of our Universe. The chance of a great reward for the lucky winner was enough to spur on the competitors; the first prize being a trip to ESO's Very Large

Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

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Saurabh Goel

2009-06-01

Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur.Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas.Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined.Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

Directory of Open Access Journals (Sweden)

Saurabh Goel

2009-06-01

Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur. Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas. Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined. Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

Learning about gender on campus: an analysis of the hidden curriculum for medical students.

Science.gov (United States)

Cheng, Ling-Fang; Yang, Hsing-Chen

2015-03-01

Gender sensitivity is a crucial factor in the provision of quality health care. This paper explores acquired gendered values and attitudes among medical students through an analysis of the hidden curriculum that exists within formal medical classes and informal learning. Discourse analysis was adopted as the research method. Data were collected from the Bulletin Board System (BBS), which represented an essential communication platform among students in Taiwan before the era of Facebook. The study examined 197 gender-related postings on the BBS boards of nine of 11 universities with a medical department in Taiwan, over a period of 10 years from 2000 to 2010. The five distinctive characteristics of the hidden curriculum were as follows: (i) gendered stereotypes of physiological knowledge; (ii) biased treatment of women; (iii) stereotyped gender-based division of labour; (iv) sexual harassment and a hostile environment, and (v) ridiculing of lesbian, gay, bisexual and transgender (LGBT) people. Both teachers and students co-produced a heterosexual masculine culture and sexism, including 'benevolent sexism' and 'hostile sexism'. As a result, the self-esteem and learning opportunities of female and LGBT students have been eroded. The paper explores gender dynamics in the context of a hidden curriculum in which heterosexual masculinity and stereotyped sexism are prevalent as norms. Both teachers and students, whether through formal medical classes or informal extracurricular interactive activities, are noted to contribute to the consolidation of such norms. The study tentatively suggests three strategies for integrating gender into medical education: (i) by separating physiological knowledge from gender stereotyping in teaching; (ii) by highlighting the importance of gender sensitivity in the language used within and outside the classroom by teachers and students, and (iii) by broadening the horizons of both teachers and students by recounting examples of the lived

Morbidity and mortality of firearm injury in peshawar region

International Nuclear Information System (INIS)

Shah, M.M.; Arif, M.; Seema, N.

2008-01-01

Firearm injuries cause significant morbidity and mortality among its victims. The present study, carried out at a major tertiary care hospital of Peshawar, Pakistan was aimed at highlighting the extent and severity of firearm-related morbidity and resultant mortality despite expert medical care. All victims of firearm injury brought to the Lady Reading Hospital Peshawar Emergency Department and thereafter admitted to hospital wards during the period mid-2006 to mid- 2007 were included in the study prospectively regardless of age, gender or socio-economic status. Data relevant to the background of firearm use, type of firearm used, types and extents of injuries, clinical condition of the patients and final outcome were collected on performas and entered into SPSS 15.0 for analysis. Seventy-four cases of firearm injury were recorded during the study period, with a predominant male to female ratio (9.6:1). Most victims (79.7%) were in the age group of 15-35 years. Although there were more cases from Peshawar (28.4%), there was no major referral pattern noted. High velocity weapons were used in 95.9% of cases and homicide was the main motive for injury (60.8%). Injuries were sustained most frequently in the abdomen and pelvis (44.6%) and 67.6% of victims sustained internal injuries. There were only 5 (6.8%) deaths from firearm injuries. It is concluded, the young males of the population must be targeted for lifestyle adjustments such as training to refrain from anger or disputes (usually over petty things) and to prevent the easy access of firearms as a weapon to settle disputes. (author)

Changes in Survival and Neonatal Morbidity in Infants with a Birth Weight of 750 g or Less

NARCIS (Netherlands)

Claas, M. J.; Bruinse, H. W.; van der Heide-Jalving, M.; Termote, J. U. M.; de Vries, L. S.

2010-01-01

Background: Improvement in perinatal and neonatal care has resulted in increased survival of extremely low birth weight (ELBW) infants. Objectives: To describe survival and neonatal morbidity in a cohort of ELBW infants, to compare two consecutive 5-year periods, and compare appropriate (AGA) with

Avoiding secondary skin graft donor site morbidity in the fibula free flap harvest.

Science.gov (United States)

Kim, Paul D; Fleck, Terry; Heffelfinger, Ryan; Blackwell, Keith E

2008-12-01

To compare donor site morbidity in patients who have undergone fibula free flap reconstruction in which the skin graft was taken from the expected cutaneous paddle of the fibula with the known complications of the popular technique of obtaining a split-thickness skin graft (STSG) from a secondary donor site. Cohort study. The tertiary care centers at Loma Linda University Medical Center and University of California, Los Angeles, Medical Center. From September 1, 2006, to March 30, 2007, 30 patients underwent fibula free flap harvest by 2 surgeons at separate tertiary care centers. Twenty-one of those procedures took place at the University of California, Los Angeles, and 9 at Loma Linda University. Patients included 15 men (50%) and 15 women (50%), with a mean age of 58 (range, 19-88) years. All 30 patients underwent fibula free flap harvest with a split-thickness skin graft (graft thickness, 0.04 cm), obtained from osteocutaneous paddle using a 5.1-cm-wide dermatome, as well as oral cavity and oropharyngeal reconstruction with the de-epithelialized skin paddle. Measures of donor site morbidity, including graft failure and wound breakdown, and measures of recipient site morbidity, including flap failure, hardware complications, intraoral complications, and the need for additional surgery. Of the 30 patients who underwent this procedure, 4 had partial skin graft failures, for a complete skin graft survival of 87%. There were no complete skin graft losses. Regarding the fibula osteocutaneous free flap, there were no complete flap losses, 1 skin paddle necrosis that required debridement, 2 postoperative orocutaneous fistulas, 1 case of infected/extruded hardware, and 1 adhesion formation that required additional surgery for lysis of adhesion and placement of the split-thickness skin graft. The outlined novel technique has similar rates of free flap survival and skin graft take compared with previously described methods. Harvesting the skin graft over the expected

The Hidden Curriculum of Veterinary Education: Mediators and Moderators of Its Effects.

Science.gov (United States)

Roder, Carrie A; May, Stephen A

The "hidden curriculum" has long been supposed to have an effect on students' learning during their clinical education, and in particular in shaping their ideas of what it means to be a professional. Despite this, there has been little evidence linking specific changes in professional attitudes to the individual components of the hidden curriculum. This study aimed to recognize those components that led to a change in students' professional attitudes at a UK veterinary school, as well as to identify the attitudes most affected. Observations were made of 11 student groups across five clinical rotations, followed by semi-structured interviews with 23 students at the end of their rotation experience. Data were combined and analyzed thematically, taking both an inductive and deductive approach. Views about the importance of technical competence and communication skills were promoted as a result of students' interaction with the hidden curriculum, and tensions were revealed in relation to their attitudes toward compassion and empathy, autonomy and responsibility, and lifestyle ethic. The assessment processes of rotations and the clinical service organization served to communicate the messages of the hidden curriculum, bringing about changes in student professional attitudes, while student-selected role models and the student rotation groups moderated the effects of these influences.

The Hidden Gifts of Quiet Kids

Science.gov (United States)

Trierweiler, Hannah

2006-01-01

The author relates that she was an introvert child. It has always taken her time and energy to find her place in a group. As a grown-up, she still needed quiet time to regroup during a busy day. In this article, the author presents an interview with Marti Olsen Laney, author of "The Hidden Gifts of the Introverted Child." During the interview,…

Co-morbidities in severe asthma

DEFF Research Database (Denmark)

Porsbjerg, Celeste; Menzies-Gow, Andrew

2017-01-01

Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma...... to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical...... impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD...

Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis.

Science.gov (United States)

Walker, Patrick G T; White, Michael T; Griffin, Jamie T; Reynolds, Alison; Ferguson, Neil M; Ghani, Azra C

2015-07-01

The ongoing Ebola epidemic in parts of west Africa largely overwhelmed health-care systems in 2014, making adequate care for malaria impossible and threatening the gains in malaria control achieved over the past decade. We quantified this additional indirect burden of Ebola virus disease. We estimated the number of cases and deaths from malaria in Guinea, Liberia, and Sierra Leone from Demographic and Health Surveys data for malaria prevalence and coverage of malaria interventions before the Ebola outbreak. We then removed the effect of treatment and hospital care to estimate additional cases and deaths from malaria caused by reduced health-care capacity and potential disruption of delivery of insecticide-treated bednets. We modelled the potential effect of emergency mass drug administration in affected areas on malaria cases and health-care demand. If malaria care ceased as a result of the Ebola epidemic, untreated cases of malaria would have increased by 45% (95% credible interval 43-49) in Guinea, 88% (83-93) in Sierra Leone, and 140% (135-147) in Liberia in 2014. This increase is equivalent to 3·5 million (95% credible interval 2·6 million to 4·9 million) additional untreated cases, with 10,900 (5700-21,400) additional malaria-attributable deaths. Mass drug administration and distribution of insecticide-treated bednets timed to coincide with the 2015 malaria transmission season could largely mitigate the effect of Ebola virus disease on malaria. These findings suggest that untreated malaria cases as a result of reduced health-care capacity probably contributed substantially to the morbidity caused by the Ebola crisis. Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems. UK Medical Research Council, UK Department for International Development, Bill & Melinda Gates Foundation. Copyright © 2015 Walker et al. Open Access article distributed under the terms of CC BY

A Rose By Other Names: Some General Musings on Lawrence and Colleagues' Hidden Curriculum Scoping Review.

Science.gov (United States)

Hafferty, Frederic W; Martimianakis, Maria Athina

2017-11-07

In this Commentary, the authors explore the scoping review by Lawrence and colleagues by challenging their conclusion that with over 25 years' worth of "ambiguous and seemingly ubiquitous use" of the hidden curriculum construct in health professions education scholarship, it is time to either move to a more uniform definitional foundation or abandon the term altogether. The commentary authors counter these remedial propositions by foregrounding the importance of theoretical diversity and the conceptual richness afforded when the hidden curriculum construct is used as an entry point for studying the interstitial space between the formal and a range of other-than-formal domains of learning. Further, they document how tightly-delimited scoping strategies fail to capture the wealth of educational scholarship that operates within a hidden curriculum framework, including "hidden" hidden curriculum articles, studies that employ alternative constructs, and investigations that target important tacit socio-cultural influences on learners and faculty without formally deploying the term. They offer examples of how the hidden curriculum construct, while undergoing significant transformation in its application within the field of health professions education, has created the conceptual foundation for the application of a number of critical perspectives that make visible the field's political investments in particular forms of knowing and associated practices. Finally, the commentary authors invite readers to consider the methodological promise afforded by conceptual heterogeneity, particularly strands of scholarship that resituate the hidden curriculum concept within the magically expansive dance of social relationships, social learning, and social life that form the learning environments of health professions education.

Estimating the Hospital Delivery Costs Associated With Severe Maternal Morbidity in New York City, 2008-2012.

Science.gov (United States)

Howland, Renata E; Angley, Meghan; Won, Sang Hee; Wilcox, Wendy; Searing, Hannah; Tsao, Tsu-Yu

2018-02-01

with and without severe maternal morbidity remained high ($6,126). Over 5 years, this difference resulted in approximately $83 million in total excess costs (13,502×$6,126). Severe maternal morbidity nearly doubled the cost of delivery above and beyond other drivers of cost, resulting in tens of millions of excess dollars spent in the health care system in New York City. These findings can be used to demonstrate the burden of severe maternal morbidity and evaluate the cost-effectiveness of interventions to improve maternal health.

Morbidity and GH deficiency: a nationwide study

DEFF Research Database (Denmark)

Stochholm, K.; Laursen, T.; Green, A.

2008-01-01

identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD. Method: Sex- and cause-specific hazard ratios (HRs) in CO and AO......Objective: To estimate morbidity in Denmark in all patients with GH deficiency (GHD). Design: Morbidity was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in the GHD patients were studied and additional morbidity noted. Diagnoses and dates of admissions were...

Prediction of super-heavy N⁎ and Λ⁎ resonances with hidden beauty

International Nuclear Information System (INIS)

Wu Jiajun; Zhao Lu; Zou, B.S.

2012-01-01

The meson-baryon coupled channel unitary approach with the local hidden gauge formalism is extended to the hidden beauty sector. A few narrow N ⁎ and Λ ⁎ resonances around 11 GeV are predicted as dynamically generated states from the interactions of heavy beauty mesons and baryons. Production cross sections of these predicted resonances in pp and ep collisions are estimated as a guide for the possible experimental search at relevant facilities.

Locality or non-locality in quantum mechanics: hidden variables without ''spooky action-at-a-distance''

International Nuclear Information System (INIS)

Aharonov, Y.; Scully, M.

2001-01-01

The folklore notion of the ''Non-Locality of Quantum Mechanics'' is examined from the point of view of hidden-variables theories according to Belinfante's classification in his Survey of Hidden Variables Theories. It is here shown that in the case of EPR, there exist hidden variables theories that successfully reproduce quantum-mechanical predictions, but which are explicitly local. Since such theories do not fall into Belinfante's classification, we propose an expanded classification which includes similar theories, which we term as theories of the ''third'' kind. Causal implications of such theories are explored. (orig.)

Does morbid obesity negatively affect the hospital course of patients undergoing treatment of closed, lower-extremity diaphyseal long-bone fractures?

Science.gov (United States)

Baldwin, Keith D; Matuszewski, Paul E; Namdari, Surena; Esterhai, John L; Mehta, Samir

2011-01-03

Obesity is prevalent in the developed world and is associated with significant costs to the health care system. The effect of morbid obesity in patients operatively treated for long-bone fractures of the lower extremity is largely unknown. The National Trauma Data Bank was accessed to determine if morbidly obese patients (body mass index >40) with lower extremity fractures have longer length of hospital stay, higher cost, greater rehabilitation admission rates, and more complications than nonobese patients. We identified patients with operatively treated diaphyseal femur (6920) and tibia (5190) fractures. Polytrauma patients and patients younger than 16 years were excluded. Morbidly obese patients were identified by ICD-9 and database comorbidity designation (femur, 131 morbidly obese; tibia, 75 morbidly obese). Patients meeting these criteria who were not morbidly obese were used as controls. Sensitivity analyses were performed to analyze patients with isolated trauma to the tibia or femur. Morbidly obese patients were more likely to be admitted to a subacute facility. Length of stay trended higher in morbidly obese patients. There was no significant relationship between obesity and inpatient mortality or inpatient complications. These trends held true when considering patients with multiple injuries and patients who had isolated long-bone injuries. Our study showed that morbidly obese patients may have greater rehabilitation needs following long-bone fractures in the lower extremity. Our study showed no difference in mortality or complications, although further studies are needed to confirm these findings. Copyright 2011, SLACK Incorporated.

Gender Differences in Co-Morbid Psychopathology and Clinical Management in Adults with Autism Spectrum Disorders

Science.gov (United States)

Tsakanikos, Elias; Underwood, Lisa; Kravariti, Eugenia; Bouras, Nick; McCarthy, Jane

2011-01-01

The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N =…

Hidden magnetism in periodically modulated one dimensional dipolar fermions

Science.gov (United States)

Fazzini, S.; Montorsi, A.; Roncaglia, M.; Barbiero, L.

2017-12-01

The experimental realization of time-dependent ultracold lattice systems has paved the way towards the implementation of new Hubbard-like Hamiltonians. We show that in a one-dimensional two-components lattice dipolar Fermi gas the competition between long range repulsion and correlated hopping induced by periodically modulated on-site interaction allows for the formation of hidden magnetic phases, with degenerate protected edge modes. The magnetism, characterized solely by string-like nonlocal order parameters, manifests in the charge and/or in the spin degrees of freedom. Such behavior is enlighten by employing Luttinger liquid theory and numerical methods. The range of parameters for which hidden magnetism is present can be reached by means of the currently available experimental setups and probes.

The role of 'hidden' community volunteers in community-based health service delivery platforms: examples from sub-Saharan Africa.

Science.gov (United States)

Leon, Natalie; Sanders, David; Van Damme, Wim; Besada, Donela; Daviaud, Emmanuelle; Oliphant, Nicholas P; Berzal, Rocio; Mason, John; Doherty, Tanya

2015-01-01

Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs), but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or 'hidden' community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the 'hidden' contribution of volunteers. We need to better characterize the volunteers' interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa.

Hospital morbidity among Guarani Indians in Southeastern and Southern Brazil.

Science.gov (United States)

Cardoso, Andrey Moreira; Coimbra, Carlos E A; Tavares, Felipe Guimarães

2010-03-01

Studies on hospital morbidity among Brazilian indigenous peoples are relatively recent, show limited coverage, and lack data sources capable of generating specific indicators according to ethnic group. The current study describes hospital morbidity in the indigenous population living in 83 Guarani villages in Southern and Southeastern Brazil (N=6,483), based on primary data obtained from a hospital admissions surveillance system implemented in 2007-2008, specifically for a case-control study on acute respiratory infections (ARI) in Guarani children. During the study period there were 666 hospitalizations in a total of 497 individuals, the majority under 5 years of age (71.9%). Respiratory illnesses were the main causes of hospitalization (64.6%), especially in children (<5 years: 77.6%; <1 year: 83.4%) and exceeded the proportions of hospital admissions from these causes in other indigenous groups. The overall hospitalization rate (per 100 person-years) was 8.8, or 71.4 under 1 year and 21.0 from 1 to 4 years of age. The ARI hospitalization rate (5.3) was 6.5 and 2.0 times higher than for diarrhea and other causes, respectively, while in children under 5 years of age (ARI=23.7) these differences were 7.4 and 5.4 times, respectively. The standardized Guarani hospitalization rate exceeded the standardized rates for the South and Southeast of Brazil by 40% and 210%, respectively. Hospitalization for primary care sensitive conditions and the high ARI rates indicate the need for studies to understand the epidemiology of ARI and investments to upgrade primary health care for the Guarani.

Ocular morbidity among porters at high altitudes.

Science.gov (United States)

Gnyawali, Subodh; Shrestha, Gauri Shankar; Khanal, Safal; Dennis, Talisa; Spencer, John C

2017-01-01

High altitude, often characterized by settings over 2400m, can be detrimental to the human body and pose a significant risk to ocular health. Reports concerning various ocular morbidities occurring as a consequence of high altitude are limited in the current literature. This study was aimed at evaluating the ocular health of porters working at high altitudesof Himalayas in Nepal. A mobile eye clinic was set up in Ghat and patient data were collected from its out- patient unit by a team of seven optometrists which was run for five days. Ghat is a small village in north-eastern Nepal, located at 2860 m altitude. Travellers walking through the trekking route were invited to get their eyes checked at the clinic. Comprehensive ocular examinations were performed, including visual acuities, objective and subjective refraction, anterior and posterior segment evaluations, and intraocular pressure measurements; blood pressure and blood glucose levels were also measured as required. Ocular therapeutics, prescription glasses, sunglasses and ocular health referrals were provided free of cost as necessary. A total of 1890 people visited the eye clinic, among which 57.4% (n=1084) were porters. Almost half of the porters had an ocular morbidity. Correctable refractive error was most prevalent, with other ocular health-related complications, including dry eye disease, infectious disorders, glaucoma and cataract. Proper provision of regular and effective eye care services should be made more available for those residing at these high altitudes in Nepal. © NEPjOPH.

Identification of hidden failures in control systems: a functional modelling approach

International Nuclear Information System (INIS)

Jalashgar, A.; Modarres, M.

1996-01-01

This paper presents a model which encompasses knowledge about a process control system's functionalities in a function-oriented failure analysis task. The technique called Hybrid MFM-GTST, mainly utilizes two different function - oriented methods (MFM and GTST) to identify all functions of the system components, and hence possible sources of hidden failures in process control systems. Hidden failures are referred to incipient failures within the system that in long term may lead to loss of major functions. The features of the method are described and demonstrated by using an example of a process control system

Heisenberg (and Schrödinger, and Pauli) on hidden variables

Science.gov (United States)

Bacciagaluppi, Guido; Crull, Elise

In this paper, we discuss various aspects of Heisenberg's thought on hidden variables in the period 1927-1935. We also compare Heisenberg's approach to others current at the time, specifically that embodied by von Neumann's impossibility proof, but also views expressed mainly in correspondence by Pauli and by Schrödinger. We shall base ourselves mostly on published and unpublished materials that are known but little-studied, among others Heisenberg's own draft response to the EPR paper. Our aim will be not only to clarify Heisenberg's thought on the hidden-variables question, but in part also to clarify how this question was understood more generally at the time.

Prevalence of psychiatric morbidity at Mobile Health Clinic in an urban community in North India.

Science.gov (United States)

Salve, Harshal; Goswami, Kiran; Nongkynrih, Baridalyne; Sagar, Rajesh; Sreenivas, V

2012-01-01

The objective was to estimate the prevalence of psychiatric morbidity amongst patients attending Mobile Health Clinic (MHC) in an urban community in South Delhi. Adult subjects were recruited by systematic random sampling at outpatient MHC. Primary Care Evaluation of Mental Disorder Patient Health Questionnaire (PHQ) was used for screening, and Mini International Neuropsychiatric Interview (M.I.N.I.) was used for the confirmation of diagnosis of psychiatric disorder of all PHQ-positive and 20% of PHQ-negative patients. Association of selected sociodemographic factors with psychiatric morbidity was also assessed. In total, 350 subjects were recruited, out of which 92 (26.3%) [95% confidence interval (CI) 21.7-31.0] were found to be PHQ positive. M.I.N.I. was administered to 141 subjects (92 PHQ positives and 52 PHQ negatives). Total estimated magnitude of psychiatric morbidity by M.I.N.I. was 25.4% (95% CI 20.9-29.9). Depression (15.7%) was observed to be the most common psychiatric disorder followed by generalized anxiety disorder (11.1%) and phobic disorders (10.1%). Suicidal ideation was reported by 37 (10.6%) patients. Literate status [odds ratio (OR)=0.43] and duration of migration >20 years to study area (OR=1.27) were found to be significantly associated with psychiatric morbidity. In resource-poor country like India, high psychiatric morbidity at MHC justifies the use of MHC for providing outreach mental health services in difficult areas. Copyright © 2012 Elsevier Inc. All rights reserved.