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  1. Childhood Depression: Relation to Adaptive, Clinical and Predictor Variables

    OpenAIRE

    Garaigordobil, Maite; Bernar?s, Elena; Jaureguizar, Joana; Machimbarrena, Juan M.

    2017-01-01

    The study had two goals: (1) to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2) to identify predictor variables of childhood depression. Participants were 420 students aged 7–10 years old (53.3% boys, 46.7% girls). Results revealed: (1) positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and...

  2. Childhood Depression: Relation to Adaptive, Clinical and Predictor Variables

    Directory of Open Access Journals (Sweden)

    Maite Garaigordobil

    2017-05-01

    Full Text Available The study had two goals: (1 to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2 to identify predictor variables of childhood depression. Participants were 420 students aged 7–10 years old (53.3% boys, 46.7% girls. Results revealed: (1 positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and childhood stress; and (2 negative correlations between depression and personal adaptation, global self-concept, social skills, and resilience (sense of competence and affiliation. Linear regression analysis including the global dimensions revealed 4 predictors of childhood depression that explained 50.6% of the variance: high clinical maladjustment, low global self-concept, high level of stress, and poor social skills. However, upon introducing the sub-dimensions, 9 predictor variables emerged that explained 56.4% of the variance: many internalizing problems, low family self-concept, high anxiety, low responsibility, low personal self-assessment, high social stress, few aggressive behaviors toward peers, many health/psychosomatic problems, and external locus of control. The discussion addresses the importance of implementing prevention programs for childhood depression at early ages.

  3. Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.

    Science.gov (United States)

    Passik, Steven D; Lowery, Amy

    2011-06-01

    Opioid-related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians' assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become "chemical copers" as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive-behavioral (acceptance and commitment, dialectical behavior), existential (meaning-centered, dignity), and psychotropic therapies have been effective in treating these high-risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose. Wiley Periodicals, Inc.

  4. Epidemiological and clinical variables related with the predominant polarity on bipolar disorder: A systematic review.

    Science.gov (United States)

    García-Jiménez, Jesús; Álvarez-Fernández, Marisol; Aguado-Bailón, Lidia; Gutiérrez-Rojas, Luis

    2017-08-14

    Current classification of bipolar disorder (BD) in type i or type ii, however useful, may be insufficient to provide relevant clinical information in some patients. As a result, complementary classifications are being proposed, like the predominant polarity (PP) based, which is defined as a clear tendency in the patient to present relapses in the manic or depressive poles. We carried out a search in PubMed and Web of Science databases, following the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses -PRISMA- guidelines, to identify studies about BD reporting PP. The search is updated to June 2016. Initial search revealed 907 articles, of which 16 met inclusion criteria. Manic PP was found to be associated with manic onset, drug consumption prior to onset and a better response to atypical antipsychotics and mood stabilisers. Depressive PP showed an association with depressive onset, more relapses, prolonged acute episodes, a greater suicide risk and a later diagnosis of BD. Depressive PP was also associated with anxiety disorders, mixed symptoms, melancholic symptoms and a wider use of quetiapine and lamotrigine. Few prospective studies. Variability in some results. PP may be useful as a supplement to current BD classifications. We have found consistent data on a great number of studies, but there is also contradictory information regarding PP. Further studies are needed, ideally of a prospective design and with a unified methodology. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Demographic, clinical, and quality of life variables related to embarrassment in veterans living with an intestinal stoma.

    Science.gov (United States)

    Mitchell, Kimberly A; Rawl, Susan M; Schmidt, C Max; Grant, Marcia; Ko, Clifford Y; Baldwin, Carol M; Wendel, Christopher; Krouse, Robert S

    2007-01-01

    The study aims were to identify demographic, clinical, and quality of life variables related to embarrassment for people living with ostomies and to determine the experiences and/or feelings of veterans who were embarrassed by their ostomy. This was a cross-sectional, correlational study. A convenience sample of veterans (n = 239) living with ostomies from 3 VA medical centers was studied. The veterans were primarily Caucasian (84%), male (92%), and older (M = 69). The modified City of Hope Quality of Life-Ostomy questionnaire was used. Additionally, an open-ended question related to living with an ostomy was asked. The questionnaire packets were mailed to participants and self-administered. Approximately half of the participants (48%) rated their embarrassment as low, but 26% reported high embarrassment. Participants with high embarrassment were compared to those with low embarrassment on demographic, clinical, and quality of life variables. High embarrassment was associated with poorer total quality of life (P hopefulness were associated with low embarrassment (P < .001). Sources of embarrassment included leakage, odor, and noise. Embarrassment may negatively impact a person's quality of life; therefore, the variables associated with high embarrassment should be recognized and addressed.

  6. Pursuit of Muscularity in Adolescent Boys: Relations among Biopsychosocial Variables and Clinical Outcomes

    Science.gov (United States)

    Cafri, Guy; van den Berg, Patricia; Thompson, J. Kevin

    2006-01-01

    Adolescent boys (n = 269) were assessed for levels of several risky behaviors related to the pursuit of muscularity, including substance use (anabolic steroids, prohormones, and ephedrine) dieting to gain weight, and symptoms of muscle dysmorphia (MD). The association between these behaviors and a variety of putative biological, psychological, and…

  7. Work-related stress disorders: variability in clinical expression and pitfalls in psychiatric diagnosis.

    Science.gov (United States)

    Buselli, Rodolfo; Veltri, Antonello; Baldanzi, Sigrid; Bozzi, Silvia; Marino, Riccardo; Chiumiento, Martina; Dell'Osso, Liliana; Cristaudo, Alfonso

    2016-03-24

    Putative occupational stress-related psychiatric disorders are Adjustment Disorders (AD) and Post-Traumatic Stress Disorder (PTSD). Mood Disorders (MD) are not excluded but are unlikely to be identified as occupational diseases. The differential diagnosis between AD and MD is not easy and is based on strict categorical criteria. The aim of this study  was to explore differences in personality and mood spectrum symptoms among workers investigated for occupational stress suffering from AD or MD. Sixty-two patients with AD and 43 with MD were recruited and evaluated by means of rating scales for psychosocial occupational risk and work-related stress (WHS, CDL, OSQ), for sleep disturbances (PSQI), for personality disorders (SCID-II) and for mood spectrum symptoms (MOODS-SR). The diagnostic groups did not differ for WHS, OSQ and PSQI scores. The duration of exposure to stressful/adversative work situations was significantly higher in the MD group (p=0.03). Positive family psychiatric history (p=0.005), personality disorders (p=0.009) and pathological personality traits (p<0.0001) were significantly more frequent in the MD group. The MOODS-SR questionnaire total score (p=0.019) and the manic component score (p=0.001) but not the depressive score were significantly higher in the MD group. The present study suggests that  positive family psychiatric history, pathological personality traits and  spectrum manic symptoms represent markers of vulnerability and low resilience for workers exposed to occupational stress. These characteristics could weaken the etiological relationship between work-related stress and an initial  major depressive episode when it is under investigation as a possible occupational disease.

  8. Is the occurrence of spontaneous epistaxis related to climatic variables? A retrospective clinical, epidemiological and meteorological study.

    Science.gov (United States)

    Mangussi-Gomes, João; Enout, Mariana Junqueira Reis; Castro, Thaiana Carneiro de; de Andrade, José Santos Cruz; Penido, Norma de Oliveira; Kosugi, Eduardo Macoto

    2016-11-01

    Epistaxis has a bimodal age distribution. Anterior epistaxis of mild severity is more common in children; severe epistaxis occurs more often in adults and elderly patients. The occurrence of spontaneous epistaxis was shown to be weakly-to-moderately and inversely correlated to the mean monthly temperature, relative humidity and total rainfall. To describe the clinical and epidemiological profiles of patients diagnosed with spontaneous epistaxis; to correlate its monthly occurrence with meteorological variables. A retrospective cross-sectional study was performed in a referral ENT service in São Paulo, Brazil. The study assessed the clinical and epidemiological features of 508 patients with spontaneous epistaxis treated between February 2010 and January 2011. The occurrence of epistaxis was associated with weather variables for the same study period. Spontaneous epistaxis presented two age peaks of higher incidence (11-20 and 51-70 years). Children more frequently had localized bleeding (p = 0.003), in the anterior region of the nasal cavity (p = 0.0001), of absent-mild severity (p = 0.0082). Diffuse bleeding (p = 0.005), of moderate-severe intensity (p = 0.003), was more common in adults and elderly patients. The total number of visits because of epistaxis was inversely correlated to mean temperature (R = -0.489; p = 0.011), mean relative humidity (R = -0.364; p = 0.038), and total rainfall (R = -0.512; p = 0.009) during each month of the analyzed period.

  9. Relative value of clinical variables, bicycle ergometry, rest radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring at discharge to predict 1 year survival after myocardial infarction

    NARCIS (Netherlands)

    P.M. Fioretti (Paolo); R.W. Brower (Ronald); M.L. Simoons (Maarten); H.J. ten Katen (Harald); A. Beelen (Anita); T. Baardman (Taco); J. Lubsen (Jacob); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractThe relative value of predischarge clinical variables, bicycle ergometry, radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring for predicting survival during the first year in 351 hospital survivors of acute myocardial infarction was assessed. Discriminant

  10. Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Zanchetta, Flávia Cristina; Trevisan, Danilo Donizetti; Apolinario, Priscila Peruzzo; Silva, Juliana Bastoni da; Lima, Maria Helena de Melo

    2016-01-01

    To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients. A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS). About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The "emotional burden", "regimen-related distress", and "interpersonal distress" domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175). These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study. Avaliar a relação entre o estresse relacionado ao diabetes e as características clínicas e sociodemográficas de pacientes com diabetes mellitus do tipo 2. Estudo transversal com base na análise secundária de dados coletados em um ambulatório de atendimento terciário no Brasil. Os participantes preencheram um questionário sobre as características sociodemográficas e clínicas, e a versão brasileira da Diabetes Distress Scale (B-DDS). Aproximadamente 31% dos 130 pacientes elegíveis relataram estresse relacionado ao diabetes, e a média do escore da B-DDS foi de 2,6. O modelo de regressão múltipla mostrou que a pontuação B-DDS foi positivamente correlacionada com o estado civil (p=0

  11. Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Awad Al Qahtani

    2012-06-01

    Full Text Available Small bowel obstruction is a known complication of Crohn’s disease. Determining need for operation is a demanding task. The aim of this study was to fine tune the decision-making process by evaluating standard clinical and laboratory parameters in small bowel obstruction of any cause and compare etiologies. Consecutive patients with Crohn’s disease and small bowel obstruction were selected retrospectively and compared to a randomly selected group of non Crohn’s patients with obstruction over a 9 year period. Twenty-two clinical, laboratory and radiological variables were assessed for the following outcomes: i diagnosis of Crohn’s; ii operative or non operative treatment in Crohn’s; iii operative or non operative treatment without Crohn’s; iv exacerbation or adhesions causing obstruction among Crohn’s patients. Multivariable models were developed for each outcome using logistic regression. Age less than 50, history of smoking, Jewish ethnicity, white count >11x10E9, neutrophils >7.5x10E9 and platelet volume <9.9 fL, supported the diagnosis of Crohn’s disease. Operation in Crohn’s disease within the same admission was associated with a history of smoking, temperature >38˚, high pulse >100, leukocytosis (>11x10E9 and obstruction on abdominal scan, while operation in patients without Crohn’s in the sentinel admission, was associated with temperature >38˚, tachycardia, leukocytosis (>11x10E9 and previous operation. Confirmation of these predictive patterns in a validation group could help in clinical decisions regarding therapeutic options in an emergency setting.

  12. Clinical variables in radiotracer biodistributions

    International Nuclear Information System (INIS)

    Lentle, B.C.; Scott, J.R.; Schmidt, R.P.; Noujaim, A.A.

    1981-01-01

    Radionuclide dosimetry must, by its nature, define tissue irradiation in terms of mean exposure in a population of a statistically acceptable size. In the daily practice of clinical nuclear medicine there are, however, quite large variations in the biodistribution of tracers and thus in resulting radiation doses. Age is a variable, particularly in respect of bone-seeking tracers. Sex imposes variations in radiation dose on account of the differing anatomical configurations of the gonads. Breast uptake and excretion of certain tracers in women are additional variables. Activity and occupation are occasional variables. Numerous iatrogenic causes of altered radiotracer biodistributions have been described. Cancer chemotherapy is a particularly potent cause of changed biodistributions while even a trivial matter such as preparing the skin with an iodine containing antiseptic may cause displacement of technetium from its compounds. In the blocking of thyroid uptake of radioiodines, there is good precedent for the manipulation of regional tissue dosimetry. It is possible to go beyond the mere cataloguing of these effects to look creatively at the subject of comparative tissue biodistributions and hence comparative dosimetry. Effects such as the clinical observation of the interference by cis-platinum with the usual biodistribution of radio-gallium suggest that such compounds can be used as probes each to lead to a better understanding of the mechanism of action of the other

  13. Social cognition in patients with schizophrenia, their unaffected first degree relatives and healthy controls. Comparison between groups and analysis of associated clinical and sociodemographic variables.

    Science.gov (United States)

    Rodríguez Sosa, Juana Teresa; Gil Santiago, Hiurma; Trujillo Cubas, Angel; Winter Navarro, Marta; León Pérez, Petra; Guerra Cazorla, Luz Marina; Martín Jiménez, José María

    2013-01-01

    To evaluate and compare the social cognition in patients with schizophrenia, healthy first-degree relatives and controls, by studying the relationship between social cognition and nonsocial cognition, psychopathology, and other clinical and sociodemographic variables. The total sample was comprised of patients diagnosed with paranoid schizophrenia (N = 29), healthy first-degree relatives (N = 21) and controls (N = 28). All groups were assessed with an ad hoc questionnaire and a Social Cognition Scale, which assessed the domains: emotional processing, social perception and attributional style in a Spanish population. The patient group was also assessed with the Scale for the Positive and Negative Syndrome Scale and the Mini-mental state examination. Statistical analyses were performed with SPSS version 15.0. Patients scored significantly worse in all domains of social cognition assessed, compared with controls, and mastery attributional style, compared with relatives. The type of psychopathology correlated negatively and statistically significantly with different domains of social cognition: negative symptoms with emotional processing and attributional style, and positive symptoms with social perception. Basic cognition scores correlated positively and statistically significantly with the domains social perception and attributional style. Social cognition has become an interesting object of study, especially in how it relates to non-social cognition, psychopathology and global functioning of patients, bringing new elements to be considered in the early detection, comprehensive treatment and psychosocial rehabilitation of patients. Its conceptualization as trait variable, the consideration of the existence of a continuum between patients and relatives are plausible hypotheses that require further research. Copyright © 2012 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  14. Clinical variables in radiotracer biodistributions

    International Nuclear Information System (INIS)

    Lentle, B.C.; Scott, J.R.; Schmidt, R.P.; Noujaim, A.A.

    1981-01-01

    Numerous iatrogenic causes of altered radiotracer biodistributions have been described. Cancer chemotherapy is a particularly potent cause of changed biodistributions while even a trivial matter such as preparing the skin with an iodine containing antiseptic may cause displacement of technetium from its compounds. In the blocking of thyroid uptake of radioiodines, there is good precedent for the manipulation of regional tissue dosimetry. It is possible to go beyond the mere cataloguing of these effects to look creatively at the subject of comparative tissue biodistributions and hence comparative dosimetry. Effects such as the clinical observation of the interference by cis-platinum with the usual biodistribution of radio-gallium suggests that such compounds can be used as probes each to lead to a better understanding of the mechanism of action of the other

  15. Effects of orlistat vs. metformin on weight loss-related clinical variables in women with PCOS: systematic review and meta-analysis.

    Science.gov (United States)

    Graff, S K; Mario, F M; Ziegelmann, P; Spritzer, P M

    2016-06-01

    The aim of this study was to assess the effects of orlistat on weight loss-related clinical variables in overweight/obese women with polycystic ovary syndrome (PCOS) and to compare treatment with orlistat vs. metformin in this group. We conducted a systematic review and meta-analysis of the evidence about the use of orlistat in women with PCOS. We searched the literature published until May 2015 in MEDLINE, Cochrane Central Register of Controlled Trials and LILACS. Of 3951 studies identified, nine were included in the systematic review (three prospective, non-randomised studies and six randomised control trials). Eight studies used the Rotterdam criteria and 1 used NIH criteria to diagnose PCOS. Data suggest that orlistat promotes a significant reduction in BMI/weight in overweight/obese PCOS women. Eight studies evaluated orlistat impact on testosterone. Seven reported an improvement in testosterone levels. Eight studies evaluated impact on insulin resistance, and five reported improvement. Finally, five studies evaluated impact on lipid profile, and four reported improvement. Three randomised control trials were included in the fixed effects model meta-analysis for a total of 121 women with PCOS. Orlistat and metformin had similar positive effects on BMI (-0.65%, 95% CI: -2.03 to 0.73), HOMA (-3.60%, 95% CI: -16.99 to 9.78), testosterone (-2.08%, 95% CI: -13.08 to 8.93) and insulin (-5.51%, 95% CI: -22.27 to 11.26). The present results suggest that orlistat leads to significant reduction in BMI/body weight in PCOS. In addition, the available evidence indicates that orlistat and metformin have similar effects in reducing BMI, HOMA, testosterone and insulin in overweight/obese PCOS women. This study was registered in PROSPERO under number CRD42014012877. © 2016 John Wiley & Sons Ltd.

  16. What variables can influence clinical reasoning?

    Directory of Open Access Journals (Sweden)

    Vahid Ashoorion

    2012-01-01

    Full Text Available Background: Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Materials and Methods: Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. Results: There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34 (R 2 chnage = 0.46, P Value = 0.000. Conclusion: Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales is the only variable that can be used for clinical reasoning prediction.

  17. What variables can influence clinical reasoning?

    Science.gov (United States)

    Ashoorion, Vahid; Liaghatdar, Mohammad Javad; Adibi, Peyman

    2012-12-01

    Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34) (R(2) chnage = 0.46, P Value = 0.000). Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales) is the only variable that can be used for clinical reasoning prediction.

  18. Clinical and acoustical variability in hypokinetic dysarthria

    International Nuclear Information System (INIS)

    Metter, E.J.; Hanson, W.R.

    1986-01-01

    Ten male patients with parkinsonism secondary to Parkinson's disease or progressive supranuclear palsy had clinical neurological, speech, and acoustical speech evaluations. In addition, seven of the patients were evaluated by x-ray computed tomography (CT) and (F-18)-fluorodeoxyglucose (FDG) positron emission tomography (PET). Extensive variability of speech features, both clinical and acoustical, were found and seemed to be independent of the severity of any parkinsonian sign, CT, or FDG PET. In addition, little relationship existed between the variability across each measured speech feature. What appeared to be important for the appearance of abnormal acoustic measures was the degree of overall severity of the dysarthria. These observations suggest that a better understanding of hypokinetic dysarthria may result from more extensive examination of the variability between patients. Emphasizing a specific feature such as rapid speaking rate in characterizing hypokinetic dysarthria focuses on a single and inconstant finding in a complex speech pattern

  19. Clinical variables, lifestyle and coping in hemodialysis.

    Science.gov (United States)

    Comelis Bertolin, Daniela

    2016-10-01

    To verify the relationship between coping strategies of people with chronic kidney disease undergoing hemodialysis and their clinical variables and lifestyle habits. It was developed a cross-sectional study that used the Coping Strategies Inventory of Folkman and Lazarus and a semi-structured questionnaire for collecting clinical variables and lifestyles of patients undergoing hemodialysis in the Urology and Nephrology Institute of São Jose do Rio Preto-SP (Brazil). Participants were 107 adults undergoing hemodialysis, with an average age of 51 years; 62.4% were men. The main causes of chronic kidney disease were chronic glomerulonephritis, diabetes mellitus, undetermined cause and hypertension. The most reported coping strategies were focused on emotion. There were greater coping scores among people who had diabetes, those who had leisure and those who referred religion. People who exercised and those who had undergone renal transplantation had more positive coping. Clinical variables of people undergoing hemodialysis can be sources of stress, and lifestyle habits are associated with coping strategies to mitigate the effects of stress. Copyright© by the Universidad de Antioquia.

  20. Health related quality of life and psychological variables among a ...

    African Journals Online (AJOL)

    Health related quality of life and psychological variables among a sample of asthmatics in Ile-Ife South-Western Nigeria. ... Sociodemographic and clinical variables were also obtained from the patients, the lung function was assessed using Peak Expiratory Flow Rate (PEFR). Results: Mean age of all the patients was 35.22 ...

  1. Variability of centric relation position in TMD patients.

    NARCIS (Netherlands)

    Zonnenberg, A.J.J.; Mulder, J.

    2006-01-01

    Reproducibility of the centric relation position for patients with temporomandibular disorders (TMD) is not documented in the current literature. It was the objective of this study to assess clinical variability of the centric relation position for TMD patients with a muscle-determined technique by

  2. Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

    Directory of Open Access Journals (Sweden)

    Ludmylla Teixeira Soares

    2015-06-01

    Full Text Available BACKGROUND:Vascular traumas are associated with high morbidity rates.OBJECTIVE: To report the characteristics of vascular traumas in the Brazilian state of Pará, in trauma victims treated at the Hospital Metropolitano de Urgência e Emergência (HMUE, from 2011 to 2013.METHOD: This was a descriptive, cross-sectional, retrospective and quantitative study that analyzed data on sex, age group, geographical origin, time waiting for care, mechanism of trauma, clinical status, anatomic site of injury, prevalence of associated fractures, vascular structures injured, types of vascular injury, principal types of surgery, early postoperative outcomes, level of amputation, number of deaths, length of hospital stay and multidisciplinary care for 264 medical records.RESULTS: The majority of victims were male and the most common age group was from 16 to 30 years. The majority of cases were from towns other than the state capital, accounting for 169 cases (64.02%. The principal mechanism of injury was firearm wounding - 110 (41.67% followed by cold weapon wounds - 65 (24.62% and traffic accidents - 42 (15.91%. The segments of the body and the vascular structures most often injured were lower limbs - 120 (45.45% and injuries to the popliteal and femoral arteries and veins. The most common clinical presentation at admission was hemorrhage - 154 (58.33%. The most common surgeries were ligatures of veins and arteries. There were 163 (61.74% hospital discharges and 33 (12.5% deaths.CONCLUSIONS: The greatest prevalence observed was related to traumas caused by urban violence. Victims were most frequently male, of working age and from towns other than the capital of the state of Pará.

  3. Noonan syndrome and clinically related disorders

    Science.gov (United States)

    Tartaglia, Marco; Gelb, Bruce D.; Zenker, Martin

    2010-01-01

    Noonan syndrome is a relatively common, clinically variable developmental disorder. Cardinal features include postnatally reduced growth, distinctive facial dysmorphism, congenital heart defects and hypertrophic cardiomyopathy, variable cognitive deficit and skeletal, ectodermal and hematologic anomalies. Noonan syndrome is transmitted as an autosomal dominant trait, and is genetically heterogeneous. So far, heterozygous mutations in nine genes (PTPN11, SOS1, KRAS, NRAS, RAF1, BRAF, SHOC2, MEK1 and CBL) have been documented to underlie this disorder or clinically related phenotypes. Based on these recent discoveries, the diagnosis can now be confirmed molecularly in approximately 75% of affected individuals. Affected genes encode for proteins participating in the RAS-mitogen-activated protein kinases (MAPK) signal transduction pathway, which is implicated in several developmental processes controlling morphology determination, organogenesis, synaptic plasticity and growth. Here, we provide an overview of clinical aspects of this disorder and closely related conditions, the molecular mechanisms underlying pathogenesis, and major genotype-phenotype correlations. PMID:21396583

  4. Variability in ACL tunnel placement: observational clinical study of surgeon ACL tunnel variability.

    Science.gov (United States)

    Wolf, Brian R; Ramme, Austin J; Wright, Rick W; Brophy, Robert H; McCarty, Eric C; Vidal, Armando R; Parker, Richard D; Andrish, Jack T; Amendola, Annunziato

    2013-06-01

    Multicenter and multisurgeon cohort studies on anterior cruciate ligament (ACL) reconstruction are becoming more common. Minimal information exists on intersurgeon and intrasurgeon variability in ACL tunnel placement. Purpose/ The purpose of this study was to analyze intersurgeon and intrasurgeon variability in ACL tunnel placement in a series of The Multicenter Orthopaedic Outcomes Network (MOON) ACL reconstruction patients and in a clinical cohort of ACL reconstruction patients. The hypothesis was that there would be minimal variability between surgeons in ACL tunnel placement. Cross-sectional study; Level of evidence, 3. Seventy-eight patients who underwent ACL reconstruction by 8 surgeons had postoperative imaging with computed tomography, and ACL tunnel location and angulation were analyzed using 3-dimensional surface processing and measurement. Intersurgeon and intrasurgeon variability in ACL tunnel placement was analyzed. For intersurgeon variability, the range in mean ACL femoral tunnel depth between surgeons was 22%. For femoral tunnel height, there was a 19% range. Tibial tunnel location from anterior to posterior on the plateau had a 16% range in mean results. There was only a small range of 4% for mean tibial tunnel location from the medial to lateral dimension. For intrasurgeon variability, femoral tunnel depth demonstrated the largest ranges, and tibial tunnel location from medial to lateral on the plateau demonstrated the least variability. Overall, surgeons were relatively consistent within their own cases. Using applied measurement criteria, 85% of femoral tunnels and 90% of tibial tunnels fell within applied literature-based guidelines. Ninety-one percent of the axes of the femoral tunnels fell within the boundaries of the femoral footprint. The data demonstrate that surgeons performing ACL reconstructions are relatively consistent between each other. There is, however, variability of average tunnel placement up to 22% of mean condylar depth

  5. Inter-observer variability of visual analysis of "stress"-only adenosine first-pass myocardial perfusion imaging in relation to clinical experience and reading criteria

    NARCIS (Netherlands)

    Lubbers, D. D.; Kuijpers, D.; Bodewes, R.; Kappert, P.; Kerkhof, M.; van Ooijen, P. M. A.; Oudkerk, M.

    To assess the inter-observer agreement of adenosine "stress"-only visual analysis of perfusion MR images in relation to experience and reading criteria. 106 adenosine perfusion MR examinations out of 350, 46 consecutive positive examinations and 60 randomly selected negative examinations were

  6. The interrelationship between clinical and immunity variables in epilepsy

    Directory of Open Access Journals (Sweden)

    Kalinin Vladimir V.

    2016-12-01

    Full Text Available Introduction. The role of cellular immunity in the pathogenesis of epilepsy, as an interaction between immunity and clinical and neurobiological variables is not properly understood.

  7. Clinical characteristics and premorbid variables in childhoodonset ...

    African Journals Online (AJOL)

    Objective: To analyze clinical and demographic data of childhood-onset (12 years and younger) schizophrenia patients collected for a genetic study in schizophrenia, undertaken nationally in South Africa, using multiple parameters. Method: Patients with an onset of schizophrenia at 12 years or younger, were included.

  8. Variability of clinical features in attacks of migraine with aura

    DEFF Research Database (Denmark)

    Hansen, Jakob M; Goadsby, Peter J; Charles, Andrew C

    2016-01-01

    . CONCLUSION: These findings are consistent with variable involvement of different brain regions during a migraine attack. The variable occurrence of nausea, and phonophobia in conjunction with photophobia, both defining features of migraine, may be an important consideration in designing clinical studies......BACKGROUND: There is significant variability in the clinical presentation of migraine, both among patients, and between attacks in an individual patient. We examined clinical features of migraine with aura in a large group of patients enrolled in a clinical trial, and compared retrospective...... a detailed retrospective description of the clinical features of their attacks of migraine. During the trial, clinical symptoms in migraine attacks starting with aura were recorded prospectively in 861 attacks. RESULTS: Retrospectively reported visual aura symptoms were variable and often overlapping...

  9. Rainfall spatiotemporal variability relation to wetlands hydroperiods

    Science.gov (United States)

    Serrano-Hidalgo, Carmen; Guardiola-Albert, Carolina; Fernandez-Naranjo, Nuria

    2017-04-01

    Doñana natural space (Southwestern Spain) is one of the largest protected wetlands in Europe. The wide marshes present in this natural space have such ecological value that this wetland has been declared a Ramsar reserve in 1982. Apart from the extensive marsh, there are also small lagoons and seasonally flooded areas which are likewise essential to maintain a wide variety of valuable habitats. Hydroperiod, the length of time each point remains flooded along an annual cycle, is a critical ecological parameter that shapes aquatic plants and animals distribution and determines available habitat for many of the living organisms in the marshes. Recently, there have been published two different works estimating the hydroperiod of Doñana lagoons with Landsat Time Series images (Cifuentes et al., 2015; Díaz-Delgado et al., 2016). In both works the flooding cycle hydroperiod in Doñana marshes reveals a flooding regime mainly driven by rainfall, evapotranspiration, topography and local hydrological management actions. The correlation found between rainfall and hydroperiod is studied differently in both works. While in one the rainfall is taken from one raingauge (Cifuentes et al., 2015), the one performed by Díaz-Delgado (2016) uses annual rainfall maps interpolated with the inverse of the distance method. The rainfall spatiotemporal variability in this area can be highly significant; however the amount of this importance has not been quantified at the moment. In the present work the geostatistical tool known as spatiotemporal variogram is used to study the rainfall spatiotemporal variability. The spacetime package implemented in R (Pebesma, 2012) facilities its computation from a high rainfall data base of more than 100 raingauges from 1950 to 2016. With the aid of these variograms the rainfall spatiotemporal variability is quantified. The principal aim of the present work is the study of the relation between the rainfall spatiotemporal variability and the

  10. Unmodifiable variables related to thyroid cancer incidence

    Directory of Open Access Journals (Sweden)

    Cornelia Nitipir

    2018-04-01

    Full Text Available The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the most frequent age at presentation, the predominance of one sex over the other, the incidence of malignant thyroid disease, and the relative risk for each sex to develop thyroid carcinoma. The incidence of thyroid carcinoma was higher for women than for men, with a higher relative risk in the female subgroup. Incidence was also highest in the 50-60-year-old group. Given that studies show better survival for women and for younger patients, even when presenting with advanced disease, compared with older, male patients, such prognostic indicators should be a factor in the treatment decision.

  11. Handbook of latent variable and related models

    CERN Document Server

    Lee, Sik-Yum

    2011-01-01

    This Handbook covers latent variable models, which are a flexible class of models for modeling multivariate data to explore relationships among observed and latent variables.- Covers a wide class of important models- Models and statistical methods described provide tools for analyzing a wide spectrum of complicated data- Includes illustrative examples with real data sets from business, education, medicine, public health and sociology.- Demonstrates the use of a wide variety of statistical, computational, and mathematical techniques.

  12. Clinical Implications of Glucose Variability: Chronic Complications of Diabetes

    Directory of Open Access Journals (Sweden)

    Hye Seung Jung

    2015-06-01

    Full Text Available Glucose variability has been identified as a potential risk factor for diabetic complications; oxidative stress is widely regarded as the mechanism by which glycemic variability induces diabetic complications. However, there remains no generally accepted gold standard for assessing glucose variability. Representative indices for measuring intraday variability include calculation of the standard deviation along with the mean amplitude of glycemic excursions (MAGE. MAGE is used to measure major intraday excursions and is easily measured using continuous glucose monitoring systems. Despite a lack of randomized controlled trials, recent clinical data suggest that long-term glycemic variability, as determined by variability in hemoglobin A1c, may contribute to the development of microvascular complications. Intraday glycemic variability is also suggested to accelerate coronary artery disease in high-risk patients.

  13. Clinically related anatomy for physicists

    International Nuclear Information System (INIS)

    Wright, A.E.; Boyer, A.L.

    1987-01-01

    With the advent of CT and MR imaging, delineation of malignancies and the shaping of radiation treatment fields have become much more precise. Treatment planning in more than one transverse plane is more widely practiced as the use of sophisticated computers grow. These developments emphasize the need for the physicist to have a basic knowledge of human anatomy. This course is designed to familiarize the clinical physicist with the gross anatomy and topographic landmarks used by the physician in planning three-dimensional radiation treatment volumes. The significance of the various anatomic structures and their related lymphatics in the spread of disease is discussed. Emphasis is placed on disease entities that pose particular problems due to overlying or nearby healthy structures at risk

  14. Impact of demographic and clinical variables on the oral health-related quality of life among five-year-old children: a population-based study using self-reports.

    Science.gov (United States)

    Abanto, Jenny; Panico, Claudia; Bönecker, Marcelo; Frazão, Paulo

    2018-01-01

    Although SOHO-5 has been validated, there is no study testing this instrument in population-based samples. To evaluate the impact of demographic and oral clinical variables on the oral health-related quality of life (OHRQoL) in 5-year-old children from a socially deprived Brazilian area using selfreports. Data from 588 children were analyzed. Examinations included untreated dental caries and occlusal deviations. Children answered the Brazilian SOHO-5 version and interviewers collected demographic characteristics of the child (sex and skin color). Robust Poisson regression associated outcome and exposures. General, the oral impacts were reported by 71.1% of children. The mean and standard deviation total score of the Brazilian SOHO-5 were 3.51 and 3.82, respectively. Children with untreated dental caries (PR = 1.28; P = 0.004) and increased overjet (PR = 1.35; P = 0.002) experienced a worse OHRQoL. Dark and mixed skin color children did not have a good impact on their OHRQoL (PR = 1.53; P = 0.006 and PR = 1.44; P < 0.000, respectively) compared to light ones. Untreated dental caries and increased overjet were independently associated with worst OHRQoL in 5-year-old children. As an indication of social deprivation, dark and mixed skin color children compared to light ones presented higher probability for reporting worst OHRQoL independently of the oral clinical conditions. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Unmodifiable variables related to thyroid cancer incidence

    OpenAIRE

    Cornelia Nitipir; Lucian Alecu; Iulian Slavu; Raluca Tulin; Radu C. Jecan

    2018-01-01

    The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the...

  16. Review and classification of variability analysis techniques with clinical applications.

    Science.gov (United States)

    Bravi, Andrea; Longtin, André; Seely, Andrew J E

    2011-10-10

    Analysis of patterns of variation of time-series, termed variability analysis, represents a rapidly evolving discipline with increasing applications in different fields of science. In medicine and in particular critical care, efforts have focussed on evaluating the clinical utility of variability. However, the growth and complexity of techniques applicable to this field have made interpretation and understanding of variability more challenging. Our objective is to provide an updated review of variability analysis techniques suitable for clinical applications. We review more than 70 variability techniques, providing for each technique a brief description of the underlying theory and assumptions, together with a summary of clinical applications. We propose a revised classification for the domains of variability techniques, which include statistical, geometric, energetic, informational, and invariant. We discuss the process of calculation, often necessitating a mathematical transform of the time-series. Our aims are to summarize a broad literature, promote a shared vocabulary that would improve the exchange of ideas, and the analyses of the results between different studies. We conclude with challenges for the evolving science of variability analysis.

  17. Review and classification of variability analysis techniques with clinical applications

    Science.gov (United States)

    2011-01-01

    Analysis of patterns of variation of time-series, termed variability analysis, represents a rapidly evolving discipline with increasing applications in different fields of science. In medicine and in particular critical care, efforts have focussed on evaluating the clinical utility of variability. However, the growth and complexity of techniques applicable to this field have made interpretation and understanding of variability more challenging. Our objective is to provide an updated review of variability analysis techniques suitable for clinical applications. We review more than 70 variability techniques, providing for each technique a brief description of the underlying theory and assumptions, together with a summary of clinical applications. We propose a revised classification for the domains of variability techniques, which include statistical, geometric, energetic, informational, and invariant. We discuss the process of calculation, often necessitating a mathematical transform of the time-series. Our aims are to summarize a broad literature, promote a shared vocabulary that would improve the exchange of ideas, and the analyses of the results between different studies. We conclude with challenges for the evolving science of variability analysis. PMID:21985357

  18. Short-term Variability of Vitamin D-Related Biomarkers.

    Science.gov (United States)

    Lutsey, Pamela L; Parrinello, Christina M; Misialek, Jeffrey R; Hoofnagle, Andy N; Henderson, Clark M; Laha, Thomas J; Michos, Erin D; Eckfeldt, John H; Selvin, Elizabeth

    2016-12-01

    Quantifying the variability of biomarkers is important, as high within-person variability can lead to misclassification of individuals. Short-term variability of important markers of vitamin D metabolism is relatively unknown. A repeatability study was conducted in 160 Atherosclerosis Risk in Communities study participants (60% female, 28% black, mean age 76 years). Fasting serum was drawn at 2 time points, a median of 6 (range 3-13) weeks apart. Vitamin D binding protein (VDBP) and 25-hydroxyvitamin D [25(OH)D] were measured by LC-MS, fibroblast growth factor (FGF23) and parathyroid hormone (PTH) by enzyme-linked immunoassay, and calcium and phosphorus by Roche Cobas 6000. Free and bioavailable 25(OH)D were calculated. We calculated the within-person CV (CV W ), intraclass correlation coefficient (ICC), Spearman rank correlation coefficient (r), and percent reclassified. The CV W was lowest for calcium (2.0%), albumin (3.6%), 25(OH)D (6.9%), VDBP (7.0%) and phosphorus (7.6%); intermediate for free 25(OH)D (9.0%) and bioavailable 25(OH)D (9.9%); and highest for PTH (16.7%) and FGF23 (17.8%). Reclassification was highest for PTH, VDBP, and phosphorus (all 7.5%). The ICC and r were highest (≥0.80) for 25(OH)D, free 25(OH)D, bioavailable 25(OH)D and PTH, but somewhat lower (approximately 0.60-0.75) for the other biomarkers. Six-week short-term variability, as assessed by CV W , was quite low for VDBP, calcium and phosphorus, but fairly high for FGF23 and PTH. As such, multiple measurements of FGF23 and PTH may be needed to minimize misclassification. These results provide insight into the extent of potential misclassification of vitamin D markers in research and clinical settings. © 2016 American Association for Clinical Chemistry.

  19. Clinical polymorphism and variability in education of autistic children

    Directory of Open Access Journals (Sweden)

    Morozov S.A.Morozova T.I.

    2016-12-01

    Full Text Available Children with autism spectrum disorders are considered a highly heterogeneous group by clinical signs, which makes it impossible to develop a common method of correctional and educational development for them. In this article, results of an analysis of clinical, psychological and pedagogic polymorphism in autism spectrum disorders are shown, emphasized are its main components and basic consequences necessary for organizing education. Results are viewed in the context of the principle of variability in education. A dual structure of variability in education of autistic children has been discovered. Shortly reviewed are some topical problems of correctional education process for autism spectrum disorders

  20. Refractive error magnitude and variability: Relation to age.

    Science.gov (United States)

    Irving, Elizabeth L; Machan, Carolyn M; Lam, Sharon; Hrynchak, Patricia K; Lillakas, Linda

    2018-03-19

    To investigate mean ocular refraction (MOR) and astigmatism, over the human age range and compare severity of refractive error to earlier studies from clinical populations having large age ranges. For this descriptive study patient age, refractive error and history of surgery affecting refraction were abstracted from the Waterloo Eye Study database (WatES). Average MOR, standard deviation of MOR and astigmatism were assessed in relation to age. Refractive distributions for developmental age groups were determined. MOR standard deviation relative to average MOR was evaluated. Data from earlier clinically based studies with similar age ranges were compared to WatES. Right eye refractive errors were available for 5933 patients with no history of surgery affecting refraction. Average MOR varied with age. Children <1 yr of age were the most hyperopic (+1.79D) and the highest magnitude of myopia was found at 27yrs (-2.86D). MOR distributions were leptokurtic, and negatively skewed. The mode varied with age group. MOR variability increased with increasing myopia. Average astigmatism increased gradually to age 60 after which it increased at a faster rate. By 85+ years it was 1.25D. J 0 power vector became increasingly negative with age. J 45 power vector values remained close to zero but variability increased at approximately 70 years. In relation to comparable earlier studies, WatES data were most myopic. Mean ocular refraction and refractive error distribution vary with age. The highest magnitude of myopia is found in young adults. Similar to prevalence, the severity of myopia also appears to have increased since 1931. Copyright © 2018 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  1. Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study

    Directory of Open Access Journals (Sweden)

    Rakic JM

    2013-09-01

    < 0.0001. The mean visual acuity increase over baseline at 12 months was not significant (P = 0.08; the decline over baseline at 24 months statistically significant (P = 0.02. Overall, 94.3% of patients showed stable or improved disease at 6 months and 81.5% of patients showed stable or improved disease at 24 months. At 6 months, improvements over baseline were significant for VFQ-25 (P = 0.03 and HUI3 (P = 0.02, but not at 12 months and 24 months. Improvements in VFQ-25 and HUI3 were maintained at 24 months in 38% and 34% of patients, respectively. In total 78 serious adverse events were reported in 40 patients and 77 nonserious adverse events in 34 patients. Nine serious adverse events and nine nonserious adverse events in 14 patients were suspected to be related to ranibizumab treatment. Conclusion: The "real-world" clinical effectiveness of ranibizumab was evidenced by the initial improvements over baseline in visual acuity and quality of life, as well as the maintenance of these outcomes at baseline levels at 24 months, and this was observed under variable treatment conditions. The findings underscore the need for individualized treatment with regular monitoring to achieve optimal vision and quality of life outcomes. Keywords: ranibizumab, age-related macular degeneration, neovascular macular degeneration, visual acuity, visual function, quality of life

  2. Relationship between socio-demographic and clinical variables, and health-related quality of life in patients with inflammatory bowel disease Relación entre variables sociodemográficas y clínicas y calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal

    Directory of Open Access Journals (Sweden)

    B. López Blanco

    2005-12-01

    Full Text Available Objective: the principal aim of the present study is to evaluate the influence of socio-demographic and clinical variables on health-related quality of life (HRQL in patients with inflammatory bowel disease. Patients and method: this was a cross-sectional study. health-related quality of life was measured with the Inflammatory Bowel Disease Questionnaire (IBDQ. A total of 120 patients, 60 with ulcerative colitis and 60 with Crohn's disease, participated in the study. Results: no significant differences were observed between ulcerative colitis and Crohn's disease patients in IBDQ dimensions. However, a multivariate analysis revealed that sex, type of treatment, extraintestinal symptoms, number of relapses in previous year, satisfaction with surgery, and need for psychological support were related to HRQL. Conclusions: the identification of these variables associated with HRQL in patients with inflammatory bowel disease shows them to be basically non-disease factors. Knowledge of such elements can turn out to be very useful in order to guide future research and modify specific factors in further interventions.Objetivo: el objetivo principal del presente trabajo consiste en evaluar la influencia de las variables sociodemográficas y clínicas en la calidad de vida relacionada con la salud de los pacientes con enfermedad inflamatoria intestinal. Pacientes y método: se trata de un estudio transversal. La calidad de vida relacionada con la salud se investigó utilizando el "Inflammatory Bowel Disease Questionnaire" (IBDQ. Un total de 120 pacientes, 60 con colitis ulcerosa y 60 con enfermedad de Crohn participaron en el estudio. Resultados: no se apreciaron diferencias significativas en la calidad de vida relacionada con la salud en las dimensiones del IBDQ en función de la enfermedad, sin embargo, tras el análisis multivariante, el sexo, el tipo de tratamiento, las manifestaciones extradigestivas, el número de recaídas anual, la satisfacción con

  3. Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

    Science.gov (United States)

    Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

    2016-07-01

    The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Platelet Function Tests: Preanalytical Variables, Clinical Utility, Advantages, and Disadvantages.

    Science.gov (United States)

    Hvas, Anne-Mette; Grove, Erik Lerkevang

    2017-01-01

    Platelet function tests are mainly used in the diagnostic work-up of platelet disorders. During the last decade, the additional use of platelet function tests to evaluate the effect of antiplatelet therapy has also emerged in an attempt to identify patients with an increased risk of arterial thrombosis. Furthermore, platelet function tests are increasingly used to measure residual effect of antiplatelet therapy prior to surgery with the aim of reducing the risk of bleeding. To a limited extend, platelet function tests are also used to evaluate hyperaggregability as a potential marker of a prothrombotic state outside the setting of antiplatelet therapy. This multifaceted use of platelet function tests and the development of simpler point-of-care tests with narrower application have increased the use of platelet function testing and also facilitated the use of platelet function tests outside the highly specialized laboratories. The present chapter describes the preanalytical variables, which should be taken into account when planning platelet function testing. Also, the most widely used platelet function tests are introduced, and their clinical utility and their relative advantages and disadvantages are discussed.

  5. Preliminary evaluations related to the ranges of hematological and biochemical variables in hospitalized patients with stroke

    Directory of Open Access Journals (Sweden)

    Ahmad Chitsaz

    2013-01-01

    Conclusions: Any considerable alter in patients′ biochemical and hematological figures (BS, Hgb, Plt and Lymph may necessitate further attention related to inter- and intra-individual variability in clinical supervision and drug′s assortment. Therefore, success in treatment could be achieved by the close management of clinical, biochemical, hematological, and pharmacological manifestation. To reduce disability, mortality, and morbidity in Iranian stroke population further clinical studies are needed to correlate drugs and laboratory markers to associated clinical events in order.

  6. Golden Era of Cataclysmic Variables and Related Objects: concluding remarks

    Czech Academy of Sciences Publication Activity Database

    Hudec, René

    2012-01-01

    Roč. 83, č. 2 (2012), s. 883-890 ISSN 0037-8720. [Workshop on the golden age of cataclysmic variables and related objects /2./. Palermo , 09.09.2013-14.09.2013] R&D Projects: GA ČR GA205/08/1207 Institutional research plan: CEZ:AV0Z10030501 Keywords : stars * variable stars * cataclysmic variables Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics

  7. Low heart rate variability in patients with clinical burnout.

    Science.gov (United States)

    Lennartsson, Anna-Karin; Jonsdottir, Ingibjörg; Sjörs, Anna

    2016-12-01

    Several studies have shown that acute psychosocial stress and chronic psychosocial stress reduce heart rate variability (HRV). It is likely that individuals suffering from burnout have reduced HRV, as a consequence of the long-term stress exposure. This study investigated HRV in 54 patients with clinical burnout (40 women and 14 men) and in 55 individuals reporting low burnout scores (healthy; 24 women and 31 men) and 52 individuals reporting high burnout scores (non-clinical burnout; 33 women and 19 men). The participants underwent a 300s ECG recording in the supine position. Standard deviation of normal R-R intervals (SDNN) and the root mean square of successive normal interval differences (RMSSD) were derived from time domain HRV analysis. Frequency domain HRV measures; total power (TP), low frequency power (LF), high frequency power (HF), and LF/HF ratio were calculated. All HRV measures, except LF/HF ratio, were lower in the clinical burnout patients compared to both the non-clinical burnout group and the healthy group. The difference was larger between the patients and the healthy group than between the patients and the non-clinical burnout group. HRV did not differ significantly between the non-clinical burnout group and the healthy group. Low HRV in burnout patients may constitute one of the links to associated adverse health, since low HRV reflects low parasympathetic activity - and accordingly low anabolic/regenerative activity. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Variability of CSF Alzheimer's disease biomarkers: implications for clinical practice.

    Directory of Open Access Journals (Sweden)

    Stephanie J B Vos

    Full Text Available BACKGROUND: Cerebrospinal fluid (CSF biomarkers are increasingly being used for diagnosis of Alzheimer's disease (AD. OBJECTIVE: We investigated the influence of CSF intralaboratory and interlaboratory variability on diagnostic CSF-based AD classification of subjects and identified causes of this variation. METHODS: We measured CSF amyloid-β (Aβ 1-42, total tau (t-tau, and phosphorylated tau (p-tau by INNOTEST enzyme-linked-immunosorbent assays (ELISA in a memory clinic population (n = 126. Samples were measured twice in a single or two laboratories that served as reference labs for CSF analyses in the Netherlands. Predefined cut-offs were used to classify CSF biomarkers as normal or abnormal/AD pattern. RESULTS: CSF intralaboratory variability was higher for Aβ1-42 than for t-tau and p-tau. Reanalysis led to a change in biomarker classification (normal vs. abnormal of 26% of the subjects based on Aβ1-42, 10% based on t-tau, and 29% based on p-tau. The changes in absolute biomarker concentrations were paralleled by a similar change in levels of internal control samples between different assay lots. CSF interlaboratory variability was higher for p-tau than for Aβ1-42 and t-tau, and reanalysis led to a change in biomarker classification of 12% of the subjects based on Aβ1-42, 1% based on t-tau, and 22% based on p-tau. CONCLUSIONS: Intralaboratory and interlaboratory CSF variability frequently led to change in diagnostic CSF-based AD classification for Aβ1-42 and p-tau. Lot-to-lot variation was a major cause of intralaboratory variability. This will have implications for the use of these biomarkers in clinical practice.

  9. Clinical Trials With Large Numbers of Variables: Important Advantages of Canonical Analysis.

    Science.gov (United States)

    Cleophas, Ton J

    2016-01-01

    Canonical analysis assesses the combined effects of a set of predictor variables on a set of outcome variables, but it is little used in clinical trials despite the omnipresence of multiple variables. The aim of this study was to assess the performance of canonical analysis as compared with traditional multivariate methods using multivariate analysis of covariance (MANCOVA). As an example, a simulated data file with 12 gene expression levels and 4 drug efficacy scores was used. The correlation coefficient between the 12 predictor and 4 outcome variables was 0.87 (P = 0.0001) meaning that 76% of the variability in the outcome variables was explained by the 12 covariates. Repeated testing after the removal of 5 unimportant predictor and 1 outcome variable produced virtually the same overall result. The MANCOVA identified identical unimportant variables, but it was unable to provide overall statistics. (1) Canonical analysis is remarkable, because it can handle many more variables than traditional multivariate methods such as MANCOVA can. (2) At the same time, it accounts for the relative importance of the separate variables, their interactions and differences in units. (3) Canonical analysis provides overall statistics of the effects of sets of variables, whereas traditional multivariate methods only provide the statistics of the separate variables. (4) Unlike other methods for combining the effects of multiple variables such as factor analysis/partial least squares, canonical analysis is scientifically entirely rigorous. (5) Limitations include that it is less flexible than factor analysis/partial least squares, because only 2 sets of variables are used and because multiple solutions instead of one is offered. We do hope that this article will stimulate clinical investigators to start using this remarkable method.

  10. Genetic variability of genital mycoplasmas and its clinical value

    Directory of Open Access Journals (Sweden)

    K. I. Plakhova

    2015-01-01

    Full Text Available The article presents data on genetic variability of genital mycoplasmas. The author presents the results of genetic variability studies for M. hominis, gene vaa, U. parvum, gene mba, and M. genitalium, gene mg192, sampled from women with different clinical manifestations of inflammatory diseases of the urogenital system. Based on the molecular typing results for 138 samples of genital mycoplasmas, the author revealed a relationship between clinical manifestations of inflammatory diseases of the urogenital system caused by U. parvum and different U. parvum serovars as well as different genetic variations of M. hominis.Infection with 6 U. parvum serovar results in the development of inflammatory diseases of the urogenital tract accompanied by subjective manifestations (р < 0.05. Genetic variant II of М. hominis was revealed more often in patients with clinical manifestations of inflammatory diseases while variant I was revealed more often in patients infected with М. hominis without any signs of inflammation (р < 0.05. Genetic variants of M. genitalium were determined; no significant differences in terms of their prevalence in the examined patients were revealed.

  11. Changes in sleep polygraphic variables and clinical state in depressed patients during treatment with citalopram

    NARCIS (Netherlands)

    Bemmel, Alex L. van; Hoofdakker, Rutger H. van den; Beersma, Domien G.M.; Bouhuys, Antoinette L.

    1993-01-01

    Drug-induced improvement of depression may be mediated by changes in sleep physiology. The aim of this study was to relate changes in sleep polygraphic variables to clinical state during treatment with citalopram, a highly specific serotonin uptake inhibitor. Sixteen patients took part. The study

  12. Causal Relationship Between Relative Price Variability and Inflation in Turkey:

    Directory of Open Access Journals (Sweden)

    Nebiye Yamak

    2016-09-01

    Full Text Available This study investigates the causal relationship between inflation and relative price variability in Turkey for the period of January 2003-January 2014, by using panel data. In the study, a Granger (1969 non-causality test in heterogeneous panel data models developed by Dumitrescu and Hurlin (2012 is utilized to determine the causal relations between inflation rate relative price variability. The panel data consists of 4123 observations: 133 time observations and 31 cross-section observations. The results of panel causality test indicate that there is a bidirectional causality between inflation rate and relative price variability by not supporting the imperfection information model of Lucas and the menu cost model of Ball and Mankiw.

  13. [Relations between biomedical variables: mathematical analysis or linear algebra?].

    Science.gov (United States)

    Hucher, M; Berlie, J; Brunet, M

    1977-01-01

    The authors, after a short reminder of one pattern's structure, stress on the possible double approach of relations uniting the variables of this pattern: use of fonctions, what is within the mathematical analysis sphere, use of linear algebra profiting by matricial calculation's development and automatiosation. They precise the respective interests on these methods, their bounds and the imperatives for utilization, according to the kind of variables, of data, and the objective for work, understanding phenomenons or helping towards decision.

  14. Quantum teleportation for continuous variables and related quantum information processing

    International Nuclear Information System (INIS)

    Furusawa, Akira; Takei, Nobuyuki

    2007-01-01

    Quantum teleportation is one of the most important subjects in quantum information science. This is because quantum teleportation can be regarded as not only quantum information transfer but also a building block for universal quantum information processing. Furthermore, deterministic quantum information processing is very important for efficient processing and it can be realized with continuous-variable quantum information processing. In this review, quantum teleportation for continuous variables and related quantum information processing are reviewed from these points of view

  15. Input-variable sensitivity assessment for sediment transport relations

    Science.gov (United States)

    Fernández, Roberto; Garcia, Marcelo H.

    2017-09-01

    A methodology to assess input-variable sensitivity for sediment transport relations is presented. The Mean Value First Order Second Moment Method (MVFOSM) is applied to two bed load transport equations showing that it may be used to rank all input variables in terms of how their specific variance affects the overall variance of the sediment transport estimation. In sites where data are scarce or nonexistent, the results obtained may be used to (i) determine what variables would have the largest impact when estimating sediment loads in the absence of field observations and (ii) design field campaigns to specifically measure those variables for which a given transport equation is most sensitive; in sites where data are readily available, the results would allow quantifying the effect that the variance associated with each input variable has on the variance of the sediment transport estimates. An application of the method to two transport relations using data from a tropical mountain river in Costa Rica is implemented to exemplify the potential of the method in places where input data are limited. Results are compared against Monte Carlo simulations to assess the reliability of the method and validate its results. For both of the sediment transport relations used in the sensitivity analysis, accurate knowledge of sediment size was found to have more impact on sediment transport predictions than precise knowledge of other input variables such as channel slope and flow discharge.

  16. Discovering Related Clinical Concepts Using Large Amounts of Clinical Notes.

    Science.gov (United States)

    Ganesan, Kavita; Lloyd, Shane; Sarkar, Vikren

    2016-01-01

    The ability to find highly related clinical concepts is essential for many applications such as for hypothesis generation, query expansion for medical literature search, search results filtering, ICD-10 code filtering and many other applications. While manually constructed medical terminologies such as SNOMED CT can surface certain related concepts, these terminologies are inadequate as they depend on expertise of several subject matter experts making the terminology curation process open to geographic and language bias. In addition, these terminologies also provide no quantifiable evidence on how related the concepts are. In this work, we explore an unsupervised graphical approach to mine related concepts by leveraging the volume within large amounts of clinical notes. Our evaluation shows that we are able to use a data driven approach to discovering highly related concepts for various search terms including medications, symptoms and diseases.

  17. Discovering Related Clinical Concepts Using Large Amounts of Clinical Notes

    Directory of Open Access Journals (Sweden)

    Kavita Ganesan

    2016-01-01

    Full Text Available The ability to find highly related clinical concepts is essential for many applications such as for hypothesis generation, query expansion for medical literature search, search results filtering, ICD-10 code filtering and many other applications. While manually constructed medical terminologies such as SNOMED CT can surface certain related concepts, these terminologies are inadequate as they depend on expertise of several subject matter experts making the terminology curation process open to geographic and language bias. In addition, these terminologies also provide no quantifiable evidence on how related the concepts are. In this work, we explore an unsupervised graphical approach to mine related concepts by leveraging the volume within large amounts of clinical notes. Our evaluation shows that we are able to use a data driven approach to discovering highly related concepts for various search terms including medications, symptoms and diseases.

  18. Which clinical variable influences health-related quality of life the most after spontaneous subarachnoid hemorrhage? Hunt and Hess scale, Fisher score, World Federation of Neurosurgeons score, Brussels coma score, and Glasgow coma score compared.

    Science.gov (United States)

    Kapapa, Thomas; Tjahjadi, Martin; König, Ralph; Wirtz, Christian Rainer; Woischneck, Dieter

    2013-12-01

    To determine the strength of the correlation between the Hunt and Hess scale, Fisher score, Brussels coma score, World Federation of Neurosurgeons score, and Glasgow coma score and health-related quality of life. Evaluable questionnaires from 236 patients (5.6 years [± standard deviation, 2.854 years] on average after hemorrhage) were included in the analysis. Quality of life was documented using the MOS-36 item short form health survey. Because of the ordinal nature of the variables, Kendall tau was used for calculation. Significance was established as P ≤ 0.05. Weak and very weak correlations were found in general (r ≤ 0.28). The strongest correlations were found between the Glasgow coma score and quality of life (r = 0.236, P = 0.0001). In particular, the "best verbal response" achieved the strongest correlations in the comparison, at r = 0.28/P = 0.0001. The Fisher score showed very weak correlations (r = -0.148/P = 0.012). The Brussels coma score (r = -0.216/P = 0.0001), Hunt and Hess scale (r = -0.197/P = 0.0001), and the World Federation of Neurosurgeons score (r = -0.185/P = 0.0001) revealed stronger correlations, especially in terms of the physical aspects of quality of life. The Glasgow coma scale revealed the strongest, and the Fisher score showed the weakest correlations. Thus the Fisher score, as an indicator of the severity of a hemorrhage, has little significance in terms of health-related quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Relative Influence Of Sociodemographic Variables On Oral Health ...

    African Journals Online (AJOL)

    This paper reports the results of a study to investigate the relative influence of some sociodemographic variables on oral hygiene and health of primary school children in Ibadan, Nigeria. The pupils were from two different socioeconomic strata of the society and their ages ranged between 7 and 16 years. They were ...

  20. Lie-theoretic generating relations of two variable Laguerre polynomials

    International Nuclear Information System (INIS)

    Khan, Subuhi; Yasmin, Ghazala

    2002-07-01

    Generating relations involving two variable Lagneire polynonuals L n (x, y) are derived. The process involves the construction of a three dimensional Lie algebra isomorphic to special linear algebra sl(2) with the help of Weisner's method by giving suitable interpretations to the index n of the polynomials L n (x, y). (author)

  1. Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation.

    Science.gov (United States)

    Baslaim, Muna M; Khayat, Hind A; Al-Amoudi, Shefaa A

    2007-08-01

    Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease that presents with variable local manifestations. We describe here the different management protocols based on the clinical presentation of these patients. A retrospective review of 20 histopathologic confirmed cases of IGM seen over a period of 10 years was performed. The median age was 34 years (age range: 21-45 years). All were married, parous with history of breast feeding. Ill-defined mass mimicking carcinoma was the commonest presentation (70%); however, with the presence of signs of inflammation like pain (55%), redness (40%), and peau d'orange (40%), an inflammatory process appeared more likely. Axillary lymph node enlargement was infrequently seen (40%). Radiologic findings (mammography and ultrasound) were nonspecific. Histopathology showed the characteristic lobular distribution of granulomatous inflammation in all cases. Surgically, 7 patients had abscess drainage with open biopsy, and 7 patients had lumpectomy. Six patients with diffuse breast involvement were diagnosed by core needle biopsy only. Microbial cultures showed no growth. Antibiotics were given empirically when signs of inflammation where present. Two patients needed further abscess drainage followed by persistent sinus excision 3-6 weeks later. The median follow-up was 24 months (range: 15-42 months). Seventeen patients (85%) were recurrence-free, and 3 patients (15%) were lost to follow-up. Management of IGM cases needs to be tailored according to the clinical presentation. Precise radiologic and pathologic data interpretation by a multidisciplinary breast team will facilitate diagnosis and minimize unnecessary intervention.

  2. Chaos resulting from nonlinear relations between different variables

    International Nuclear Information System (INIS)

    Dohtani, Akitaka

    2011-01-01

    Research highlights: → We prove a general result on the existence of chaos. → We focus on the cyclic composites of interdependent relations between different variables. → By considering several examples, we conclude that the cyclic composites play an important role in detecting chaotic dynamics. - Abstract: In this study, we further develop the perturbation method of Marotto and investigate the general mechanisms responsible for nonlinear dynamics, which are typical of multidimensional systems. We focus on the composites of interdependent relations between different variables. First, we prove a general result on chaos, which shows that the cyclic composites of nonlinear interdependent relations are sources of chaotic dynamics in multidimensional systems. By considering several examples, we conclude that the cyclic composites play an important role in detecting chaotic dynamics.

  3. Nature Relation Between Climatic Variables and Cotton Production

    Directory of Open Access Journals (Sweden)

    Zakaria M. Sawan

    2014-08-01

    Full Text Available This study investigated the effect of climatic variables on flower and boll production and retention in cotton (Gossypium barbadense. Also, this study investigated the relationship between climatic factors and production of flowers and bolls obtained during the development periods of the flowering and boll stage, and to determine the most representative period corresponding to the overall crop pattern. Evaporation, sunshine duration, relative humidity, surface soil temperature at 1800 h, and maximum air temperature, are the important climatic factors that significantly affect flower and boll production. The least important variables were found to be surface soil temperature at 0600 h and minimum temperature. There was a negative correlation between flower and boll production and either evaporation or sunshine duration, while that correlation with minimum relative humidity was positive. Higher minimum relative humidity, short period of sunshine duration, and low temperatures enhanced flower and boll formation.

  4. Impact of menstruation on select hematology and clinical chemistry variables in cynomolgus macaques.

    Science.gov (United States)

    Perigard, Christopher J; Parrula, M Cecilia M; Larkin, Matthew H; Gleason, Carol R

    2016-06-01

    In preclinical studies with cynomolgus macaques, it is common to have one or more females presenting with menses. Published literature indicates that the blood lost during menses causes decreases in red blood cell mass variables (RBC, HGB, and HCT), which would be a confounding factor in the interpretation of drug-related effects on clinical pathology data, but no scientific data have been published to support this claim. This investigation was conducted to determine if the amount of blood lost during menses in cynomolgus macaques has an effect on routine hematology and serum chemistry variables. Ten female cynomolgus macaques (Macaca fascicularis), 5 to 6.5 years old, were observed daily during approximately 3 months (97 days) for the presence of menses. Hematology and serum chemistry variables were evaluated twice weekly. The results indicated that menstruation affects the erythrogram including RBC, HGB, HCT, MCHC, MCV, reticulocyte count, RDW, the leukogram including neutrophil, lymphocyte, and monocyte counts, and chemistry variables, including GGT activity, and the concentrations of total proteins, albumin, globulins, and calcium. The magnitude of the effect of menstruation on susceptible variables is dependent on the duration of the menstrual phase. Macaques with menstrual phases lasting ≥ 7 days are more likely to develop changes in variables related to chronic blood loss. In preclinical toxicology studies with cynomolgus macaques, interpretation of changes in several commonly evaluated hematology and serum chemistry variables requires adequate clinical observation and documentation concerning presence and duration of menses. There is a concern that macaques with long menstrual cycles can develop iron deficiency anemia due to chronic menstrual blood loss. © 2016 American Society for Veterinary Clinical Pathology.

  5. Frecuencia de la hipertensión arterial y su relación con algunas variables clínicas en pacientes con diabetes mellitus tipo 2 High blood pressure frequency and its relation to some clinical variables in patients diagnosed with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Eduardo Valdés Ramos

    2009-12-01

    Full Text Available Se realizó un estudio descriptivo transversal con 300 pacientes diabéticos tipo 2 ingresados en el Centro de Atención al Diabético de Bayamo, Granma, en el período comprendido entre octubre de 2007 y mayo de 2008, con el objetivo de conocer la frecuencia de hipertensión arterial y su relación con algunas variables clínicas en estos casos. Se revisaron las historias clínicas de cada uno de ellos para obtener datos de los aspectos siguientes: edad, sexo, color de la piel, hábitos tóxicos, edad al comienzo de la diabetes, estado nutricional, circunferencia de la cintura, tensión arterial y complicaciones crónicas de la diabetes. Se encontró hipertensión arterial en 210 pacientes (70 %; de ellos, 57 (27,1 % presentaron hipertensión sistólica aislada, 39 (18,5 % hipertensión diastólica, y 114 (54,4 % hipertensión sistodiastólica. La hipertensión arterial se presentó desde el inicio de la diabetes en el 62,9 %. El 76,1 % de los pacientes hipertensos tenían sobrepeso u obesidad (P=0,0557. Resultó significativa la asociación entre la hipertensión arterial y la cardiopatía isquémica (p= 0,0117. En relación con el ictus y la insuficiencia arterial periférica, aunque la mayoría de los casos eran hipertensos, no llegó a ser estadísticamente significativo (p= 0,8261, p= 0,8600. El 71,1 % de los pacientes con retinopatía diabética y el 75 % con nefropatía diabética eran hipertensos (p= 0,8261, p= 0,8600. Se concluye que la hipertensión arterial tiene una elevada incidencia en los pacientes con diabetes mellitas tipo 2, porque está presente en un porcentaje importante desde el diagnóstico de la diabetes y se asocia significativamente a la presencia de cardiopatía isquémica.A cross-sectional and descriptive study was conducted in 300 patients with type 2 diabetes admitted in Diabetes Care Center of Bayamo, Granma province between October, 2007 and May, 2008 to know the high blood pressure frequency and its relation to

  6. Las complicaciones macrovasculares y su relación con algunas variables clínicas y bioquímicas en diabéticos tipo 2 The macrovascular complications and its relation to some clinical and biochemical variables in type 2 diabetes patients

    Directory of Open Access Journals (Sweden)

    Eduardo Valdés Ramos

    2010-12-01

    Full Text Available OBJETIVO: determinar la frecuencia de macroangiopatía diabética, así como su relación con algunas variables clínicas y bioquímicas en diabéticos tipo 2 (DM 2. MÉTODOS: se realizó un estudio transversal y descriptivo con 438 pacientes DM 2 ingresados en el Centro de Atención al Diabético de Bayamo, Granma, en el período comprendido desde octubre de 2007 a diciembre de 2008. Las variables utilizadas fueron: edad, sexo, color de la piel, consumo de tabaco y alcohol, tiempo de evolución de la diabetes, peso, talla, circunferencia de la cintura, tensión arterial, niveles séricos de colesterol y triglicéridos, así como la presencia de complicaciones macrovasculares de la diabetes. Los sujetos se dividieron en 2 grupos: con macroangiopatía y sin macroangiopatía. RESULTADOS: de los 438 pacientes DM 2 estudiados, 107 (24,4 % tenían algún tipo de macroangiopatía. Predominó la insuficiencia arterial periférica en 67 casos (15,3 %, seguido de la cardiopatía isquémica con 52 (11,8 % y el ictus con 4 (0,9 %. En 16 casos se presentó más de una complicación. Resultó significativa la asociación entre la edad (p=0,0000, el tiempo de evolución de la diabetes (p=0,0000, la hipertensión arterial sistólica (p=0,0361, el colesterol (p=0,0000 y los triglicéridos (p=0,0000, con el desarrollo de macroangiopatía. Los pacientes DM 2 con síndrome metabólico presentaron 4,31 veces más probabilidades de desarrollar cardiopatía isquémica, que aquellos que no lo tenían (p=0,0388. CONCLUSIONES: la frecuencia de complicaciones cardiovasculares en los pacientes con DM 2 en nuestro medio es elevada y se asocia a la edad, el tiempo de evolución de la diabetes, la hipertensión arterial y con los altos niveles de colesterol y triglicéridos. El síndrome metabólico incrementa el riesgo de cardiopatía isquémica en los pacientes con DM 2.OBJETIVE: to determine the diabetic macroangiopathy frequency, as well as its relation to some clinical

  7. [Orofacial clinical manifestations in adult patients with variable common immunodeficiency].

    Science.gov (United States)

    Chávez-García, Aurora Alejandra; Moreno-Alba, Miguel Ángel; Elizalde-Monroy, Martín; Segura-Méndez, Nora Hilda; Romero-Flores, Jovita; Cambray-Gutiérrez, Julio César; López-Pérez, Patricia; Del Rivero-Hernández, Leonel Gerardo

    2015-01-01

    Common variable immunodeficiency is the primary immunodeficiency (CVID) frequently found in adults. Its prevalence is estimated from 1:25,000 to 75,000 alive newborns; there are variations by ethnic groups, it is estimated about 50-70% in Caucasian patients. Oral cavity lesions are rarely found in adult patients with CVID, there are reports about lesions on pediatric patients mostly caused by infections. To describe the orofacial lesions (oral, maxillofacial and neck area) affecting adults with CVID. A transversal, prospective study was done in patients with CVID attended at Specialties Hospital, CMN SXXI, Mexico City. Patients where examined by the oral and maxillofacial surgeon and clinical findings were reported, then the descriptive analysis of the lesions was done. We evaluated 26 patients, 16 female and 10 males, average age of 38.6 years. In 18/26 patients we found oral lesions on 7 different types. The most frequent was minor salivary glands hiperplasia (19/26),petechiae (12/26) and herpetic ulcers (7/26). In head and neck, we found 4 different lesions, the most common was lymphadenopathy <2cm (4/26). The immunologic alterations associated to CVID favors the development of lesions mainly of infectious and probably autoinmune origin that affects the oral cavity and head and neck area.

  8. Clinical Characteristics and Genetic Variability of Human Rhinovirus in Mexico

    Directory of Open Access Journals (Sweden)

    Hilda Montero

    2012-01-01

    Full Text Available Human rhinovirus (HRV is a leading cause of acute respiratory infection (ARI in young children and infants worldwide and has a high impact on morbidity and mortality in this population. Initially, HRV was classified into two species: HRV-A and HRV-B. Recently, a species called HRV-C and possibly another species, HRV-D, were identified. In Mexico, there is little information about the role of HRV as a cause of ARI, and the presence and importance of species such as HRV-C are not known. The aim of this study was to determine the clinical characteristics and genetic variability of HRV in Mexican children. Genetic characterization was carried out by phylogenetic analysis of the 5′-nontranslated region (5′-NTR of the HRV genome. The results show that the newly identified HRV-C is circulating in Mexican children more frequently than HRV-B but not as frequently as HRV-A, which was the most frequent species. Most of the cases of the three species of HRV were in children under 2 years of age, and all species were associated with very mild and moderate ARI.

  9. Clinical and Immunological Features of Common Variable Immunodeficiency in China

    Directory of Open Access Journals (Sweden)

    Lian-Jun Lin

    2015-01-01

    Full Text Available Background: Common variable immunodeficiency (CVID is one of the most common symptomatic primary immunodeficiency syndromes. The purpose of this article was to broaden our knowledge about CVID for better diagnosis and treatment. Methods: Clinical and immunological features of 40 Chinese patients with CVID were analyzed retrospectively. Results: The median age at onset was 11-year-old (range 4-51 years. The median age at diagnosis was 14.5-year-old (range 5-66 years. The average time of delay in diagnosis was 5.3 years (range 1-41 years. The most common main complaint was fever due to infections (35 cases, 87.5%. Pneumonia (28 cases, 70% was the most common type of infections. Bronchiectasis was present in 6 patients (15%. Autoimmune disease was detected in 6 cases of CVID, and malignancy in 2 cases. The median total serum levels of IgG, IgA, and IgM at diagnosis were 1.07 g/L, 0.07 g/L, and 0.28 g/L, respectively. The percentages of CD3− /CD19 + B-cells were 1%-3.14%. Conclusions: Infection is the most frequent presentation of CVID. Patients with unexplainable infections should receive further examination including serum immunoglobulin (Ig and lymphocyte subset analysis. Regular and sufficient substitution with Ig is recommended.

  10. Observing cataclysmic variables and related objects with different techniques

    Czech Academy of Sciences Publication Activity Database

    Šimon, Vojtěch

    2012-01-01

    Roč. 83, č. 2 (2012), s. 675-682 ISSN 0037-8720. [Workshop on the golden age of cataclysmic variables and related objects /2./. Palermo , 09.09.2013-14.09.2013] R&D Projects: GA ČR GA205/08/1207 Institutional research plan: CEZ:AV0Z10030501 Keywords : X-rays * binaries * circumstellar matter Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics

  11. [Jealousy in close relationships: personal, relational and situational variables].

    Science.gov (United States)

    Demirtaş, H Andaç; Dönmez, Ali

    2006-01-01

    In this study, the effects of personal, situational, and relational variables (such as age, gender, gender role orientation, duration of relationship, relational satisfaction, and physical attractiveness of the partner) on jealousy are investigated. A sample of 454 individuals currently involved in dating or marital relationships (48 % married, 52 % unmarried) completed the Romantic Jealousy Questionnaire, Bem Sex Role Inventory, and Rosenberg Self-Esteem Scale. Stepwise regression analyses and 2 (gender) x2 (gender role orientation) x2 (relational type) ANOVA's were submitted for analyzing the data. Analysis indicated that unmarried people reported higher levels of jealousy than married people (F1-446 = 5.029). Married women reported less jealousy than unmarried women and married women reported more jealousy than married men. Age, relational satisfaction level, expectation level about the duration of the relationship, and physical attractiveness of the partner were unique predictors of the reported level of jealousy (R2 = 0.12; adjusted R2 = 0.11; P physical, emotional, and cognitive responses to jealousy compared to men. Women used more constructive (F1-446 = 6.27) and less destructive strategies than men (F1-446 = 6.27). Unmarried people used more destructive strategies than married people (F1-446 = 3.84). Age, self-esteem, and the duration of the relationship were unique predictors of coping strategies. The present study revealed that jealousy was a multidimensional variable. In particular, relational type, self-esteem, age, relational satisfaction, and sex are highly correlated with jealousy.

  12. [Blood pressure variability: clinical interest or simple curiosity?].

    Science.gov (United States)

    Ciaroni, Stefano

    2007-03-14

    Blood pressure variability is a physiological phenomenon influenced by many internal and external factors. This variability could be also influenced by pathological conditions such as arterial hypertension. Two forms must be mainly distinguished: the blood pressure variability at long and short-term. The latter could only be studied by continuous recordings. In this article will be analysed the interest of measuring blood pressure variability, its cardiovascular prognosis and the therapeutic tools when it is increased.

  13. Fluctuation relations with intermittent non-Gaussian variables.

    Science.gov (United States)

    Budini, Adrián A

    2011-12-01

    Nonequilibrium stationary fluctuations may exhibit a special symmetry called fluctuation relations (FRs). Here, we show that this property is always satisfied by the subtraction of two random and independent variables related by a thermodynamiclike change of measure. Taking one of them as a modulated Poisson process, it is demonstrated that intermittence and FRs are compatible properties that may coexist naturally. Strong non-Gaussian features characterize the probability distribution and its generating function. Their associated large deviation functions develop a "kink" at the origin and a plateau regime respectively. Application of this model in different stationary nonequilibrium situations is discussed.

  14. Hyperthyroidism in adults: variable clinical presentations and approaches to diagnosis.

    Science.gov (United States)

    Knudson, P B

    1995-01-01

    Hyperthyroidism is a disease that has various symptoms and can present in many ways. In the elderly patient hyperthyroidism often is not expressed in the classical manner. A case report of a middle-aged man who had hyperthyroidism with only one symptom is detailed. A literature review utilizing MEDLINE files from 1988 to the present, as well as current textbooks of medicine and endocrinology, was used to prepare this report. Keywords for the search were "hyperthyroidism," "symptoms," "unintentional weight loss," and "differential diagnosis." The clinical presentation of hyperthyroidism can vary from almost asymptomatic to apathetic in appearance to a marked hyperdynamic physiologic response. Family physicians must be well informed of this variation in disease expression. Overlooking the diagnosis of this relatively easily treated condition can be detrimental to patient care and expensive.

  15. [Mother-newborn relational risk - Study of prevalence and associated variables].

    Science.gov (United States)

    Muñoz, Maribel; Poo, Ana María; Baeza, Bernardita; Bustos, M Luis

    2015-01-01

    Clinical evidence reveals the importance of mother-newborn bonding experience for health promoting and maintenance of human life. If the newborn lacks care and affection, she/he may develop an attachment disorder. A predictive scale regarding the risk of mothernewborn relationships is available, which makes possible an early intervention to prevent the development of relational disorders. The aim of this study is to apply the Kimelman measurement scale to determine the relational risk in mother-newborn pairs, as well as the prevalence and the associated biopsychosocial variables. A cross-sectional study with a probabilistic sample of 333 mother-infant pairs in postpartum maternity at Temuco hospital. The Kimelman mother-newborn attachment assessment guide was used. Biopsychosocial variables were obtained from the mothers studied. The association of biopsychosocial variables with relational risk was analyzed using OR and confidence intervals of 95%. The prevalence of high relational risk was 43.8%. The associated biopsychosocial variables included, women with no steady partner, single parent, teenage mothers, unwanted and unplanned pregnancy. Almost half of the mothers were in the high risk group. Early identification of relational risk and its related variables could help in the intervention in this vulnerable group. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  16. The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection

    Directory of Open Access Journals (Sweden)

    Jung Lim Byun

    2010-02-01

    Full Text Available Purpose : To evaluate the significance of clinical signs and laboratory findings as predictors of renal parenchymal lesions and vesicoureteral reflux (VUR in childhood urinary tract infection (UTI. Methods : From July 2005 to July 2008, 180 patients admitted with a first febrile UTI at the Pediatric Department of Konkuk University Hospital were included in this study. The following were the clinical variables: leukocytosis, elevated C-reactive protein (CRP, positive urine nitrite, positive urine culture, and fever duration both before and after treatment. We evaluated the relationships between clinical variables and dimercaptosuccinic acid (DMSA scan and voiding cystourethrography (VCUG results. Results : VCUG was performed in 148 patients; of them, 37 (25.0% had VUR: 18 (12.2% had low-grade (I-II VUR, and 19 (10.5% had high-grade (III-V VUR. Of the 95 patients who underwent DMSA scanning, 29 (30.5% had cortical defects, of which 21 (63.6% had VUR: 10 (30.3%, low-grade (I-II VUR; and 11 (33.3%, high-grade VUR. Of the 57 patients who were normal on DMSA scan, 8 (14.0% had low-grade VUR and 6 (10.5% had high-grade VUR. The sensitivity, specificity, and positive and negative predictive values of the DMSA scan in predicting high-grade VUR were 64.7%, 69.9%, 33.3%, and 89.5%, respectively. Leukocytosis, elevated CRP, and prolonged fever (?#243;6 hours after treatment were significantly correlated with the cortical defects on DMSA scans and high-grade VUR. Conclusion : Clinical signs, including prolonged fever after treatment, elevated CRP, and leukocytosis, are positive predictors of acute pyelonephritis and high-grade VUR.

  17. Clinical picture and treatment of 2212 patients with common variable immunodeficiency

    NARCIS (Netherlands)

    Gathmann, Benjamin; Mahlaoui, Nizar; Gérard, Laurence; Oksenhendler, Eric; Warnatz, Klaus; Schulze, Ilka; Kindle, Gerhard; Kuijpers, Taco W.; van Beem, Rachel T.; Guzman, David; Workman, Sarita; Soler-Palacín, Pere; de Gracia, Javier; Witte, Torsten; Schmidt, Reinhold E.; Litzman, Jiri; Hlavackova, Eva; Thon, Vojtech; Borte, Michael; Borte, Stephan; Kumararatne, Dinakantha; Feighery, Conleth; Longhurst, Hilary; Helbert, Matthew; Szaflarska, Anna; Sediva, Anna; Belohradsky, Bernd H.; Jones, Alison; Baumann, Ulrich; Meyts, Isabelle; Kutukculer, Necil; Wågström, Per; Galal, Nermeen Mouftah; Roesler, Joachim; Farmaki, Evangelia; Zinovieva, Natalia; Ciznar, Peter; Papadopoulou-Alataki, Efimia; Bienemann, Kirsten; Velbri, Sirje; Panahloo, Zoya; Grimbacher, Bodo; de Vergnes, Nathalie; Costes, Laurence; Andriamanga, Chantal; Courteille, Virginie; Brosselin, Pauline; Korganow, Anne-Sophie; Lutz, Patrick; ten Berge, R. J. M.

    2014-01-01

    Common variable immunodeficiency (CVID) is an antibody deficiency with an equal sex distribution and a high variability in clinical presentation. The main features include respiratory tract infections and their associated complications, enteropathy, autoimmunity, and lymphoproliferative disorders.

  18. Clinical picture and treatment of 2212 patients with common variable immunodeficiency

    NARCIS (Netherlands)

    Gathmann, B.; Mahlaoui, N.; Gerard, L.; Oksenhendler, E.; Warnatz, K.; Schulze, I.; Kindle, G.; Kuijpers, T.W.; Dutch, W.I.D.; Beem, R.T. van; Guzman, D.; Workman, S.; Soler-Palacin, P.; Gracia, J.; Witte, T. de; Schmidt, R.E.; Litzman, J.; Hlavackova, E.; Thon, V.; Borte, M.; Borte, S.; Kumararatne, D.; Feighery, C.; Longhurst, H.; Helbert, M.; Szaflarska, A.; Sediva, A.; Belohradsky, B.H.; Jones, A.; Baumann, U.; Meyts, I.; Kutukculer, N.; Wagstrom, P.; Galal, N.M.; Roesler, J.; Farmaki, E.; Zinovieva, N.; Ciznar, P.; Papadopoulou-Alataki, E.; Bienemann, K.; Velbri, S.; Panahloo, Z.; Grimbacher, B.; Meer, L.T. van der; Deuren, M. van; Netea, M.G.; Meer, J.W.M. van der; et al.,

    2014-01-01

    BACKGROUND: Common variable immunodeficiency (CVID) is an antibody deficiency with an equal sex distribution and a high variability in clinical presentation. The main features include respiratory tract infections and their associated complications, enteropathy, autoimmunity, and lymphoproliferative

  19. Clinical presentation of neurocysticercosis-related epilepsy.

    Science.gov (United States)

    Duque, Kevin R; Burneo, Jorge G

    2017-11-01

    Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system and a major risk factor for seizures and epilepsy. Seizure types in NCC vary largely across studies and seizure semiology is poorly understood. We discuss here the studies regarding seizure types and seizure semiology in NCC, and examine the clinical presentation in patients with NCC and drug-resistant epilepsy. We also provide evidence of the role of MRI and EEG in the diagnosis of NCC-related epilepsy. Focal seizures are reported in 60-90% of patients with NCC-related epilepsy, and around 90% of all seizures registered prospectively are focal not evolving to bilateral tonic-clonic seizures. A great number of cases suggest that seizure semiology is topographically related to NCC lesions. Patients with hippocampal sclerosis and NCC have different clinical and neurophysiological characteristics than those with hippocampal sclerosis alone. Different MRI protocols have allowed to better differentiate NCC from other etiologies. Lesions' stages might account on the chances of finding an interictal epileptiform discharge. Studies pursuing the seizure onset in patients with NCC are lacking and they are specially needed to determine both whether the reported events of individual cases are seizures, and whether they are related to the NCC lesion or lesions. This article is part of a Special Issue entitled "Neurocysticercosis and Epilepsy". Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder.

    Science.gov (United States)

    Kaufmann, Christopher N; Gershon, Anda; Eyler, Lisa T; Depp, Colin A

    2016-10-01

    Sleep disturbances are prevalent, persistent, and impairing features of bipolar disorder. However, the near-term and cumulative impact of the severity and variability of sleep disturbances on symptoms and functioning remains unclear. We examined self-reported daily sleep duration and variability in relation to mood symptoms, medication adherence, cognitive functioning, and concurrent daily affect. Forty-one outpatients diagnosed with bipolar disorder were asked to provide daily reports of sleep duration and affect collected via ecological momentary assessment with smartphones over eleven weeks. Measures of depressive and manic symptoms, medication adherence, and cognitive function were collected at baseline and concurrent assessment of affect were collected daily. Analyses examined whether sleep duration or variability were associated with baseline measures and changes in same-day or next-day affect. Greater sleep duration variability (but not average sleep duration) was associated with greater depressive and manic symptom severity, and lower medication adherence at baseline, and with lower and more variable ratings of positive affect and higher ratings of negative affect. Sleep durations shorter than 7-8 h were associated with lower same-day ratings of positive and higher same-day ratings of negative affect, however this did not extend to next-day affect. Greater cumulative day-to-day sleep duration variability, but not average sleep duration, was related to more severe mood symptoms, lower self-reported medication adherence and higher levels of negative affect. Bouts of short- or long-duration sleep had transient impact on affect. Day-to-day sleep variability may be important to incorporate into clinical assessment of sleep disturbances in bipolar disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. An attempt to assess the energy related climate variability

    Energy Technology Data Exchange (ETDEWEB)

    Iotova, A [Bulgarian Academy of Sciences, Sofia (Bulgaria). National Inst. of Meteorology and Hydrology

    1996-12-31

    A lot of efforts are directed now to study the interactions between energy and climate because of their significant importance for our planet. Globally, energy related emissions of Greenhouse Gases (GHGs) contribute for atmospheric warming. On regional level, where it is more difficult to determine concrete direction of climate variability and change, the role of energy remains considerable being not so direct as in the case of emissions` impact. Still there is essential necessity for further analyses and assessments of energy related climate variations and change in order to understand better and to quantify the energy - climate relations. In the presentation an attempt is made to develop approach for assessment of energy related climate variations on regional level. For this purpose, data and results from the research within Bulgarian Case Study (BCS) in the DECADES Inter-Agency Project framework are used. Considering the complex nature of the examined interconnections and the medium stage of the Study`s realisation, at the moment the approach can be presented in conceptual form. Correspondingly, the obtained results are illustrative and preliminary

  2. An attempt to assess the energy related climate variability

    Energy Technology Data Exchange (ETDEWEB)

    Iotova, A. [Bulgarian Academy of Sciences, Sofia (Bulgaria). National Inst. of Meteorology and Hydrology

    1995-12-31

    A lot of efforts are directed now to study the interactions between energy and climate because of their significant importance for our planet. Globally, energy related emissions of Greenhouse Gases (GHGs) contribute for atmospheric warming. On regional level, where it is more difficult to determine concrete direction of climate variability and change, the role of energy remains considerable being not so direct as in the case of emissions` impact. Still there is essential necessity for further analyses and assessments of energy related climate variations and change in order to understand better and to quantify the energy - climate relations. In the presentation an attempt is made to develop approach for assessment of energy related climate variations on regional level. For this purpose, data and results from the research within Bulgarian Case Study (BCS) in the DECADES Inter-Agency Project framework are used. Considering the complex nature of the examined interconnections and the medium stage of the Study`s realisation, at the moment the approach can be presented in conceptual form. Correspondingly, the obtained results are illustrative and preliminary

  3. Clinical Operations Variables are Associated With Blood Pressure Outcomes.

    Science.gov (United States)

    Kressin, Nancy R; Lasser, Karen E; Paasche-Orlow, Michael; Allison, Jeroan; Ash, Arlene S; Adams, William G; Shanahan, Christopher W; Legler, Aaron; Pizer, Steven D

    2015-06-01

    Uncontrolled blood pressure (BP), among patients diagnosed and treated for the condition, remains an important clinical challenge; aspects of clinical operations could potentially be adjusted if they were associated with better outcomes. To assess clinical operations factors' effects on normalization of uncontrolled BP. Observational cohort study. Patients diagnosed with hypertension from a large urban clinical practice (2005-2009). We obtained clinical data on BP, organized by person-month, and administrative data on primary care provider (PCP) staffing. We assessed the resolution of an episode of uncontrolled BP as a function of time-varying covariates including practice-level appointment volume, individual clinicians' appointment volume, overall practice-level PCP staffing, and number of unique PCPs. Among the 7409 unique patients representing 50,403 person-months, normalization was less likely for the patients in whom the episode starts during months when the number of unique PCPs were high [the top quintile of unique PCPs was associated with a 9 percentage point lower probability of normalization (Ppercentage point reduction in the probability of normalization (P=0.01)]. Neither clinician appointment volume nor practice clinician staffing levels were significantly associated with the probability of normalization. Findings suggest that clinical operations factors can affect clinical outcomes like BP normalization, and point to the importance of considering outcome effects when organizing clinical care.

  4. EEC syndrome sans clefting: Variable clinical presentations in a family

    Directory of Open Access Journals (Sweden)

    Thakkar Sejal

    2007-01-01

    Full Text Available Ectrodactyly, ectodermal dysplasia and cleft palate/lip syndrome (EEC is a rare autosomal dominant syndrome with varied presentation and is actually a multiple congenital anomaly syndrome leading to intra- and interfamilial differences in severity because of its variable expression and reduced penetrance. The cardinal features include ectrodactyly, sparse, wiry, hypopigmented hair, peg-shaped teeth with defective enamel and cleft palate/lip. A family comprising father, daughter and son presented to us with split hand-split foot deformity (ectrodactyly, epiphora, hair changes and deafness with variable involvement in each family member.

  5. Clinical factors related to schizophrenia relapse.

    Science.gov (United States)

    Porcelli, Stefano; Bianchini, Oriana; De Girolamo, Giovanni; Aguglia, Eugenio; Crea, Luciana; Serretti, Alessandro

    2016-01-01

    Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse. A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included. Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning. Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.

  6. Birth order and selected work-related personality variables.

    Science.gov (United States)

    Phillips, A S; Bedeian, A G; Mossholder, K W; Touliatos, J

    1988-12-01

    A possible link between birth order and various individual characteristics (e. g., intelligence, potential eminence, need for achievement, sociability) has been suggested by personality theorists such as Adler for over a century. The present study examines whether birth order is associated with selected personality variables that may be related to various work outcomes. 3 of 7 hypotheses were supported and the effect sizes for these were small. Firstborns scored significantly higher than later borns on measures of dominance, good impression, and achievement via conformity. No differences between firstborns and later borns were found in managerial potential, work orientation, achievement via independence, and sociability. The study's sample consisted of 835 public, government, and industrial accountants responding to a national US survey of accounting professionals. The nature of the sample may have been partially responsible for the results obtained. Its homogeneity may have caused any birth order effects to wash out. It can be argued that successful membership in the accountancy profession requires internalization of a set of prescribed rules and standards. It may be that accountants as a group are locked in to a behavioral framework. Any differentiation would result from spurious interpersonal differences, not from predictable birth-order related characteristics. A final interpretation is that birth order effects are nonexistent or statistical artifacts. Given the present data and particularistic sample, however, the authors have insufficient information from which to draw such a conclusion.

  7. Binge drinking among adolescents: prevalence, risk practices and related variables.

    Science.gov (United States)

    Golpe, Sandra; Isorna, Manuel; Barreiro, Carmen; Braña, Teresa; Rial, Antonio

    2017-09-29

    According to the last Survey on Drug Use among Secondary School Students (ESTUDES 2014-2015), consumption levels of alcohol and other substances have decreased in the last years in Spain. However, available data on binge drinking remain worrying, given the negative consequences related with this pattern. The aim of this paper is to analyse binge drinking among adolescents, providing updated data on prevalence in addition to information about the consequences and some predictive factors of binge drinking. A correlational method was used for this purpose, comprised of administering a survey to Compulsory Secondary School, High School and Vocational Training students. Based on a sample of 3,419 Galician adolescents aged between 12 and 18 years (M = 14.57; SD = 1.76), the results show that binge drinking is a common and global practice, with few socio-demographic differences but related with a wide range of risk practices. Furthermore, variables such as consumption expectancies, consumption by family and friends, as well as curfew time and allowance money have been identified as interesting predictive factors that should be taken into account at the preventive level.

  8. Variability in the clinical expression of Parkinson's disease

    NARCIS (Netherlands)

    Wolters, E.C.

    2008-01-01

    Parkinsonism is a clinical syndrome characterized by bradykinesia, hypo-/akinesia, muscular rigidity, and resting tremor, mainly caused by Parkinson's disease (PD). Symptoms of PD are due to a progressive loss of nigral neurons causing striatal dopaminergic denervation. However, nigral degeneration

  9. Persistent fatigue in young athletes: measuring the clinical course and identifying variables affecting clinical recovery.

    Science.gov (United States)

    Locke, S; Osborne, M; O'Rourke, P

    2011-02-01

    The objective of this paper is to measure the clinical course (months) in young athletes with persistent fatigue and to identify any covariates affecting the duration of recovery. This was a prospective longitudinal study of 68 athletes; 87% were elite (42 males, 26 females), aged 20.5±3.74 years (SD), who presented with the symptom of persistent fatigue. The collective duration to full clinical recovery was estimated using Kaplan-Meier product-limit curves, and covariates associated with prolonging recovery were identified from Cox proportional hazard models. The median recovery was 5 months (range 1-60 months). The range of presenting symptom duration was 0.5-36 months. The covariates identified were an increased duration of presenting symptoms [hazard ratio (HR), 1.06; 95% confidence interval (CI), 1.02-1.12; P=0.005] and the response of serum cortisol concentration to a standard exercise challenge (HR, 1.92; 95% CI, 1.09-3.38; P=0.03). Delay in recovery was not associated with categories of fatigue that included medical, training-related diagnoses, or other causes. In conclusion, the fatigued athlete represents a significant clinical problem with a median recovery of 5 months, whose collective clinical course to recovery can be estimated by Kaplan-Meier curves and appears to be a continuum. © 2009 John Wiley & Sons A/S.

  10. Heart rate variability in sleep-related migraine without aura.

    Science.gov (United States)

    Vollono, Catello; Gnoni, Valentina; Testani, Elisa; Dittoni, Serena; Losurdo, Anna; Colicchio, Salvatore; Di Blasi, Chiara; Mazza, Salvatore; Farina, Benedetto; Della Marca, Giacomo

    2013-07-15

    This is an observational study aimed to investigate the activity of autonomic nervous system during sleep in patients with sleep-related migraine. Eight consecutive migraineurs without aura were enrolled (6 women and 2 men), aged 30 to 62 years (mean 48.1 ± 9.3 years). Inclusion criteria were: high frequency of attacks (> 5 per month) and occurrence of more than 75% of the attacks during sleep causing an awakening. Patients were compared with a control group of 55 healthy subjects (23 men and 32 women, mean age 54.2 ± 13.0 years), and with a further control group of 8 age- and gender-matched healthy controls. Patient and controls underwent polysomnography and heart rate variability analysis. A significant reduction of the LF/HF ratio during N2 and N3 sleep stages was observed in migraineurs compared with controls. No differences in sleep macrostructure were observed; cyclic alternating pattern (CAP) time and CAP rate were lower in migraineurs than in controls. These findings indicate a peculiar modification of the autonomic balance during sleep in sleep-related migraine. The reduction of LF/HF ratio in NREM sleep was observed in controls, but it was quantitatively much more evident in migraineurs. Changes in LF/HF could be consequent to an autonomic unbalance which could manifest selectively (or alternatively become more evident) during sleep. These findings, together with the reduction in CAP rate, could be an expression of reduced arousability during sleep in patients with sleep-related migraine. The simultaneous involvement of the autonomic, arousal, and pain systems might suggest involvement of the hypothalamic pathways.

  11. Clinical and non-clinical depression and anxiety in young people: A scoping review on heart rate variability.

    Science.gov (United States)

    Paniccia, Melissa; Paniccia, David; Thomas, Scott; Taha, Tim; Reed, Nick

    2017-12-01

    Heart rate variability (HRV), a measure of cardiac autonomic nervous system functioning, has emerged as a physiological indicator for emotional regulation and psychological well-being. HRV is understudied in the context of depression and anxiety in young people (10-24years old). Main objectives: (1) describe the nature and breadth of reviewed studies; and (2) synthesize main findings in the context of clinical and non-clinical populations of young people with depression and/or anxiety. The Arksey and O'Malley methodology was utilized for this scoping review. CINHAL, EMBASE, Medline, PsychInfo, Scopus, Web of Science, as well as grey literature, were searched. Two reviewers screened titles, abstracts and full papers for inclusion. A total of 20 citations were included in the final review (19 citations peer-reviewed journal articles, 1 journal abstract). Numerical and thematic analysis was used to summarize study findings. In clinical populations of either depression or anxiety, HRV was lower compared to controls. In non-clinical populations of either depression or anxiety, HRV was found to be lower in those who reported more depression or anxiety symptoms. The quality of the reviewed articles was not assessed which limits the ability to generate conclusions regarding study findings. Changes in HRV were found across the spectrum of clinical and non-clinical populations of young people with depression or anxiety. Neurophysiological research on depression and anxiety in young people can act as a first step to understanding how physiological flexibility (i.e. HRV) is related to psychological flexibility (i.e. adaptive or maladaptive responses to life events). Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Joubert syndrome: large clinical variability and a unique neuroimaging aspect

    International Nuclear Information System (INIS)

    Leao, Emilia Katiane Embirucu; Lima, Marcilia Martyn; Kok, Fernando; Parizotto, Juliana; Maia Junior, Otacilio de Oliveira

    2010-01-01

    Joubert syndrome (JS) is an autosomal recessive inherited disorder characterized by hypotonia, cerebellar vermis hypoplasia, ocular abnormalities (e.g. pigmentary retinopathy, oculomotor apraxia and nystagmus), renal cysts and hepatic fibrosis. Respiratory abnormalities, as apnoea and hyperpnoea, may be present, as well as mental retardation. At least seven JS loci have been determined and five genes identified. Herein, we report five children, belonging to independent families, with JS: they shared the same typical MRI abnormality, known as molar tooth sign, but had an otherwise quite variable phenotype, regarding mostly their cognitive performance, visual abilities and extra-neurological compromise. (author)

  13. Joubert syndrome: large clinical variability and a unique neuroimaging aspect

    Energy Technology Data Exchange (ETDEWEB)

    Leao, Emilia Katiane Embirucu; Lima, Marcilia Martyn; Kok, Fernando; Parizotto, Juliana [University of Sao Paulo (USP), Sao Paulo, SP (Brazil). Clinical Hospital. Dept. of Child Neurology; Maia Junior, Otacilio de Oliveira [University of Sao Paulo (USP), Sao Paulo, SP (Brazil). Clinical Hospital. Dept. of Child Ophthalmology

    2010-04-15

    Joubert syndrome (JS) is an autosomal recessive inherited disorder characterized by hypotonia, cerebellar vermis hypoplasia, ocular abnormalities (e.g. pigmentary retinopathy, oculomotor apraxia and nystagmus), renal cysts and hepatic fibrosis. Respiratory abnormalities, as apnoea and hyperpnoea, may be present, as well as mental retardation. At least seven JS loci have been determined and five genes identified. Herein, we report five children, belonging to independent families, with JS: they shared the same typical MRI abnormality, known as molar tooth sign, but had an otherwise quite variable phenotype, regarding mostly their cognitive performance, visual abilities and extra-neurological compromise. (author)

  14. Frecuencia de retinopatía diabética y su relación con algunas variables clínicas y bioquímicas asociadas a la diabetes tipo 1 Frequency of diabetic retinopathy and its relation to some clinical and biochemical variables associated with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Manuel E. Licea Puig

    2006-12-01

    Full Text Available La aparición de la retinopatía diabética (RD se asocia a la presencia de varios factores de riesgo que determinan tanto su surgimiento como el incremento de su severidad. El objetivo de este trabajo es determinar la frecuencia y severidad de la RD y su relación con algunas variables clínicas y bioquímicas en un grupo de personas con diabetes mellitus tipo 1 (DM1. Fue realizado un estudio retrospectivo y descriptivo en 240 diabéticos tipo 1 atendidos en el Centro de Atención al Diabético del Instituto Nacional de Endocrinología. Se estudiaron: edad, sexo, duración de la DM 1, presión arterial sistólica (PAS y diastólica (PAD, índice de masa corporal (IMC, hábito de fumar, glucemia en ayunas y posprandial de 2 h, hemoglobina glucosilada (HbA1, excreción urinaria de albúmina (EUA en orina de 24 h y presencia y tipo de RD: no proliferativa (RDNP y proliferativa (RD. 40,4 % de los diabéticos tenían algún tipo de RD (RDNP 35,4 % y RDP 5,0 %. A mayor edad cronológica se incrementó la frecuencia de RD. De los 39 sujetos con una DM1 de ³ 20 años de evolución, 34 tenían algún tipo de RD. La hipertensión arterial (HTA apareció en 30,6 y 50,0 % de los individuos que presentaban RDNP y RDP, respectivamente. La glucemia en ayunas fue significativamente (pThe appearance of diabetic retinopathy (DR is associated with the presence of several risk factors that determine its emergence and the increase of its severity. The objective of this paper is to know the frequency and severity of DR and its connection with some clinical and biochemical variables in a group of persons with type1 diabetes mellitus. A retrospective and descriptive study was conducted in 240 type 1 diabetics seen at the Diabetes Care Center of the National Institute of Endocrinology. The studied variables were age, sex, duration of type 1 diabetes mellitus, systolic (SAP and diastolic arterial pressure (DAP, body mass index (BMI, smoking habit, fasting and 2-hour

  15. Possibilities of segmentation variables in relation with advertising

    OpenAIRE

    Erbanová, Nela

    2011-01-01

    The aim of this thesis is to capture significant segmentation variables that shape marketing communication with an emphasis on advertising. The theoretical part deals with the concepts of market segmentation, segmentation variables, marketing communication, advertising and research. The practical part is focused on the realization of the actual research using a questionnaire survey and the evaluation of questions from Market Media Lifestyle. Only traditional descriptive segmentation variables...

  16. Evaluating measurement models in clinical research: covariance structure analysis of latent variable models of self-conception.

    Science.gov (United States)

    Hoyle, R H

    1991-02-01

    Indirect measures of psychological constructs are vital to clinical research. On occasion, however, the meaning of indirect measures of psychological constructs is obfuscated by statistical procedures that do not account for the complex relations between items and latent variables and among latent variables. Covariance structure analysis (CSA) is a statistical procedure for testing hypotheses about the relations among items that indirectly measure a psychological construct and relations among psychological constructs. This article introduces clinical researchers to the strengths and limitations of CSA as a statistical procedure for conceiving and testing structural hypotheses that are not tested adequately with other statistical procedures. The article is organized around two empirical examples that illustrate the use of CSA for evaluating measurement models with correlated error terms, higher-order factors, and measured and latent variables.

  17. Coevolution of variability models and related software artifacts

    DEFF Research Database (Denmark)

    Passos, Leonardo; Teixeira, Leopoldo; Dinztner, Nicolas

    2015-01-01

    models coevolve with other artifact types, we study a large and complex real-world variant-rich software system: the Linux kernel. Specifically, we extract variability-coevolution patterns capturing changes in the variability model of the Linux kernel with subsequent changes in Makefiles and C source...

  18. Dysthymic disorder: clinical characteristics in relation to age at onset.

    Science.gov (United States)

    Barzega, G; Maina, G; Venturello, S; Bogetto, F

    2001-09-01

    The variability in the clinical presentation of dysthymia has given rise to a rich debate in literature, and various hypotheses have been proposed. One is that the clinical presentation differs in relation to age at onset. The aim of the study was to evaluate differences in socio-demographic and clinical characteristics in a sample of patients with dysthymia (DSM-IV), in relation to age at onset. 84 consecutive outpatients with a diagnosis of dysthymia (DSM-IV) were studied. All subjects were evaluated by a semistructured clinical interview and the following rating scales: HAM-A, HAM-D, MADRS, Paykel's Interview for Recent Life Events. 23.8% of the sample had early-onset (dysthymia. Patients with early-onset disorder were significantly younger at the observation, more frequently female and single. They had a significantly longer duration of illness and in a significantly higher percentage had already received a specialist treatment before admission in the present trial. No differences in the frequency of symptoms were observed. A significantly higher percentage of patients with late-onset disease reported at least one stressful event in the year preceding the onset of dysthymia. A positive history of major depression was significantly more common among the early-onset group; social phobia, panic disorder and conversive disorder were also more frequent in this group. The late-onset patients frequently presented generalized anxiety disorder, substance abuse and somatization disorder. The study is retrospective and enrolls a limited number of cases. The present study agrees with other reports on the differences in clinical presentation of dysthymia according to age at onset. Although they are not actually related to age at onset, some interesting findings emerged in the symptomatological characterization of the disorder, referring to the diagnostic criteria proposed in DSM-IV.

  19. Health Related Quality of Life in Children with Autism Spectrum Disorders: The Clinical and Demographic Related Factors in Turkey

    Science.gov (United States)

    Kose, Sezen; Erermis, Serpil; Ozturk, Onder; Ozbaran, Burcu; Demiral, Nagehan; Bildik, Tezan; Aydin, Cahide

    2013-01-01

    We aimed to investigate the Health Related Quality of Life and related clinical variables (HRQoL) of children with Autism Spectrum Disorders (ASD). We included 102 children with ASD (46 with autism, 38 with pervasive developmental disorder not otherwise specified (PDD-NOS) and 18 with Asperger's syndrome (AS)) and 39 typically developing children…

  20. How novice, skilled and advanced clinical researchers include variables in a case report form for clinical research: a qualitative study.

    Science.gov (United States)

    Chu, Hongling; Zeng, Lin; Fetters, Micheal D; Li, Nan; Tao, Liyuan; Shi, Yanyan; Zhang, Hua; Wang, Xiaoxiao; Li, Fengwei; Zhao, Yiming

    2017-09-18

    Despite varying degrees in research training, most academic clinicians are expected to conduct clinical research. The objective of this research was to understand how clinical researchers of different skill levels include variables in a case report form for their clinical research. The setting for this research was a major academic institution in Beijing, China. The target population was clinical researchers with three levels of experience, namely, limited clinical research experience, clinicians with rich clinical research experience and clinical research experts. Using a qualitative approach, we conducted 13 individual interviews (face to face) and one group interview (n=4) with clinical researchers from June to September 2016. Based on maximum variation sampling to identify researchers with three levels of research experience: eight clinicians with limited clinical research experience, five clinicians with rich clinical research experience and four clinical research experts. These 17 researchers had diverse hospital-based medical specialties and or specialisation in clinical research. Our analysis yields a typology of three processes developing a case report form that varies according to research experience level. Novice clinician researchers often have an incomplete protocol or none at all, and conduct data collection and publication based on a general framework. Experienced clinician researchers include variables in the case report form based on previous experience with attention to including domains or items at risk for omission and by eliminating unnecessary variables. Expert researchers consider comprehensively in advance data collection and implementation needs and plan accordingly. These results illustrate increasing levels of sophistication in research planning that increase sophistication in selection for variables in the case report form. These findings suggest that novice and intermediate-level researchers could benefit by emulating the comprehensive

  1. Variability in Clinical Integration Achieved by Athletic Training Students across Different Clinical Sport Assignments

    Science.gov (United States)

    Dodge, Thomas M.; Mazerolle, Stephanie M.; Bowman, Thomas G.

    2015-01-01

    Context: Clinical integration impacts athletic training students' (ATSs) motivation and persistence. Research has yet to elucidate the manner in which different clinical placements can influence clinical integration. Objective: To examine differences in the levels of clinical integration achieved by ATSs across various clinical sport assignments.…

  2. Influence of clinical and lipid variables on the magnitude of postprandial lipemia in subjects with and without hipertriglyceridemia

    Directory of Open Access Journals (Sweden)

    Clara Eugenia Pérez G.

    2007-01-01

    Full Text Available Introduction. The postprandial lipemia is characterized by some prolonged increase in circulation of triglycerides rich lipoproteins that can produce atherosclerosis, which is an important cause of death in our population. Objective. To evaluate the effect of lipidic and clinical variables on the values of postprandial lipemia in subjects with and without hipertriglyceridemia. Materials and methods. Forty-eight subjects of both sexes were studied, half of them, with basal triglycerides above 200mg/dl, who ingested a standardized lipidic load (breakfast with 30g of fat and then they were followed during seven hours gathering total blood every hour to determine the level of postprandial triglycerides and the postprandial lipemia values. The later data was correlated with clinical variables as age, body mass index, waist circumference, among other; and with lipidic variable as total cholesterol, HDL, LDL and basal triglycerides. Results. There was alteration in the clearence of postprandial triglycerides in those subjects with a basal concentration of triglycerides above 186 mg/dl. The clinical variables most related tothe magnitude of postprandial lipemia were age (p=0.009 and waist perimeter, while the lipidic variables that were strongly related with the postprandial lipemia were the basal triglycerides concentration (p=<0.001, the VLDL cholesterol (p=<0.001 and the HDL cholesterol(p=0.041. Conclusion. The variables that could predict the behavior of postprandial triglycerides in the individuals of this study are age, waist perimeter, VLDL cholesterol, HDL cholesterol and the basal triglycerides concentration.

  3. Prediction of the Chemoreflex Gain by Common Clinical Variables in Heart Failure.

    Directory of Open Access Journals (Sweden)

    Gianluca Mirizzi

    Full Text Available Peripheral and central chemoreflex sensitivity, assessed by the hypoxic or hypercapnic ventilatory response (HVR and HCVR, respectively, is enhanced in heart failure (HF patients, is involved in the pathophysiology of the disease, and is under investigation as a potential therapeutic target. Chemoreflex sensitivity assessment is however demanding and, therefore, not easily applicable in the clinical setting. We aimed at evaluating whether common clinical variables, broadly obtained by routine clinical and instrumental evaluation, could predict increased HVR and HCVR.191 patients with systolic HF (left ventricular ejection fraction--LVEF--<50% underwent chemoreflex assessment by rebreathing technique to assess HVR and HCVR. All patients underwent clinical and neurohormonal evaluation, comprising: echocardiogram, cardiopulmonary exercise test (CPET, daytime cardiorespiratory monitoring for breathing pattern evaluation. Regarding HVR, multivariate penalized logistic regression, Bayesian Model Averaging (BMA logistic regression and random forest analysis identified, as predictors, the presence of periodic breathing and increased slope of the relation between ventilation and carbon dioxide production (VE/VCO2 during exercise. Again, the above-mentioned statistical tools identified as HCVR predictors plasma levels of N-terminal fragment of proBNP and VE/VCO2 slope.In HF patients, the simple assessment of breathing pattern, alongside with ventilatory efficiency during exercise and natriuretic peptides levels identifies a subset of patients presenting with increased chemoreflex sensitivity to either hypoxia or hypercapnia.

  4. Relationships of Cerebrospinal Fluid Monoamine Metabolite Levels With Clinical Variables in Major Depressive Disorder.

    Science.gov (United States)

    Yoon, Hyung Shin; Hattori, Kotaro; Ogawa, Shintaro; Sasayama, Daimei; Ota, Miho; Teraishi, Toshiya; Kunugi, Hiroshi

    Many studies have investigated cerebrospinal fluid (CSF) monoamine metabolite levels in depressive disorders. However, their clinical significance is still unclear. We tried to determine whether CSF monoamine metabolite levels could be a state-dependent marker for major depressive disorder (MDD) based on analyses stratified by clinical variables in a relatively large sample. Subjects were 75 patients with MDD according to DSM-IV criteria and 87 healthy controls, matched for age, sex, and ethnicity (Japanese). They were recruited between May 2010 and November 2013. We measured homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) in CSF samples by high-performance liquid chromatography. We analyzed the relationships of the metabolite levels with age, sex, diagnosis, psychotropic medication use, and depression severity. There was a weak positive correlation between age and 5-HIAA levels in controls (ρ = 0.26, P 12) were significantly lower than those in controls (P .1), were related to depression severity. CSF 5-HIAA and HVA levels could be state-dependent markers in MDD patients. Since 5-HIAA levels greatly decrease with the use of antidepressants, HVA levels might be more useful in the clinical setting. © Copyright 2017 Physicians Postgraduate Press, Inc.

  5. Screening program for Waardenburg syndrome in Colombia: clinical definition and phenotypic variability.

    Science.gov (United States)

    Tamayo, Marta L; Gelvez, Nancy; Rodriguez, Marcela; Florez, Silvia; Varon, Clara; Medina, David; Bernal, Jaime E

    2008-04-15

    A screening program to detect Waardenburg syndrome (WS) conducted between 2002 and 2005, among 1,763 deaf individuals throughout Columbia identified 95 affected individuals belonging to 95 families, giving a frequency of 5.38% of WS among the institutionalized deaf population. We confirmed the clinical diagnosis of WS in the 95 propositi and, through the family evaluation, we also identified 45 non-institutionalized affected relatives. Audiologic, ophthalmologic, and genetic studies were performed to confirm the diagnosis. Following the classification of the WS consortium, based on the Waardenburg Index (WI), to define the type of WS. We classified 62.1% of the propositi as WS2 and 37.9% as WS1. We present here the results of the study of clinical manifestations, analyzing the presence, severity, and symmetry of clinical findings among this affected population. Overall, among the 95 propositi, in addition to sensorineural deafness in all, the most frequent features were broad nasal root (58.9%), a first degree relative affected (37.9%), heterochromia irides (36.8%), skin hypopigmentation (31.6%), white forelock (28.0%), intense blue iris (27.4%), synophrys (12.6%), premature graying (10.5%), ptosis of the eyelids (9.5%), and hypoplasia alae nasi (1.1%). The majority of individuals had normal psychomotor development (87%), while the remaining 13% had developmental delay. Among the latter, 9.4% corresponded to WS2 and 3.6% to WS1. Our data confirm an interesting inter- and intrafamilial variability in the phenotypic manifestations as well as extremely variable expression. Copyright 2008 Wiley-Liss, Inc.

  6. Economic impact of clinical variability in preoperative testing for major outpatient surgery.

    Science.gov (United States)

    Gil-Borrelli, Christian Carlo; Agustí, Salomé; Pla, Rosa; Díaz-Redondo, Alicia; Zaballos, Matilde

    2016-05-01

    With the purpose of decreasing the existing variability in the criteria of preoperative evaluation and facilitating the clinical decision-making process, our hospital has a protocol of preoperative tests to use with ASA I and ASA II patients. The aim of the study was to calculate the economic impact caused by clinicians' non-adherence to the protocol for the anaesthesiological evaluation of ASA 1 and ASA II patients. A retrospective study of costs with a random sample of 353 patients that were seen in the consultation for Anesthesiology over a period of one year. Aspects related to the costs, patient's profiles and specialties were analysed, according to the degree of fulfillment of the protocol. The lack of adherence to the the protocol was 70%. 130 chest X-rays and 218 ECG were performed without indication. This generated an excess costs of 34 € per patient. Taking into account the expenses of both tests and the attended population undergoing ambulatory surgery during the one-year period, an excess spending for the hospital of between 69.164 € and 83.312 € was estimated. Clinical variability should be reduced and the creation of synergies between the different departments should be enhanced in order to adjust the request for unnecessary complementary tests to decrease health care and to improve the quality of patient care. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Beat-to-beat variability of cardiac action potential duration: underlying mechanism and clinical implications.

    Science.gov (United States)

    Nánási, Péter P; Magyar, János; Varró, András; Ördög, Balázs

    2017-10-01

    Beat-to-beat variability of cardiac action potential duration (short-term variability, SV) is a common feature of various cardiac preparations, including the human heart. Although it is believed to be one of the best arrhythmia predictors, the underlying mechanisms are not fully understood at present. The magnitude of SV is basically determined by the intensity of cell-to-cell coupling in multicellular preparations and by the duration of the action potential (APD). To compensate for the APD-dependent nature of SV, the concept of relative SV (RSV) has been introduced by normalizing the changes of SV to the concomitant changes in APD. RSV is reduced by I Ca , I Kr , and I Ks while increased by I Na , suggesting that ion currents involved in the negative feedback regulation of APD tend to keep RSV at a low level. RSV is also influenced by intracellular calcium concentration and tissue redox potential. The clinical implications of APD variability is discussed in detail.

  8. The effect of respiratory disorders on clinical pharmacokinetic variables.

    Science.gov (United States)

    Taburet, A M; Tollier, C; Richard, C

    1990-12-01

    Respiratory disorders induce several pathophysiological changes involving gas exchange and acid-base balance, regional haemodynamics, and alterations of the alveolocapillary membrane. The consequences for the absorption, distribution and elimination of drugs are evaluated. Drug absorption after inhalation is not significantly impaired in patients. With drugs administered by this route, an average of 10% of the dose reaches the lungs. It is not completely clear whether changes in pulmonary endothelium in respiratory failure enhance lung absorption. The effects of changes in blood pH on plasma protein binding and volume of distribution are discussed, but relevant data are not available to explain the distribution changes observed in acutely ill patients. Lung diffusion of some antimicrobial agents is enhanced in patients with pulmonary infections. Decreased cardiac output and hepatic blood flow in patients under mechanical ventilation cause an increase in the plasma concentration of drugs with a high hepatic extraction ratio, such as lidocaine (lignocaine). On a theoretical basis, hypoxia should lead to decreased biotransformation of drugs with a low hepatic extraction ratio, but in vivo data with phenazone (antipyrine) or theophylline are conflicting. The effects of disease on the lung clearance of drugs are discussed but clinically relevant data are lacking. The pharmacokinetics of drugs in patients with asthma or chronic obstructive pulmonary disease are reviewed. Stable asthma and chronic obstructive pulmonary disease do not appear to affect the disposition of theophylline or beta 2-agonists such as salbutamol (albuterol) or terbutaline. Important variations in theophylline pharmacokinetics have been reported in critically ill patients, the causes of which are more likely to be linked to the poor condition of the patients than to a direct effect of hypoxia or hypercapnia. Little is known regarding the pharmacokinetics of cromoglycate, ipratropium, corticoids or

  9. When to trust our learners? Clinical teachers' perceptions of decision variables in the entrustment process.

    Science.gov (United States)

    Duijn, Chantal C M A; Welink, Lisanne S; Bok, Harold G J; Ten Cate, Olle T J

    2018-06-01

    Clinical training programs increasingly use entrustable professional activities (EPAs) as focus of assessment. However, questions remain about which information should ground decisions to trust learners. This qualitative study aimed to identify decision variables in the workplace that clinical teachers find relevant in the elaboration of the entrustment decision processes. The findings can substantiate entrustment decision-making in the clinical workplace. Focus groups were conducted with medical and veterinary clinical teachers, using the structured consensus method of the Nominal Group Technique to generate decision variables. A ranking was made based on a relevance score assigned by the clinical teachers to the different decision variables. Field notes, audio recordings and flip chart lists were analyzed and subsequently translated and, as a form of axial coding, merged into one list, combining the decision variables that were similar in their meaning. A list of 11 and 17 decision variables were acknowledged as relevant by the medical and veterinary teacher groups, respectively. The focus groups yielded 21 unique decision variables that were considered relevant to inform readiness to perform a clinical task on a designated level of supervision. The decision variables consisted of skills, generic qualities, characteristics, previous performance or other information. We were able to group the decision variables into five categories: ability, humility, integrity, reliability and adequate exposure. To entrust a learner to perform a task at a specific level of supervision, a supervisor needs information to support such a judgement. This trust cannot be credited on a single case at a single moment of assessment, but requires different variables and multiple sources of information. This study provides an overview of decision variables giving evidence to justify the multifactorial process of making an entrustment decision.

  10. A study of school adjustment related variables of young children

    African Journals Online (AJOL)

    for identifying relevant variables that affect the school adjustment of young ... Keywords: cognitive ability; hot executive function; peer relationships; school ... tend to act independently and have fewer positive feelings about their ... cognition provides a basis for developing social ..... is associated with hot EF is not activated,.

  11. Age-Related Intraindividual Performance Variability with Practice

    Science.gov (United States)

    Miller, Suzanne Bonneau; Odell, Katharine H.

    2007-01-01

    Fluctuations in cognitive task performance in older individuals have been reported. To examine intraindividual variability as a function of practice, 34 younger and 34 older female participants, aged 20-30 years and 70-82 years, respectively, performed a reading span task 16 times over four sessions. Each individual's recall accuracy was analyzed…

  12. A Controlled Study of Variables Related to Counseling Center Use.

    Science.gov (United States)

    Bosmajian, C. Perry, Jr.; Mattson, Robert E.

    1980-01-01

    Investigated the utility of several variables in discriminating between students who seek counseling and those who do not. Interaction between personal adjustment and help-seeking status was also examined. Alternate sources of help, counseling usefulness, and perceived severity of help-seeker pathology descriminated seekers from nonseekers.…

  13. Relative Contributions of Socio-Cultural Variables to the Prediction ...

    African Journals Online (AJOL)

    Erah

    the Prediction of Maternal Mortality in Edo South. Senatorial ... variables across the two locations (rural and urban) was early marriage/early child bearing (R2 = 0.200;. F = 401.40 ... severe bleeding, infections, obstructed or prolonged .... Analytical System (SAS) mode. Descriptive .... incontinence of urine and faeces due to.

  14. Job satisfaction and work related variables in Chinese cardiac critical care nurses.

    Science.gov (United States)

    Liu, Yun-E; While, Alison; Li, Shu-Jun; Ye, Wen-Qin

    2015-05-01

    To explore critical care nurses' views of their job satisfaction and the relationship with job burnout, practice environment, coping style, social support, intention to stay in current employment and other work-related variables. Nurse shortage is a global issue, especially in critical care. Job satisfaction is the most frequently cited factor linked to nurses' turnover. A convenience sample of cardiac critical care nurses (n = 215; 97.7% response rate) from 12 large general hospitals in Shanghai was surveyed from December 2010 to March 2011. Over half of the sample reported satisfaction with their jobs. Nurses with 10-20 years of professional experience and those who had taken all their holiday entitlement reported higher levels of job satisfaction. The independent variables of practice environment, intention to stay, emotional exhaustion, personal accomplishment and positive coping style explained about 55% of the variance in job satisfaction. Chinese cardiac critical care nurses' job satisfaction was related to work related variables, which are amenable to managerial action. Our findings highlight the imperative of improving intrinsic and extrinsic rewards, together with the flexibility of work schedules to promote job satisfaction and staff retention. A clinical ladder system is needed to provide promotion opportunities for Chinese nurses. © 2013 John Wiley & Sons Ltd.

  15. [Cognitive complaints in people with human immunodeficiency virus in Spain: prevalence and related variables].

    Science.gov (United States)

    Muñoz-Moreno, José A; Fuster-Ruiz de Apodaca, Maria J; Fumaz, Carmina R; Ferrer, Maria J; Molero, Fernando; Jaen, Àngels; Clotet, Bonaventura; Dalmau, David

    2014-05-20

    Cognitive complaints have been scarcely studied in people with HIV in Spain. The aim of this research was to know the prevalence of cognitive complaints in HIV-infected people, as well as its potential relationships with demographic, clinical and psychological variables, in the era of combination antiretroviral therapies. Observational multicenter study developed in 4 hospitals and 10 NGOs, in which 791 people with HIV in Spain participated. A self-reported questionnaire was used to evaluate demographic and clinical variables, and an assessment of cognitive complaints, emotional status and quality of life variables was also included. Descriptive and inferential tests were used for statistical analyses. Almost half of the sample (49.8%) referred cognitive complaints, in 72.1% of them an association with interference on daily living activities was found. Memory and attention were the areas most prevalently perceived as affected. The existence of cognitive complaints correlated with a longer HIV infection, lower CD4+ cell count, undetectable viral load and worse quality of life. A discriminant analysis determined that depression, anxiety, older age, living with no partner and low education level allowed to classify optimally HIV-infected people with cognitive complaints. Self-reported cognitive complaints are frequent in people infected with HIV in the current era of combination antiretroviral therapies. This fact is related to emotional disturbances and poor quality of life, but also to impaired immunological and virological status. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  16. Variability amongst radiographers in the categorization of clinical acceptability for digital trauma radiography

    Science.gov (United States)

    Decoster, Robin; Toomey, Rachel; Smits, Dirk; Mol, Harrie; Verhelle, Filip; Butler, Marie-Louise

    2016-03-01

    Introduction: Radiographers evaluate anatomical structures to judge clinical acceptability of a radiograph. Whether a radiograph is deemed acceptable for diagnosis or not depends on the individual decision of the radiographer. Individual decisions cause variation in the accepted image quality. To minimise these variations definitions of acceptability, such as in RadLex, were developed. On which criteria radiographers attribute a RadLex categories to radiographs is unknown. Insight into these criteria helps to further optimise definitions and reduce variability in acceptance between radiographers. Therefore, this work aims the evaluation of the correlation between the RadLex classification and the evaluation of anatomical structures, using a Visual Grading Analysis (VGA) Methods: Four radiographers evaluated the visibility of five anatomical structures of 25 lateral cervical spine radiographs on a secondary class display with a VGA. They judged clinical acceptability of each radiograph using RadLex. Relations between VGAS and RadLex category were analysed with Kendall's Tau correlation and Nagelkerke pseudo-R². Results: The overall VGA score (VGAS) and the RadLex score correlate (rτ= 0.62, pscore. The reproduction of spinous processes (rτ=0.67, pscore. Conclusion: RadLex scores and VGAS correlate positively, strongly and significantly. The predictive value of bony structures may support the use of these in the judgement of clinical acceptability. Considerable inter-observer variations in the VGAS within a certain RadLex category, suggest that observers use of observer specific cut-off values.

  17. Clinical intrafamilial variability in lethal familial neonatal seizure disorder caused by TBC1D24 mutations.

    Science.gov (United States)

    Lozano, Reymundo; Herman, Kristin; Rothfuss, Melanie; Rieger, Hillary; Bayrak-Toydemir, Pinar; Aprile, Davide; Fruscione, Floriana; Zara, Federico; Fassio, Anna

    2016-12-01

    TBC1D24-related disorders include a wide phenotypic ranging from mild to lethal seizure disorders, non-syndromic deafness, and composite syndromes such as DOORS (deafness, onychodystrophy, osteodystrophy, mental retardation, and seizures). The TBC1D24 gene has a role in cerebral cortex development and in presynaptic neurotransmission. Here, we present a familial case of a lethal early-onset epileptic encephalopathy, associated with two novel compound heterozygous missense variants on the TBC1D24 gene, which were detected by exome sequencing. The detailed clinical data of the three siblings is summarized in order to support the variability of the phenotype, severity, and progression of this disorder among these family members. Functional studies demonstrated that the identified novel missense mutations result in a loss of expression of the protein, suggesting a correlation between residual expression, and the disease severity. This indicates that protein expression analysis is important for interpreting genetic results when novel variants are found, as well as for complementing clinical assessment by predicting the functional impact. Further analysis is necessary to delineate the clinical presentation of individuals with TBC1D24 pathogenic variants, as well as to develop markers for diagnosis, prognosis, and potential targeted treatments. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

    Science.gov (United States)

    Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

    2017-09-01

    There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  19. Estimating water equivalent snow depth from related meteorological variables

    International Nuclear Information System (INIS)

    Steyaert, L.T.; LeDuc, S.K.; Strommen, N.D.; Nicodemus, M.L.; Guttman, N.B.

    1980-05-01

    Engineering design must take into consideration natural loads and stresses caused by meteorological elements, such as, wind, snow, precipitation and temperature. The purpose of this study was to determine a relationship of water equivalent snow depth measurements to meteorological variables. Several predictor models were evaluated for use in estimating water equivalent values. These models include linear regression, principal component regression, and non-linear regression models. Linear, non-linear and Scandanavian models are used to generate annual water equivalent estimates for approximately 1100 cooperative data stations where predictor variables are available, but which have no water equivalent measurements. These estimates are used to develop probability estimates of snow load for each station. Map analyses for 3 probability levels are presented

  20. Building prognostic models for breast cancer patients using clinical variables and hundreds of gene expression signatures

    Directory of Open Access Journals (Sweden)

    Liu Yufeng

    2011-01-01

    Full Text Available Abstract Background Multiple breast cancer gene expression profiles have been developed that appear to provide similar abilities to predict outcome and may outperform clinical-pathologic criteria; however, the extent to which seemingly disparate profiles provide additive prognostic information is not known, nor do we know whether prognostic profiles perform equally across clinically defined breast cancer subtypes. We evaluated whether combining the prognostic powers of standard breast cancer clinical variables with a large set of gene expression signatures could improve on our ability to predict patient outcomes. Methods Using clinical-pathological variables and a collection of 323 gene expression "modules", including 115 previously published signatures, we build multivariate Cox proportional hazards models using a dataset of 550 node-negative systemically untreated breast cancer patients. Models predictive of pathological complete response (pCR to neoadjuvant chemotherapy were also built using this approach. Results We identified statistically significant prognostic models for relapse-free survival (RFS at 7 years for the entire population, and for the subgroups of patients with ER-positive, or Luminal tumors. Furthermore, we found that combined models that included both clinical and genomic parameters improved prognostication compared with models with either clinical or genomic variables alone. Finally, we were able to build statistically significant combined models for pathological complete response (pCR predictions for the entire population. Conclusions Integration of gene expression signatures and clinical-pathological factors is an improved method over either variable type alone. Highly prognostic models could be created when using all patients, and for the subset of patients with lymph node-negative and ER-positive breast cancers. Other variables beyond gene expression and clinical-pathological variables, like gene mutation status or DNA

  1. The Perceived Success of Tutoring Students with Learning Disabilities: Relations to Tutee and Tutoring Variables

    Science.gov (United States)

    Michael, Rinat

    2016-01-01

    The current study examined the contribution of two types of variables to the perceived success of a tutoring project for college students with learning disabilities (LD): tutoring-related variables (the degree of engagement in different tutoring activities and difficulties encountered during tutoring), and tutee-related variables (learning…

  2. The clinical popularity of object relations concepts.

    Science.gov (United States)

    Friedman, L

    1988-10-01

    Object relations theory has the effect of supporting the psychoanalyst when he feels that the patient's effort is strongly opposed to his own. The current popularity of object relations theory may be related to the gradual disappearance from Freudian theory of a simple, clear image of an obligatory insistence by the patient that is useful even though it is unreflective. Object relations theory offers the practitioner a way of fortifying himself against blind demand, while newer Freudian theorists cope with the problem by orienting themselves more stringently toward the original paradigm of optional choice.

  3. Relating Psychosocial Variables in High School to Alcohol Use Trajectories During the Transition to Young Adulthood

    National Research Council Canada - National Science Library

    Morrow, Craig

    2000-01-01

    .... This study examined psychosocial variables-including peer focus, social skills, affect, antisocial behavior, gender, and sex-role attitudes-in an attempt to uncover variables related to changes...

  4. Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health.

    Science.gov (United States)

    Kroshus, Emily

    2016-05-01

    Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders. To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics. Cross-sectional study. College sports medicine departments. Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate). Electronic survey of departmental mental health screening activities. A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening. The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to

  5. Spatial variability of nitrogen-15 and its relation to the variability of other soil properties

    International Nuclear Information System (INIS)

    Selles, F.; Karamanos, R.E.; Kachanoski, R.G.

    1986-01-01

    The spatial variability of natural 15 N abundance of a cultivated Chernozemic soil and its native prairie counterpart were smaller than that of total N, organic C, and the C/N ratio. Further, the number of samples required to estimate the true mean of total N with a given precision at various probability levels were twofold those required to estimate the true mean of total N with a given precision at various probability levels were twofold those required to determine the mean 15 N abundance of total soil N in the surface horizons may reflect the isotopic composition of the nitrogenous substances entering the soil system or changes in the isotopic composition of soil N due to humification processes, probably induced by variations in topographic and microrelief features of the soil

  6. The importance of histopathological and clinical variables in predicting the evolution of colon cancer.

    Science.gov (United States)

    Diculescu, Mircea; Iacob, Răzvan; Iacob, Speranţa; Croitoru, Adina; Becheanu, Gabriel; Popeneciu, Valentin

    2002-09-01

    It has been a consensus that prognostic factors should always be taken into account before planning treatment in colorectal cancer. A 5 year prospective study was conducted, in order to assess the importance of several histopathological and clinical prognostic variables in the prediction of evolution in colon cancer. Some of the factors included in the analysis are still subject to dispute by different authors. 46 of 53 screened patients qualified to enter the study and underwent a potentially curative resection of the tumor, followed, when necessary, by adjuvant chemotherapy. Univariate and multivariate analyses were carried out in order to identify independent prognostic indicators. The endpoint of the study was considered the recurrence of the tumor or the detection of metastases. 65.2% of the patients had a good evolution during the follow up period. Multivariate survival analysis performed by Cox proportional hazard model identified 3 independent prognostic factors: Dukes stage (p = 0.00002), the grade of differentiation (p = 0.0009) and the weight loss index, representing the weight loss of the patient divided by the number of months when it was actually lost (p = 0.02). Age under 40 years, sex, microscopic aspect of the tumor, tumor location, anemia degree were not identified by our analysis as having prognostic importance. Histopathological factors continue to be the most valuable source of information regarding the possible evolution of patients with colorectal cancer. Individual clinical symptoms or biological parameters such as erytrocyte sedimentation rate or hemoglobin level are of little or no prognostic value. More research is required relating to the impact of a performance status index (which could include also weight loss index) as another reliable prognostic variable.

  7. Hydration behaviour of synthetic saponite at variable relative humidity

    Indian Academy of Sciences (India)

    Hydration behaviour of synthetic saponite was examined by X-ray powder diffraction simulation at various relative humidities (RH). The basal spacing of the Ca-saponite increased stepwise with increase in RH. The (00) reflections observed reflect single or dual hydration states of smectite. Quasi-rational, intermediate, or ...

  8. Work/Family Benefits: Variables Related to Employees' Fairness Perceptions.

    Science.gov (United States)

    Parker, Lauren; Allen, Tammy D.

    2001-01-01

    A study of 283 workers showed that younger people, minorities, those who used flexible work arrangements, and those whose jobs required greater interdependence had more favorable perceptions of family-related benefits. Gender and children's ages influenced perceptions of the fairness of benefits. (Contains 37 references.) (SK)

  9. Variability of Extragalactic Objects in Relation to Redshift, Color ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    properties of the objects, viz., redshift, color indices, radio spectral index ... properties of different types of closely related objects are expected to throw light on the ...... z = 3.0, OVV objects are concentrated at the lower range of the scale, mostly at ..... from the practical point of view in the sense that redshifts can be predicted ...

  10. Investigation of clinical pharmacokinetic variability of an opioid antagonist through physiologically based absorption modeling.

    Science.gov (United States)

    Ding, Xuan; He, Minxia; Kulkarni, Rajesh; Patel, Nita; Zhang, Xiaoyu

    2013-08-01

    Identifying the source of inter- and/or intrasubject variability in pharmacokinetics (PK) provides fundamental information in understanding the pharmacokinetics-pharmacodynamics relationship of a drug and project its efficacy and safety in clinical populations. This identification process can be challenging given that a large number of potential causes could lead to PK variability. Here we present an integrated approach of physiologically based absorption modeling to investigate the root cause of unexpectedly high PK variability of a Phase I clinical trial drug. LY2196044 exhibited high intersubject variability in the absorption phase of plasma concentration-time profiles in humans. This could not be explained by in vitro measurements of drug properties and excellent bioavailability with low variability observed in preclinical species. GastroPlus™ modeling suggested that the compound's optimal solubility and permeability characteristics would enable rapid and complete absorption in preclinical species and in humans. However, simulations of human plasma concentration-time profiles indicated that despite sufficient solubility and rapid dissolution of LY2196044 in humans, permeability and/or transit in the gastrointestinal (GI) tract may have been negatively affected. It was concluded that clinical PK variability was potentially due to the drug's antagonism on opioid receptors that affected its transit and absorption in the GI tract. Copyright © 2013 Wiley Periodicals, Inc.

  11. Correlation between measured energy expenditure and clinically obtained variables in trauma and sepsis patients.

    Science.gov (United States)

    Frankenfield, D C; Omert, L A; Badellino, M M; Wiles, C E; Bagley, S M; Goodarzi, S; Siegel, J H

    1994-01-01

    Indirect calorimetry is the preferred method for determining caloric requirements of patients, but availability of the device is limited by high cost. A study was therefore conducted to determine whether clinically obtainable variables could be used to predict metabolic rate. Patients with severe trauma or sepsis who required mechanical ventilation were measured by an open-circuit indirect calorimeter. Several clinical variables were obtained simultaneously. Measurements were repeated every 12 hours for up to 10 days. Twenty-six trauma and 30 sepsis patients were measured 423 times. Mean resting energy expenditure was 36 +/- 7 kcal/kg (trauma) vs 45 +/- 8 kcal/kg (sepsis) (p types.

  12. Validation of the Oral Hygiene Habits Scale: Relationships with sociodemographic variables in the general and clinical population of Monterrey, Mexico.

    Directory of Open Access Journals (Sweden)

    Norma Rodríguez

    2016-12-01

    Full Text Available Several socioeconomic factors are associated with poor oral hygiene habits. A version of the Oral Hygiene Habits Scale (OHHS was developed in Mexico to measure these factors; however, its relationship with sociodemographic variables has not been studied. The verification of these relationships could contribute to the validation of the scale. Objective: To evaluate the relationship between oral hygiene habits and sociodemographic variables of sex, age, schooling, self-defined socioeconomic stratum, occupation and marital status in the general and clinical population of Monterrey, Mexico. Materials and Methods: A general population sample (GPS of 256 participants and a clinical sample (CPS of 240 participants were studied. The OHHS consisted of an eight-item Likert scale of 4 points ranging from 0 to 4. A descriptive correlational study was performed with a cross-sectional design. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman correlation coefficient, Cramer's V coefficient, and multivariate aligned rank test. Results: In GPS and CPS groups, OHHS was related to sex, schooling, socioeconomic stratum, occupation and marital status, but not to age. There were no significant interactions between the samples (GPS and CPS and sociodemographic variables. Conclusion: There is a statistically significant relationship between oral hygiene habits and some sociodemographic variables in the general and clinical population. This relationship supports the validity of the OHHS.

  13. A non-local variable for general relativity

    International Nuclear Information System (INIS)

    Kozameh, C.N.; Newman, E.T.

    1983-01-01

    The usual description of differential geometry and general relativity is in terms of local fields, e.g. the metric, the curvature tensor, etc, which satisfy local differential equations. The authors introduce a new non-local field (Z) from which the local fields can be derived. Basically Z, though it is non-local, should be thought of as a function on the bundle of null directions on a space-time. The program can be divided into two parts; first the authors want to show the geometric meaning of and the relationship between Z and the local field. Then they want to provide field equations (non-local) for Z which will be equivalent to the vacuum Einstein equations for the local field. (Auth.)

  14. Undergraduate Nurse Variables that Predict Academic Achievement and Clinical Competence in Nursing

    Science.gov (United States)

    Blackman, Ian; Hall, Margaret; Darmawan, I Gusti Ngurah.

    2007-01-01

    A hypothetical model was formulated to explore factors that influenced academic and clinical achievement for undergraduate nursing students. Sixteen latent variables were considered including the students' background, gender, type of first language, age, their previous successes with their undergraduate nursing studies and status given for…

  15. [Phenotypic variability in 47, XXX patients: Clinical report of four new cases].

    Science.gov (United States)

    Goldschmidt, Ernesto; Márquez, Marisa; Solari, Andrea; Ziembar, María I; Laudicina, Alejandro

    2010-08-01

    The 47, XXX karyotype has a frequency of 1 in 1000 female newborns. However, this karyotype is not usually suspected at birth or childhood. These patients are usually diagnosed during adulthood when they develop premature ovarian failure or infertility, because the early phenotype doesn t have any specific features. The study describes four cases and the clinical variability of the 47, XXX karyotype.

  16. Variables Related to Romanticism and Self-Esteem in Pregnant Teenagers.

    Science.gov (United States)

    Medora, Nilufer P.; And Others

    1993-01-01

    Administered Dean Romanticism Scale and Bachman Self-Esteem Scale to 121 pregnant adolescents (ages 12-21). Found that two variables were significantly related to feelings of romanticism: adoption considerations and whether adolescent planned to have child with the baby's father. Two variables were significantly related to self-esteem: incidence…

  17. Relations between segmental and motor variability in prosodically complex nonword sequences.

    Science.gov (United States)

    Goffman, Lisa; Gerken, Louann; Lucchesi, Julie

    2007-04-01

    To assess how prosodic prominence and hierarchical foot structure influence segmental and articulatory aspects of speech production, specifically segmental accuracy and variability, and oral movement trajectory variability. Thirty individuals participated: 10 young adults, 10 children who are normally developing, and 10 children diagnosed with specific language impairment. Segmental error and segmental variability and movement trajectory variability were compared in low and high prosodic prominence conditions (i.e., strong and weak syllables) and in different prosodic foot structures. Between-participants findings were that both groups of children showed more segmental error and segmental variability and more movement trajectory variability than did adults. A similar within-participant pattern of results was observed for all 3 groups. Prosodic prominence influenced both segmental and motor levels of analysis, with weak syllables produced less accurately and with more lip and jaw movement trajectory variability than strong syllables. However, hierarchical foot structure affected segmental but not motor measures of speech production accuracy and variability. Motor and segmental variables were not consistently aligned. This pattern of results has clinical implications because inferences about motor variability may not directly follow from observations of segmental variability.

  18. The Paradox of Pelvic Exenteration: The Interaction of Clinical and Psychological Variables.

    Science.gov (United States)

    Arnaboldi, Paola; Santoro, Luigi; Mazzocco, Ketti; Oliveri, Serena; Maggioni, Angelo; Pravettoni, Gabriella

    2015-10-01

    To text the feasibility of a psychological intervention package administered to 49 pelvic exenteration candidates, aimed at evaluating the preoperative prevalence of psychological distress and assessing the presence of any correlation between preoperative psychological distress and clinical variables such as pain and hospitalization length. Patients were referred to the psychology unit from the very beginning of their clinical pathway and were administered the Psychological Distress Inventory (PDI) and the Mini-Mental Adjustment to Cancer (Mini-MAC) questionnaire at prehospital admission. Patients presenting with a significant level of distress received nonstandardized psychological support. Statistical analyses were performed to detect the presence of any correlation between psychological variables at prehospital admission and clinical outcomes. The 40% of patients had significant levels of distress at prehospital admission (PDI ≥ 30). As regards Mini-MAC, the mean value of fighting spirit attitude and fatalism was higher in our sample than in the normative sample of the Mini-MAC validation study in the Italian cancer population. Their anxious preoccupation attitude was lower. There were no correlations between clinical and psychological variables: level of postsurgery pain was higher (3.7) in the subgroup of patients with presurgery PDI < 30 compared with those with PDI ≥ 30 (3.5). However, this difference was not statistically significant (P = 1.00). Considering hospitalization length, the above described trend was similar. Although highly distressed, pelvic exenteration candidates show an adaptive range of coping mechanisms. This calls for a greater effort in studying the complexity of their psychoemotional status to provide them with the best multidisciplinary care. Extensive study of the real effectiveness of psychological intervention is warranted: randomized clinical trials could help in detecting the presence of any correlation between clinical and

  19. Variability in clinical data is often more useful than the mean: illustration of concept and simple methods of assessment

    NARCIS (Netherlands)

    Zwinderman, A. H.; Cleophas, T. J.

    2005-01-01

    BACKGROUND: Clinical investigators, although they are generally familiar with testing differences between averages, have difficulty testing differences between variabilities. OBJECTIVE: To give examples of situations where variability is more relevant than averages and to describe simple methods for

  20. Staphylococcus agnetis sp. nov., a coagulase-variable species from bovine subclinical and mild clinical mastitis.

    Science.gov (United States)

    Taponen, Suvi; Supré, Karlien; Piessens, Veerle; Van Coillie, Els; De Vliegher, Sarne; Koort, Joanna M K

    2012-01-01

    Thirteen Gram-positive-staining coagulase-variable staphylococci were isolated from subclinical and mild clinical mastitic bovine milk (n=12) and a teat apex (n=1). The results of sequence analysis of the 16S rRNA gene and two housekeeping genes, rpoB and tuf, and DNA fingerprinting with amplified fragment length polymorphism (AFLP) analysis showed that the isolates formed a separate branch within the genus Staphylococcus. The phylogenetically most closely related species were Staphylococcus hyicus and Staphylococcus chromogenes. DNA-DNA hybridization with S. hyicus DSM 20459(T) and S. chromogenes DSM 20674(T) confirmed that the isolates belonged to a separate species. The predominant fatty acids were i-C(15:0), ai-C(15:0), i-C(17:0) and C(20:0) and the peptidoglycan type was A3α L-Lys-Gly(5). Based on the results of genotypic and phenotypic analyses, it is proposed that the thirteen isolates represent a novel species, for which the name Staphylococcus agnetis sp. nov. is proposed. Strain 6-4(T) (=DSM 23656(T)=CCUG 59809(T)) is the type strain.

  1. Coupled variable selection for regression modeling of complex treatment patterns in a clinical cancer registry.

    Science.gov (United States)

    Schmidtmann, I; Elsäßer, A; Weinmann, A; Binder, H

    2014-12-30

    For determining a manageable set of covariates potentially influential with respect to a time-to-event endpoint, Cox proportional hazards models can be combined with variable selection techniques, such as stepwise forward selection or backward elimination based on p-values, or regularized regression techniques such as component-wise boosting. Cox regression models have also been adapted for dealing with more complex event patterns, for example, for competing risks settings with separate, cause-specific hazard models for each event type, or for determining the prognostic effect pattern of a variable over different landmark times, with one conditional survival model for each landmark. Motivated by a clinical cancer registry application, where complex event patterns have to be dealt with and variable selection is needed at the same time, we propose a general approach for linking variable selection between several Cox models. Specifically, we combine score statistics for each covariate across models by Fisher's method as a basis for variable selection. This principle is implemented for a stepwise forward selection approach as well as for a regularized regression technique. In an application to data from hepatocellular carcinoma patients, the coupled stepwise approach is seen to facilitate joint interpretation of the different cause-specific Cox models. In conditional survival models at landmark times, which address updates of prediction as time progresses and both treatment and other potential explanatory variables may change, the coupled regularized regression approach identifies potentially important, stably selected covariates together with their effect time pattern, despite having only a small number of events. These results highlight the promise of the proposed approach for coupling variable selection between Cox models, which is particularly relevant for modeling for clinical cancer registries with their complex event patterns. Copyright © 2014 John Wiley & Sons

  2. HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression.

    Science.gov (United States)

    Blanco, Madeline; Machado, Liuber Y; Díaz, Héctor; Ruiz, Nancy; Romay, Dania; Silva, Eladio

    2015-10-01

    INTRODUCTION Serological and molecular HIV-1 studies in Cuba have shown very low prevalence of seropositivity, but an increasing genetic diversity attributable to introduction of many HIV-1 variants from different areas, exchange of such variants among HIV-positive people with several coinciding routes of infection and other epidemiologic risk factors in the seropositive population. The high HIV-1 genetic variability observed in Cuba has possible implications for transmission and clinical progression. OBJECTIVE Study genetic variability for the HIV-1 env, gag and pol structural genes in Cuba; determine the prevalence of B and non-B subtypes according to epidemiologic and behavioral variables and determine whether a relationship exists between genetic variability and transmissibility, and between genetic variability and clinical disease progression in people living with HIV/AIDS. METHODS Using two molecular assays (heteroduplex mobility assay and nucleic acid sequencing), structural genes were characterized in 590 people with HIV-1 (480 men and 110 women), accounting for 3.4% of seropositive individuals in Cuba as of December 31, 2013. Nonrandom sampling, proportional to HIV prevalence by province, was conducted. Relationships between molecular results and viral factors, host characteristics, and patients' clinical, epidemiologic and behavioral variables were studied for molecular epidemiology, transmission, and progression analyses. RESULTS Molecular analysis of the three HIV-1 structural genes classified 297 samples as subtype B (50.3%), 269 as non-B subtypes (45.6%) and 24 were not typeable. Subtype B prevailed overall and in men, mainly in those who have sex with men. Non-B subtypes were prevalent in women and heterosexual men, showing multiple circulating variants and recombinant forms. Sexual transmission was the predominant form of infection for all. B and non-B subtypes were encountered throughout Cuba. No association was found between subtypes and

  3. Discrepancies between self and observer ratings of depression. The relationship to demographic, clinical and personality variables.

    Science.gov (United States)

    Enns, M W; Larsen, D K; Cox, B J

    2000-10-01

    The observer-rated Hamilton depression scale (HamD) and the self-report Beck Depression Inventory (BDI) are among the most commonly used rating scales for depression, and both have well demonstrated reliability and validity. However, many depressed subjects have discrepant scores on these two assessment methods. The present study evaluated the ability of demographic, clinical and personality factors to account for the discrepancies observed between BDI and HamD ratings. The study group consisted of 94 SCID-diagnosed outpatients with a current major depressive disorder. Subjects were rated with the 21-item HamD and completed the BDI and the NEO-Five Factor Inventory. Younger age, higher educational attainment, and depressive subtype (atypical, non-melancholic) were predictive of higher BDI scores relative to HamD observer ratings. In addition, high neuroticism, low extraversion and low agreeableness were associated with higher endorsement of depressive symptoms on the BDI relative to the HamD. In general, these predictive variables showed a greater ability to explain discrepancies between self and observer ratings of psychological symptoms of depression compared to somatic symptoms of depression. The study does not determine which aspects of neuroticism and extraversion contribute to the observed BDI/HamD discrepancies. Depression ratings obtained with the BDI and HamD are frequently discordant and a number of patient characteristics robustly predict the discrepancy between these two rating methods. The value of multi-modal assessment in the conduct of research on depressive disorders is re-affirmed.

  4. Effects of Amerindian Genetic Ancestry on Clinical Variables and Therapy in Patients with Rheumatoid Arthritis.

    Science.gov (United States)

    Sánchez, Elena; García de la Torre, Ignacio; Sacnún, Mónica; Goñi, Mario; Berbotto, Guillermo; Paira, Sergio; Musuruana, Jorge Luis; Graf, César; Alvarellos, Alejandro; Messina, Osvaldo D; Babini, Alejandra; Strusberg, Ingrid; Marcos, Juan Carlos; Scherbarth, Hugo; Spindler, Alberto; Quinteros, Ana; Toloza, Sergio; Moreno, José Luis C; Catoggio, Luis J; Tate, Guillermo; Eimon, Alicia; Citera, Gustavo; Pellet, Antonio Catalán; Nasswetter, Gustavo; Cardiel, Mario H; Miranda, Pedro; Ballesteros, Francisco; Esquivel-Valerio, Jorge A; Maradiaga-Ceceña, Marco A; Acevedo-Vásquez, Eduardo M; García, Conrado García; Tusié-Luna, Teresa; Pons-Estel, Bernardo A; Alarcón-Riquelme, Marta E

    2017-12-01

    To define whether Amerindian genetic ancestry correlates with clinical and therapeutic variables in admixed individuals with rheumatoid arthritis (RA) from Latin America. Patients with RA (n = 1347) and healthy controls (n = 1012) from Argentina, Mexico, Chile, and Peru were included. Samples were genotyped for the Immunochip v1 using the Illumina platform. Clinical data were obtained through interviews or the clinical history. Percentage of Amerindian ancestry was comparable between cases and controls. Morning stiffness (p ancestry after Bonferroni correction. Higher Amerindian ancestry correlated only with weight loss (p Bonferroni ancestry correlated with higher doses of azathioprine (p ancestry protects against most major clinical criteria of RA, but regarding the association of RF with increased European ancestry, age, sex, and smoking are modifiers. Ancestry also correlates with the therapeutic profiles.

  5. National Database for Clinical Trials Related to Mental Illness (NDCT)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Database for Clinical Trials Related to Mental Illness (NDCT) is an extensible informatics platform for relevant data at all levels of biological and...

  6. Assessing data quality and the variability of source data verification auditing methods in clinical research settings.

    Science.gov (United States)

    Houston, Lauren; Probst, Yasmine; Martin, Allison

    2018-05-18

    Data audits within clinical settings are extensively used as a major strategy to identify errors, monitor study operations and ensure high-quality data. However, clinical trial guidelines are non-specific in regards to recommended frequency, timing and nature of data audits. The absence of a well-defined data quality definition and method to measure error undermines the reliability of data quality assessment. This review aimed to assess the variability of source data verification (SDV) auditing methods to monitor data quality in a clinical research setting. The scientific databases MEDLINE, Scopus and Science Direct were searched for English language publications, with no date limits applied. Studies were considered if they included data from a clinical trial or clinical research setting and measured and/or reported data quality using a SDV auditing method. In total 15 publications were included. The nature and extent of SDV audit methods in the articles varied widely, depending upon the complexity of the source document, type of study, variables measured (primary or secondary), data audit proportion (3-100%) and collection frequency (6-24 months). Methods for coding, classifying and calculating error were also inconsistent. Transcription errors and inexperienced personnel were the main source of reported error. Repeated SDV audits using the same dataset demonstrated ∼40% improvement in data accuracy and completeness over time. No description was given in regards to what determines poor data quality in clinical trials. A wide range of SDV auditing methods are reported in the published literature though no uniform SDV auditing method could be determined for "best practice" in clinical trials. Published audit methodology articles are warranted for the development of a standardised SDV auditing method to monitor data quality in clinical research settings. Copyright © 2018. Published by Elsevier Inc.

  7. Nutritional variables and work-related accidents: a case-control study.

    Science.gov (United States)

    de Medeiros, M A T; Zangirolani, Lia Thieme Oikawa; Cordeiro, Ricardo Carlos; da Costa, Proença Rossana Pacheco; Diez-Garcia, Rosa Wanda

    2014-01-01

    Nutritional aspects are important for the prevention of diseases and disorders, and few studies have focused on the relationship between risk of work injury and nutritional variables. This study aimed to verify whether nutritional variables constitute risk factors for work-related accidents. 1,422 industrial workers (600 cases plus 822 controls). A case-control study was carried out in an industrial city in south-east Brazil. A multiple logistic regression model was adjusted using work-related accidents as the response variable and nutritional variables as predictors. The associations were assessed by Odds Ratio (OR), with a p-value work-related accidents were (a) attending formal education for an above average number of years (OR=0.91, pwork-related accidents. This indicates the need, during the formulation of policies for these kinds of government benefits, to include nutrition aspects in order to minimize work-related accidents risks.

  8. Visit-to-visit cholesterol variability correlates with coronary atheroma progression and clinical outcomes.

    Science.gov (United States)

    Clark, Donald; Nicholls, Stephen J; St John, Julie; Elshazly, Mohamed B; Kapadia, Samir R; Tuzcu, E Murat; Nissen, Steven E; Puri, Rishi

    2018-04-21

    Utilizing serial intravascular ultrasonography (IVUS), we aimed to exam the association of intra-individual lipid variability, coronary atheroma progression, and clinical outcomes. We performed a post hoc patient-level analysis of nine clinical trials involving 4976 patients with coronary artery disease who underwent serial coronary IVUS in the setting of a range of medical therapies. We assessed the associations between progression in percent atheroma volume (ΔPAV), clinical outcomes, and visit-to-visit lipid variability including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol (TC)/HDL-C, and apolipoprotein B (ApoB). Variability of lipid parameters was measured using intra-individual standard deviation over 3, 6, 12, 18, and 24 months. Atherogenic lipoprotein variability significantly associated with ΔPAV [odds ratio (95% confidence interval; P-value), LDL-C: 1.09 (1.02, 1.17, P = 0.01); non-HDL-C: 1.10 (1.02, 1.18, P = 0.01); TC/HDL-C: 1.14 (1.06, 1.24, P = 0.001); ApoB: 1.13 (1.03, 1.24, P = 0.01)]. Survival curves revealed significant stepwise relationships between cumulative major adverse cardiovascular events and increasing quartiles of atherogenic lipoprotein variability at 24-months follow-up (log-rank P C). Stronger associations were noted between achieved lipoprotein levels and ΔPAV [LDL-C: 1.27 (1.17, 1.39; P C: 1.32 (1.21, 1.45; P C: 1.31 (1.19, 1.45; P < 0.001); ApoB: 1.20 (1.07, 1.35; P = 0.003)]. Greater visit-to-visit variability in atherogenic lipoprotein levels significantly associates with coronary atheroma progression and clinical outcomes, although the association between achieved atherogenic lipoproteins and atheroma progression appears stronger. These data highlight the importance of achieving low and consistent atherogenic lipoprotein levels to promote plaque regression and improve clinical outcomes.

  9. Using Relational Reasoning Strategies to Help Improve Clinical Reasoning Practice.

    Science.gov (United States)

    Dumas, Denis; Torre, Dario M; Durning, Steven J

    2018-05-01

    Clinical reasoning-the steps up to and including establishing a diagnosis and/or therapy-is a fundamentally important mental process for physicians. Unfortunately, mounting evidence suggests that errors in clinical reasoning lead to substantial problems for medical professionals and patients alike, including suboptimal care, malpractice claims, and rising health care costs. For this reason, cognitive strategies by which clinical reasoning may be improved-and that many expert clinicians are already using-are highly relevant for all medical professionals, educators, and learners.In this Perspective, the authors introduce one group of cognitive strategies-termed relational reasoning strategies-that have been empirically shown, through limited educational and psychological research, to improve the accuracy of learners' reasoning both within and outside of the medical disciplines. The authors contend that relational reasoning strategies may help clinicians to be metacognitive about their own clinical reasoning; such strategies may also be particularly well suited for explicitly organizing clinical reasoning instruction for learners. Because the particular curricular efforts that may improve the relational reasoning of medical students are not known at this point, the authors describe the nature of previous research on relational reasoning strategies to encourage the future design, implementation, and evaluation of instructional interventions for relational reasoning within the medical education literature. The authors also call for continued research on using relational reasoning strategies and their role in clinical practice and medical education, with the long-term goal of improving diagnostic accuracy.

  10. Do Assault-Related Variables Predict Response to Cognitive Behavioral Treatment for PTSD?

    Science.gov (United States)

    Hembree, Elizabeth A.; Street, Gordon P.; Riggs, David S.; Foa, Edna B.

    2004-01-01

    This study examined the hypothesis that variables such as history of prior trauma, assault severity, and type of assault, previously found to be associated with natural recovery, would also predict treatment outcome. Trauma-related variables were examined as predictors of posttreatment posttraumatic stress disorder (PTSD) severity in a sample of…

  11. Vietnamese Americans' Attitudes toward Seeking Mental Health Services: Relation to Cultural Variables

    Science.gov (United States)

    Nguyen, Quang Charles X.; Anderson, Louis P.

    2005-01-01

    This study examined the relation between culturally based variables and attitudes toward seeking mental health services among a community sample of Vietnamese Americans (N = 148) with at least 8 years' residence in the United States (U.S.). Variables included Stigma, Traditional Beliefs about Mental Illness, Help-Seeking Preferences, Problem…

  12. Short-Term Blood Pressure Variability Relates to the Presence of Subclinical Brain Small Vessel Disease in Primary Hypertension.

    Science.gov (United States)

    Filomena, Josefina; Riba-Llena, Iolanda; Vinyoles, Ernest; Tovar, José L; Mundet, Xavier; Castañé, Xavier; Vilar, Andrea; López-Rueda, Antonio; Jiménez-Baladó, Joan; Cartanyà, Anna; Montaner, Joan; Delgado, Pilar

    2015-09-01

    Blood pressure (BP) variability is associated with stroke risk, but less is known about subclinical cerebral small vessel disease (CSVD). We aimed to determine whether CSVD relates to short-term BP variability independently of BP levels and also, whether they improve CSVD discrimination beyond clinical variables and office BP levels. This was a cohort study on asymptomatic hypertensives who underwent brain magnetic resonance imaging and 24-hour ambulatory BP monitoring. Office and average 24-hour, daytime and nighttime BP levels, and several metrics of BP variability (SD, weighted SD, coefficient of variation, and average real variability [ARV]) were calculated. Definition of CSVD was based on the presence of lacunar infarcts and white matter hyperintensity grades. Multivariate analysis and integrated discrimination improvement were performed to assess whether BP variability and levels were independently associated with CSVD and improved its discrimination. Four hundred eighty-seven individuals participated (median age, 64; 47% women). CSVD was identified in 18.9%, related to age, male sex, diabetes mellitus, use of treatment, ambulatory BP monitoring-defined BP levels, and ARV of systolic BP at any period. The highest prevalence (33.7%) was found in subjects with both 24-hour BP levels and ARV elevated. BP levels at any period and ARV (24 hours and nocturnal) emerged as independent predictors of CSVD, and discrimination was incrementally improved although not to a clinically significant extent (integrated discrimination improvement, 5.31%, 5.17% to 5.4%). Ambulatory BP monitoring-defined BP levels and ARV of systolic BP relate to subclinical CSVD in hypertensive individuals. © 2015 American Heart Association, Inc.

  13. A period-luminosity relation for supergiant red variables in the Large Magellanic Cloud

    International Nuclear Information System (INIS)

    Feast, M.W.; Catchpole, R.M.; Carter, B.S.; Roberts, G.

    1980-01-01

    Infrared photometry for 24 red supergiant variables in the LMC is used to derive bolometric magnitudes. The existence of a period-luminosity relation for these stars is demonstrated and compared with theory. (author)

  14. Current clinical research of immunoglobulin G4-related orbital disease

    Directory of Open Access Journals (Sweden)

    Yang Wang

    2016-05-01

    Full Text Available Immunoglobulin G4-related disease(IgG4-related diseasehas received lots of attention in medical community as a recently recognized fibro-inflammatory condition. It is characterized by infiltration of IgG4-immunopositive plasmacytes and concentration of elevated serum IgG4. IgG4-related disease shows organ enlargement or nodular/hyperplastic lesions in various organs including the pancreas, hepatobiliary tract and orbit, which is called IgG4-related orbital disease. The diagnostic criteria for IgG4-related disease and IgG4-related orbital disease has recently been established, which is based on clinical, imaging and histopathologic features of the orbital lesions. Besides, attention should be drawn to the differentiation from other diseases. The treatment is empirical including corticosteroids, immunosuppressive drugs, radiotherapy, and rituximab. This article reviews clinical progression of IgG4-related orbital disease.

  15. Nefropatía diabética incipiente en diabéticos tipo 1 atendidos en el Centro de Atención al Diabético y su relación con algunas variables clínicas y bioquímicas Incipient diabetic nephropathy in type 1 diabetics seen in the Diabetes Care Center and its relation to some clinical and biochemical variables

    Directory of Open Access Journals (Sweden)

    Manuel E. Licea Puig

    2006-12-01

    Full Text Available La nefropatía diabética (ND es la principal causa de muerte en las personas con diabetes mellitus tipo1 (DM1. Su prevención e identificación temprana puede disminuir la morbimortalidad y mejorar la calidad de vida de estas personas. Este trabajo tuvo como objetivo determinar la frecuencia de nefropatía diabética incipiente (NDI en personas con DM1 y su relación con algunas variables clínicas y bioquímicas. En 240 personas con DM1 atendidas consecutivamente en el Centro de Atención al Diabético del Instituto Nacional de Endocrinología, en Ciudad de La Habana, se estudiaron las siguientes variables: edad, sexo, peso, talla, hábito de fumar, índice de masa corporal, edad del diagnóstico y tiempo de evolución de la DM1, presión arterial, presencia de retinopatía diabética (RD, glucemia en ayunas y 2 h después del desayuno (posprandial, hemoglobina glucosilada y excreción urinaria de albúmina (EUA. No se incluyeron en el estudio personas con ND clínica, con nefropatía no diabética, ni con otras condiciones que aumenten la EUA. Se dividieron en dos grupos: 1 normoalbuminúricos (EUA 20 a Diabetic nephropathy (DN is the main cause of death in the persons with type 1 diabetes mellitus. Its prevention and early identification may reduce the morbimortality and improve the quality of life of these persons. The objective of this paper is to determine the frequency of incipient diabetic nephropathy (IDN in persons with type 1 diabetes mellitus and its connection with some clinical and biochemical variables. Age, sex, weight, height, smoking habit, body mass index, age at diagnosis and time of evolution of type diabetes mellitus, arterial pressure, presence of diabetic retinopathy (DR, fasting glycaemia and glycaemia 2 hours after breakfast (postprandial, glycosilated hemoglobin and albumin urinary excretion (AUE were the variables studied among 240 persons with type 1 diabetes mellitus seen consecutively at the Diabetes Care Center

  16. Google Flu Trends Spatial Variability Validated Against Emergency Department Influenza-Related Visits.

    Science.gov (United States)

    Klembczyk, Joseph Jeffrey; Jalalpour, Mehdi; Levin, Scott; Washington, Raynard E; Pines, Jesse M; Rothman, Richard E; Dugas, Andrea Freyer

    2016-06-28

    Influenza is a deadly and costly public health problem. Variations in its seasonal patterns cause dangerous surges in emergency department (ED) patient volume. Google Flu Trends (GFT) can provide faster influenza surveillance information than traditional CDC methods, potentially leading to improved public health preparedness. GFT has been found to correlate well with reported influenza and to improve influenza prediction models. However, previous validation studies have focused on isolated clinical locations. The purpose of the study was to measure GFT surveillance effectiveness by correlating GFT with influenza-related ED visits in 19 US cities across seven influenza seasons, and to explore which city characteristics lead to better or worse GFT effectiveness. Using Healthcare Cost and Utilization Project data, we collected weekly counts of ED visits for all patients with diagnosis (International Statistical Classification of Diseases 9) codes for influenza-related visits from 2005-2011 in 19 different US cities. We measured the correlation between weekly volume of GFT searches and influenza-related ED visits (ie, GFT ED surveillance effectiveness) per city. We evaluated the relationship between 15 publically available city indicators (11 sociodemographic, two health care utilization, and two climate) and GFT surveillance effectiveness using univariate linear regression. Correlation between city-level GFT and influenza-related ED visits had a median of .84, ranging from .67 to .93 across 19 cities. Temporal variability was observed, with median correlation ranging from .78 in 2009 to .94 in 2005. City indicators significantly associated (P<.10) with improved GFT surveillance include higher proportion of female population, higher proportion with Medicare coverage, higher ED visits per capita, and lower socioeconomic status. GFT is strongly correlated with ED influenza-related visits at the city level, but unexplained variation over geographic location and time

  17. Generating relations of multi-variable Tricomi functions of two indices using Lie algebra representation

    Directory of Open Access Journals (Sweden)

    Nader Ali Makboul Hassan

    2014-01-01

    Full Text Available This paper is an attempt to stress the usefulness of the multi-variable special functions. In this paper, we derive certain generating relations involving 2-indices 5-variables 5-parameters Tricomi functions (2I5V5PTF by using a Lie-algebraic method. Further, we derive certain new and known generating relations involving other forms of Tricomi and Bessel functions as applications.

  18. Intra-Gene DNA Methylation Variability Is a Clinically Independent Prognostic Marker in Women's Cancers.

    Directory of Open Access Journals (Sweden)

    Thomas E Bartlett

    Full Text Available We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221, which validates in two independent data sets from Mayo Clinic (n = 198 and TCGA (n = 358, with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes.

  19. Intra-Gene DNA Methylation Variability Is a Clinically Independent Prognostic Marker in Women's Cancers.

    Science.gov (United States)

    Bartlett, Thomas E; Jones, Allison; Goode, Ellen L; Fridley, Brooke L; Cunningham, Julie M; Berns, Els M J J; Wik, Elisabeth; Salvesen, Helga B; Davidson, Ben; Trope, Claes G; Lambrechts, Sandrina; Vergote, Ignace; Widschwendter, Martin

    2015-01-01

    We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV) based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221), which validates in two independent data sets from Mayo Clinic (n = 198) and TCGA (n = 358), with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF) binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes.

  20. Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

    Directory of Open Access Journals (Sweden)

    Vanessa L. Strelow

    Full Text Available ABSTRACT Meningococcal meningitis is a public health problem. The aim of this study was to describe the clinical characteristics of patients with meningococcal meningitis, and to identify associated factors with mortality. This was a retrospective study, between 2006 and 2011, at a referral center in São Paulo, Brazil. Logistic regression analysis was used to identify factors associated with mortality. We included 316 patients. The median age was 16 years (IQR: 7–27 and 60% were male. The clinical triad: fever, headache and neck stiffness was observed in 89% of the patients. The cerebrospinal triad: pleocytosis, elevated protein levels and low glucose levels was present in 79% of patients. Factors associated with mortality in the multivariate model were age above 50 years, seizures, tachycardia, hypotension and neck stiffness. The classic clinical and laboratory triads of meningococcal meningitis were variable. The fatality rate was low. Age, seizures and shock signs were independently associated with mortality.

  1. Epilepsy-related clinical factors and psychosocial functions in pediatric epilepsy.

    Science.gov (United States)

    Eom, Soyong; Eun, So-Hee; Kang, Hoon-Chul; Eun, Baik-Lin; Nam, Sang Ook; Kim, Sun Jun; Chung, Hee Jung; Kwon, Soon Hak; Lee, Young-Mock; Lee, Joon Soo; Kim, Dong Wook; Oh, Kyung Ja; Kim, Heung Dong

    2014-08-01

    The aim of this study was to identify the different influencing patterns of demographic and epilepsy-related variables on various aspects of psychosocial function in pediatric epilepsy. Five hundred ninety-eight patients with pediatric epilepsy between the ages of 4 and 18 years (boys=360, 60% and girls=238, 40%) and their parents participated in the study. Parents completed the Social Maturity Scale (SMS), the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire (K-QOLCE) to assess daily living function, behavior, and quality of life. The Children's Global Assessment Scale (CGAS) was completed by clinicians to assess general adaptive function. Demographic variables, such as age and sex of child, and epilepsy-related clinical variables, including seizure type, seizure frequency, duration of epilepsy, and number of medications, were obtained from medical records. Demographic and epilepsy-related clinical variables had a strong influence (22-32%) on the cognition-related domain such as general adaptive function, school/total competence, and quality of life for cognitive function while a comparatively smaller effect (2-16%) on the more psychological domain including behavioral, emotional, and social variables. Younger age, shorter duration of illness, and smaller number of medications showed a strong positive impact on psychosocial function in pediatric epilepsy, particularly for adaptive function, competence, and quality-of-life aspects. Given the wide range of impact of demographic and clinical variables on various facets of psychosocial functions, more specific understanding of the various aspects of factors and their particular pattern of influence may enable more effective therapeutic approaches that address both the medical and psychological needs in pediatric epilepsy. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Episiotomy and its relationship to various clinical variables that influence its performance

    Science.gov (United States)

    Ballesteros-Meseguer, Carmen; Carrillo-García, César; Meseguer-de-Pedro, Mariano; Canteras-Jordana, Manuel; Martínez-Roche, Mª Emilia

    2016-01-01

    Objective: to understand the episiotomy rate and its relationship with various clinical variables. Method: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. Conclusions: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure. PMID:27224064

  3. Relations between altered stramflow variability and fish assemblages in Eastern USA streams

    Science.gov (United States)

    Meador, Michael R.; Carlisle, Daren M.

    2012-01-01

    Although altered streamflow has been implicated as a major factor affecting fish assemblages, understanding the extent of streamflow alteration has required quantifying attributes of the natural flow regime. We used predictive models to quantify deviation from expected natural streamflow variability for streams in the eastern USA. Sites with >25% change in mean daily streamflow variability compared with what would be expected in a minimally disturbed environment were defined as having altered streamflow variability, based on the 10th and 90th percentiles of the distribution of streamflow variability at 1279 hydrological reference sites. We also used predictive models to assess fish assemblage condition and native species loss based on the proportion of expected native fish species that were observed. Of the 97 sites, 49 (50.5%) were classified as altered with reduced streamflow variability, whereas no sites had increased streamflow variability. Reduced streamflow variability was related to a 35% loss in native fish species, on average, and a >50% loss of species with a preference for riffle habitats. Conditional probability analysis indicated that the probability of fish assemblage impairment increased as the severity of altered streamflow variability increased. Reservoir storage capacity and wastewater discharges were important predictors of reduced streamflow variability as revealed by random forest analysis. Management and conservation of streams will require careful consideration of natural streamflow variation and potential factors contributing to altered streamflow within the entire watershed to limit the loss of critical stream habitats and fish species uniquely adapted to live in those habitats.

  4. Clinical and forensic signs related to opioids abuse.

    Science.gov (United States)

    Dinis-Oliveira, Ricardo Jorge; Carvalho, Felix; Moreira, Roxana; Duarte, Jose Alberto; Proenca, Jorge Brandao; Santos, Agostinho; Magalhaes, Teresa

    2012-12-01

    For a good performance in Clinical and Forensic Toxicology it is important to be aware of the biological and non-biological signs and symptoms related to xenobiotic exposure. This manuscript highlights and analyzes clinical and forensic imaging related to opioids abuse critically. Particularly, respiratory depression, track marks and hemorrhages, skin "popping", practices of phlebotomy, tissue necrosis and ulceration, dermatitis, tongue hyperpigmentation, "coma blisters", intra-arterial administration, candidiasis, wounds associated with anthrax or clostridium contaminated heroin, desomorphine related lesions and characteristic non-biological evidences are some commonly reported findings in opioids abuse, which will be discussed. For this purpose, clinical and forensic cases from our database (National Institute of Legal Medicine and Forensic Sciences, North Branch, Portugal), in addition to literature data, are reviewed.

  5. Work-related stressors experienced by part-time clinical affiliate nursing faculty in baccalaureate education.

    Science.gov (United States)

    Whalen, Kathleen S

    2009-01-01

    This descriptive and multivariate correlational study identifies work-related situations that were perceived as stressful in a sample of part-time clinical affiliate nursing faculty (n = 91) from a western state who teach in baccalaureate programs. The most stressful conditions include being physically and emotionally drained; working outside regular hours; dealing with the number of role expectations; and receiving inadequate monetary compensation. Subjects reported other specific stressful situations related to their work with clinical agencies, universities, and students. The researcher also examined the relationships between selected background factors (number of years of clinical teaching experience, clinical teacher education, and holding a second job), role stress, and job satisfaction. Even though this sample had a high job satisfaction rating, the variable, role stress, was shown to significantly predict job satisfaction. Lastly, implications for nurse educators in baccalaureate programs are explored.

  6. Predictive value of clinical and laboratory variables for vesicoureteral reflux in children.

    Science.gov (United States)

    Soylu, Alper; Kasap, Belde; Demir, Korcan; Türkmen, Mehmet; Kavukçu, Salih

    2007-06-01

    We aimed to determine the predictability of clinical and laboratory variables for vesicoureteral reflux (VUR) in children with urinary tract infection (UTI). Data of children with febrile UTI who underwent voiding cystoureterography between 2002 and 2005 were evaluated retrospectively for clinical (age, gender, fever > or = 38.5 degrees C, recurrent UTI), laboratory [leukocytosis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), pyuria, serum creatinine (S(Cr))] and imaging (renal ultrasonography) variables. Children with VUR (group 1) vs. no VUR (group 2) and children with high-grade (III-V) VUR (group 3) vs. no or low-grade (I-II) VUR (group 4) were compared. Among 88 patients (24 male), 38 had VUR and 21 high-grade VUR. Fever > or = 38.5 degrees C was associated with VUR [odds ratio (OR): 7.5]. CRP level of 50 mg/l was the best cut-off level for predicting high-grade VUR (OR 15.5; discriminative ability 0.89 +/- 0.05). Performing voiding cystourethrography based on this CRP level would result in failure to notice 9% of patients with high-grade VUR, whereas 69% of children with no/low-grade VUR would be spared from this invasive test. In conclusion, fever > or = 38 degrees C and CRP > 50 mg/l seem to be potentially useful clinical predictors of VUR and high-grade VUR, respectively, in pediatric patients with UTI. Further validation of these findings could limit unnecessary voiding cystourethrography.

  7. Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review

    Directory of Open Access Journals (Sweden)

    Alyson J. McGregor

    2017-10-01

    Full Text Available The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. This move has resulted in a rapidly increasing body of literature on SABV with important implications for changing the clinical practice of emergency medicine (EM. Translation of this new knowledge to the bedside requires an understanding of how sex-based research will ultimately impact patient care. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled.

  8. Effects of CPAP on clinical variables and autonomic modulation in children during an asthma attack.

    Science.gov (United States)

    de Freitas Dantas Gomes, Evelim Leal; Costa, Dirceu; Germano, Sandra Maria; Borges, Pâmela Vieira; Sampaio, Luciana Maria Malosá

    2013-08-01

    Continuous positive airway pressure (CPAP) causes changes in alveolar and intrathoracic pressure and the activation of pulmonary stretch receptors affects the balance of the autonomic nervous system. The acute effects of CPAP on autonomic modulation have been demonstrated in different diseases, but no studies have been carried out addressing CPAP in patients with asthma. The hypothesis tested in the present study is that CPAP can produce an autonomic effect beyond a mechanical effect of bronchial dilatation in children with asthma. The results demonstrated improvements in clinical variables and an increase in vagal tone with the administration of CPAP during an asthma attack, as demonstrated by a diminished respiratory rate and a reduction in signs of respiratory distress. Regarding autonomic modulation, an increase in parasympathetic variables was found, indicating non-cholinergic activation stemming from the persistent increase in peak flow. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Variability in the Reporting of Serum Urate and Flares in Gout Clinical Trials

    DEFF Research Database (Denmark)

    Stamp, Lisa K; Morillon, Melanie B; Taylor, William J

    2018-01-01

    OBJECTIVE: To describe the ways in which serum urate (SU) and gout flares are reported in clinical trials, and to propose minimum reporting requirements. METHODS: This analysis was done as part of a systematic review aiming to validate SU as a biomarker for gout. The ways in which SU and flares.......3%) of these reporting at more than just the final study visit. Two ways of reporting gout flares were identified: mean flare rate and percentage of participants with flares. There was variability in time periods over which flares rates were reported. CONCLUSION: There is inconsistent reporting of SU and flares in gout...... studies. Reporting the percentage of participants who achieve a target SU reflects international treatment guidelines. SU should also be reported as a continuous variable with a relevant central and dispersion estimate. Gout flares should be reported as both percentage of participants and mean flare rates...

  10. Relation between task complexity and variability of procedure progression during an emergency operation

    International Nuclear Information System (INIS)

    Kim, Yochan; Park, Jinkyun; Jung, Wondea

    2013-01-01

    Highlights: • The relation between task complexity and the variability of procedure progression was investigated. • The two quantitative measures, TACOM and VPP, were applied to this study. • The task complexity was positively related with the operator’s procedural variability. • The VPP measure can be useful for explaining the operator’s behaviors. - Abstract: In this study, the relation between task complexity and variability of procedure progression during an emergency operation was investigated by comparing the two quantitative measures. To this end, the TACOM measure and VPP measure were applied to evaluate the complexity of tasks and variability of procedure progression, respectively. The TACOM scores and VPP scores were obtained for 60 tasks in the OPERA database, and a correlation analysis between two measures and a multiple regression analysis between the sub-measures of the TACOM measure and VPP measure were conducted. The results showed that the TACOM measure is positively associated with the VPP measure, and the abstraction hierarchy complexity mainly affected the variability among the sub-measures of TACOM. From these findings, it was discussed that the task complexity is related to an operator’s procedural variability and VPP measure can be useful for explaining the operator’s behaviors

  11. Identifying emotional intelligence skills of Turkish clinical nurses according to sociodemographic and professional variables.

    Science.gov (United States)

    Kahraman, Nilgün; Hiçdurmaz, Duygu

    2016-04-01

    This study aimed to identify the emotional intelligence skills of Turkish clinical nurses according to sociodemographic and professional variables. Emotional intelligence is "the ability of a person to comprehend self-emotions, to show empathy towards the feelings of others, and to control self-emotions in a way that enriches life." Nurses with a higher emotional intelligence level offer more efficient and professional care, and they accomplish more in their social and professional lives. We designed a descriptive cross-sectional study. The Introductory Information Form and the Bar-On emotional intelligence Inventory were used to collect data between 20th June and 20th August 2012. The study was conducted with 312 nurses from 37 hospitals located within the borders of the metropolitan municipality in Ankara. There were no significant differences between emotional intelligence scores of the nurses according to demographic variables such as age, gender, marital status, having children. Thus, sociodemographic factors did not appear to be key factors, but some professional variables did. Higher total emotional intelligence scores were observed in those who had 10 years or longer experience, who found oneself successful in professional life, who stated that emotional intelligence is an improvable skill and who previously received self-improvement training. Interpersonal skills were higher in those with a graduate degree and in nurses working in polyclinics and paediatric units. These findings indicate which groups require improvement in emotional intelligence skills and which skills need improvement. Additionally, these results provide knowledge and create awareness about emotional intelligence skills of nurses and the distribution of these skills according to sociodemographic and professional variables. Implementation of emotional intelligence improvement programmes targeting the determined clinical nursing groups by nursing administrations can help the increase in

  12. Associations between period 3 gene polymorphisms and sleep- /chronotype-related variables in patients with late-life insomnia.

    Science.gov (United States)

    Mansour, Hader A; Wood, Joel; Chowdari, Kodavali V; Tumuluru, Divya; Bamne, Mikhil; Monk, Timothy H; Hall, Martica H; Buysse, Daniel J; Nimgaonkar, Vishwajit L

    2017-01-01

    A variable number tandem repeat polymorphism (VNTR) in the period 3 (PER3) gene has been associated with heritable sleep and circadian variables, including self-rated chronotypes, polysomnographic (PSG) variables, insomnia and circadian sleep-wake disorders. This report describes novel molecular and clinical analyses of PER3 VNTR polymorphisms to better define their functional consequences. As the PER3 VNTR is located in the exonic (protein coding) region of PER3, we initially investigated whether both alleles (variants) are transcribed into messenger RNA in human fibroblasts. The VNTR showed bi-allelic gene expression. We next investigated genetic associations in relation to clinical variables in 274 older adult Caucasian individuals. Independent variables included genotypes for the PER3 VNTR as well as a representative set of single nucleotide polymorphisms (SNPs) that tag common variants at the PER3 locus (linkage disequilibrium (LD) between genetic variants sleep time and sleep latency, self-rated chronotype, estimated with the Composite Scale (CS), and lifestyle regularity, estimated using the social rhythm metric (SRM). Initially, genetic polymorphisms were individually analyzed in relation to each outcome variable using analysis of variance (ANOVA). Nominally significant associations were further tested using regression analyses that incorporated individual ANOVA-associated DNA variants as potential predictors and each of the selected sleep/circadian variables as outcomes. The covariates included age, gender, body mass index and an index of medical co-morbidity. Significant genetic associations with the VNTR were not detected with the sleep or circadian variables. Nominally significant associations were detected between SNP rs1012477 and CS scores (p = 0.003) and between rs10462021 and SRM (p = 0.047); rs11579477 and average delta power (p = 0.043) (analyses uncorrected for multiple comparisons). In conclusion, alleles of the VNTR are expressed at the

  13. Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature

    Directory of Open Access Journals (Sweden)

    Harris PR

    2014-07-01

    Full Text Available Patricia RE Harris,1 Claire E Sommargren,2 Phyllis K Stein,3 Gordon L Fung,4,5 Barbara J Drew6,7 1ECG Monitoring Research Lab, 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA; 3Heart Rate Variability Laboratory, School of Medicine, Washington University, St Louis, MO, USA; 4Asian Heart & Vascular Center at Mount Zion, Division of Cardiology, University of California, 5Cardiology Consultation Service, Cardiac Noninvasive Laboratory, and The Enhanced External Counterpulsation Unit, Department of Medicine, University of California, San Francisco Medical Center, 6Division of Cardiology, 7Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA Aim: We aimed to explore links between heart rate variability (HRV and clinical depression in patients with acute coronary syndrome (ACS, through a review of recent clinical research literature. Background: Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function. Methods: A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search terms “heart rate variability” and “depression” were used in conjunction with “acute coronary syndrome”, “unstable angina”, or “myocardial infarction” to find clinical studies published within the past 10 years related to HRV and clinical depression, in patients with an ACS episode. Studies were included if HRV measurement and depression screening were undertaken during an ACS hospitalization or within 2 months of hospital discharge. Results: Nine clinical studies met the inclusion criteria. The

  14. Causal Relationship Between Relative Price Variability and Inflation in Turkey: Evidence from Panel Data

    Directory of Open Access Journals (Sweden)

    Nebiye Yamak

    2016-06-01

    Full Text Available This study investigates the causal relationship between inflation and relative price variability in Turkey for the period of January 2003-January 2014, by using panel data. In the study, a Granger (1969 non-causality test in heterogeneous panel data models developed by Dumitrescu and Hurlin (2012 is utilized to determine the causal relations between inflation rate relative price variability. The panel data consists of 4123 observations: 133 time observations and 31 cross-section observations. The results of panel causality test indicate that there is a bidirectional causality between inflation rate and relative price variability by not supporting the imperfection information model of Lucas and the menu cost model of Ball and Mankiw.

  15. Intervening Variables in the TV Violence-Aggression Relation: Evidence from Two Countries.

    Science.gov (United States)

    Huesmann, L. Rowell; And Others

    1984-01-01

    A longitudinal, cross-cultural field study was made to determine boundary conditions under which the television violence/aggression relation obtains, to determine intervening variables, and to illuminate the process through which television violence relates to aggression. Children from first through fifth grades in the United States, Australia,…

  16. Relative Importance of Political Instability and Economic Variables on Perceived Country Creditworthiness

    OpenAIRE

    Suk Hun Lee

    1993-01-01

    This paper examines the relative importance of political instability and economic variables on perceived country creditworthiness. Our results indicate that both political instability and economic variables are taken into account in evaluating country creditworthiness; however, it appears that bankers assign larger weight to economic performances, which we except of reflect longer term political stability. In addition, the frequency of changes in the regime and armed conflict, both proxying f...

  17. Integrated assessment of space, time, and management-related variability of soil hydraulic properties

    Energy Technology Data Exchange (ETDEWEB)

    Es, H.M. van; Ogden, C.B.; Hill, R.L.; Schindelbeck, R.R.; Tsegaye, T.

    1999-12-01

    Computer-based models that simulate soil hydrologic processes and their impacts on crop growth and contaminant transport depend on accurate characterization of soil hydraulic properties. Soil hydraulic properties have numerous sources of variability related to spatial, temporal, and management-related processes. Soil type is considered to be the dominant source of variability, and parameterization is typically based on soil survey databases. This study evaluated the relative significance of other sources of variability: spatial and temporal at multiple scales, and management-related factors. Identical field experiments were conducted for 3 yr. at two sites in New York on clay loam and silt loam soils, and at two sites in Maryland on silt loam and sandy loam soils, all involving replicated plots with plow-till and no-till treatments. Infiltrability was determined from 2054 measurements using parameters, and Campbell's a and b parameters were determined based on water-retention data from 875 soil cores. Variance component analysis showed that differences among the sites were the most important source of variability for a (coefficient of variation, CV = 44%) and b (CV = 23%). Tillage practices were the most important source of variability for infiltrability (CV = 10%). For all properties, temporal variability was more significant than field-scale spatial variability. Temporal and tillage effects were more significant for the medium- and fine-textured soils, and correlated to initial soil water conditions. The parameterization of soil hydraulic properties solely based on soil type may not be appropriate for agricultural lands since soil-management factors are more significant. Sampling procedures should give adequate recognition to soil-management and temporal processes at significant sources of variability to avoid biased results.

  18. Seasonal variability in clinical care of COPD outpatients: results from the Andalusian COPD audit

    Directory of Open Access Journals (Sweden)

    López-Campos JL

    2017-03-01

    Full Text Available Jose Luis López-Campos,1,2 Maria Abad Arranz,1 Carmen Calero-Acuña,1,2 Fernando Romero-Valero,3 Ruth Ayerbe-García,4 Antonio Hidalgo-Molina,3 Ricardo I Aguilar-Pérez-Grovas,4 Francisco García-Gil,5 Francisco Casas-Maldonado,6 Laura Caballero-Ballesteros,5 María Sánchez-Palop,6 Dolores Pérez-Tejero,7 Alejandro Segado Soriano,7 Jose Calvo-Bonachera,8 Bárbara Hernández-Sierra,8 Adolfo Doménech,9 Macarena Arroyo-Varela,9 Francisco González-Vargas,10 Juan J Cruz-Rueda10 1Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, 2CIBER de Enfermedades Respiratorias (CIBERES, Instituto de Salud Carlos III, Madrid, 3Sección de Neumología, Hospital Puerta del Mar, Cádiz, 4Servicio de Neumología, Hospital Juan Ramón Jiménez, Huelva, 5Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, 6Servicio de Neumología, Hospital Universitario San Cecilio, Granada, 7Sección de Neumología, Hospital Infanta Margarita, Cabra, Córdoba, 8Servicio de Neumología, Hospital Torrecárdenas, Almería, 9Servicio de Neumología, Hospital Regional Universitario de Málaga, Málaga, 10Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain Objectives: Clinical practice in chronic obstructive pulmonary disease (COPD can be influenced by weather variability throughout the year. To explore the hypothesis of seasonal variability in clinical practice, the present study analyzes the results of the 2013–2014 Andalusian COPD audit with regard to changes in clinical practice according to the different seasons.Methods: The Andalusian COPD audit was a pilot clinical project conducted from October 2013 to September 2014 in outpatient respiratory clinics of hospitals in Andalusia, Spain (8 provinces with more than 8 million inhabitants with retrospective data gathering. For the present analysis

  19. European Randomized Study of Screening for Prostate Cancer Risk Calculator: External Validation, Variability, and Clinical Significance.

    Science.gov (United States)

    Gómez-Gómez, Enrique; Carrasco-Valiente, Julia; Blanca-Pedregosa, Ana; Barco-Sánchez, Beatriz; Fernandez-Rueda, Jose Luis; Molina-Abril, Helena; Valero-Rosa, Jose; Font-Ugalde, Pilar; Requena-Tapia, Maria José

    2017-04-01

    To externally validate the European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculator (RC) and to evaluate its variability between 2 consecutive prostate-specific antigen (PSA) values. We prospectively catalogued 1021 consecutive patients before prostate biopsy for suspicion of prostate cancer (PCa). The risk of PCa and significant PCa (Gleason score ≥7) from 749 patients was calculated according to ERSPC-RC (digital rectal examination-based version 3 of 4) for 2 consecutive PSA tests per patient. The calculators' predictions were analyzed using calibration plots and the area under the receiver operating characteristic curve (area under the curve). Cohen kappa coefficient was used to compare the ability and variability. Of 749 patients, PCa was detected in 251 (33.5%) and significant PCa was detected in 133 (17.8%). Calibration plots showed an acceptable parallelism and similar discrimination ability for both PSA levels with an area under the curve of 0.69 for PCa and 0.74 for significant PCa. The ERSPC showed 226 (30.2%) unnecessary biopsies with the loss of 10 significant PCa. The variability of the RC was 16% for PCa and 20% for significant PCa, and a higher variability was associated with a reduced risk of significant PCa. We can conclude that the performance of the ERSPC-RC in the present cohort shows a high similitude between the 2 PSA levels; however, the RC variability value is associated with a decreased risk of significant PCa. The use of the ERSPC in our cohort detects a high number of unnecessary biopsies. Thus, the incorporation of ERSPC-RC could help the clinical decision to carry out a prostate biopsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A method to forecast quantitative variables relating to nuclear public acceptance

    International Nuclear Information System (INIS)

    Ohnishi, T.

    1992-01-01

    A methodology is proposed for forecasting the future trend of quantitative variables profoundly related to the public acceptance (PA) of nuclear energy. The social environment influencing PA is first modeled by breaking it down into a finite number of fundamental elements and then the interactive formulae between the quantitative variables, which are attributed to and characterize each element, are determined by using the actual values of the variables in the past. Inputting the estimated values of exogenous variables into these formulae, the forecast values of endogenous variables can finally be obtained. Using this method, the problem of nuclear PA in Japan is treated as, for example, where the context is considered to comprise a public sector and the general social environment and socio-psychology. The public sector is broken down into three elements of the general public, the inhabitants living around nuclear facilities and the activists of anti-nuclear movements, whereas the social environment and socio-psychological factors are broken down into several elements, such as news media and psychological factors. Twenty-seven endogenous and seven exogenous variables are introduced to quantify these elements. After quantitatively formulating the interactive features between them and extrapolating the exogenous variables into the future estimates are made of the growth or attenuation of the endogenous variables, such as the pro- and anti-nuclear fractions in public opinion polls and the frequency of occurrence of anti-nuclear movements. (author)

  1. Blocking Avoidance and Escape Responses: Relations With Clinically Relevant Behaviors

    Directory of Open Access Journals (Sweden)

    Juliana Maria Bubna Popovitz

    Full Text Available Abstract: The current study aims to evaluate the possible effects of interrupting problematic clinically relevant behaviors on the percentage of these responses and of clinical improvement-related responses. Two clients were treated with Functional Analytic Psychotherapy (FAP, alternating two conditions (ABAB. On condition A, procedures to the therapist consisted of responding to the clinical improvement responses, and to description of outside of therapeutic setting behaviors, but therapists were advised to ignore problem behaviors emitted in session. During condition B, therapists followed the same procedures, but they were oriented to block (interrupt problematic responses emitted in session. Results suggest increase in the percentage of problem behaviors during condition B. Results are discussed, highlighting the viability of planning the contingent response the therapist emits to clinically relevant behaviors.

  2. Recurrent Transmission of a 17q12 Microdeletion and a Variable Clinical Spectrum.

    Science.gov (United States)

    George, A M; Love, D R; Hayes, I; Tsang, B

    2012-01-01

    The relatively rare proximal microdeletion of 17q12 (including deletion of the HNF1B gene) is associated with the renal cysts and diabetes syndrome. Recent reports have suggested that there may also be an association between this microdeletion and learning difficulties/autism. This case report describes one of only a few reported families segregating the 17q12 microdeletion, but which highlights the nonpenetrance and variable expressivity of multiple features of this condition.

  3. Recurrent Transmission of a 17q12 Microdeletion and a Variable Clinical Spectrum

    OpenAIRE

    George, A.M.; Love, D.R.; Hayes, I.; Tsang, B.

    2011-01-01

    The relatively rare proximal microdeletion of 17q12 (including deletion of the HNF1B gene) is associated with the renal cysts and diabetes syndrome. Recent reports have suggested that there may also be an association between this microdeletion and learning difficulties/autism. This case report describes one of only a few reported families segregating the 17q12 microdeletion, but which highlights the nonpenetrance and variable expressivity of multiple features of this condition.

  4. Identifying novel phenotypes of acute heart failure using cluster analysis of clinical variables.

    Science.gov (United States)

    Horiuchi, Yu; Tanimoto, Shuzou; Latif, A H M Mahbub; Urayama, Kevin Y; Aoki, Jiro; Yahagi, Kazuyuki; Okuno, Taishi; Sato, Yu; Tanaka, Tetsu; Koseki, Keita; Komiyama, Kota; Nakajima, Hiroyoshi; Hara, Kazuhiro; Tanabe, Kengo

    2018-07-01

    Acute heart failure (AHF) is a heterogeneous disease caused by various cardiovascular (CV) pathophysiology and multiple non-CV comorbidities. We aimed to identify clinically important subgroups to improve our understanding of the pathophysiology of AHF and inform clinical decision-making. We evaluated detailed clinical data of 345 consecutive AHF patients using non-hierarchical cluster analysis of 77 variables, including age, sex, HF etiology, comorbidities, physical findings, laboratory data, electrocardiogram, echocardiogram and treatment during hospitalization. Cox proportional hazards regression analysis was performed to estimate the association between the clusters and clinical outcomes. Three clusters were identified. Cluster 1 (n=108) represented "vascular failure". This cluster had the highest average systolic blood pressure at admission and lung congestion with type 2 respiratory failure. Cluster 2 (n=89) represented "cardiac and renal failure". They had the lowest ejection fraction (EF) and worst renal function. Cluster 3 (n=148) comprised mostly older patients and had the highest prevalence of atrial fibrillation and preserved EF. Death or HF hospitalization within 12-month occurred in 23% of Cluster 1, 36% of Cluster 2 and 36% of Cluster 3 (p=0.034). Compared with Cluster 1, risk of death or HF hospitalization was 1.74 (95% CI, 1.03-2.95, p=0.037) for Cluster 2 and 1.82 (95% CI, 1.13-2.93, p=0.014) for Cluster 3. Cluster analysis may be effective in producing clinically relevant categories of AHF, and may suggest underlying pathophysiology and potential utility in predicting clinical outcomes. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Normalization of relative and incomplete temporal expressions in clinical narratives.

    Science.gov (United States)

    Sun, Weiyi; Rumshisky, Anna; Uzuner, Ozlem

    2015-09-01

    To improve the normalization of relative and incomplete temporal expressions (RI-TIMEXes) in clinical narratives. We analyzed the RI-TIMEXes in temporally annotated corpora and propose two hypotheses regarding the normalization of RI-TIMEXes in the clinical narrative domain: the anchor point hypothesis and the anchor relation hypothesis. We annotated the RI-TIMEXes in three corpora to study the characteristics of RI-TMEXes in different domains. This informed the design of our RI-TIMEX normalization system for the clinical domain, which consists of an anchor point classifier, an anchor relation classifier, and a rule-based RI-TIMEX text span parser. We experimented with different feature sets and performed an error analysis for each system component. The annotation confirmed the hypotheses that we can simplify the RI-TIMEXes normalization task using two multi-label classifiers. Our system achieves anchor point classification, anchor relation classification, and rule-based parsing accuracy of 74.68%, 87.71%, and 57.2% (82.09% under relaxed matching criteria), respectively, on the held-out test set of the 2012 i2b2 temporal relation challenge. Experiments with feature sets reveal some interesting findings, such as: the verbal tense feature does not inform the anchor relation classification in clinical narratives as much as the tokens near the RI-TIMEX. Error analysis showed that underrepresented anchor point and anchor relation classes are difficult to detect. We formulate the RI-TIMEX normalization problem as a pair of multi-label classification problems. Considering only RI-TIMEX extraction and normalization, the system achieves statistically significant improvement over the RI-TIMEX results of the best systems in the 2012 i2b2 challenge. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Psychological Variables Associated With Health-Related Quality-of-Life in Uruguayan Women Surgically Intervened for Breast Cancer

    Directory of Open Access Journals (Sweden)

    Micaela Reich

    2014-11-01

    Full Text Available AimThis study described demographic, clinical, psychological and health-related quality of life (HRQOL characteristics in women surgically intervened for breast cancer, and the present study was conducted to examine the association between these characteristics.MethodUruguayan women (N = 116 diagnosed and surgically intervened for breast cancer were assessed on demographic, clinical and psychological indicators and HRQOL, by self-report questionnaires (i.e., BDI-II, PSS, Brief-COPE, and SF-36. Study was conducted adopting a non-experimental, cross-sectional methodology. After studying associations between variables assessed, hierarchical regression analyses were performed to identify HRQOL predictors.ResultsHRQOL Physical Health Component (SF-36 was predicted by perceived stress and depression, above and beyond demographic and clinical factors. And HRQOL Mental Health Component (SF-36 was predicted by education, time elapsed since diagnosis of breast cancer, time hospitalized during the past year, perceived stress and depression.ConclusionResults suggest that psychological variables may have a significant role for HRQOL prediction, and need to be taken into account along with demographic and clinical markers in order to explain HRQOL outcomes in women with breast cancer.

  7. The use of ZIP and CART to model cryptosporidiosis in relation to climatic variables.

    Science.gov (United States)

    Hu, Wenbiao; Mengersen, Kerrie; Fu, Shiu-Yun; Tong, Shilu

    2010-07-01

    This research assesses the potential impact of weekly weather variability on the incidence of cryptosporidiosis disease using time series zero-inflated Poisson (ZIP) and classification and regression tree (CART) models. Data on weather variables, notified cryptosporidiosis cases and population size in Brisbane were supplied by the Australian Bureau of Meteorology, Queensland Department of Health, and Australian Bureau of Statistics, respectively. Both time series ZIP and CART models show a clear association between weather variables (maximum temperature, relative humidity, rainfall and wind speed) and cryptosporidiosis disease. The time series CART models indicated that, when weekly maximum temperature exceeded 31 degrees C and relative humidity was less than 63%, the relative risk of cryptosporidiosis rose by 13.64 (expected morbidity: 39.4; 95% confidence interval: 30.9-47.9). These findings may have applications as a decision support tool in planning disease control and risk-management programs for cryptosporidiosis disease.

  8. UL146 variability among clinical isolates of Human Cytomegalovirus from Japan

    Directory of Open Access Journals (Sweden)

    Francisco Aguayo

    2010-01-01

    Full Text Available Human Cytomegalovirus (HCMV is a herpesvirus associated with serious diseases in immunocompromised subjects. The region between ORF UL133 and UL151 from HCMV, named ULb' is frequently deleted in attenuated AD169 and in highly passaged laboratory strains. However, this region is conserved in low-passaged and more virulent HCMV, like the Toledo strain. The UL146 gene, which is located in the ULb' region, encodes a CXC-chemokine analogue. The diversity of UL146 gene was evaluated among fifty-six clinical isolates of HCMV from Japan. Results show that UL146 gene was successfully amplified by the polymerase chain reaction (PCR in only 17/56 strains (30%, while the success rate for UL145/UL147 gene was 18/56 strains (32%. After DNA sequencing, the 35 amplified strains were classified into 8 groups. When compared, variability of UL146 ranged from 25.1% to 52.9% at the DNA level and from 34.5% to 67% at the amino acid level. Seven groups had the interleukin-8 (IL-8 motif ERL (Glu-Leu-Arg CXC and one group had only the CXC motif, suggesting the absence of the IL-8 function of UL146. In conclusion, we found that UL146 gene of HCMV is hyper-variable in clinical strains from Japan suggesting the possibility of a different function in each sequence group.

  9. Clinical Variables Associated with Hydration Status in Acute Ischemic Stroke Patients with Dysphagia.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; Shabbir, Yasmeen; Miller, Leslie; Silliman, Scott

    2016-02-01

    Acute stroke patients with dysphagia are at increased risk for poor hydration. Dysphagia management practices may directly impact hydration status. This study examined clinical factors that might impact hydration status in acute ischemic stroke patients with dysphagia. A retrospective chart review was completed on 67 ischemic stroke patients who participated in a prior study of nutrition and hydration status during acute care. Prior results indicated that patients with dysphagia demonstrated elevated BUN/Cr compared to non-dysphagia cases during acute care and that BUN/Cr increased selectively in dysphagic patients. This chart review evaluated clinical variables potentially impacting hydration status: diuretics, parenteral fluids, tube feeding, oral diet, and nonoral (NPO) status. Exposure to any variable and number of days of exposure to each variable were examined. Dysphagia cases demonstrated significantly more NPO days, tube fed days, and parenteral fluid days, but not oral fed days, or days on diuretics. BUN/Cr values at discharge were not associated with NPO days, parenteral fluid days, oral fed days, or days on diuretics. Patients on modified solid diets had significantly higher mean BUN/Cr values at discharge (27.12 vs. 17.23) as did tube fed patients (28.94 vs. 18.66). No difference was noted between these subgroups at baseline (regular diet vs. modified solids diets). Any modification of solid diets (31.11 vs. 17.23) or thickened liquids (28.50 vs. 17.81) resulted in significantly elevated BUN/Cr values at discharge. Liquid or diet modifications prescribed for acute stroke patients with dysphagia may impair hydration status in these patients.

  10. Classifying medical relations in clinical text via convolutional neural networks.

    Science.gov (United States)

    He, Bin; Guan, Yi; Dai, Rui

    2018-05-16

    Deep learning research on relation classification has achieved solid performance in the general domain. This study proposes a convolutional neural network (CNN) architecture with a multi-pooling operation for medical relation classification on clinical records and explores a loss function with a category-level constraint matrix. Experiments using the 2010 i2b2/VA relation corpus demonstrate these models, which do not depend on any external features, outperform previous single-model methods and our best model is competitive with the existing ensemble-based method. Copyright © 2018. Published by Elsevier B.V.

  11. Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.

    Science.gov (United States)

    Torras, M G; Canals, E; Jurado-Bruggeman, D; Marín-Borras, S; Macià, M; Jové, J; Boladeras, A M; Muñoz-Montplet, C; Molero, J; Picón, C; Puigdemont, M; Aliste, L; Torrents, A; Guedea, F; Borras, J M

    2018-06-01

    The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Attention-deficit/hyperactivity disorder and phonological working memory: Methodological variability affects clinical and experimental performance metrics.

    Science.gov (United States)

    Tarle, Stephanie J; Alderson, R Matt; Patros, Connor H G; Lea, Sarah E; Hudec, Kristen L; Arrington, Elaine F

    2017-05-01

    Despite promising findings in extant research that suggest impaired working memory (WM) serves as a central neurocognitive deficit or candidate endophenotype of attention-deficit/hyperactivity disorder (ADHD), findings from translational research have been relatively underwhelming. This study aimed to explicate previous equivocal findings by systematically examining the effect of methodological variability on WM performance estimates across experimental and clinical WM measures. Age-matched boys (ages 8-12 years) with (n = 20) and without (n = 20) ADHD completed 1 experimental (phonological) and 2 clinical (digit span, letter-number sequencing) WM measures. The use of partial scoring procedures, administration of greater trial numbers, and high central executive demands yielded moderate-to-large between-groups effect sizes. Moreover, the combination of these best-case procedures, compared to worst-case procedures (i.e., absolute scoring, administration of few trials, use of discontinue rules, and low central executive demands), resulted in a 12.5% increase in correct group classification. Collectively, these findings explain inconsistent ADHD-related WM deficits in previous reports, and highlight the need for revised clinical measures that utilize best-case procedures. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. A class of constitutive relations with internal variable derivatives: derivation from homogenization and initial value problem

    International Nuclear Information System (INIS)

    Andrieux, S.; Joussemet, M.; Lorentz, E.

    1996-01-01

    When they are subjected to excessive loads, some materials may exhibit a softening behaviour resulting from the deterioration of their mechanical properties. To idealize such behaviours, constitutive relations with softening are introduced, for which the size of the domain of reversibility in the stress-space decreases. These models feature a strain localization within the material, in agreement with experiments, but cannot predict the subsequent behaviour because they lead to shear bands the width of which is equal to zero, physically unacceptable and numerically troublesome. It has been proposed in the literature to overcome these difficulties by adding to the list of internal variable the spatial gradients of some of them. This procedure suffers from lack of firm methodological basis. Although, some quantitative justification have been advanced relying on some kind of microscopic analysis. Therefore, we propose to extend the classical (local) models by introducing the internal state variable first gradients. Given local model within the framework of standard generalized materials, consistent homogenization procedure is put forward to derive macroscopic free energy and dissipation potentials. The standard generalized character is preserved, with an extended set of state variables, containing not only the strain and the internal variables but also the internal variable derivatives. Nevertheless, when dealing with the whole structure, the independence between the new state variables is lost. We propose then to generalize the constitutive relations, leading to a new variational principle that ensures the Clausius-Duhem inequality at the structure scale. (authors)

  14. [Feedback in relation to training of practical clinical skills

    DEFF Research Database (Denmark)

    Hansen, C.S.; Ringsted, Charlotte Vibeke

    2008-01-01

    Feedback has been identified as an essential component of motor learning. However, feedback principles derived from motor learning theories cannot uncritically be applied to clinical skills training because this knowledge is based primarily on the study of very simple motor skills. Research...... into feedback in relation to clinical skills training is currently limited. Theories on motor learning can serve as the basis for designing research in this domain, especially the importance of including retention tests when measuring permanent learning outcomes Udgivelsesdato: 2008/10/27...

  15. Executive function impairments in fibromyalgia syndrome: Relevance of clinical variables and body mass index

    Science.gov (United States)

    2018-01-01

    Background Several investigations suggest the presence of deterioration of executive function in fibromyalgia syndrome (FMS). The study quantified executive functions in patients with FMS. A wide array of functions was assessed, including updating, shifting and inhibition, as well as decision making and mental planning. Moreover, clinical variables were investigated as possible mediators of executive dysfunction, including pain severity, psychiatric comorbidity, medication and body mass index (BMI). Methods Fifty-two FMS patients and 32 healthy controls completed a battery of 14 neuropsychological tests. Clinical interviews were conducted and the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, Fatigue Severity Scale and Oviedo Quality of Sleep Questionnaire were presented. Results Patients performed poorer than controls on the Letter Number Sequencing, Arithmetic and Similarities subtests of the Wechsler Adult Intelligence Scale, the Spatial Span subtest of the Wechsler Memory Scale, an N-back task, a verbal fluency task, the Ruff Figural Fluency Test, the Inhibition score of the Stroop Test, the Inhibition and Shifting scores of the Five Digits Test, the Key Search Test and the Zoo Map Task. Moreover, patients exhibited less steep learning curves on the Iowa Gambling Task. Among clinical variables, BMI and pain severity explained the largest proportion of performance variance. Conclusions This study demonstrated impairments in executive functions of updating, shifting inhibition, decision making and planning in FMS. While the mediating role of pain in cognitive impairments in FMS had been previously established, the influence of BMI is a novel finding. Overweight and obesity should be considered by FMS researchers, and in the treatment of the condition. PMID:29694417

  16. Executive function impairments in fibromyalgia syndrome: Relevance of clinical variables and body mass index.

    Science.gov (United States)

    Muñoz Ladrón de Guevara, Cristina; Fernández-Serrano, María José; Reyes Del Paso, Gustavo A; Duschek, Stefan

    2018-01-01

    Several investigations suggest the presence of deterioration of executive function in fibromyalgia syndrome (FMS). The study quantified executive functions in patients with FMS. A wide array of functions was assessed, including updating, shifting and inhibition, as well as decision making and mental planning. Moreover, clinical variables were investigated as possible mediators of executive dysfunction, including pain severity, psychiatric comorbidity, medication and body mass index (BMI). Fifty-two FMS patients and 32 healthy controls completed a battery of 14 neuropsychological tests. Clinical interviews were conducted and the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, Fatigue Severity Scale and Oviedo Quality of Sleep Questionnaire were presented. Patients performed poorer than controls on the Letter Number Sequencing, Arithmetic and Similarities subtests of the Wechsler Adult Intelligence Scale, the Spatial Span subtest of the Wechsler Memory Scale, an N-back task, a verbal fluency task, the Ruff Figural Fluency Test, the Inhibition score of the Stroop Test, the Inhibition and Shifting scores of the Five Digits Test, the Key Search Test and the Zoo Map Task. Moreover, patients exhibited less steep learning curves on the Iowa Gambling Task. Among clinical variables, BMI and pain severity explained the largest proportion of performance variance. This study demonstrated impairments in executive functions of updating, shifting inhibition, decision making and planning in FMS. While the mediating role of pain in cognitive impairments in FMS had been previously established, the influence of BMI is a novel finding. Overweight and obesity should be considered by FMS researchers, and in the treatment of the condition.

  17. Psychosocial Variables Related to Why Women are Less Active than Men and Related Health Implications

    OpenAIRE

    Edwards, Elizabeth Skidmore; Sackett, Sarah Carson

    2016-01-01

    This article reviews psychosocial influences on women's participation in physical activity as they differ from men and how associated activity differences impact women's risk for a number of chronic diseases. This topic directly aligns with the mission of this special edition related to disparities in women's health as the typically lower level of physical activity in females directly impacts their health. On average, females participate in physical activity at lower rates than their male cou...

  18. Psychosocial Variables Related to Why Women are Less Active than Men and Related Health Implications

    Directory of Open Access Journals (Sweden)

    Elizabeth Skidmore Edwards

    2016-01-01

    Full Text Available This article reviews psychosocial influences on women's participation in physical activity as they differ from men and how associated activity differences impact women's risk for a number of chronic diseases. This topic directly aligns with the mission of this special edition related to disparities in women's health as the typically lower level of physical activity in females directly impacts their health. On average, females participate in physical activity at lower rates than their male counterparts. These lower rates of physical activity are directly related to both incidence of and outcomes from cardiovascular disease, type 2 diabetes, and breast and gynecological cancers. The relationship between psychosocial factors that are understood to affect physical activity differs between men and women. Specifically, self-efficacy, social support, and motivation are empirically substantiated factors that found to impact physical activity participation among women differently than men. Understanding these relationships is integral to designing effective interventions to target physical activity participation in women so that the related health risks are adequately addressed.

  19. Retirement planning and work-related variables in Chinese older nurses: A cross-sectional study.

    Science.gov (United States)

    Liu, Peng-Cheng; Zhang, Huan-Huan; Zhang, Mei-Ling; Ying, Jie; Shi, Ying; Wang, Shou-Qi; Sun, Jiao

    2018-03-01

    To explore the situation of older nurses approaching retirement with regard to their retirement planning, and the relationship of their retirement planning behaviour with the job environment and job satisfaction under their current employment arrangements and other work-related variables. Nurse shortage has become a global phenomenon that can be alleviated by retaining older nurses in service. The Chinese government proposed the "Incremental Delay Retirement Age Policy." However, older nurses face delayed retirement but lack retirement plans. A cross-sectional questionnaire survey was conducted among a convenience sample of older retiring nurses (n = 152; 84.92% response rate) recruited from every department of four large general hospitals in Changchun, Jilin Province from June to August 2016. The majority of the respondents presented poor retirement planning (n = 122, 80.3%). The independent variables of information exchange with patients, teamwork and personal growth and development explained approximately 16.6% of the variance in retirement planning. Nurse-patient communication and personal growth and development can promote retirement planning, but teamwork is negatively related to retirement planning. Retirement planning by Chinese older nurses is related to certain work-related variables. However, many other work-related variables were not associated with retirement planning and require further research. Overall, Chinese older retiring nurses must improve their retirement planning practices. © 2017 John Wiley & Sons Ltd.

  20. Dispositional and situational variables related to evacuation at Three Mile Island

    International Nuclear Information System (INIS)

    Miller, I.S.

    1981-01-01

    The purpose of this study was to explore some of the factors influential in local residents' evacuating or remaining in the Three Mile Island area during the nuclear power plant accident of March, 1979. Investigated variables included individuals' behavioral dispositions to attend or to avoid threatening stimuli as well as situational concerns related to demographic characteristics and subjective experience. Investigation of situational variables also probed respondents' concerns about accident-related fears. Two main relationships were investigated. The first hypothesized that positive relationships existed both between dispositional attention to threat and evacuation and between dispositional avoidance of threat and remaining. The second investigation task of the research explored evacuation-related situational variables in regard to individuals' awareness of potential danger at TMI. No support was found for the hypothesized relationships between evacuation and dispositions relative to threat. Situational variables significantly related to evacuation included: specific directives to evacuate the area; disruption of telephone service during the week of the accident; and household proximity to TMI

  1. Bounding the conservatism in flaw-related variables for pressure vessel integrity analyses

    International Nuclear Information System (INIS)

    Foulds, J.R.; Kennedy, E.L.

    1993-01-01

    The fracture mechanics-based integrity analysis of a pressure vessel, whether performed deterministically or probabilistically, requires use of one or more flaw-related input variables, such as flaw size, number of flaws, flaw location, and flaw type. The specific values of these variables are generally selected with the intent to ensure conservative predictions of vessel integrity. These selected values, however, are largely independent of vessel-specific inspection results, or are, at best, deduced by ''conservative'' interpretation of vessel-specific inspection results without adequate consideration of the pertinent inspection system performance (reliability). In either case, the conservatism associated with the flaw-related variables chosen for analysis remains examination (NDE) technology and the recently formulated ASME Code procedures for qualifying NDE system capability and performance (as applied to selected nuclear power plant components) now provides a systematic means of bounding the conservatism in flaw-related input variables for pressure vessel integrity analyses. This is essentially achieved by establishing probabilistic (risk)-based limits on the assigned variable values, dependent upon the vessel inspection results and on the inspection system unreliability. Described herein is this probabilistic method and its potential application to: (i) defining a vessel-specific ''reference'' flaw for calculating pressure-temperature limit curves in the deterministic evaluation of pressurized water reactor (PWR) reactor vessels, and (ii) limiting the flaw distribution input to a PWR reactor vessel-specific, probabilistic integrity analysis for pressurized thermal shock loads

  2. Aggressive and unsportsmanlike behaviours in competitive sports: an analysis of related personal and environmental variables

    Directory of Open Access Journals (Sweden)

    Antonia Pelegrín

    2013-10-01

    Full Text Available This paper gives an analysis of personal and environmental variables related to aggressive and unsportsmanlike behaviours in a sample of Spanish sports competitors. We aim to: 1 ascertain how personality and expression variables relate to trait anger control and unsportsmanlike behaviors, in relation to men and women, age groups and type of sport, 2 identify and analyze the most maladjusted and the most adjusted profiles in a sample of sportsmen and women; 3 identify personality variables as predictors of aggressive and unsportsmanlike behaviours. Differences in gender, age and type of sport were appreciated in personality variables and in aggressive and unsportsmanlike behaviours. Men have better emotional adjustment (more behaviours of emotional stability, better self-esteem, self-confidence and leadership, and have worse social adjustment (fewer behaviours of tolerance, social skills and responsibility; more aggressive and unsportsmanlike behaviours. Women have better social adjustment (more behaviours of tolerance, understanding, adaptation, responsibility, discipline and sociability, and have worse emotional adjustment (greater anxiety. More aggressive and unsportsmanlike behaviours and greater emotional maladjustment were found in the youngest sportsmen and women. Aggressive and unsportsmanlike behaviours were more frequent in team sports. This study highlights personality variables as predictors of aggressive and unsportsmanlike behaviours.

  3. Sleep variability and fatigue in adolescents: Associations with school-related features.

    Science.gov (United States)

    Matos, M G; Gaspar, T; Tomé, G; Paiva, T

    2016-10-01

    This study aims to evaluate the influences of sleep duration and sleep variability (SleepV), upon adolescents' school-related situations. The Health Behaviour in School-Aged Children (HBSC) survey is based on a self-completed questionnaire. The participants were 3164 pupils (53.7% girls), attending the 8th and 10th grades, 14.9 years old, and were inquired about subjective sleep duration during the week and weekends, SleepV, fatigue, difficulties in sleep initiation, school achievement, feelings towards schools, pressure with school work and skipping classes. Multiple regression models used, as dependent variables: (a) school achievement, (b) disliking school, (c) pressure with school work and (d) skipping classes, using as independent variables, each of the remaining school-related variables, fatigue, total sleep duration and difficulties in sleep initiation. The average sleep duration in the week and during weekdays was lower than recommended for these age groups, and almost half of students had high SleepV between weekdays and weekends. A logistic model revealed that the absence of SleepV was associated with lower perception of school work pressure, less frequent skipping classes, more infrequent fatigue and more infrequent difficulties in sleep initiation. Poor sleep quality, SleepV and insufficient sleep duration affected negatively school-related variables. © 2015 International Union of Psychological Science.

  4. High Intrapatient Variability of Tacrolimus Levels and Outpatient Clinic Nonattendance Are Associated With Inferior Outcomes in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Dawn L. Goodall, MSc

    2017-08-01

    Conclusions. This study shows that high tacrolimus IPV and clinic nonattendance are associated with inferior allograft survival. Interventions to minimize the causes of high variability, particularly nonadherence are essential to improve long-term allograft outcomes.

  5. [Explore objective clinical variables for detecting delirium in ICU patients: a prospective case-control study].

    Science.gov (United States)

    Liu, Xiaojiang; Lyu, Jie; An, Youzhong

    2017-04-01

    The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU). Then these patients were observed by domestic multifunctional detector for electroencephalographic (EEG) variables such as brain lateralization, brain introvert, brain activity, brain energy consumption, focus inward, focus outward, cerebral inhibition, fatigue, sleep severity, sedation index, pain index, anxiety index, fidgety index, stress index and the cerebral blood flow (CBF) index which was named of perfusion index. Other variables including indexes of ICU blood gas analysis, which was consisted of variables of blood gas analysis, routine blood test and biochemistry, previous history and prognostic outcome was recorded. Binary logistic regression was used for multivariate analysis. Forty-three postoperative patients, who needed intensive care, were included. Eighteen were in delirium group and twenty-five in control group. Excluding the trauma, variables like gender, age, temperature, heart rate, respiratory rate, mean arterial pressure, acute physiology and chronic health evaluationII(APACHEII) score, organ failure, dementia and emergency surgery didn't show any statistical significance between two groups. The trauma in delirious patients increased obviously compared with the control group (33.3% vs. 4.0%, P = 0.031). Except for the brain activity [122.47 (88.62, 154.21) vs. 89.40 (86.27, 115.97), P = 0.034], there were no statistical differences in

  6. Variability in anatomical features of human clavicle: Its forensic anthropological and clinical significance

    Directory of Open Access Journals (Sweden)

    Jagmahender Singh Sehrawat

    2016-06-01

    Full Text Available Bones can reflect the basic framework of human body and may provide valuable information about the biological identity of the deceased. They, often, survive the morphological alterations, taphonomic destructions, decay/mutilation and decomposition insults. In-depth knowledge of variations in clavicular shape, size and its dimensions is very important from both clinical (fixation of clavicular fractures using external or inter-medullary devices, designing orthopedic fixation devices as well as forensic anthropological perspectives. Human clavicle is the most frequently fractured bone of human skeleton, possessing high degree of variability in its anatomical, biomechanical and morphological features. Extended period of skeletal growth (up to third decade in clavicle imparts it an additional advantage for forensic identification purposes. In present study, five categories of clavicular features like lengths, diameters, angles, indices and robustness were examined to explore the suitability of collarbone for forensic and clinical purposes. For this purpose, 263 pairs of adult clavicles (195 Males and 68 Females were collected from autopsied cadavers and were studied for 13 anatomical features. Gender and occupational affiliations of cadavers were found to have significant influences on anatomical dimensions of their clavicles. Product index, weight and circumference of collarbone were found the best univariate variables, discriminating sex of more than 80% individuals. The best multivariate Function-I (DF: -17.315 + 0.054 CL-L+0.196 CC-R+0.184 DM-L could identify sex and occupation of 89.4% (89.2% Male and 89.7% Female and 65.4% individuals, respectively. All clavicular variables were found bilaterally asymmetric; left clavicles being significantly longer in length, lighter in weight, smooth in texture and less curved than the right side bones. Among non-metric traits, sub-clavian groove, nutrient foramina and ‘type’ of clavicle exhibited

  7. Meta-Analysis of Clinical Studies Supports the Pharmacokinetic Variability Hypothesis for Acquired Drug Resistance and Failure of Antituberculosis Therapy

    OpenAIRE

    Pasipanodya, Jotam G.; Srivastava, Shashikant; Gumbo, Tawanda

    2012-01-01

    Laboratory studies have questioned nonadherence as a cause of antituberculosis drug failure and propose that between-patient pharmacokinetic variability may be the cause. This meta-analysis provides clinical evidence that pharmacokinetic variability of isoniazid alone leads to worse microbiological failure, relapse, and acquired drug resistance.

  8. Fostering new relational experience: clinical process in couple psychotherapy.

    Science.gov (United States)

    Marmarosh, Cheri L

    2014-03-01

    One of the most critical goals for couple psychotherapy is to foster a new relational experience in the session where the couple feels safe enough to reveal more vulnerable emotions and to explore their defensive withdrawal, aggressive attacking, or blaming. The lived intimate experience in the session offers the couple an opportunity to gain integrative insight into their feelings, expectations, and behaviors that ultimately hinder intimacy. The clinical processes that are necessary include empathizing with the couple and facilitating safety within the session, looking for opportunities to explore emotions, ruptures, and unconscious motivations that maintain distance in the relationship, and creating a new relational experience in the session that has the potential to engender integrative insight. These clinical processes will be presented with empirical support. Experts from a session will be used to highlight how these processes influence the couple and promote increased intimacy. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  9. An Investigation of Selected Variables Related to Student Algebra I Performance in Mississippi

    Science.gov (United States)

    Scott, Undray

    2016-01-01

    This research study attempted to determine if specific variables were related to student performance on the Algebra I subject-area test. This study also sought to determine in which of grades 8, 9, or 10 students performed better on the Algebra I Subject Area Test. This study also investigated the different criteria that are used to schedule…

  10. Period--luminosity--color relations and pulsation modes of pulsating variable stars

    International Nuclear Information System (INIS)

    Breger, M.; Bregman, J.N.

    1975-01-01

    The periods of delta Scuti, RR Lyrae, dwarf Cepheid, and W Virginis variables have been investigated for their dependence on luminosity, color, mass, and pulsation modes. A maximum-likelihood method, which includes consideration of the observational errors in each coordinate, has been applied to obtain observational period-luminosity-color (P-L-C) relations

  11. A Proposal for Testing Local Realism Without Using Assumptions Related to Hidden Variable States

    Science.gov (United States)

    Ryff, Luiz Carlos

    1996-01-01

    A feasible experiment is discussed which allows us to prove a Bell's theorem for two particles without using an inequality. The experiment could be used to test local realism against quantum mechanics without the introduction of additional assumptions related to hidden variables states. Only assumptions based on direct experimental observation are needed.

  12. State-related differences in heart rate variability in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Brage, Søren; Kessing, Lars Vedel

    2017-01-01

    Heart rate variability (HRV) is a validated measure of sympato-vagal balance in the autonomic nervous system. HRV appears decreased in patients with bipolar disorder (BD) compared with healthy individuals, but the extent of state-related alterations has been sparingly investigated. The present...... bipolar disorder and could...

  13. ENSO related decadal scale climate variability from the Indo-Pacific Warm Pool

    NARCIS (Netherlands)

    Brijker, J.M.; Jung, S.J.A.; Ganssen, G.M.; Bickert, T.; Kroon, D.

    2006-01-01

    The El Niño-Southern Oscillation (ENSO) is a climatic phenomenon that affects socio-economical welfare in vast areas in the world. A continuous record of Holocene ENSO related climate variability of the Indo-Pacific Warm pool (IPWP) is constructed on the basis of stable oxygen isotopes in shells of

  14. Structural Modeling of Variables Related to Parental Support in Mexican Children's Perfomance on Reading and Writing

    Science.gov (United States)

    Bazan-Ramirez, Aldo; Castellanos-Simons, Doris; Lopez-Valenzuela, Mercedes

    2010-01-01

    This paper aims at analysing the structural relationships among some latent and observed variables related to the assessment of written language performance in 139 fourth grade students of Elementary School selected from nine public schools of the northwest of Mexico. Questionnaires were also applied to the children's parents and teachers. The…

  15. Estimation of storm runoff loads based on rainfall-related variables ...

    African Journals Online (AJOL)

    2004-11-19

    Nov 19, 2004 ... ... rainfall-related variables and power law models – Case study in Alexandra ... and appropriate technology for treating runoff and grey-water. To achieve this ... schools, and other open spaces take up 20% of the area. If the.

  16. The Implications of Demographic Variables as Related to Burnout among a Sample of Special Education Teachers

    Science.gov (United States)

    Williams, Joy; Dikes, Catherine

    2015-01-01

    The attrition rate of highly qualified special education teachers is a pervasive problem in the United States. This study investigated the association between the burnout subscales of emotional exhaustion, depersonalization, and personal accomplishment relative to 10 demographic variables. Sixty-five special education teachers constituted the…

  17. Urban vs. Rural CLIL: An Analysis of Input-Related Variables, Motivation and Language Attainment

    Science.gov (United States)

    Alejo, Rafael; Piquer-Píriz, Ana

    2016-01-01

    The present article carries out an in-depth analysis of the differences in motivation, input-related variables and linguistic attainment of the students at two content and language integrated learning (CLIL) schools operating within the same institutional and educational context, the Spanish region of Extremadura, and differing only in terms of…

  18. Variability of creatinine measurements in clinical laboratories: results from the CRIC study.

    Science.gov (United States)

    Joffe, Marshall; Hsu, Chi-yuan; Feldman, Harold I; Weir, Matthew; Landis, J R; Hamm, L Lee

    2010-01-01

    Estimating equations using serum creatinine (SCr) are often used to assess glomerular filtration rate (GFR). Such creatinine (Cr)-based formulae may produce biased estimates of GFR when using Cr measurements that have not been calibrated to reference laboratories. In this paper, we sought to examine the degree of this variation in Cr assays in several laboratories associated with academic medical centers affiliated with the Chronic Renal Insufficiency Cohort (CRIC) Study; to consider how best to correct for this variation, and to quantify the impact of such corrections on eligibility for participation in CRIC. Variability of Cr is of particular concern in the conduct of CRIC, a large multicenter study of subjects with chronic renal disease, because eligibility for the study depends on Cr-based assessment of GFR. A library of 5 large volume plasma specimens from apheresis patients was assembled, representing levels of plasma Cr from 0.8 to 2.4 mg/dl. Samples from this library were used for measurement of Cr at each of the 14 CRIC laboratories repetitively over time. We used graphical displays and linear regression methods to examine the variability in Cr, and used linear regression to develop calibration equations. We also examined the impact of the various calibration equations on the proportion of subjects screened as potential participants who were actually eligible for the study. There was substantial variability in Cr assays across laboratories and over time. We developed calibration equations for each laboratory; these equations varied substantially among laboratories and somewhat over time in some laboratories. The laboratory site contributed the most to variability (51% of the variance unexplained by the specimen) and variation with time accounted for another 15%. In some laboratories, calibration equations resulted in differences in eligibility for CRIC of as much as 20%. The substantial variability in SCr assays across laboratories necessitates calibration

  19. A Non-linear "Inflation-Relative Prices Variability" Relationship: Evidence from Latin America

    OpenAIRE

    Mª Ángeles Caraballo Pou; Carlos Dabús; Diego Caramuta

    2006-01-01

    This paper presents evidence on a non-linear "inflation-relative prices variability" relationship in three Latin American countries with very high inflation experiences: Argentina, Brazil and Peru. More precisely, and in contrast to results found in previous literature for similar countries, we find a non-concave relation at higher inflation regimes, i.e. when inflation rate surpasses certain threshold. This non-concavity is mainly explained by the unexpected component of inflation, which sug...

  20. Associated and mediating variables related to quality of life among service users with mental disorders.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2018-02-01

    This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

  1. Anthropometric, cardiovascular and functional variables as indicators of health related physical fitness in university professors

    Directory of Open Access Journals (Sweden)

    Osvaldo Costa Moreira

    Full Text Available AbstractObjective To verify the behavior of anthropometric, cardiovascular and functional variables as indicators of health-related physical fitness in university professors and perform a comparison of these variables between sexes.Materials and methods We conducted an observational epidemiological cross-sectional study in 145 professors (45.86 ± 9.7 years, 103 men (71.03%, which were evaluated by measuring heart rate (HR and systolic (SBP and diastolic (DBP pressure at rest, body weight, height, body mass index (BMI, body fat percentage (BF%, handgrip strength (HGS, flexibility and cardiorespiratory fitness (CRF. We proceeded to the descriptive analysis, Student t-test for comparison between sexes and multiple regression analysis to verify the association between the variables analyzed. It was adopted a significance level of p < 0.05.Results The sex affected all variables. Women had better levels of BMI, flexibility, SBP and DBP. The BF% and CRF were associated with SBP and BMI in both sexes.Conclusion The behavior of anthropometric, cardiovascular and functional variables indicated unsatisfactory values for flexibility, HGS and BMI, with the worst levels among men. Furthermore, the variables that showed better association with HRPF were BF% and CRF.

  2. Long-term Prognosis in COPD Exacerbation: Role of Biomarkers, Clinical Variables and Exacerbation Type.

    Science.gov (United States)

    Grolimund, Eva; Kutz, Alexander; Marlowe, Robert J; Vögeli, Alaadin; Alan, Murat; Christ-Crain, Mirjam; Thomann, Robert; Falconnier, Claudine; Hoess, Claus; Henzen, Christoph; Zimmerli, Werner; Mueller, Beat; Schuetz, Philipp

    2015-06-01

    Long-term outcome prediction in COPD is challenging. We conducted a prospective 5-7-year follow-up study in patients with COPD to determine the association of exacerbation type, discharge levels of inflammatory biomarkers including procalctionin (PCT), C-reactive protein (CRP), white blood cell count (WBC) and plasma proadrenomedullin (ProADM), alone or combined with demographic/clinical characteristics, with long-term all-cause mortality in the COPD setting. The analyzed cohort comprised 469 patients with index hospitalization for pneumonic (n = 252) or non-pneumonic (n = 217) COPD exacerbation. Five-to-seven-year vital status was ascertained via structured phone interviews with patients or their household members/primary care physicians. We investigated predictive accuracy using univariate and multivariate Cox regression models and area under the receiver operating characteristic curve (AUC). After a median [25th-75th percentile] 6.1 [5.6-6.5] years, mortality was 55% (95%CI 50%-59%). Discharge ProADM concentration was strongly associated with 5-7-year non-survival: adjusted hazard ratio (HR)/10-fold increase (95%CI) 10.4 (6.2-17.7). Weaker associations were found for PCT and no significant associations were found for CRP or WBC. Combining ProADM with demographic/clinical variables including age, smoking status, BMI, New York Heart Association dyspnea class, exacerbation type, and comorbidities significantly improved long-term predictive accuracy over that of the demographic/clinical model alone: AUC (95%CI) 0.745 (0.701-0.789) versus 0.727 (0.681-0.772), (p) = .043. In patients hospitalized for COPD exacerbation, discharge ProADM levels appeared to accurately predict 5-7-year all-cause mortality and to improve long-term prognostic accuracy of multidimensional demographic/clinical mortality risk assessment.

  3. Quantifying temporal glucose variability in diabetes via continuous glucose monitoring: mathematical methods and clinical application.

    Science.gov (United States)

    Kovatchev, Boris P; Clarke, William L; Breton, Marc; Brayman, Kenneth; McCall, Anthony

    2005-12-01

    Continuous glucose monitors (CGMs) collect detailed blood glucose (BG) time series, which carry significant information about the dynamics of BG fluctuations. In contrast, the methods for analysis of CGM data remain those developed for infrequent BG self-monitoring. As a result, important information about the temporal structure of the data is lost during the translation of raw sensor readings into clinically interpretable statistics and images. The following mathematical methods are introduced into the field of CGM data interpretation: (1) analysis of BG rate of change; (2) risk analysis using previously reported Low/High BG Indices and Poincare (lag) plot of risk associated with temporal BG variability; and (3) spatial aggregation of the process of BG fluctuations and its Markov chain visualization. The clinical application of these methods is illustrated by analysis of data of a patient with Type 1 diabetes mellitus who underwent islet transplantation and with data from clinical trials. Normative data [12,025 reference (YSI device, Yellow Springs Instruments, Yellow Springs, OH) BG determinations] in patients with Type 1 diabetes mellitus who underwent insulin and glucose challenges suggest that the 90%, 95%, and 99% confidence intervals of BG rate of change that could be maximally sustained over 15-30 min are [-2,2], [-3,3], and [-4,4] mg/dL/min, respectively. BG dynamics and risk parameters clearly differentiated the stages of transplantation and the effects of medication. Aspects of treatment were clearly visualized by graphs of BG rate of change and Low/High BG Indices, by a Poincare plot of risk for rapid BG fluctuations, and by a plot of the aggregated Markov process. Advanced analysis and visualization of CGM data allow for evaluation of dynamical characteristics of diabetes and reveal clinical information that is inaccessible via standard statistics, which do not take into account the temporal structure of the data. The use of such methods improves the

  4. Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome.

    Science.gov (United States)

    Varghese, George M; Janardhanan, Jeshina; Trowbridge, Paul; Peter, John V; Prakash, John A J; Sathyendra, Sowmya; Thomas, Kurien; David, Thambu S; Kavitha, M L; Abraham, Ooriapadickal C; Mathai, Dilip

    2013-11-01

    This study sought to document the clinical and laboratory manifestations, genetic variability, and outcomes of scrub typhus, an often severe infection caused by Orientia tsutsugamushi, in South India. Patients admitted to a large teaching hospital with IgM ELISA-confirmed scrub typhus were evaluated. Clinical examination with a thorough search for an eschar, laboratory testing, chest X-ray, and outcome were documented and analyzed. Additionally, a 410-bp region of the 56-kDa type-specific antigen gene of O. tsutsugamushi was sequenced and compared with isolates from other regions of Asia. Most of the 154 patients evaluated presented with fever and non-specific symptoms. An eschar was found in 86 (55%) patients. Mild hepatic involvement was seen in most, with other organ involvement including respiratory, cardiovascular, and renal. Multi-organ dysfunction was noted in 59 (38.3%), and the fatality rate was 7.8%. Hypotension requiring vasoactive agents was found to be an independent predictor of mortality (p<0.001). The phylogeny of 26 samples showed 17 (65%) clustering with the Kato-like group and eight (31%) with the Karp-like group. The presentation of scrub typhus can be variable, often non-specific, but with potentially severe multi-organ dysfunction. Prompt recognition is key to specific treatment and good outcomes. Further study of the circulating strains is essential for the development of a successful vaccine and sensitive point-of-care testing. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Clinical and Demographic Variables Associated Coping and the Burden of Caregivers of Schizophrenia Patients.

    Science.gov (United States)

    Mora-Castañeda, Belvy; Márquez-González, María; Fernández-Liria, Alberto; de la Espriella, Ricardo; Torres, Néstor; Arenas Borrero, Álvaro

    To analyse of the relationship between burden of illness and coping strategies and the demographic variables of caregivers, and the demographic and clinical variables of people diagnosed with schizophrenia. Multicentre correlational cross-sectional study including 70 people diagnosed with schizophrenia, or a schizoaffective disorder, and 70 primary informal caregivers. They were evaluated using Zarit Caregiver Burden Inventory, Family Coping Strategies Questionnaire, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and the brief Disability Assessment Scale. Burden of illness positively associated with patient impairment in occupational and social functioning, and negatively with education level. Avoidance, coercion and positive communication were positively associated with impairment in occupational and social functioning of patients. Social interest and friendships showed a positive association with the education level of caregivers. Spiritual assistance negatively correlated with impairment in social functioning and patient age, and resignation was negatively associated with length of the disorder and patient education level. Burden and dysfunctional coping strategies, such as avoidance and coercion, are associated with functional impairment of the patient. These findings suggest the need to provide support to caregivers, adjusted to the functional level of the patient, in order to prevent burden of care. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Basal (18)F-FDG PET/CT in follicular lymphoma: A comparison of metabolic and clinical variables in the prognostic assessment.

    Science.gov (United States)

    Jiménez Londoño, G A; García Vicente, A M; Poblete García, V M; Amo-Salas, M; Calle Primo, C; Ibañez García, Á; Martínez Sanchís, B; López-Fidalgo, J F; Solano Ramos, F; Martínez Hellín, A; Díaz Morfa, M; Soriano Castrejón, Á

    2016-01-01

    To analyze the relationship of clinical variables related to prognosis and tumor burden, with metabolic variables obtained in the staging (18)F-FDG PET/CT, and their value in the prognosis in follicular lymphoma (FL). 82 patients with FL, a (18)F-FDG PET/CT at diagnosis and a follow-up for a minimum of 12 months, were retrospectively enrolled in the present study. Clinical variables (Tumor grade, Follicular Lymphoma International Prognostic Index (FLIPI) and Tumor burden) were evaluated. Metabolic variables such as SUVmax in the highest hypermetabolic lesion, extralymphatic locations, number of involved lymph node locations, bone marrow (BM) involvement, PET stage and diameter of the biggest hypermetabolic lesion, were analyzed in order to establish a PET score and classify the studies in low, intermediate and high metabolic risk. Clinical and metabolic variables (included metabolic risk) were compared. The relation among all variables and disease-free survival (DFS) was studied. The 28% of patients had a high-grade tumor. The 30.5% had FLIPI risk low, 29.3% intermediate y 40.2% high. The 42.7% presented a high tumor burden. The PET/CT was positive in 94% of patients. The tumor grade did not show significant relation with metabolic variable. FLIPI risk and tumor burden showed statistical relations with the SUV max and the PET score (p<0.008 and p=0.003 respectively). With respect to DFS, significant differences were detected for the PET stage and FLIPI risk (p=0.015 and p=0.047 respectively). FLIPI risk was the only significant predictor in Cox regression analysis, with a Hazard Ratio of 5.13 between high risk and low risk. The present research highlights the significant relation between metabolic variables obtained with FDG PET/CT and clinical variables although their goal as an independent factor of prognosis was not demonstrated in the present work. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  7. Children with language problems in a speech and hearing clinic : Background variables and extent of language problems

    NARCIS (Netherlands)

    Keegstra, A.L.; Knijff, W.A.; Post, W.J.; Goorhuis-Brouwer, S.M.

    Objective: Analysis of a clinical population referred for language analysis in terms of background variables and extent of language problems. Design: Descriptive study. Materials and methods: Children referred to a speech and hearing clinic because of assumed language problems were analyzed with

  8. Elucidation of salvage laryngectomy pathologic and clinical variables to guide further treatment intensification investigation.

    Science.gov (United States)

    Scharpf, Joseph; Ward, Matthew; Adelstein, David; Koyfman, Shlomo; Li, Mingsi

    2018-04-01

    There are limited treatment options beyond surgical salvage for patients who fail nonoperative treatment for laryngeal squamous cell carcinoma. In this study, we examine the failure patterns after surgical salvage and the potential pathologic and clinical prognostic variables that might guide further postoperative intensification investigation. Retrospective analysis at a tertiary academic referral center. From an institutional review board-approved institutional head and neck cancer registry, a consecutive series of 147 patients who underwent salvage laryngectomy for squamous cell cancer recurrence or persistence after radiotherapy with or without chemotherapy between May 1995 and May 2016 were identified. Variables potentially associated with oncologic outcome after surgical salvage were then collected and retrospectively evaluated. The projected 2-year locoregional failure rate was 21.8% (95% confidence interval [CI], 14.6%-29.0%]), and the overall survival 65% (95% CI, 57.5%-74.3%) for the entire cohort after salvage laryngectomy. On multivariable analysis, sarcomatoid/spindle cell pathology (hazard ratio [HR], 3.147; 95% CI, 1.181-8.386; P = 0.022), lymphovascular space invasion (LVSI) (positive vs. negative; HR, 2.31; 95% CI, 1.21-4.42; P = 0.011), and advanced initial American Joint Committee on Cancer 7th Edition grouped stage (stages III-IVB vs. stages I-II; HR, 1.64; 95% CI, 1.04-2.6; P = 0.035) were found to be independently associated with inferior disease-free survival. No other clinical or pathologic variables predicted failure. Salvage laryngectomy after nonoperative treatment failure results in successful locoregional control rates and survival in the majority of patients failing initial therapy. This should temper enthusiasm for routine treatment intensification with postoperative re-irradiation and/or other systemic treatments for the vast majority of patients. Sarcomatoid pathology, LVSI, and an advanced initial stage are associated with inferior

  9. Dissecting Time- from Tumor-Related Gene Expression Variability in Bilateral Breast Cancer

    Directory of Open Access Journals (Sweden)

    Maurizio Callari

    2018-01-01

    Full Text Available Metachronous (MBC and synchronous bilateral breast tumors (SBC are mostly distinct primaries, whereas paired primaries and their local recurrences (LRC share a common origin. Intra-pair gene expression variability in MBC, SBC, and LRC derives from time/tumor microenvironment-related and tumor genetic background-related factors and pairs represents an ideal model for trying to dissect tumor-related from microenvironment-related variability. Pairs of tumors derived from women with SBC (n = 18, MBC (n = 11, and LRC (n = 10 undergoing local-regional treatment were profiled for gene expression; similarity between pairs was measured using an intraclass correlation coefficient (ICC computed for each gene and compared using analysis of variance (ANOVA. When considering biologically unselected genes, the highest correlations were found for primaries and paired LRC, and the lowest for MBC pairs. By instead limiting the analysis to the breast cancer intrinsic genes, correlations between primaries and paired LRC were enhanced, while lower similarities were observed for SBC and MBC. Focusing on stromal-related genes, the ICC values decreased for MBC and were significantly different from SBC. These findings indicate that it is possible to dissect intra-pair gene expression variability into components that are associated with genetic origin or with time and microenvironment by using specific gene subsets.

  10. Quality of Working Life of cancer survivors: associations with health- and work-related variables.

    Science.gov (United States)

    de Jong, Merel; Tamminga, Sietske J; Frings-Dresen, Monique H W; de Boer, Angela G E M

    2017-05-01

    This study aimed to (1) describe the Quality of Working Life (QWL) of cancer survivors and (2) explore associations between the QWL of cancer survivors and health- and work-related variables. Employed and self-employed cancer survivors were recruited through hospitals and patient organizations. They completed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) and health- and work-related variables in this cross-sectional study. The QWL scores of cancer survivors were described, and associations between QWL and health- and work-related variables were assessed. The QWLQ-CS was completed by 302 cancer survivors (28% male) with a mean age of 52 ± 8 years. They were diagnosed between 0 and 10 years ago with various types of cancer, such as breast cancers, gastrointestinal cancers, urological cancers, and haematological cancers. The QWL mean score of cancer survivors was 75 ± 12 (0-100). Cancer survivors had statistically significant lower QWL scores when they had been treated with chemotherapy or when they reported co-morbidity (p ≤ 0.05). Cancer survivors without managerial positions, with low incomes or physically demanding work, and who worked a proportion of their contract hours had statistically significantly lower QWL scores (p ≤ 0.05). This study described the QWL of cancer survivors and associations between QWL and health- and work-related variables. Based on these variables, it is possible to indicate groups of cancer survivors who need more attention and support regarding QWL and work continuation.

  11. From genotype to phenotype; clinical variability in Lesch-Nyhan disease. The role of epigenetics.

    Science.gov (United States)

    Trigueros Genao, M; Torres, R J

    2014-11-01

    Lesch-Nyhan disease is a rare genetic disease characterized by a deficiency in the function of the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT). Patients affected by this disease experience hyperuricemia, motor disorders, mental retardation and, in the most severe cases, self-mutilation. Its clinical manifestations depend on the enzymatic activity of HGPRT, which is classically linked to the type of alteration in the HGPRT gene. More than 400 mutations of this gene have been found. At present, one of the controversial aspects of the disease is the relationship between the genotype and phenotype; cases have been described lacking a mutation, such as the patient presented in this article, as well as families who despite sharing the same genetic defect show disorders with differing severity. Epigenetic processes, which modify the genetic expression without changing the sequence of the deoxyribonucleic acid (DNA), could explain the clinical variability observed in this disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Clinical Impact of Speed Variability to Identify Ultramarathon Runners at Risk for Acute Kidney Injury.

    Directory of Open Access Journals (Sweden)

    Sen-Kuang Hou

    Full Text Available Ultramarathon is a high endurance exercise associated with a wide range of exercise-related problems, such as acute kidney injury (AKI. Early recognition of individuals at risk of AKI during ultramarathon event is critical for implementing preventative strategies.To investigate the impact of speed variability to identify the exercise-related acute kidney injury anticipatively in ultramarathon event.This is a prospective, observational study using data from a 100 km ultramarathon in Taipei, Taiwan. The distance of entire ultramarathon race was divided into 10 splits. The mean and variability of speed, which was determined by the coefficient of variation (CV in each 10 km-split (25 laps of 400 m oval track were calculated for enrolled runners. Baseline characteristics and biochemical data were collected completely 1 week before, immediately post-race, and one day after race. The main outcome was the development of AKI, defined as Stage II or III according to the Acute Kidney Injury Network (AKIN criteria. Multivariate analysis was performed to determine the independent association between variables and AKI development.26 ultramarathon runners were analyzed in the study. The overall incidence of AKI (in all Stages was 84.6% (22 in 26 runners. Among these 22 runners, 18 runners were determined as Stage I, 4 runners (15.4% were determined as Stage II, and none was in Stage III. The covariates of BMI (25.22 ± 2.02 vs. 22.55 ± 1.96, p = 0.02, uric acid (6.88 ± 1.47 vs. 5.62 ± 0.86, p = 0.024, and CV of speed in specific 10-km splits (from secondary 10 km-split (10th - 20th km-split to 60th - 70th km-split were significantly different between runners with or without AKI (Stage II in univariate analysis and showed discrimination ability in ROC curve. In the following multivariate analysis, only CV of speed in 40th - 50th km-split continued to show a significant association to the development of AKI (Stage II (p = 0.032.The development of exercise-related

  13. Clinical Competence and Its Related Factors of Nurses in Neonatal Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Jila Mirlashari

    2016-12-01

    Full Text Available Introduction: Clinical competence of nurses working in the neonatal intensive care units together with advancements in medical science and technology increased the survival rate of newborns that need specialized care. To ensure the quality of care and provide the safety of patients, evaluating the clinical competence of nurses seems necessary. This study aimed to evaluate the clinical competence of nurses in the neonatal intensive care units. Methods: In this cross-sectional study, 117 nurses working in the neonatal intensive care units of the hospitals affiliated to Tehran University of Medical Sciences were selected by census method. The research tool was Development of Competency Inventory for Registered Nurses questionnaire which completed by self-assessment. The mean clinical competence scores of participants categorized into 3 levels: weak: 273. Data were analyzed by SPSS version 13 using the Pearson correlation coefficient, t-test and Chi-square test. Results: The highest levels of competence were related to critical thinking and research attitude and interpersonal relationships, and the lowest level was related to training and mentoring. There was a direct statistically significant relationship between marital status, employment status, level of interest in working in the neonatal intensive-care units and the clinical competence of nurses. Conclusion: Since the clinical competence of nurses in the Neonatal Intensive Care Units is vital, some variables such as interest in the nursing profession, employment status, the neonatal intensive theoretical and practical training courses and the amount of overtime working hours should be taken into consideration.

  14. Comparisons of hypertension-related costs from multinational clinical studies.

    Science.gov (United States)

    Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

    2004-01-01

    This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and

  15. Clinical variables affecting survival in patients with decompensated diastolic versus systolic heart failure.

    Science.gov (United States)

    Gorelik, Oleg; Almoznino-Sarafian, Dorit; Shteinshnaider, Miriam; Alon, Irena; Tzur, Irma; Sokolsky, Ilya; Efrati, Shai; Babakin, Zoanna; Modai, David; Cohen, Natan

    2009-04-01

    The impact of various clinical variables on long-term survival of patients with acutely decompensated diastolic heart failure (DHF) compared to systolic heart failure (SHF) has not been sufficiently investigated. Clinical, laboratory, electrocardiographic and echocardiographic data were collected and analyzed for all-cause mortality in 473 furosemide-treated patients aged >or=60 years, hospitalized for acutely decompensated HF. Diastolic heart failure patients (n = 183) were more likely to be older, female, hypertensive, obese, with shorter preexisting HF duration, atrial fibrillation, lower New York Heart Association (NYHA) class, lower maintenance furosemide dosages, and to receive calcium antagonists. The SHF group (290 patients) demonstrated prevailing coronary artery disease, nitrate or digoxin treatment, and electrocardiographic conduction disturbances (P clinical variables. This observation might carry practical implications.

  16. Clinical variability in hereditary optic neuropathies: Two novel mutations in two patients with dominant optic atrophy and Wolfram syndrome.

    Science.gov (United States)

    Galvez-Ruiz, Alberto

    2015-01-01

    Dominant optic atrophy (DOA) and Wolfram syndrome share a great deal of clinical variability, including an association with hearing loss and the presence of optic atrophy at similar ages. The objective of this paper was to discuss the phenotypic variability of these syndromes with respect to the presentation of two clinical cases. We present two patients, each with either DOA or Wolfram syndrome, and contribute to the research literature through our findings of two novel mutations. The overlapping of several clinical characteristics in hereditary optic neuropathies can complicate the differential diagnosis. Future studies are needed to better determine the genotype-phenotype correlation for these diseases.

  17. Clinical analysis of 503 cases of hyperthyroidism related hepatic damage

    International Nuclear Information System (INIS)

    Zhang Xiaoxia

    2004-01-01

    The clinical characteristics and the therapeutic method of 503 hyperthyroidism related hepatic damage in the paper was discussed. The incidence of the disease of hyperthyroidism related hepatic damage was 39.7%, the rate increases with the increase in age of the patients and the increase of the course of hyperthy-roidism (P 3 and FT 4 . The state of the illness may be get better with the treatment, and ALT and AST were all resumed; The hyperthyroidism was easy to lead to hepatic damage. Treatment was given priority to controlling of hyperthyroidism and put the protection of liver to the second place: the degree of hepatic damage was closely related to age, the course of disease and the state of illness. A timely diagnoses and proper therapy may be lead to desirable result. (author)

  18. Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder.

    Science.gov (United States)

    Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

    2016-01-01

    Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry "A. Fiorini" Hospital, Terracina (Latina, Italy), was performed. The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium-high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications.

  19. On the relation of earthquake stress drop and ground motion variability

    Science.gov (United States)

    Oth, Adrien; Miyake, Hiroe; Bindi, Dino

    2017-07-01

    One of the key parameters for earthquake source physics is stress drop since it can be directly linked to the spectral level of ground motion. Stress drop estimates from moment corner frequency analysis have been shown to be extremely variable, and this to a much larger degree than expected from the between-event ground motion variability. This discrepancy raises the question whether classically determined stress drop variability is too large, which would have significant consequences for seismic hazard analysis. We use a large high-quality data set from Japan with well-studied stress drop data to address this issue. Nonparametric and parametric reference ground motion models are derived, and the relation of between-event residuals for Japan Meteorological Agency equivalent seismic intensity and peak ground acceleration with stress drop is analyzed for crustal earthquakes. We find a clear correlation of the between-event residuals with stress drops estimates; however, while the island of Kyushu is characterized by substantially larger stress drops than Honshu, the between-event residuals do not reflect this observation, leading to the appearance of two event families with different stress drop levels yet similar range of between-event residuals. Both the within-family and between-family stress drop variations are larger than expected from the ground motion between-event variability. A systematic common analysis of these parameters holds the potential to provide important constraints on the relative robustness of different groups of data in the different parameter spaces and to improve our understanding on how much of the observed source parameter variability is likely to be true source physics variability.

  20. Relative effects of precipitation variability and warming on tallgrass prairie ecosystem function

    Directory of Open Access Journals (Sweden)

    P. A. Fay

    2011-10-01

    interannual climate variability, intra-annual rainfall variability, and temperature, (2 interannual climate variation was a larger source of variation in ecosystem function than intra-annual rainfall variability and warming, and (3 effects of increased growing season rainfall variability and warming were small, but ecologically important. The relative effects of these climate drivers are likely to vary for different ecosystem processes and in wetter or drier ecosystems.

  1. Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

    2016-04-30

    Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Interannual and spatial variability of maple syrup yield as related to climatic factors

    Science.gov (United States)

    Houle, Daniel

    2014-01-01

    Sugar maple syrup production is an important economic activity for eastern Canada and the northeastern United States. Since annual variations in syrup yield have been related to climate, there are concerns about the impacts of climatic change on the industry in the upcoming decades. Although the temporal variability of syrup yield has been studied for specific sites on different time scales or for large regions, a model capable of accounting for both temporal and regional differences in yield is still lacking. In the present study, we studied the factors responsible for interregional and interannual variability in maple syrup yield over the 2001–2012 period, by combining the data from 8 Quebec regions (Canada) and 10 U.S. states. The resulting model explained 44.5% of the variability in yield. It includes the effect of climatic conditions that precede the sapflow season (variables from the previous growing season and winter), the effect of climatic conditions during the current sapflow season, and terms accounting for intercountry and temporal variability. Optimal conditions for maple syrup production appear to be spatially restricted by less favourable climate conditions occurring during the growing season in the north, and in the south, by the warmer winter and earlier spring conditions. This suggests that climate change may favor maple syrup production northwards, while southern regions are more likely to be negatively affected by adverse spring conditions. PMID:24949244

  3. Relation of increased short-term variability of QT interval to congenital long-QT syndrome

    DEFF Research Database (Denmark)

    Hinterseer, Martin; Beckmann, Britt-Maria; Thomsen, Morten B

    2009-01-01

    Apart from clinical symptoms the diagnosis and risk stratification in long-QT syndrome (LQTS) is usually based on the surface electrocardiogram. Studies have indicated that not only prolongation of the QT interval but also an increased short-term variability of QT interval (STV(QT)) is a marker...... that an STV(QT) of 4.9 ms was the optimal cut-off value to predict mutation carriers. When incorporating an STV(QT) >4.9 ms for those whose QTc interval was within the normal limits, sensitivity to distinguish mutation carriers increased to 83% with a specificity of 68%, so that another 15 mutation carriers...

  4. Clinical features of IgG4-related rhinosinusitis.

    Science.gov (United States)

    Hanaoka, Machiko; Kammisawa, Terumi; Koizumi, Satomi; Kuruma, Sawako; Chiba, Kazuro; Kikuyama, Masataka; Shirakura, Satoshi; Sugimoto, Taro; Hishima, Tsunekazu

    2017-09-01

    IgG4-related disease is a systemic disease that affects various organs of the body. Aim of this study is to elucidate the clinical characteristics of IgG4-related rhinosinusitis. Clinical features, laboratory findings, radiological and endoscopic findings, associated disease, treatment and prognosis were retrospectively examined in 10 patients with IgG4-related rhinosinusitis. The age was 59.1±11.3 years old and male-to-female ratio was 1:1. The chief nasal complaints were hyposmia (n=4), nasal obstruction (n=3), and nothing (n=3). Serum IgG4 levels were elevated in all patients and the value was 740.4±472.4mg/dl. Other IgG4-related diseases were associated in all 10 patients, including IgG4-related sialadenitis (n=6), IgG4-related dacryoadenitis (n=5), and autoimmune pancreatitis (n=5). Imaging findings on CT/MRI were obstruction of the way of elimination (n=10), thickening of the sinus mucous membrane (n=10), and fluid in the sinus (n=6). All of the cases had bilateral findings. Nasal endoscopic findings were chiefly deviated nasal septum (n=5), polyps (n=4), edema of the mucous membrane (n=3). Histologically, abundant infiltration of IgG4 positive plasma cell and lymphocyte and an elevated IgG4+/IgG+ cell ration was detected in all 8 patients and 5 patients, respectively. Endoscopic sinus surgery was performed in 8 patients. Eight patients were treated with steroid therapy for other associated IgG4-related diseases. Symptoms improved in all 6 patients after an initial treatment (endoscopic surgery (n=5) and steroids (n=1)), but one patient suffered relapse. IgG4-related rhinosinusitis is a distinct entity of IgG4-related disease, and is associated in patients with multiple IgG4-related diseases. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

  5. Assessing factors related to waist circumference and obesity: application of a latent variable model.

    Science.gov (United States)

    Dalvand, Sahar; Koohpayehzadeh, Jalil; Karimlou, Masoud; Asgari, Fereshteh; Rafei, Ali; Seifi, Behjat; Niksima, Seyed Hassan; Bakhshi, Enayatollah

    2015-01-01

    Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults. Data included 18,990 Iranian individuals aged 20-65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity) with independent variables including age, gender, PR (Place of Residence), PA (physical activity), smoking status, SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), CHOL (cholesterol), FBG (Fasting Blood Glucose), diabetes, and FHD (family history of diabetes). All variables were related to both obesity and waist circumference (WC). Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.

  6. Assessing Factors Related to Waist Circumference and Obesity: Application of a Latent Variable Model

    Directory of Open Access Journals (Sweden)

    Sahar Dalvand

    2015-01-01

    Full Text Available Background. Because the use of BMI (Body Mass Index alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome and obesity (binary outcome among Iranian adults. Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity with independent variables including age, gender, PR (Place of Residence, PA (physical activity, smoking status, SBP (Systolic Blood Pressure, DBP (Diastolic Blood Pressure, CHOL (cholesterol, FBG (Fasting Blood Glucose, diabetes, and FHD (family history of diabetes. Results. All variables were related to both obesity and waist circumference (WC. Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity. Conclusions. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.

  7. Profiles of drug addicts in relation to personality variables and disorders.

    Science.gov (United States)

    Carou, María; Romero, Estrella; Luengo, Mª Ángeles

    2016-10-07

    In recent decades, research has identified a set of impulsive/disinhibited personality variables closely associated with drug addiction. As well as this, disorders linked with these variables, such as ADHD and personality disorders, are being closely studied in the field of drug addiction. Although much knowledge has been accumulated about the relation of these variables and disorders taken separately, less is known about how these constructs allow identify-specific profiles within the drug dependent population to be identified. This work, on the basis of data collected on a sample of drug addicts in treatment, analyzes how impulsiveness, sensation seeking, self-control, ADHD and personality disorders contribute to identifying specific profiles of addicts. Cluster analysis allowed two profiles to be outlined according to these personality and psychopathology characteristics. Self-control, impulsiveness, impulsive and antisocial personality disorders, as well as scores in ADHD, emerge as the variables that contribute more to profile differentiation. One of these profiles (56.1% of participants) with a high disinhibition pattern, is associated with severe indicators of consumption and criminal career patterns. These results allow us to emphasize the role of personality and impulsiveness-related disorders in the identification of distinctive profiles within the addict population, and suggest the need to generate treatment strategies adapted to personal/psychopathology configurations of drug addicts.

  8. Clinical and forensic signs related to cocaine abuse.

    Science.gov (United States)

    Dinis-Oliveira, Ricardo Jorge; Carvalho, Félix; Duarte, José Alberto; Proença, Jorge Brandão; Santos, Agostinho; Magalhães, Teresa

    2012-03-01

    Good laboratory practice in toxicological analysis requires pre-analytical steps for collection of detailed information related to the suspected poisoning episodes, including biological and non-biological circumstantial evidences, which should be carefully scrutinized. This procedure provides great help to unveil the suspected cause of poisoning, to select the appropriate and correct samples to be analyzed and can facilitate the decision about the analytical techniques to perform. This implies a good knowledge of the signs related to acute and chronic intoxications by drugs of abuse. In this manuscript we highlight and discuss clinical and forensic imaging related to cocaine abuse, namely the midline destructive lesion, dental health, pseudoscleradermatous triad and crack hands, necrosis and gangrene of extremities and several other skin manifestations, reticular purpura, intracerebral and peripheral hemorrhages, angioneurotic edema, rhabdomyolysis, and crack lung. For this purpose, the state of the art on this topic is discussed, using clinical and forensic cases from our professional database in complement to images and mechanistic data from literature.

  9. Performance variability is related to change in cognition: evidence from the Victoria Longitudinal Study.

    Science.gov (United States)

    MacDonald, Stuart W S; Hultsch, David F; Dixon, Roger A

    2003-09-01

    Performance variability across repeated task administrations may be an important indicator of age-related cognitive functioning. In the present investigation, the authors examined whether age differences and change in inconsistency were related to 6-year (3 occasion) cognitive change. Inconsistency scores were computed from 4 reaction time tasks performed by 446 older adults (54-89 years). Replicating previous cross-sectional results, greater inconsistency was observed for older participants even after controlling for differences in response speed. New longitudinal results demonstrated (a) associations between inconsistency at baseline measurement and 6-year change in cognitive performance; (b) longitudinal change in inconsistency; and (c) intraindividual covariation between 6-year change in inconsistency and 6-year change in level of cognitive function. These findings support the view that performance variability serves as a marker of cognitive aging.

  10. Increased default-mode variability is related to reduced task-performance and is evident in adults with ADHD

    Directory of Open Access Journals (Sweden)

    Athanasia M. Mowinckel

    2017-01-01

    Full Text Available Insufficient suppression and connectivity of the default mode network (DMN is a potential mediator of cognitive dysfunctions across various disorders, including attention deficit/hyperactivity disorder (ADHD. However, it remains unclear if alterations in sustained DMN suppression, variability and connectivity during prolonged cognitive engagement are implicated in adult ADHD pathophysiology, and to which degree methylphenidate (MPH remediates any DMN abnormalities. This randomized, double-blinded, placebo-controlled, cross-over clinical trial of MPH (clinicaltrials.gov/ct2/show/NCT01831622 explored large-scale brain network dynamics in 20 adults with ADHD on and off MPH, compared to 27 healthy controls, while performing a reward based decision-making task. DMN task-related activation, variability, and connectivity were estimated and compared between groups and conditions using independent component analysis, dual regression, and Bayesian linear mixed models. The results show that the DMN exhibited more variable activation patterns in unmedicated patients compared to healthy controls. Group differences in functional connectivity both between and within functional networks were evident. Further, functional connectivity between and within attention and DMN networks was sensitive both to task performance and case-control status. MPH altered within-network connectivity of the DMN and visual networks, but not between-network connectivity or temporal variability. This study thus provides novel fMRI evidence of reduced sustained DMN suppression in adults with ADHD during value-based decision-making, a pattern that was not alleviated by MPH. We infer from multiple analytical approaches further support to the default mode interference hypothesis, in that higher DMN activation variability is evident in adult ADHD and associated with lower task performance.

  11. Utility of Childhood Glucose Homeostasis Variables in Predicting Adult Diabetes and Related Cardiometabolic Risk Factors

    OpenAIRE

    Nguyen, Quoc Manh; Srinivasan, Sathanur R.; Xu, Ji-Hua; Chen, Wei; Kieltyka, Lyn; Berenson, Gerald S.

    2009-01-01

    OBJECTIVE This study examines the usefulness of childhood glucose homeostasis variables (glucose, insulin, and insulin resistance index [homeostasis model assessment of insulin resistance {HOMA-IR}]) in predicting pre-diabetes and type 2 diabetes and related cardiometabolic risk factors in adulthood. RESEARCH DESIGN AND METHODS This retrospective cohort study consisted of normoglycemic (n = 1,058), pre-diabetic (n = 37), and type 2 diabetic (n = 25) adults aged 19–39 years who were followed o...

  12. Effects of an emotional intelligence program in variables related to the prevention of violence

    OpenAIRE

    Garaigordobil, Maite; Peña-Sarrionandia, Ainize

    2015-01-01

    In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (El) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged fro...

  13. The Golden Age of Cataclysmic Variables and Related Objects - II Concluding Address

    Directory of Open Access Journals (Sweden)

    F. Giovannelli

    2015-02-01

    Full Text Available Before to conclude officially this workshop — far from me the idea to attempt some concluding remarks already dealt at the meeting with various burning by Joseph Patterson, Mariko Kato, Dmitry Bisikalo, and Rene Hudec —, I would like to comment few highlights coming out from our fruitful week of discussions about The Golden Age of Cataclysmic Variables and Related Objects - II, without any pretension of completeness.

  14. The Relation Between Skill Levels and the Cyclical Variability of Employment, Hours, and Wages

    OpenAIRE

    Michael P. Keane; Eswar S Prasad

    1993-01-01

    This paper uses micro data to examine differences in the cyclical variability of employment, hours, and wages for skilled and unskilled workers. Contrary to conventional wisdom, we find that, at the aggregate level, skilled and unskilled workers are subject to essentially the same degree of cyclical variation in wages. That is, relative offer wage differentials between skilled and unskilled workers are acyclical. However, we do find important differences in the patterns of employment and hour...

  15. TNF-α levels in cancer patients relate to social variables

    Science.gov (United States)

    Marucha, Phillip T.; Crespin, Timothy R.; Shelby, Rebecca A.; Andersen, Barbara L.

    2008-01-01

    Tumor necrosis factor-α (TNF-α) is an important cytokine associated with tumor regression and increased survival time for cancer patients. Research evidence relates immune factors (e.g., natural killer (NK) cell counts, NK cell lysis, lymphocyte profile, and lymphocyte proliferation) to the frequency and quality of social relations among cancer patients. We hypothesized that disruptions in social relations would be associated with lower TNF-α responses, and conversely, that reports of positive changes in social relations correlate with stronger responses. A prospective design measured changes in social activity and relationship satisfaction with a partner in 44 breast cancer patients at the time of cancer diagnosis, and initial surgery and 12 months later. Results indicated that patients reporting increased social activities or satisfaction exhibited stronger stimulated TNF-α responses. This is the first study to link changes in patient social relations with a cancer-relevant immune variable. PMID:15890493

  16. [Progress of midfacial fat compartments and related clinical applications].

    Science.gov (United States)

    Wen, Lihong; Wang, Jinhuang; Li, Yang; Liu, Dalie

    2018-02-01

    To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow's space can restore the appearance of midface effectively. In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.

  17. Soil fauna and its relation with environmental variables in soil management systems

    Directory of Open Access Journals (Sweden)

    Dilmar Baretta

    Full Text Available The present study aims to generate knowledge about the soil fauna, its relation to other explanatory environmental variables, and, besides it, to select edaphic indicators that more contribute to separate the land use systems (LUS. Five different LUS were chosen: conventional tillage with crop rotation (CTCR; no-tillage with crop rotation (NTCR; conventional tillage with crop succession (CTCS; no-tillage with crop succession (NTCS and minimum tillage with crop succession (MTCS. The samples were made in the counties Chapecó, Xanxerê and Ouro Verde located in the state of Santa Catarina, Brazil, and were considered the true replicates of the LUS. In each site, nine points were sampled in a sampling grid of 3 x 3. At the same points, soil was sampled for the physical, chemical and biological attributes (environmental variables. Pitfall traps were used to evaluate the soil fauna. Data were analyzed using principal component analysis (PCA and canonical discriminant analysis (CDA. The soil fauna presented potential to be used as indictors of soil quality, since some groups proved to be sensible to changes of the environmental variables and to soil management and tillage. The soil management using crop rotation (NTCR and CTCR presented higher diversity, compared to the systems using crop succession (NTCS, MTCS and NTCS, evidencing the importance of the soil tillage, independent of the season (summer or winter. The variable that better contributed to explain these changes were the chemical variables (potassium, pH, calcium, organic matter, available phosphorus, potential acidity, and biological variables (Shannon diversity index, Collembola, Pielou equitability index and microbial biomass carbon, respectively.

  18. An audit of the nature and impact of clinical coding subjectivity variability and error in otolaryngology.

    Science.gov (United States)

    Nouraei, S A R; Hudovsky, A; Virk, J S; Chatrath, P; Sandhu, G S

    2013-12-01

    To audit the accuracy of clinical coding in otolaryngology, assess the effectiveness of previously implemented interventions, and determine ways in which it can be further improved. Prospective clinician-auditor multidisciplinary audit of clinical coding accuracy. Elective and emergency ENT admissions and day-case activity. Concordance between initial coding and the clinician-auditor multi-disciplinary teams (MDT) coding in respect of primary and secondary diagnoses and procedures, health resource groupings health resource groupings (HRGs) and tariffs. The audit of 3131 randomly selected otolaryngology patients between 2010 and 2012 resulted in 420 instances of change to the primary diagnosis (13%) and 417 changes to the primary procedure (13%). In 1420 cases (44%), there was at least one change to the initial coding and 514 (16%) health resource groupings changed. There was an income variance of £343,169 or £109.46 per patient. The highest rates of health resource groupings change were observed in head and neck surgery and in particular skull-based surgery, laryngology and within that tracheostomy, and emergency admissions, and specially, epistaxis management. A randomly selected sample of 235 patients from the audit were subjected to a second audit by a second clinician-auditor multi-disciplinary team. There were 12 further health resource groupings changes (5%) and at least one further coding change occurred in 57 patients (24%). These changes were significantly lower than those observed in the pre-audit sample, but were also significantly greater than zero. Asking surgeons to 'code in theatre' and applying these codes without further quality assurance to activity resulted in an health resource groupings error rate of 45%. The full audit sample was regrouped under health resource groupings 3.5 and was compared with a previous audit of 1250 patients performed between 2007 and 2008. This comparison showed a reduction in the baseline rate of health resource

  19. [Environmental and genetic variables related with alterations in language acquisition in early childhood].

    Science.gov (United States)

    Moriano-Gutierrez, A; Colomer-Revuelta, J; Sanjuan, J; Carot-Sierra, J M

    2017-01-01

    A great deal of research has addressed problems in the correct acquisition of language, but with few overall conclusions. The reasons for this lie in the individual variability, the existence of different measures for assessing language and the fact that a complex network of genetic and environmental factors are involved in its development. To review the environmental and genetic variables that have been studied to date, in order to gain a better under-standing of the causes of specific language impairment and create new evidence that can help in the development of screening systems for the early detection of these disorders. The environmental variables related with poorer early child language development include male gender, low level of education of the mother, familial history of problems with language or psychiatric problems, perinatal problems and health problems in early childhood. Bilingualism seems to be a protective factor. Temperament and language are related. Within the genetic factors there are several specific genes associated with language, two of which have a greater influence on its physiological acquisition: FOXP2 and CNTNAP2. The other genes that are most related with specific language disorders are ATP2C2, CMIP, ROBO2, ZNF277 and NOP9. The key to comprehending the development of specific language disorders lies in reaching an understanding of the true role played by genes in the ontogenesis, in the regulation of the different developmental processes, and how this role is modulated by the environment.

  20. The Influence of Unsportsmanlike Fouls on Basketball Teams' Performance According to Context-Related Variables.

    Science.gov (United States)

    Gómez, Miguel-Ángel; Ortega Toro, Enrique; Furley, Philip

    2016-07-01

    The aim of the current study was to analyze the temporal effects that unsportsmanlike fouls may have on basketball teams' scoring performance under consideration of context-related variables. The authors analyzed 130 unsportsmanlike fouls from 362 elite basketball games (men's and women's Olympic Games, European and World Championships). The context-related variables studied were score-line, quality of opposition, timeout situation, minutes remaining, and player status. The data were analyzed with linear-regression models. The results showed that both teams (the team that made the foul and the opponent) had similar positive scoring performances during 1 and 3 ball possessions after the unsportsmanlike foul (short-term effect). However, 5 ball possessions after the foul (midterm effect), the team that made the foul had a scoring disadvantage (-0.96) and the opponent team an advantage (0.78). The context-related variable quality of opposition was significant only during 1 ball possession, with negative effects for the team that made the foul and positive effects for the opponent. The final outcome showed a positive effect for score-line when the unsportsmanlike foul was made (0.96) and for quality of opposition (0.64).

  1. Comparison of Personal, Social and Academic Variables Related to University Drop-out and Persistence.

    Science.gov (United States)

    Bernardo, Ana; Esteban, María; Fernández, Estrella; Cervero, Antonio; Tuero, Ellián; Solano, Paula

    2016-01-01

    Dropping out of university has serious consequences not only for the student who drops out but also for the institution and society as a whole. Although this phenomenon has been widely studied, there is a need for broader knowledge of the context in which it occurs. Yet research on the subject often focuses on variables that, although they affect drop-out rates, lie beyond a university's control. This makes it hard to come up with effective preventive measures. That is why a northern Spanish university has undertaken a ex post facto holistic research study on 1,311 freshmen (2008/9, 2009/10, and 2010/11 cohorts). The study falls within the framework of the ALFA-GUIA European Project and focuses on those drop-out factors where there is scope for taking remedial measures. This research explored the possible relationship of degree drop-out and different categories of variables: variables related to the educational stage prior to university entry (path to entry university and main reason for degree choice), variables related to integration and coexistence at university (social integration, academic integration, relationships with teachers/peers and value of the living environment) financial status and performance during university studies (in terms of compliance with the program, time devoted to study, use of study techniques and class attendance). Descriptive, correlational and variance analyses were conducted to discover which of these variables really distinguish those students who drop-out from their peers who complete their studies. Results highlight the influence of vocation as main reason for degree choice, path to university entry, financial independency, social and academic adaptation, time devoted to study, use of study techniques and program compliance in the studied phenomenon.

  2. Comparison of personal, social and academic variables related to University Dropout and Persistence

    Directory of Open Access Journals (Sweden)

    Ana B. Bernardo

    2016-10-01

    Full Text Available Dropping out of university has serious consequences not only for the student who drops out but also for the institution and society as a whole. Although this phenomenon has been widely studied, there is a need for broader knowledge of the context in which it occurs. Yet research on the subject often focuses on variables that, although they affect drop-out rates, lie beyond a university's control. This makes it hard to come up with effective preventive measures. That is why a northern Spanish university has undertaken a ex post facto holistic research study on 1,311 freshmen (2008/9, 2009/10 and 2010/11 cohorts. The study falls within the framework of the ALFA-GUIA European Project and focuses on those drop-out factors where there is scope for taking remedial measures. This research explored the possible relationship of degree dropout and different categories of variables: variables related to the educational stage prior to university entry (path to entry university and main reason for degree choice, variables related to integration and coexistence at university (social integration, academic integration, relationships with teachers/ peers and value of the living environment financial status and performance during university studies (in terms ofcompliance with the program, time devoted to study, use of study techniques and class attendance. Descriptive, correlational and variance analyses were conducted to discover which of these variables really distinguish those students who drop out from their peers who complete their studies. Results highlight the influence of vocation as main reason for degree choice, path to university entry, financial independency, social and academic adaptation, time devoted to study, use of study techniques and program compliance in the studied phenomenon.

  3. Systemic relational therapy and the case from the clinical practice

    Directory of Open Access Journals (Sweden)

    Tatjana Rožič

    2003-06-01

    Full Text Available In the present article are represented the principal guidelines of the systemic relational model of psychotherapy and an example of clinical practice where the pacient was incluced in this kind of therapy. In the essence of systemic relational model there is a person which is captured in the repetition of old patterns in spite of its painfulness and hardness. Captured and helpless in old patterns, the person not only repeats but also recreates them, because they promise safety, belonging and connectedness. From the review of the therapy it is evident that behind the pacient's concrete problems stands her family system to which she is loyal in the way that only deepens her distress. By the increasing the responsability for herself, for her feelings and her acts, it increases the pacient's funcionality, too.

  4. Biochemical and Clinical Variables of Normal Parathyroid and Hyperparathyroid Diabetic Chronic Kidney Disease Patients

    Directory of Open Access Journals (Sweden)

    Syed Abdul Kader

    2016-09-01

    Full Text Available Background: In chronic kidney disease (CKD intact parathyroid hormone (iPTH level is often increased before clinical hyperphosphatemia occurs. Despite its importance very few studies evaluated parathyroid status in CKD. Objective: The study was undertaken to estimate level of parathormone in diabetic CKD patients at a tertiary level hospital and assessing its relationship with different parameters like hemoglobin, calcium etc. and comparing biochemical and clinical variables between normal parathyroid and hyperparathyroid groups. Materials and Methods: It was a hospital based cross-sectional study involving purposively selected chronic kidney disease patients attending nephrology and endocrinology outdoor and indoor services of BIRDEM hospital, Dhaka, Bangladesh. Study was conducted during the period of April to October 2010. All the subjects were divided into two groups based on serum parathormone level and different parameters were compared between groups. Results: The mean duration of chronic kidney disease was significantly higher in hyperparathyroid group than that in the normal group (<0.001. Retinopathy and hypertension were more common in hyperparathyroid group than that in patients with normal serum parathormone (p<0.001 and p=0.012. Neuropathy was solely present in hyperparathyroid group (p<0.001. Mean fasting blood glucose, serum creatinine and serum phosphate were significantly higher in the hyperparathyroid group compared to normal group (p<0.001 in all cases while the mean serum calcium and haemoglobin were lower in hyperparathyroid group than those in the normal group (p<0.001 in both cases. Serum creatinine and serum parathormone bears a significantly linear relationship (r=0.986, p<0.001, while serum parathormone and serum calcium bears a significantly negative relationship (r=−0.892 and p<0.001. Conclusion: Earlier intervention on the basis of iPTH in addition to other biochemical parameters of chronic kidney disease is

  5. Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

    Science.gov (United States)

    Howanitz, Peter J; Lehman, Christopher M; Jones, Bruce A; Meier, Frederick A; Horowitz, Gary L

    2015-08-01

    Hemolysis is an important clinical laboratory quality attribute that influences result reliability. To determine hemolysis identification and rejection practices occurring in clinical laboratories. We used the College of American Pathologists Survey program to distribute a Q-Probes-type questionnaire about hemolysis practices to Chemistry Survey participants. Of 3495 participants sent the questionnaire, 846 (24%) responded. In 71% of 772 laboratories, the hemolysis rate was less than 3.0%, whereas in 5%, it was 6.0% or greater. A visual scale, an instrument scale, and combination of visual and instrument scales were used to identify hemolysis in 48%, 11%, and 41% of laboratories, respectively. A picture of the hemolysis level was used as an aid to technologists' visual interpretation of hemolysis levels in 40% of laboratories. In 7.0% of laboratories, all hemolyzed specimens were rejected; in 4% of laboratories, no hemolyzed specimens were rejected; and in 88% of laboratories, some specimens were rejected depending on hemolysis levels. Participants used 69 different terms to describe hemolysis scales, with 21 terms used in more than 10 laboratories. Slight and moderate were the terms used most commonly. Of 16 different cutoffs used to reject hemolyzed specimens, moderate was the most common, occurring in 30% of laboratories. For whole blood electrolyte measurements performed in 86 laboratories, 57% did not evaluate the presence of hemolysis, but for those that did, the most common practice in 21 laboratories (24%) was centrifuging and visually determining the presence of hemolysis in all specimens. Hemolysis practices vary widely. Standard assessment and consistent reporting are the first steps in reducing interlaboratory variability among results.

  6. Time-dependent inelastic analysis of metallic media using constitutive relations with state variables

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, V; Mukherjee, S [Cornell Univ., Ithaca, N.Y. (USA)

    1977-03-01

    A computational technique in terms of stress, strain and displacement rates is presented for the solution of boundary value problems for metallic structural elements at uniform elevated temperatures subjected to time varying loads. This method can accommodate any number of constitutive relations with state variables recently proposed by other researchers to model the inelastic deformation of metallic media at elevated temperatures. Numerical solutions are obtained for several structural elements subjected to steady loads. The constitutive relations used for these numerical solutions are due to Hart. The solutions are discussed in the context of the computational scheme and Hart's theory.

  7. Revisiting relationships between sex-related variables and continuation in counseling.

    Science.gov (United States)

    Hatchett, Gregory T; Park, Heather L

    2004-04-01

    This study examined the relationships between three sex-related variables (client sex, therapist sex, and dyad matching on sex) and continuation in counseling. 245 college students who were clients at three university counseling centers participated. Consistent with previous studies, women comprised 68.2% of the clients seeking services at these counseling centers. Clients' sex was significantly related to counseling duration, explaining 2.2% of the common variance. Female clients, on the average, attended 1.8 more sessions than male clients. However, neither the therapists' sex nor dyad matching on sex was significantly related to the duration of counseling. None of the sex-related variables correlated with premature termination of counseling. The results have implications for providing counseling and outreach services to male students. Despite relatively equivalent rates in the incidence of mental health problems, female students continue to comprise the majority of clients. Therefore, university counseling centers need to communicate their services better to male students in need of mental health services.

  8. Associated and Mediating Variables Related to Job Satisfaction among Professionals from Mental Health Teams.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Chiocchio, François

    2018-06-01

    Using a structural analysis, this study examines the relationship between job satisfaction among 315 mental health professionals from the province of Quebec (Canada) and a wide range of variables related to provider characteristics, team characteristics, processes, and emergent states, and organizational culture. We used the Job Satisfaction Survey to assess job satisfaction. Our conceptual framework integrated numerous independent variables adapted from the input-mediator-output-input (IMOI) model and the Integrated Team Effectiveness Model (ITEM). The structural equation model predicted 47% of the variance of job satisfaction. Job satisfaction was associated with eight variables: strong team support, participation in the decision-making process, closer collaboration, fewer conflicts among team members, modest knowledge production (team processes), firm affective commitment, multifocal identification (emergent states) and belonging to the nursing profession (provider characteristics). Team climate had an impact on six job satisfaction variables (team support, knowledge production, conflicts, affective commitment, collaboration, and multifocal identification). Results show that team processes and emergent states were mediators between job satisfaction and team climate. To increase job satisfaction among professionals, health managers need to pursue strategies that foster a positive climate within mental health teams.

  9. Child-rearing practices toward children with hemophilia: The relative importance of clinical characteristics and parental emotional reactions

    NARCIS (Netherlands)

    Banis, Hendrika; Suurmeijer, Th.P.B.M.; van Peer, D.R.

    This study addresses the relative importance of clinical characteristics of the child and parental emotional reactions, to child-rearing practices towards children who suffer from hemophilia. The variables were assessed in a Dutch sample of 108 zero-to-twelve-year-old boys with hemophilia and their

  10. Growth of self-perceived clinical competence in postgraduate training for general practice and its relation to potentially influencing factors.

    NARCIS (Netherlands)

    Kramer, A.W.M.; Zuithoff, P.; Jansen, J.J.; Tan, L.H.; Grol, R.P.T.M.; Vleuten, C.P.M. van der

    2007-01-01

    OBJECTIVE: To examine the increase in self-perceived clinical competence during a three-year postgraduate training in general practice and to explore the relation between the growth of self-perceived competence and several background variables. DESIGN: Cohort, 1995-1998. SETTING: Three-year

  11. Lie symmetry and the generalized Hojman conserved quantity of Nielsen equations for a variable mass holonomic system of relative motion

    International Nuclear Information System (INIS)

    Zhang Mei-Ling; Wang Xiao-Xiao; Xie Yin-Li; Jia Li-Qun; Sun Xian-Ting

    2011-01-01

    Lie symmetry and the generalized Hojman conserved quantity of Nielsen equations for a variable mass holonomic system of relative motion are studied. The determining equation of Lie symmetry of Nielsen equations for a variable mass holonomic system of relative motion under the infinitesimal transformations of groups is given. The expression of generalized Hojman conserved quantity deduced directly from Lie symmetry for a variable mass holonomic system of relative motion is obtained. An example is given to illustrate the application of the results. (general)

  12. Traumatic event exposure and gambling: associations with clinical, neurocognitive, and personality variables.

    Science.gov (United States)

    Leppink, Eric W; Grant, Jon E

    2015-02-01

    Epidemiological research has shown high comorbidity rates between at-risk/problem (ARP) gambling and trauma. However, few studies have assessed the neurocognitive implications of this comorbidity, and even fewer have been conducted with young adults. The present study sought to determine the neurocognitive, clinical, personality types associated with trauma in ARP gamblers. The present study analyzed young adult gamblers age 18 to 29 drawn from a study investigating impulsivity. Of the 230 gamblers, 52 (22.6%) reported experiencing a traumatic event during their life to which they responded with intense fear, helplessness, or horror. The remaining participants indicated no experience with trauma. ARP gamblers who had experienced trauma showed significant neurocognitive deficits on tasks related to decision-making, risk adjustment, sustained attention, and spatial working memory. We did not detect significant differences in gambling severity. Trauma was associated with lower perceived quality of life and self-esteem, and higher rates of current comorbid diagnoses, suicidality, substance use disorders, and nicotine use. This study suggests that trauma may not exacerbate the severity of gambling in ARP gamblers. However, significant differences in supplemental clinical and neurocognitive measures may indicate that trauma is an important consideration when assessing problems beyond those related directly to gambling severity.

  13. Latent variables underlying the memory beliefs of Chartered Clinical Psychologists, Hypnotherapists and undergraduate students.

    Science.gov (United States)

    Ost, James; Easton, Simon; Hope, Lorraine; French, Christopher C; Wright, Daniel B

    2017-01-01

    In courts in the United Kingdom, understanding of memory phenomena is often assumed to be a matter of common sense. To test this assumption 337 UK respondents, consisting of 125 Chartered Clinical Psychologists, 88 individuals who advertised their services as Hypnotherapists (HTs) in a classified directory, the Yellow Pages TM , and 124 first year undergraduate psychology students, completed a questionnaire that assessed their knowledge of 10 memory phenomena about which there is a broad scientific consensus. HTs' responses were the most inconsistent with the scientific consensus, scoring lowest on six of these ten items. Principal Components Analysis indicated two latent variables - reflecting beliefs about memory quality and malleability - underlying respondents' responses. In addition, respondents were asked to rate their own knowledge of the academic memory literature in general. There was no significant relationship between participants' self reported knowledge and their actual knowledge (as measured by their responses to the 10-item questionnaire). There was evidence of beliefs among the HTs that could give rise to some concern (e.g., that early memories from the first year of life are accurately stored and are retrievable).

  14. Clinical variability of neuroacanthocytosis syndromes-a series of six patients with long follow-up.

    Science.gov (United States)

    Dulski, J; Sołtan, W; Schinwelski, M; Rudzińska, M; Wójcik-Pędziwiatr, M; Wictor, L; Schön, F; Puschmann, A; Klempíř, J; Tilley, L; Roth, J; Tacik, P; Fujioka, S; Drozdowski, W; Sitek, E J; Wszolek, Z; Sławek, J

    2016-08-01

    To provide clinical clues to differential diagnosis in patients with chorea and other movement disorders with blood acanthocytes. We present a long-term video accompanied follow-up of six Caucasian patients with neuroacanthocytosis from several centers, three diagnosed with chorea-acanthocytosis (ChAc): 34-y.o.(no.1), 36-y.o.(no.2), 43-y.o.(no.3), two diagnosed with McLeod Syndrome (MLS): 52-y.o.(no.4), 61-y.o.(no.5) and one 63-y.o.(no.6), a brother of no.5, with clinical suspicion of MLS. Additionally we report pathological findings of the mother of two brothers with MLS reported in our series with acanthocytes on peripheral blood smear The patients had an unremarkable family history and were asymptomatic until adulthood. Patients no. 1,2,4,5,6 developed generalized chorea and patient no. 3 had predominant bradykinesia. Patients no. 1,2,3 had phonic and motor tics, additionally patients no. 1 and 2 exhibited peculiar oromandibular dystonia with tongue thrusting. In patients no. 2 and 3 dystonic supination of feet was observed, patient no. 3 subsequently developed bilateral foot drop. Patients no. 2 and 4 had signs of muscle atrophy. Tendon reflexes were decreased or absent and electroneurography demonstrated sensorimotor neuropathy in patients no. 1,2,3,4,5, except no. 6. Generalized seizures were seen in patients no. 2,3,5,6 and myoclonic jerks in patient no. 1. Cognitive deterioration was reported in patients no. 1,2,3,5,6. Serum creatine kinase levels were elevated in all six patients. We highlight the variability of clinical presentation of neuroacanthocytosis syndromes and the long time from the onset to diagnosis with the need to screen the blood smears in uncertain cases, however, as in one of our cases acanthocytes may even be not found. Based on our observations and data from the literature we propose several red flags that should raise the suspicion of an NA syndrome in a patient with a movement disorder: severe orofacial dyskinesia with tongue and lip

  15. Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder

    Directory of Open Access Journals (Sweden)

    Anastasia A

    2016-04-01

    Full Text Available Annalisa Anastasia,1 Chiara Colletti,1 Valentina Cuoco,1 Adele Quartini,1 Stefania Urso,2 Raffaella Rinaldi,2 Giuseppe Bersani1 1Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 2Department of Anatomical, Istological, Forensic and Locomotor System Sciences, Sapienza University of Rome, Rome, Italy Introduction: Although adjustment disorder (AD is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD.Methods: A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry “A. Fiorini” Hospital, Terracina (Latina, Italy, was performed.Results: The sample consisted of 93 patients (46 males and 47 females, aged between 26 and 85, with medium–high educational level who were mainly employed. In most cases (54.80%, a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%, was reported. The main stressors linked to the development of AD were represented by working problems (32.30%, family problems (23.70%, and/or somatic disease (22.60% with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records.Conclusion: Confirming previous data from previous reports, our results

  16. Aspect-related Vegetation Differences Amplify Soil Moisture Variability in Semiarid Landscapes

    Science.gov (United States)

    Yetemen, O.; Srivastava, A.; Kumari, N.; Saco, P. M.

    2017-12-01

    Soil moisture variability (SMV) in semiarid landscapes is affected by vegetation, soil texture, climate, aspect, and topography. The heterogeneity in vegetation cover that results from the effects of microclimate, terrain attributes (slope gradient, aspect, drainage area etc.), soil properties, and spatial variability in precipitation have been reported to act as the dominant factors modulating SMV in semiarid ecosystems. However, the role of hillslope aspect in SMV, though reported in many field studies, has not received the same degree of attention probably due to the lack of extensive large datasets. Numerical simulations can then be used to elucidate the contribution of aspect-driven vegetation patterns to this variability. In this work, we perform a sensitivity analysis to study on variables driving SMV using the CHILD landscape evolution model equipped with a spatially-distributed solar-radiation component that couples vegetation dynamics and surface hydrology. To explore how aspect-driven vegetation heterogeneity contributes to the SMV, CHILD was run using a range of parameters selected to reflect different scenarios (from uniform to heterogeneous vegetation cover). Throughout the simulations, the spatial distribution of soil moisture and vegetation cover are computed to estimate the corresponding coefficients of variation. Under the uniform spatial precipitation forcing and uniform soil properties, the factors affecting the spatial distribution of solar insolation are found to play a key role in the SMV through the emergence of aspect-driven vegetation patterns. Hence, factors such as catchment gradient, aspect, and latitude, define water stress and vegetation growth, and in turn affect the available soil moisture content. Interestingly, changes in soil properties (porosity, root depth, and pore-size distribution) over the domain are not as effective as the other factors. These findings show that the factors associated to aspect-related vegetation

  17. Adaptive functioning in pediatric epilepsy: contributions of seizure-related variables and parental anxiety.

    Science.gov (United States)

    Kerne, Valerie; Chapieski, Lynn

    2015-02-01

    Young people with epilepsy are less likely to achieve the level of independence attained by their peers. We examined the seizure-related variables that placed a group of 97 pediatric patients with intractable seizures at risk for poor adaptive functioning. Analyses evaluated both the direct effects of the medical variables and indirect effects that were mediated through increased parental anxiety about their child's epilepsy. Higher numbers of anticonvulsants, presence of seizures that secondarily generalize, longer duration of seizure disorder, and younger age at onset were all identified as risk factors for poor adaptive functioning. Depending on the specific behavioral domain of adaptive functioning, the effects were sometimes direct and sometimes indirect. Lower levels of parental education and positive family history of seizures were associated with higher levels of parental anxiety. Interventions that target parental anxiety about seizures may mitigate the deleterious effects of epilepsy on social development. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Climate related diseases. Current regional variability and projections to the year 2100

    Directory of Open Access Journals (Sweden)

    Błażejczyk Krzysztof

    2018-03-01

    Full Text Available The health of individuals and societies depends on different factors including atmospheric conditions which influence humans in direct and indirect ways. The paper presents regional variability of some climate related diseases (CRD in Poland: salmonellosis intoxications, Lyme boreliosis, skin cancers (morbidity and mortality, influenza, overcooling deaths, as well as respiratory and circulatory mortality. The research consisted of two stages: 1 statistical modelling basing on past data and 2 projections of CRD for three SRES scenarios of climate change (A1B, A2, B1 to the year 2100. Several simple and multiply regression models were found for the relationships between climate variables and CRD. The models were applied to project future levels of CRD. At the end of 21st century we must expect increase in: circulatory mortality, Lyme boreliosis infections and skin cancer morbidity and mortality. There is also projected decrease in: respiratory mortality, overcooling deaths and influenza infections.

  19. Relational Aggression in Preschool Students: An Exploration of the Variables of Sex, Age, and Siblings

    Directory of Open Access Journals (Sweden)

    Karen A. Morine

    2011-01-01

    Full Text Available In this study, researchers wished to ascertain whether there were age (three- and four-year old, sibling (with or without older siblings, and sex (male and female differences in the use of relational aggression in preschool students as rated by peers and teachers. In order to answer this research question, two 2 × 2 × 2 factorial ANOVA procedures with the relational aggression composite score as the dependent variable on the PSBS-P and PSBS-T were used for peer and teacher assessment, respectively, of relational aggression. Results revealed that in the peer ratings of preschool students' relationally aggressive behavior, there was an disordinal age by sibling interaction, in which four-year-old children with siblings were significantly more likely to be rated by their peers as using relational aggression than three-year-old children without siblings. In the teacher ratings of preschool students' relationally aggressive behavior, a main effect for age was observed. Teachers rated four-year old children as evidencing significantly higher levels of relational aggression as compared to three-year-olds. No sex differences were observed in the use of relational aggression either at age three or age four in this sample. Implications for these findings are presented.

  20. Earthworm assemblages in different intensity of agricultural uses and their relation to edaphic variables

    Directory of Open Access Journals (Sweden)

    LB Falco

    2015-05-01

    Full Text Available The objective of this study was to relate earthworm assemblage structure with three different soil use intensities, and to indentify the physical, chemical, and microbiological soil variables that are associated to the observed differences. Three soil uses were evaluated: 1-Fifty year old naturalized grasslands, low use intensity; 2-Recent agricultural fields, intermediate use intensity, and 3-Fifty year old intensive agricultural fields, high use intensity. Three different sites for each soil use were evaluated from winter 2008 through summer 2011. Nine earthworm species were identified across all sampling sites. The sites shared five species: the native Microscolex dubius, and the introduced Aporrectodea caliginosa, A. rosea, Octalasion cyaneum, and O. lacteum, but they differed in relative abundance by soil use. The results show that the earthworm community structure is linked to and modulated by soil properties. Both species abundance and diversity showed significant differences depending on soil use intensity. A principal component analysis showed that species composition is closely related to the environmental variability. The ratio of native to exotic species was significantly lower in the intensive agricultural system when compared to the other two, lower disturbance systems. Microscolex dubius abundance was related to naturalized grasslands along with soil Ca, pH, mechanical resistance, and microbial respiration. Aporrectodea caliginosa abundance was related to high K levels, low enzymatic activity, slightly low pH, low Ca, and appeared related to the highly disturbed environment. Eukerria stagnalis and Aporrectodea rosea, commonly found in the recent agricultural system, were related to high soil moisture condition, low pH, low Ca and low enzymatic activity. These results show that earthworm assemblages can be good indicators of soil use intensities. In particular, Microscolex dubius, Aporrectodea caliginosa, and Aporrectodea rosea

  1. Incorporation of expert variability into breast cancer treatment recommendation in designing clinical protocol guided fuzzy rule system models.

    Science.gov (United States)

    Garibaldi, Jonathan M; Zhou, Shang-Ming; Wang, Xiao-Ying; John, Robert I; Ellis, Ian O

    2012-06-01

    It has been often demonstrated that clinicians exhibit both inter-expert and intra-expert variability when making difficult decisions. In contrast, the vast majority of computerized models that aim to provide automated support for such decisions do not explicitly recognize or replicate this variability. Furthermore, the perfect consistency of computerized models is often presented as a de facto benefit. In this paper, we describe a novel approach to incorporate variability within a fuzzy inference system using non-stationary fuzzy sets in order to replicate human variability. We apply our approach to a decision problem concerning the recommendation of post-operative breast cancer treatment; specifically, whether or not to administer chemotherapy based on assessment of five clinical variables: NPI (the Nottingham Prognostic Index), estrogen receptor status, vascular invasion, age and lymph node status. In doing so, we explore whether such explicit modeling of variability provides any performance advantage over a more conventional fuzzy approach, when tested on a set of 1310 unselected cases collected over a fourteen year period at the Nottingham University Hospitals NHS Trust, UK. The experimental results show that the standard fuzzy inference system (that does not model variability) achieves overall agreement to clinical practice around 84.6% (95% CI: 84.1-84.9%), while the non-stationary fuzzy model can significantly increase performance to around 88.1% (95% CI: 88.0-88.2%), psystems in any application domain. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. The relation between quality of clinical trials and acupuncture efficacy

    Directory of Open Access Journals (Sweden)

    David Gonçalves Nordon

    2013-06-01

    Full Text Available Introduction: Clinical trials of acupuncture not always have concordant results, mostly due to their great heterogeneity. Two indexes have been developed to analyze the quality of acupuncture trials. This study hypothesizes that, the more adequate the intervention and the control techniques, the more efficacious the acupuncture. Methods: Both indexes were applied to 27 randomized clinical trials comparing acupuncture to placebo. Results were compared by using the Mann-Whitney test. Results: Studies favorable to acupuncture had a intervention score’s median of 11.5; for the unfavorable ones, it was 7, p: 0.0017. Articles with and without statistically significant differences, though, had the same median for their scores in the control index: 6. Discussion: There is a positive relation between a better score for acupuncture technique and a statistically significant difference between acupuncture and interventional control. However, due to the little heterogeneity in the degree of physiological effect from each article, the control index had no statistical significance. Conclusion: This study established that, among acupuncture RCT controlled by placebo or sham of moderate physiological effect, the adequacy of the technique is more important than the adequacy of control in establishing a statistically significant difference between acupuncture and interventional control.

  3. Fibrin related antigens: assay development, clinical and kinetic studies

    Energy Technology Data Exchange (ETDEWEB)

    Kruskal, J B

    1987-08-01

    This thesis describes an assay which is able to measure and to determine the proportions of fibrin- and fibrinogen-related antigens (FRA) present in clinical samples. No assay exists at present which is capable of distinguishing between fibrin and fibrinogen degradation products concurrently and in a clinical setting. The assay may be used as a tool with which to gain further insight to pathophysiology of disorders characterized by activation of the coagulation and fibrinolytic pathways. This study provides and analysis of the FRA profiles in patients with disorders characterised by possible enhanced fibrinolytic activity. Studies have been undertaken on patients with acute and chronic liver diseases, on patients with the various syndromes of coronary artery disease and on patients with insulin-dependent diabetes mellitus with and without evidence of microvascular disease. Certain observations made it evident that further studies were required in order to explain previously undocumented fibrinolytic abnormalities in certain patient groups. Data obtained from patients with liver disease provided information compatible with the activation of their fibrinolytic pathways. The initial scope of this study was then extended to further investigate the deranged haemostatic mechanisms in patients with severe liver diseases. Kinetic studies were performed which required the development of specific technology to be able to measure certain previously undertermined parameters. Mathematical models describing the rates of fibrin formation and lysis were developed for human studies. Fibrin-derived D-dimer was radiolabelled and its validity as and intravenous tracer and maker of fibrin degradation established.

  4. Vomiting and migraine-related clinical parameters in pediatric migraine.

    Science.gov (United States)

    Eidlitz-Markus, Tal; Haimi-Cohen, Yishai; Zeharia, Avraham

    2017-06-01

    To investigate the characteristics of vomiting in pediatric migraineurs and the relationship of vomiting with other migraine-related parameters. The cohort included children and adolescents with migraine attending a headache clinic of a tertiary pediatric medical center from 2010 to 2016. Patients were identified by a retrospective database search. Data were collected from medical files. The presence of vomiting was associated with background and headache-related parameters. The study group included 453 patients, 210 boys (46.4%) and 243 girls (53.6%), of mean age 11.3 ± 3.7 years. Vomiting was reported by 161 patients (35.5%). On comparison of patients with and without vomiting, vomiting was found to be significantly associated with male gender (54% vs 42.1%, P migraine onset (8.0 ± 3. years vs 9.6 ± 3.7 years, P migraine (67% vs 58.7%, P migraine (24.1% vs 10.1%, P migraine in both parents (9.3% vs 3.1%, P = .007), and migraine in either parent (57.5% vs 45.5%, P = .02). The higher rate of vomiting in the younger patients and the patients with awakening pain may be explained by a common underlying pathogenetic mechanism of vomiting and migraine involving autonomic nerve dysfunction/immaturity. The association of vomiting with parental migraine points to a genetic component of vomiting and migraine. It should be noted that some of the findings may simply reflect referral patterns in the tertiary clinic. © 2017 American Headache Society.

  5. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean; Tremblay-Boudreault, Valérie; Beaudoin, Audrée-Jeanne

    2012-01-01

    To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

  6. Incidence of temonera, sulphuhydryl variables and cefotaximase genes associated with ?-lactamase producing escherichia coli in clinical isolates

    OpenAIRE

    Isaiah, Ibeh Nnana; Nche, Bikwe Thomas; Nwagu, Ibeh Georgina; Nwagu, Ibeh Isaiah

    2011-01-01

    Background: The occurrence of the different types of Extended spectrum beta Lactamase producing Escherichia coli with the, Sulphurhydryl variable, Temonera and the Cefotaximase have been on the rise Aim: The study was to determine the prevalence of extended spectrum beta lactamase gene resistance across the clinical isolates of hospitalized patients. Materials and Method: Three hundred and fifty isolates of Escherichia coli were received from different clinical specimens. The susceptibility p...

  7. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    Santos, Emilie M.M.; Yoo, Albert J.; Beenen, Ludo F.; Majoie, Charles B.; Berkhemer, Olvert A.; Blanken, Mark D. den; Wismans, Carrie; Niessen, Wiro J.; Marquering, Henk A.

    2016-01-01

    Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert observers. For 132 consecutive patients with acute ischemic stroke, three experts and two trained observers determined thrombus density by placing three standardized regions of interest (ROIs) in the thrombus and corresponding contralateral arterial segment. Subsequently, absolute and relative thrombus densities were determined using either one or three ROIs. Intraclass correlation coefficient (ICC) was determined, and Bland-Altman analysis was performed to evaluate interobserver and intermethod agreement. Accuracy of the trained observer was evaluated with a reference expert observer using the same statistical analysis. The highest interobserver agreement was obtained for absolute thrombus measurements using three ROIs (ICCs ranging from 0.54 to 0.91). In general, interobserver agreement was lower for relative measurements, and for using one instead of three ROIs. Interobserver agreement of trained non-experts and experts was similar. Accuracy of the trained observer measurements was comparable to the expert interobserver agreement and was better for absolute measurements and with three ROIs. The agreement between the one ROI and three ROI methods was good. Absolute thrombus density measurement has superior interobserver agreement compared to relative density measurement. Interobserver variation is smaller when multiple ROIs are used. Trained non-expert observers can accurately and reproducibly assess absolute thrombus densities using three ROIs. (orig.)

  8. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Emilie M.M. [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, P.O. Box 2040, Rotterdam (Netherlands); Department of Radiology, AMC, Amsterdam (Netherlands); Yoo, Albert J. [Texas Stroke Institute, Plano, TX (United States); Beenen, Ludo F.; Majoie, Charles B. [Department of Radiology, AMC, Amsterdam (Netherlands); Berkhemer, Olvert A. [Department of Radiology, AMC, Amsterdam (Netherlands); Department of Neurology, Erasmus MC, Rotterdam (Netherlands); Blanken, Mark D. den; Wismans, Carrie [AMC, Department of Biomedical Engineering and Physics, Amsterdam (Netherlands); Niessen, Wiro J. [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, P.O. Box 2040, Rotterdam (Netherlands); Delft University of Technology, Faculty of Applied Sciences, Delft (Netherlands); Marquering, Henk A. [Department of Radiology, AMC, Amsterdam (Netherlands); AMC, Department of Biomedical Engineering and Physics, Amsterdam (Netherlands); Collaboration: on behalf of the MR CLEAN investigators

    2016-02-15

    Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert observers. For 132 consecutive patients with acute ischemic stroke, three experts and two trained observers determined thrombus density by placing three standardized regions of interest (ROIs) in the thrombus and corresponding contralateral arterial segment. Subsequently, absolute and relative thrombus densities were determined using either one or three ROIs. Intraclass correlation coefficient (ICC) was determined, and Bland-Altman analysis was performed to evaluate interobserver and intermethod agreement. Accuracy of the trained observer was evaluated with a reference expert observer using the same statistical analysis. The highest interobserver agreement was obtained for absolute thrombus measurements using three ROIs (ICCs ranging from 0.54 to 0.91). In general, interobserver agreement was lower for relative measurements, and for using one instead of three ROIs. Interobserver agreement of trained non-experts and experts was similar. Accuracy of the trained observer measurements was comparable to the expert interobserver agreement and was better for absolute measurements and with three ROIs. The agreement between the one ROI and three ROI methods was good. Absolute thrombus density measurement has superior interobserver agreement compared to relative density measurement. Interobserver variation is smaller when multiple ROIs are used. Trained non-expert observers can accurately and reproducibly assess absolute thrombus densities using three ROIs. (orig.)

  9. Clinical course and core variability in HBV infected patients without detectable anti-HBc antibodies.

    Science.gov (United States)

    Anastasiou, Olympia E; Widera, Marek; Verheyen, Jens; Korth, Johannes; Gerken, Guido; Helfritz, Fabian A; Canbay, Ali; Wedemeyer, Heiner; Ciesek, Sandra

    2017-08-01

    The presence of anti-HBc antibodies indicates direct encounter of the immune system with hepatitis B virus (HBV). Aim of our study was to seek for anti-HBc negative but HBV replicating patients and analyze their clinical course and preconditions. From 1568 HBV-DNA positive patients, 29 patients (1.85%) tested negative for anti-HBc. The absence of anti-HBc could be confirmed in 19 patients using an alternative assay. In 16 of 19 cases, a partial or full HBV genome analysis was performed with NGS sequencing to evaluate if specific mutations were associated with anti-HBc absence. As a control group samples from 32 matched HBV infected patients with detectable anti-HBc were sequenced. Patients with detectable HBV-DNA and sequenced HBV core region in the confirmed absence of anti-HBc were diagnosed with acute HBV infection (n=3), HBV reactivation (n=9) and chronic hepatitis B (n=4). Most patients (12/16) were immunosuppressed: 3/16 patients had an HIV coinfection, 7/16 patients suffered from a malignant disease and 4/16 patients underwent solid organ transplantation (from which 2/4 had a malignant disease). Compared to the control cohort, HBV variants from anti-HBc negative patients showed less variability in the core region. In the absence of anti-HBc, HBV-DNA was most often found in immunocompromised hosts. Distinct mutations or deletions in the core region did not explain anti-HBc negativity. It would be advisable not to rely only on a single result of anti-HBc negativity to exclude HBV infection in immunocompromised hosts, but to measure anti-HBc repeatedly or with different methods. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. 3D.07: CORRELATION BETWEEN THE ARTERIAL PRESSURE VARIABILITY ESTIMATED AT CLINICS, MAPA AND AMPA.

    Science.gov (United States)

    Abellan-Huerta, J; García-Escribano, I A; Soto, R M; Leal, M; Torres, A; Guerrero, B; Melgar, A C; Soto, M; Soria, F; Abellan-Aleman, J

    2015-06-01

    To measure the variability (VB) of the arterial pressure (AP) with the use of serial measurements at the clinics (VBCLIN), with 24 h ambulatory monitoring (MAPA) (VBMAPA) and home automonitoring -AMPA- (VBAMPA) and to estimate a relationship among each method. This is an observational, descriptive and transversal study assessed with 91 hypertensive patients in treatment and stable with AP MAPA was assessed to all the patients included in the study in order to obtain the VBMAPA and an AMPA in two non-consecutive weeks to obtain the VBAMPA (total of 54 measurements). 91 patients with 66 ± 7.7 years old and 58.2% males were recruited. AP values were 134 ± 14/82 ± 10 mmHg for systolic and diastolic APCLIN, respectively. AP values were 122 ± 17 / 68 ± 12 mmHg for systolic and diastolic APMAPA, respectively. AP values were 125 ± 13/75 ± 7 mmHg for systolic and diastolic APAMPA, respectively. The systolic VB for the three above methods was significantly correlated being maximal between VBCLIN and VBAMPA (r = 0.45; 0 MAPA methods is weak. This observation suggests that these are not interchangeable methodologies. Future studies focused on the relationship between VB -with different methods- and vascular target organ damage would be of great help in order to define the best analytical method.

  11. Events per variable for risk differences and relative risks using pseudo-observations

    DEFF Research Database (Denmark)

    Hansen, Stefan Nygaard; Andersen, Per Kragh; Parner, Erik Thorlund

    2014-01-01

    A method based on pseudo-observations has been proposed for direct regression modeling of functionals of interest with right-censored data, including the survival function, the restricted mean and the cumulative incidence function in competing risks. The models, once the pseudo-observations have...... been computed, can be fitted using standard generalized estimating equation software. Regression models can however yield problematic results if the number of covariates is large in relation to the number of events observed. Guidelines of events per variable are often used in practice. These rules...

  12. Invariance and variability in interaction error-related potentials and their consequences for classification

    Science.gov (United States)

    Abu-Alqumsan, Mohammad; Kapeller, Christoph; Hintermüller, Christoph; Guger, Christoph; Peer, Angelika

    2017-12-01

    Objective. This paper discusses the invariance and variability in interaction error-related potentials (ErrPs), where a special focus is laid upon the factors of (1) the human mental processing required to assess interface actions (2) time (3) subjects. Approach. Three different experiments were designed as to vary primarily with respect to the mental processes that are necessary to assess whether an interface error has occurred or not. The three experiments were carried out with 11 subjects in a repeated-measures experimental design. To study the effect of time, a subset of the recruited subjects additionally performed the same experiments on different days. Main results. The ErrP variability across the different experiments for the same subjects was found largely attributable to the different mental processing required to assess interface actions. Nonetheless, we found that interaction ErrPs are empirically invariant over time (for the same subject and same interface) and to a lesser extent across subjects (for the same interface). Significance. The obtained results may be used to explain across-study variability of ErrPs, as well as to define guidelines for approaches to the ErrP classifier transferability problem.

  13. The Relationship Between Posttraumatic Growth and Psychosocial Variables in Survivors of State Terrorism and Their Relatives.

    Science.gov (United States)

    Cárdenas-Castro, Manuel; Faúndez-Abarca, Ximena; Arancibia-Martini, Héctor; Ceruti-Mahn, Cristián

    2017-08-01

    The present study explores reports of growth in survivors and family members of victims of state terrorism ( N = 254) in Chile from 1973 to 1990. The results indicate the presence of reports of posttraumatic growth ( M = 4.69) and a positive and statistically significant correlation with variables related to the life impact of the stressful events ( r = .46), social sharing of emotions ( r = .32), deliberate rumination ( r = .37), positive reappraisal ( r = .35), reconciliation ( r = .39), spiritual practices ( r = .33), and meaning in life ( r = .51). The relationship between growth and forgiveness is not statistically significant. The variables that best predict posttraumatic growth are positive reappraisal (β = .28), life impact (β = .24), meaning in life β = .23), and reconciliation (β = .20). The forward-method hierarchical model indicates that these variables are significant predictors of growth levels, R 2 = .53, F(8, 210) = 30.08, p state terrorism manage to grow after these experiences, and the redefinition of meaning in life and the positive reappraisal of the traumatic experiences are the elements that make it possible to create a new narrative about the past.

  14. Within and between Individual Variability of Exposure to Work-Related Musculoskeletal Disorder Risk Factors

    Directory of Open Access Journals (Sweden)

    Mohsen Zare

    2018-05-01

    Full Text Available Industrial companies indicate a tendency to eliminate variations in operator strategies, particularly following implementation of the lean principle. Companies believe when the operators perform the same prescribed tasks, they have to execute them in the same manner (completing the same gestures and being exposed to the same risk factors. They attempt to achieve better product quality by standardizing and reducing operational leeway. However, operators adjust and modify ways of performing tasks to balance between their abilities and the requirements of the job. This study aims to investigate the variability of exposure to physical risk factors within and between operators when executing the same prescribed tasks. The Ergonomic Standard method was used to evaluate two workstations. Seven operators were observed thirty times between repeated cycle times at those workstations. The results revealed the variability of exposure to risk factors between and within operators in the repeated execution of the same tasks. Individual characteristics and operators’ strategies might generate the variability of exposure to risk factors that may be an opportunity to reduce the risks of work-related musculoskeletal disorders (WR-MSDs. However, sometimes operators’ strategies may cause overexposure to risk factors; operators most often adopt such strategies to undertake their tasks while reducing the workload.

  15. Effects of plyometric training on soccer related physical fitness variables of intercollegiate female soccer players

    Directory of Open Access Journals (Sweden)

    Mesfin Mengesh

    2016-07-01

    Full Text Available Plyometric training is an important training program in improving physical fitness and soccer skills of players. The study was conducted to find out the effects of plyometric training on soccer related physical fitness variables of Haramaya University intercollegiate female soccer players. For this study forty female (age, 20±1.5 years; height, 1.61±0.7 m; BMI, 20.41±0.7Kg/cm2 soccer players were selected through purposive sampling. Experimental group (n= 20 participants were engaged in a supervised plyometric training program 3 days/week for 12 weeks. The control group (n= 20 did not participate in any of the program except regular soccer training however, the tests were conducted for them. The physical fitness and soccer skill variables selected for the study were: Speed, Explosive power, Agility, Dribbling, Kicking Right and Left Feet. Tests were taken three times at pre training, during training and post training. Comparison of mean was done by paired t-test. The results obtained in this study indicated that there was significant improvement in selected physical fitness and soccer skill variables due to the effects of plyometric training. After 12 weeks of plyometric training participant’s speed (0.78 m/sec., agility (2.64 sec, and explosive power (7.85 cm were changed significantly (p<0.05. Participant’s dribbling soccer skill (1.92 sec., kicking right foot for distance (2.19 m and kicking left foot for distance (2.91 m were significantly improved through plyometric training. This study proved that plyometric training was significantly better in improving the physical fitness variables and soccer skills of female soccer players.

  16. Clinical profile of patients with nascent alcohol related seizures

    Directory of Open Access Journals (Sweden)

    P Sandeep

    2013-01-01

    Full Text Available Aim: The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS and to identify the prevalence of idiopathic generalized epilepsy (IGE in the same. Materials and Methods: 100 consecutive male patients presenting to a tertiary care center in South India with new onset ARS were analyzed with alcohol use disorders identification test (AUDIT score. All underwent 19 channel digital scalp electroencephalography (EEG and at least computed tomography (CT scan. Results: A total of 27 patients (27% who had cortical atrophy on CT had a mean duration of alcohol intake of 23.62 years compared with 14.55 years in patients with no cortical atrophy (P < 0.001. Twenty-two patients (22% had clustering in the current episode of whom 18 had cortical atrophy. Nearly, 88% patients had generalized tonic clonic seizures while 12% who had partial seizures underwent magnetic resonance imaging (MRI, which identified frontal focal cortical dysplasia in one. Mean lifetime duration of alcohol intake in patients presenting with seizures within 6 hours (6H-gp of intake of alcohol was significantly lower (P = 0.029. One patient in the 6H-gp with no withdrawal symptoms had EEG evidence for IGE and had a lower AUDIT score compared with the rest. Conclusion: CT evidence of cortical atrophy is related to the duration of alcohol intake and portends an increased risk for clustering. Partial seizures can be a presenting feature of ARS and those patients may benefit from MRI to identify underlying symptomatic localization related epilepsy (8.3% of partial seizures. IGE is more likely in patients presenting with ARS within first 6 hours especially if they do not have alcohol withdrawal symptoms and scalp EEG is helpful to identify this small subgroup (~1% who may require long-term anti-epileptic medication.

  17. Age-related distance esotropia: Clinical features and therapeutic outcomes.

    Science.gov (United States)

    Gómez de Liaño Sánchez, P; Olavarri González, G; Merino Sanz, P; Escribano Villafruela, J C

    2016-12-01

    To describe the clinical characteristics and surgical outcomes of a group of patients with age-related distance esotropia (ARDE). A retrospective study was conducted on a consecutive case series of 16 adult patients diagnosed with ARDE between 2008 and 2015. The clinical features evaluated included mean age and gender, primary position deviations at distance and near, measured in prism dioptres (pd), treatment offered in each case, and post-surgical deviations. Ductions and versions were full, with no evidence of lateral rectus paresis. None of these patients had any obvious underlying neurological disorder, such as, high myopia or thyroid disease. A good result is considered to be the disappearance of diplopia in all positions of gaze. A total of 16 patients (11 females [68.8%]) were identified. The mean age at diagnosis was 78.19±6.77 years. The mean initial esodeviation was 2.25±3.08 pd at near (-4 to +8 pd) and 9.5±4.18 pd at distance (2 to 18 pd). Treatment was not necessary in 5 cases because the symptoms were intermittent or well-tolerated. Of the 11 patients with symptoms, one was corrected with an external base therapeutic prism. Botulinum toxin was administered in another patient, without satisfactory results. Unilateral medial rectus muscle recession was performed on one patient, and unilateral lateral rectus plication on 7 patients, indicating prisms before surgery. One patient refused surgery despite continuous diplopia in far vision. After a mean follow-up of 16.5 months, all operated patients were asymptomatic. Not all patients with ARDE require treatment, as the tolerance to diplopia varies from one subject to another. Both medial rectus weakening and lateral rectus strengthening provides excellent results. Crown Copyright © 2016. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Systematic review of clinical practice guidelines related to multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Jia Guo

    Full Text Available BACKGROUND: High quality clinical practice guidelines (CPGs can provide clinicians with explicit recommendations on how to manage health conditions and bridge the gap between research and clinical practice. Unfortunately, the quality of CPGs for multiple sclerosis (MS has not been evaluated. OBJECTIVE: To evaluate the methodological quality of CPGs on MS using the AGREE II instrument. METHODS: According to the inclusion and exclusion criteria, we searched four databases and two websites related to CPGs, including the Cochrane library, PubMed, EMBASE, DynaMed, the National Guideline Clearinghouse (NGC, and Chinese Biomedical Literature database (CBM. The searches were performed on September 20th 2013. All CPGs on MS were evaluated by the AGREE II instrument. The software used for analysis was SPSS 17.0. RESULTS: A total of 27 CPGs on MS met inclusion criteria. The overall agreement among reviews was good or substantial (ICC was above 0.70. The mean scores for each of all six domains were presented as follows: scope and purpose (mean ± SD: 59.05 ± 16.13, stakeholder involvement (mean ± SD: 29.53 ± 17.67, rigor of development (mean ± SD: 31.52 ± 21.50, clarity of presentation (mean ± SD: 60.39 ± 13.73, applicability (mean ± SD: 27.08 ± 17.66, editorial independence (mean ± SD: 28.70 ± 22.03. CONCLUSIONS: The methodological quality of CPGs for MS was acceptable for scope, purpose and clarity of presentation. The developers of CPGs need to pay more attention to editorial independence, applicability, rigor of development and stakeholder involvement during the development process. The AGREE II instrument should be adopted by guideline developers.

  19. The relations between the academic success levels of the boys playing basketball and certain variables

    Directory of Open Access Journals (Sweden)

    Umut CANLI

    2016-06-01

    Full Text Available Aim: The aim of this study is to investigate the relation between the academic success levels of the boys playing basketball and certain variables such as age, basketball playing times, the number of the weekly average trainings and motoric skills. Material and Methods: 93 students participated voluntarily in the study from three different sports clubs. The ages in which the participants started basketball varied between 10 and 13, and their durations of weekly trainings differed from each other. The end-of-the-year academic success average points of the participants were considered in determining the academic success levels; and the International Physical Performance Test Profile (IPPTP (Kamar, 2008 was used in measuring the motoric skills. The issue of whether there was a significant difference between the participants was determined by using the SPSS 21.0 Package Program together with the One-Way ANOVA Test. Results: According to the findings, it was determined that there were no relations between the academic success rates and the basketball playing durations, the number of weekly trainings, and their motoric skills (p>0.05. On the other hand, a statistically significant difference was determined between the age variable and the academic success levels (p<0.05. Conclusions: No significant differences were detected between the motoric skills, number of trainings, starting basketball dates and the academic success levels of the sportsmen who receive basic basketball training (which contribute to the development of motoric skills with different numbers of weekly training and with different basketball starting dates; while a negative significance was detected between the age variable and academic success.

  20. Genetic variability of six French meat sheep breeds in relation to their genetic management.

    Science.gov (United States)

    Huby, Marie; Griffon, Laurent; Moureaux, Sophie; De Rochambeau, Hubert; Danchin-Burge, Coralie; Verrier, Etienne

    2003-01-01

    Some demographic parameters, the genetic structure and the evolution of the genetic variability of six French meat sheep breeds were analysed in relation with their management. Four of these breeds are submitted to more or less intense selection: the Berrichon du Cher (BCH), Blanc du Massif Central (BMC), Charollais (CHA) and Limousin (LIM); the other two breeds are under conservation: the Roussin de La Hague (RLH) and Solognot (SOL). Genealogical data of the recorded animals born from 1970 to 2000 and of their known ancestors were used. The most balanced contributions of the different flocks to the sire-daughter path was found in the SOL. In the BCH, a single flock provided 43% of the sire-AI sire path, whereas the contributions of the flocks were more balanced in the BMC and LIM (the only other breeds where AI is used to a substantial amount). The distribution of the expected genetic contribution of the founder animals was found to be unbalanced, especially in the BCH and LIM. The effective numbers of ancestors (founders or not) for the ewes born from 1996 to 2000 were equal to 35 (BCH), 144 (BMC), 112 (CHA), 69 (LIM), 40 (RLH) and 49 (SOL). Inbreeding was not analysed in the BMC, due to incomplete pedigree information. From 1980 on, the rates of inbreeding, in percentage points per year, were +0.112 (BCH), +0.045 (CHA), +0.036 (LIM), +0.098 (RLH) and +0.062 (SOL). The implications of the observed trends on genetic variability are discussed in relation to the genetic management of each breed. The need for a larger selection basis in the BCH, the efficiency of the rules applied in the SOL to preserve the genetic variability and the need for a more collective organisation in the CHA and RLH are outlined.

  1. Genetic variability of six French meat sheep breeds in relation to their genetic management

    Directory of Open Access Journals (Sweden)

    Coralie Danchin-Burge

    2003-11-01

    Full Text Available Abstract Some demographic parameters, the genetic structure and the evolution of the genetic variability of six French meat sheep breeds were analysed in relation with their management. Four of these breeds are submitted to more or less intense selection: the Berrichon du Cher (BCH, Blanc du Massif Central (BMC, Charollais (CHA and Limousin (LIM; the other two breeds are under conservation: the Roussin de La Hague (RLH and Solognot (SOL. Genealogical data of the recorded animals born from 1970 to 2000 and of their known ancestors were used. The most balanced contributions of the different flocks to the sire-daughter path was found in the SOL. In the BCH, a single flock provided 43% of the sire-AI sire path, whereas the contributions of the flocks were more balanced in the BMC and LIM (the only other breeds where AI is used to a substantial amount. The distribution of the expected genetic contribution of the founder animals was found to be unbalanced, especially in the BCH and LIM. The effective numbers of ancestors (founders or not for the ewes born from 1996 to 2000 were equal to 35 (BCH, 144 (BMC, 112 (CHA, 69 (LIM, 40 (RLH and 49 (SOL. Inbreeding was not analysed in the BMC, due to incomplete pedigree information. From 1980 on, the rates of inbreeding, in percentage points per year, were +0.112 (BCH, +0.045 (CHA, +0.036 (LIM, +0.098 (RLH and +0.062 (SOL. The implications of the observed trends on genetic variability are discussed in relation to the genetic management of each breed. The need for a larger selection basis in the BCH, the efficiency of the rules applied in the SOL to preserve the genetic variability and the need for a more collective organisation in the CHA and RLH are outlined.

  2. Anthropometric and training variables related to half-marathon running performance in recreational female runners.

    Science.gov (United States)

    Knechtle, Beat; Knechtle, Patrizia; Barandun, Ursula; Rosemann, Thomas

    2011-05-01

    The relationship between skin-fold thickness and running has been investigated in distances ranging from 100 m to the marathon distance (42.195 km), with the exclusion of the half-marathon distance (21.0975 km). We investigated the association between anthropometric variables, prerace experience, and training variables with race time in 42 recreational, nonprofessional, female half-marathon runners using bi- and multivariate analysis. Body weight (r, 0.60); body mass index (r, 0.48); body fat percentage (r, 0.56); pectoral (r, 0.61), mid-axilla (r, 0.69), triceps (r, 0.49), subscapular (r, 0.61), abdominal (r, 0.59), suprailiac (r, 0.55), and medial calf (r, 0.53) skin-fold thickness; mean speed of the training sessions (r, -0.68); and personal best time in a half-marathon (r, 0.69) correlated with race time after bivariate analysis. Body weight (P = 0.0054), pectoral skin-fold thickness (P = 0.0068), and mean speed of the training sessions (P = 0.0041) remained significant after multivariate analysis. Mean running speed during training was related to mid-axilla (r, -0.31), subscapular (r, -0.38), abdominal (r, -0.44), and suprailiac (r, -0.41) skin-fold thickness, the sum of 8 skin-fold thicknesses (r, -0.36); and percent body fat (r, -0.31). It was determined that variables of both anthropometry and training were related to half-marathon race time, and that skin-fold thicknesses were associated with running speed during training. For practical applications, high running speed during training (as opposed to extensive training) may both reduce upper-body skin-fold thicknesses and improve race performance in recreational female half-marathon runners.

  3. Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia

    Science.gov (United States)

    Chee, H; Rampal, K

    2003-01-01

    Aims: To determine the relation between sick leave and selected exposure variables among women semiconductor workers. Methods: This was a cross sectional survey of production workers from 18 semiconductor factories. Those selected had to be women, direct production operators up to the level of line leader, and Malaysian citizens. Sick leave and exposure to physical and chemical hazards were determined by self reporting. Three sick leave variables were used; number of sick leave days taken in the past year was the variable of interest in logistic regression models where the effects of age, marital status, work task, work schedule, work section, and duration of work in factory and work section were also explored. Results: Marital status was strongly linked to the taking of sick leave. Age, work schedule, and duration of work in the factory were significant confounders only in certain cases. After adjusting for these confounders, chemical and physical exposures, with the exception of poor ventilation and smelling chemicals, showed no significant relation to the taking of sick leave within the past year. Work section was a good predictor for taking sick leave, as wafer polishing workers faced higher odds of taking sick leave for each of the three cut off points of seven days, three days, and not at all, while parts assembly workers also faced significantly higher odds of taking sick leave. Conclusion: In Malaysia, the wafer fabrication factories only carry out a limited portion of the work processes, in particular, wafer polishing and the processes immediately prior to and following it. This study, in showing higher illness rates for workers in wafer polishing compared to semiconductor assembly, has implications for the governmental policy of encouraging the setting up of wafer fabrication plants with the full range of work processes. PMID:12660374

  4. Results of the study of variables related to tasks of workers of a radioactive facility

    International Nuclear Information System (INIS)

    Alves, Alice S.; Campos, Daniela; Carneiro, Janete C.G.G.

    2015-01-01

    This paper presents the results of the evaluation study of the association degree between physical risk agent, ionizing radiation, and tasks performed by the occupationally exposed individuals (OEI), in the production of radioisotopes and radiopharmaceuticals of a radioactive facility. Initially, has been performed a qualitative assessment of the workplace, work groups and the processes as well. Starting from the inventoried subjective information, interviews and observations were identified seven homogeneous exposure groups, assuming they receive the same exposure to a range of specific agents. The data were analyzed by means of descriptive statistics with quantitative and qualitative approaches of the variables. In the analysis was used nonparametric tests (Equality of two proportions, Chi-square and Yates correction), descriptive measures of location (mean, median and quartiles) and dispersion (standard deviation and coefficient of variation). A significance level of 5% (p < 0.05) was adopted. The results have shown five risk factors (variables) related to the tasks performance. After the characterization distribution of the relative frequencies, all variables showed a significant degree of association (p < 0.001) to the exposure to ionizing radiation. Descriptive analysis of effective doses received by OEIs (n=102) resulted in the average of 4.06 mSv obtained in 2013 and 3.41 mSv in 2014. The collective doses corresponding to the same year were 414.41 mSv.person and 347.61 mSv.person. The doses values found during the analyzed period are in accordance to the limits established by the current national standards. (author)

  5. Results of the study of variables related to tasks of workers of a radioactive facility

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Alice S.; Campos, Daniela; Carneiro, Janete C.G.G., E-mail: alicesante@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This paper presents the results of the evaluation study of the association degree between physical risk agent, ionizing radiation, and tasks performed by the occupationally exposed individuals (OEI), in the production of radioisotopes and radiopharmaceuticals of a radioactive facility. Initially, has been performed a qualitative assessment of the workplace, work groups and the processes as well. Starting from the inventoried subjective information, interviews and observations were identified seven homogeneous exposure groups, assuming they receive the same exposure to a range of specific agents. The data were analyzed by means of descriptive statistics with quantitative and qualitative approaches of the variables. In the analysis was used nonparametric tests (Equality of two proportions, Chi-square and Yates correction), descriptive measures of location (mean, median and quartiles) and dispersion (standard deviation and coefficient of variation). A significance level of 5% (p < 0.05) was adopted. The results have shown five risk factors (variables) related to the tasks performance. After the characterization distribution of the relative frequencies, all variables showed a significant degree of association (p < 0.001) to the exposure to ionizing radiation. Descriptive analysis of effective doses received by OEIs (n=102) resulted in the average of 4.06 mSv obtained in 2013 and 3.41 mSv in 2014. The collective doses corresponding to the same year were 414.41 mSv.person and 347.61 mSv.person. The doses values found during the analyzed period are in accordance to the limits established by the current national standards. (author)

  6. Cell to Cell Variability of Radiation-Induced Foci: Relation between Observed Damage and Energy Deposition.

    Science.gov (United States)

    Gruel, Gaëtan; Villagrasa, Carmen; Voisin, Pascale; Clairand, Isabelle; Benderitter, Marc; Bottollier-Depois, Jean-François; Barquinero, Joan Francesc

    2016-01-01

    Most studies that aim to understand the interactions between different types of photon radiation and cellular DNA assume homogeneous cell irradiation, with all cells receiving the same amount of energy. The level of DNA damage is therefore generally determined by averaging it over the entire population of exposed cells. However, evaluating the molecular consequences of a stochastic phenomenon such as energy deposition of ionizing radiation by measuring only an average effect may not be sufficient for understanding some aspects of the cellular response to this radiation. The variance among the cells associated with this average effect may also be important for the behaviour of irradiated tissue. In this study, we accurately estimated the distribution of the number of radiation-induced γH2AX foci (RIF) per cell nucleus in a large population of endothelial cells exposed to 3 macroscopic doses of gamma rays from 60Co. The number of RIF varied significantly and reproducibly from cell to cell, with its relative standard deviation ranging from 36% to 18% depending on the macroscopic dose delivered. Interestingly, this relative cell-to-cell variability increased as the dose decreased, contrary to the mean RIF count per cell. This result shows that the dose effect, in terms of the number of DNA lesions indicated by RIF is not as simple as a purely proportional relation in which relative SD is constant with dose. To analyse the origins of this observed variability, we calculated the spread of the specific energy distribution for the different target volumes and subvolumes in which RIF can be generated. Variances, standard deviations and relative standard deviations all changed similarly from dose to dose for biological and calculated microdosimetric values. This similarity is an important argument that supports the hypothesis of the conservation of the association between the number of RIF per nucleus and the specific energy per DNA molecule. This comparison allowed us to

  7. Cell to Cell Variability of Radiation-Induced Foci: Relation between Observed Damage and Energy Deposition.

    Directory of Open Access Journals (Sweden)

    Gaëtan Gruel

    Full Text Available Most studies that aim to understand the interactions between different types of photon radiation and cellular DNA assume homogeneous cell irradiation, with all cells receiving the same amount of energy. The level of DNA damage is therefore generally determined by averaging it over the entire population of exposed cells. However, evaluating the molecular consequences of a stochastic phenomenon such as energy deposition of ionizing radiation by measuring only an average effect may not be sufficient for understanding some aspects of the cellular response to this radiation. The variance among the cells associated with this average effect may also be important for the behaviour of irradiated tissue. In this study, we accurately estimated the distribution of the number of radiation-induced γH2AX foci (RIF per cell nucleus in a large population of endothelial cells exposed to 3 macroscopic doses of gamma rays from 60Co. The number of RIF varied significantly and reproducibly from cell to cell, with its relative standard deviation ranging from 36% to 18% depending on the macroscopic dose delivered. Interestingly, this relative cell-to-cell variability increased as the dose decreased, contrary to the mean RIF count per cell. This result shows that the dose effect, in terms of the number of DNA lesions indicated by RIF is not as simple as a purely proportional relation in which relative SD is constant with dose. To analyse the origins of this observed variability, we calculated the spread of the specific energy distribution for the different target volumes and subvolumes in which RIF can be generated. Variances, standard deviations and relative standard deviations all changed similarly from dose to dose for biological and calculated microdosimetric values. This similarity is an important argument that supports the hypothesis of the conservation of the association between the number of RIF per nucleus and the specific energy per DNA molecule. This

  8. Relation between small-mammal species composition and anthropic variables in the Brazilian Atlantic Forest

    Directory of Open Access Journals (Sweden)

    N. Olifiers

    Full Text Available Anthropic activities are frequently related in many ways to forest fragmentation and alteration of natural communities. In this study, we correlate the presence of hunting, tourism activity, agriculture/pasturing, and the distance of the study sites to the nearest human residences with the species composition of small Atlantic forest mammals. To do this, we utilize a multiple regression analysis of similarity matrices. The presence of both agriculture/pasturing and human residences near the study sites proved to be determinant factors in species composition of small mammals of the studied areas. Working with socioeconomic variables related directly with the study site could be a reliable and a direct way to predict the influence of human presence and entailed activity on small mammal communities.

  9. Chemical equilibrium. [maximizing entropy of gas system to derive relations between thermodynamic variables

    Science.gov (United States)

    1976-01-01

    The entropy of a gas system with the number of particles subject to external control is maximized to derive relations between the thermodynamic variables that obtain at equilibrium. These relations are described in terms of the chemical potential, defined as equivalent partial derivatives of entropy, energy, enthalpy, free energy, or free enthalpy. At equilibrium, the change in total chemical potential must vanish. This fact is used to derive the equilibrium constants for chemical reactions in terms of the partition functions of the species involved in the reaction. Thus the equilibrium constants can be determined accurately, just as other thermodynamic properties, from a knowledge of the energy levels and degeneracies for the gas species involved. These equilibrium constants permit one to calculate the equilibrium concentrations or partial pressures of chemically reacting species that occur in gas mixtures at any given condition of pressure and temperature or volume and temperature.

  10. INFRARED PERIOD-LUMINOSITY RELATIONS OF EVOLVED VARIABLE STARS IN THE LARGE MAGELLANIC CLOUD

    International Nuclear Information System (INIS)

    Riebel, David; Meixner, Margaret; Fraser, Oliver; Srinivasan, Sundar; Cook, Kem; Vijh, Uma

    2010-01-01

    We combine variability information from the MAssive Compact Halo Objects survey of the Large Magellanic Cloud with infrared photometry from the Spitzer Space Telescope Surveying the Agents of a Galaxy's Evolution survey to create a data set of ∼30,000 variable red sources. We photometrically classify these sources as being on the first ascent of the red giant branch, or as being in one of three stages along the asymptotic giant branch (AGB): oxygen-rich, carbon-rich, or highly reddened with indeterminate chemistry ('extreme' AGB candidates). We present linear period-luminosity (P-L) relationships for these sources using eight separate infrared bands (J, H, K s , 3.6, 4.5, 5.8, 8.0, and 24 μm) as proxies for the luminosity. We find that the wavelength dependence of the slope of the P-L relationship is different for different photometrically determined classes of AGB stars. Stars photometrically classified as O-rich show the least variation of slope with wavelength, while dust enshrouded extreme AGB stars show a pronounced trend toward steeper slopes with increasing wavelength. We find that O-rich AGB stars pulsating in the fundamental mode obey a period-magnitude relation with a slope of -3.41 ± 0.04 when magnitude is measured in the 3.6 μm band, in contrast to C-rich AGB stars, which obey a relation of slope -3.77 ± 0.05.

  11. Dissociating neural variability related to stimulus quality and response times in perceptual decision-making.

    Science.gov (United States)

    Bode, Stefan; Bennett, Daniel; Sewell, David K; Paton, Bryan; Egan, Gary F; Smith, Philip L; Murawski, Carsten

    2018-03-01

    According to sequential sampling models, perceptual decision-making is based on accumulation of noisy evidence towards a decision threshold. The speed with which a decision is reached is determined by both the quality of incoming sensory information and random trial-by-trial variability in the encoded stimulus representations. To investigate those decision dynamics at the neural level, participants made perceptual decisions while functional magnetic resonance imaging (fMRI) was conducted. On each trial, participants judged whether an image presented under conditions of high, medium, or low visual noise showed a piano or a chair. Higher stimulus quality (lower visual noise) was associated with increased activation in bilateral medial occipito-temporal cortex and ventral striatum. Lower stimulus quality was related to stronger activation in posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (DLPFC). When stimulus quality was fixed, faster response times were associated with a positive parametric modulation of activation in medial prefrontal and orbitofrontal cortex, while slower response times were again related to more activation in PPC, DLPFC and insula. Our results suggest that distinct neural networks were sensitive to the quality of stimulus information, and to trial-to-trial variability in the encoded stimulus representations, but that reaching a decision was a consequence of their joint activity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Effect of formulation- and administration-related variables on deposition pattern of nasal spray pumps evaluated using a nasal cast.

    Science.gov (United States)

    Kundoor, Vipra; Dalby, Richard N

    2011-08-01

    To systematically evaluate the effect of formulation- and administration-related variables on nasal spray deposition using a nasal cast. Deposition pattern was assessed by uniformly coating a transparent nose model with Sar-Gel®, which changes from white to purple on contact with water. Sprays were subsequently discharged into the cast, which was then digitally photographed. Images were quantified using Adobe® Photoshop. The effects of formulation viscosity (which influences droplet size), simulated administration techniques (head orientation, spray administration angle, spray nozzle insertion depth), spray pump design and metering volume on nasal deposition pattern were investigated. There was a significant decrease in the deposition area associated with sprays of increasing viscosity. This appeared to be mediated by an increase in droplet size and a narrowing of the spray plume. Administration techniques and nasal spray pump design also had a significant effect on the deposition pattern. This simple color-based method provides quantitative estimates of the effects that different formulation and administration variables may have on the nasal deposition area, and provides a rational basis on which manufacturers of nasal sprays can base their patient instructions or post approval changes when it is impractical to optimize these using a clinical study.

  13. Aspergillus fumigatus-Related Species in Clinical Practice.

    Science.gov (United States)

    Lamoth, Frédéric

    2016-01-01

    Aspergillus fumigatus is the main etiologic agent of invasive aspergillosis (IA). Other Aspergillus species belonging to the section Fumigati (A. fumigatus complex) may occasionally be the cause of IA. These strains are often misidentified, as they cannot be distinguished from A. fumigatus by conventional morphological analysis and sequencing methods. This lack of recognition may have important consequences as these A. fumigatus-related species often display some level of intrinsic resistance to azoles and other antifungal drugs. A. lentulus, A. udagawae, A. viridinutans, and A. thermomutatus (Neosartorya pseudofischeri) have been associated with refractory cases of IA. Microbiologists should be able to suspect the presence of these cryptic species behind a putative A. fumigatus isolate on the basis of some simple characteristics, such as defect in sporulation and/or unusual antifungal susceptibility profile. However, definitive species identification requires specific sequencing analyses of the beta-tubulin or calmodulin genes, which are not available in most laboratories. Multiplex PCR assays or matrix-assisted laser desorption ionization - time-of-flight mass spectrometry (MALDI-TOF MS) gave promising results for rapid and accurate distinction between A. fumigatus and other Aspergillus spp. of the section Fumigati in clinical practice. Improved diagnostic procedures and antifungal susceptibility testing may be helpful for the early detection and management of these particular IA cases.

  14. Aspergillus fumigatus-Related Species in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Frederic eLamoth

    2016-05-01

    Full Text Available Aspergillus fumigatus is the main etiologic agent of invasive aspergillosis (IA. Other Aspergillus species belonging to the section Fumigati (A. fumigatus complex may occasionally be the cause of IA. These strains are often misidentified, as they cannot be distinguished from A. fumigatus by conventional morphological analysis and sequencing methods. This lack of recognition may have important consequences as these A. fumigatus-related species often display some level of intrinsic resistance to azoles and other antifungal drugs. A. lentulus, A. udagawae, A. viridinutans and A. thermomutatus (Neosartorya pseudofischeri have been associated with refractory cases of IA. Microbiologists should be able to suspect the presence of these cryptic species behind a putative A. fumigatus isolate on the basis of some simple characteristics, such as defect in sporulation and/or unusual antifungal susceptibility profile. However, definitive species identification requires specific sequencing analyses of the beta-tubulin or calmodulin genes, which are not available in most laboratories. Multiplex PCR assays or matrix-assisted laser desorption ionization – time-of-flight mass spectrometry (MALDI-TOF MS gave promising results for rapid and accurate distinction between A. fumigatus and other Aspergillus spp. of the section Fumigati in clinical practice. Improved diagnostic procedures and antifungal susceptibility testing may be helpful for the early detection and management of these particular IA cases.

  15. Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment.

    Science.gov (United States)

    Xu, Tianhua; Sheng, Zitong; Yao, Li

    2017-09-01

    In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria ( < 3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin-angiotensin-aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.

  16. RISK FACTORS AND CLINICAL SIGNIFICANCE OF PRECHOROIDAL CLEFT IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Kim, Jong Min; Kang, Se Woong; Son, Dae Yong; Bae, Kunho

    2017-11-01

    To investigate the risk factors associated with prechoroidal cleft occurrence after treatment for neovascular age-related macular degeneration (nAMD) and to elucidate its clinical significance. Two hundred thirty-four subjects who were treated for neovascular age-related macular degeneration were assessed to identify prechoroidal cleft on optical coherence tomography. Clinical variables were compared between patients manifesting a cleft (cleft group) and patients who did not (control group). Prechoroidal cleft was detected in 29 of 234 patients (8.1%). Although the baseline visual acuity was not different between the 2 groups, logMAR visual acuity at final visit was 0.89 ± 0.74 (with approximate Snellen equivalent of 20/160) in the cleft group and 0.65 ± 0.69 (with approximate Snellen equivalent of 20/100) in controls (P age-related macular degeneration (P age-related macular degeneration, and a submacular hemorrhage treated by pneumatic displacement were the independent risk factors for development of prechoroidal cleft. Eyes with a cleft, especially clefts that develop early, generally had worse prognoses than eyes without clefts.

  17. A hidden variable in shear transformation zone volume versus Poisson's ratio relation in metallic glasses

    Science.gov (United States)

    Kim, S. Y.; Oh, H. S.; Park, E. S.

    2017-10-01

    Herein, we elucidate a hidden variable in a shear transformation zone (STZ) volume (Ω) versus Poisson's ratio (ν) relation and clarify the correlation between STZ characteristics and the plasticity of metallic glasses (MGs). On the basis of cooperative shear model and atomic stress theories, we carefully formulate Ω as a function of molar volume (Vm) and ν. The twofold trend in Ω and ν is attributed to a relatively large variation of Vm as compared to that of ν as well as an inverse relation between Vm and ν. Indeed, the derived equation reveals that the number of atoms in an STZ instead of Ω is a microstructural characteristic which has a close relationship with plasticity since it reflects the preference of atomistic behaviors between cooperative shearing and the generation of volume strain fluctuation under stress. The results would deepen our understanding of the correlation between microscopic behaviors (STZ activation) and macroscopic properties (plasticity) in MGs and enable a quantitative approach in associating various STZ-related macroscopic behaviors with intrinsic properties of MGs.

  18. Investigating demographic, work-related and job satisfaction variables as predictors of motivation in Greek nurses.

    Science.gov (United States)

    Gaki, Eleni; Kontodimopoulos, Nick; Niakas, Dimitris

    2013-04-01

    To investigate whether demographic variables and work-related factors predict work motivation in Greek nurses. Nurses' motivation is crucial for an effective health-care system. Herzberg's and Maslow's motivation theories constitute the framework of this study. The sample consisted of 200 nurses from every sector and registration level in a University Hospital in Greece. The response rate was 76%. A previously developed and validated questionnaire addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) on a five-point Likert scale. Most participants were women, married, between 36 years and 45 years old and higher education graduates. The highest mean score was recorded for 'achievements' (mean 4.07, SD 0.72), which emerged as the most important motivator. Job satisfaction, work sector and age were statistically significantly related to motivational factors. Nurses placed emphasis on motivators not strictly relating to economic rewards, but which can be seen as intrinsic and could lead to self-actualization. The constantly changing health sector requires that human resources and job context be a priority for health administrators. By promoting nurses' satisfaction and efficacy, an improvement in service quality is expected. © 2012 Blackwell Publishing Ltd.

  19. Clinical characteristics of impulse control and related disorders in Chinese Parkinson's disease patients.

    Science.gov (United States)

    Zhang, Yu; He, An Qi; Li, Lin; Chen, Wei; Liu, Zhen Guo

    2017-05-18

    Impulse control and related disorders (ICRDs) are clinically complications in Parkinson's disease (PD). However, the clinical characteristics of ICRDs in Chinese PD patients were rarely reported. We aimed to explore the prevalence and the clinical profile of ICRDs in Chinese patients with PD. 142 Chinese PD patients were consecutively enrolled. The symptoms of ICRDs were assessed with the Questionnaire for Impulsive-Compulsive Disorders. The clinical characteristics of patients with ICRDs and without ICRDs were compared. ICRDs were present in 31% of our patients. The most common ICRDs were compulsive medication use (11.3%) and punding (9.2%); the least frequent were walkabout (1.4%). Variables independently associated with ICRDs were earlier onset of the disease (≤55 years), severe cognitive impairment (MMSE 10-20), the dose of dopamine agonist (>1 mg/d) and dyskinesia. ICRDs was commonly found in Chinese PD patients. Earlier onset of the disease, the dose of dopamine agonist, severe cognitive impairment and dyskinesia are independent factors associated with ICRDs. Our results will be benefit for clinicians to assess the risk of developing ICRDs before delivering dopaminergic medication.

  20. Spacesuit Glove-Induced Hand Trauma and Analysis of Potentially Related Risk Variables

    Science.gov (United States)

    Charvat, Chacqueline M.; Norcross, Jason; Reid, Christopher R.; McFarland, Shane M.

    2015-01-01

    Injuries to the hands are common among astronauts who train for extravehicular activity (EVA). When the gloves are pressurized, they restrict movement and create pressure points during tasks, sometimes resulting in pain, muscle fatigue, abrasions, and occasionally more severe injuries such as onycholysis. Glove injuries, both anecdotal and recorded, have been reported during EVA training and flight persistently through NASA's history regardless of mission or glove model. Theories as to causation such as glove-hand fit are common but often lacking in supporting evidence. Previous statistical analysis has evaluated onycholysis in the context of crew anthropometry only. The purpose of this study was to analyze all injuries (as documented in the medical records) and available risk factor variables with the goal to determine engineering and operational controls that may reduce hand injuries due to the EVA glove in the future. A literature review and data mining study were conducted between 2012 and 2014. This study included 179 US NASA crew who trained or completed an EVA between 1981 and 2010 (crossing both Shuttle and ISS eras) and wore either the 4000 Series or Phase VI glove during Extravehicular Mobility Unit (EMU) spacesuit EVA training and flight. All injuries recorded in medical records were analyzed in their association to candidate risk factor variables. Those risk factor variables included demographic characteristics, hand anthropometry, glove fit characteristics, and training/EVA characteristics. Utilizing literature, medical records and anecdotal causation comments recorded in crewmember injury data, investigators were able to identify several risk factors associated with increased risk of glove related injuries. Prime among them were smaller hand anthropometry, duration of individual suited exposures, and improper glove-hand fit as calculated by the difference in the anthropometry middle finger length compared to the baseline EVA glove middle finger length.

  1. Cold season Africa-Asia multidecadal teleconnection pattern and its relation to the Atlantic multidecadal variability

    Science.gov (United States)

    Sun, Cheng; Li, Jianping; Ding, Ruiqiang; Jin, Ze

    2017-06-01

    A prominent teleconnection pattern of multidecadal variability of cold season (November to April) upper-level atmospheric circulation over North Africa and Eurasia (NA-EA) is revealed by empirical orthogonal function analysis of the Twentieth Century Reanalysis data. This teleconnection pattern is characterized by an eastward propagating wave train with a zonal wavenumber of 5-6 between 20° and 40°N, extending from the northwest coast of Africa to East Asia, and thus is referred to as the Africa-Asia multidecadal teleconnection pattern (AAMT). One-point correlation maps show that the teleconnectivity of AAMT is strong and further demonstrate the existence of the AAMT. The AAMT shapes the spatial structure of multidecadal change in atmospheric circulation over the NA-EA region, and in particular the AAMT pattern and associated fields show similar structures to the change occurring around the early 1960s. A strong in-phase relationship is observed between the AAMT and Atlantic multidecadal variability (AMV) and this connection is mainly due to Rossby wave dynamics. Barotropic modeling results suggest that the upper-level Rossby wave source generated by the AMV can excite the AAMT wave train, and Rossby wave ray tracing analysis further highlights the role of the Asian jet stream in guiding the wave train to East Asia. The AAMT acts as an atmospheric bridge conveying the influence of AMV onto the downstream multidecadal climate variability. The AMV is closely related to the coordinated change in surface and tropospheric air temperatures over Northwest Africa, the Arabian Peninsula and Central China, which may result from the adiabatic expansion/compression of air associated with the AAMT.

  2. [Final clinical indications and etiology in 1,023 enucleations. Descriptive databank evaluation with SPSS software in variable response mode with dummy variables].

    Science.gov (United States)

    Becker, H; Bialasiewicz, A A; Schaudig, U; Schäfer, H; von Domarus, D

    2002-05-01

    A new data bank developed for ophthalmopathology using a computer-generated, multidigital data code is expected to be able to accomplish complex clinicopathologic correlations of diagnoses and signs, as provided by (multiple) clinical events and histopathologically proven etiologies, and to facilitate the documentation of new data. In the ophthalmopathology laboratory 2890 eyes were examined between January 20, 1975 and December 12, 1996. The main diagnoses and patient data from this 22-year period were recorded. To facilitate the presentation of data, a 10-year period with eyes of 976 patients enucleated from December, 1986 to December, 1996 was chosen. Principal and secondary diagnoses served for establishing the data bank. The frequencies of successive histologic and clinical diagnoses were evaluated by a descriptive computing program using an SPSS-multi-response mode with dummy variables and a categorical variable listing of the software (SPSS version 10.0) classified as (a) non-filtered random, (b) filtered by multiple etiologies, and (c) filtered by multiple events. The principal groups (e.g., histologic diagnoses concerning etiology) and subgroups (e.g., trauma, neoplasia, surgery, systemic diseases, and inflammations) were defined and correlated with 798 separate diagnoses. From 11 diagnoses/events ascribed to the clinical cases, 11,198 namings resulted. Thus, a comparative study of complex etiologies and events leading to enucleation in different hospitals of a specific area may be performed using this electronic ophthalmopathologic data bank system. The complexity of rare disease and integration into a superimposed structure can be managed with this custom-made data bank. A chronologically and demographically oriented consideration of reasons for enucleation is thus feasible.

  3. FDG-PET imaging in HIV-infected subjects: relation with therapy and immunovirological variables

    International Nuclear Information System (INIS)

    Lucignani, Giovanni; Orunesu, Eva; Cesari, Miriam; Marzo, Katia; Chiti, Arturo; Pacei, Michela; Bechi, Giulia; Gori, Andrea; Gaito, Sabrina; Clerici, Mario

    2009-01-01

    To characterise tissue sites of immune activation and HIV replication we performed FDG-PET in ART-treated and ART-naive HIV-infected individuals. Specific aims were to establish whether HIV-infected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to ART, and whether these FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients were divided into five groups as follows: subgroup A1 (full responders, n=8): current ART treatment, CD4+ T lymphocytes >500/mL, viral load 50,000 copies/mL; group C (ART-naive, n=5): no current or previous ART treatment, increased viral load. PET images revealed different patterns of FDG uptake. All ART-treated patients with either suppressed (<50 copies/mL; Group A) or high viremia (group B) showed a normal pattern of FDG uptake. On the contrary, the ART-naive subjects with high viraemia (group C) displayed multiple foci of increased glucose metabolism in the lymph nodes. In the ART-naive subjects, FDG uptake, apparently related to viraemia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viraemia below 100,000 copies/mL; in those with viraemia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal lymph nodes. The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that seems to confer prognostic value on FDG uptake. FDG uptake is strongly associated with response to ART independently of a previous AIDS diagnosis. Notably, no differences were observed between ART-treated subjects classed as immunological responders and those classed as non responders. Data herewith indicate that FDG uptake and immunological variables are

  4. Quality of Streams in Johnson County, Kansas, and Relations to Environmental Variables, 2003-07

    Science.gov (United States)

    Rasmussen, Teresa J.; Poulton, Barry C.; Graham, Jennifer L.

    2009-01-01

    The quality of streams and relations to environmental variables in Johnson County, northeastern Kansas, were evaluated using water, streambed sediment, land use, streamflow, habitat, algal periphyton (benthic algae), and benthic macroinvertebrate data. Water, streambed sediment, and macroinvertebrate samples were collected in March 2007 during base flow at 20 stream sites that represent 11 different watersheds in the county. In addition, algal periphyton samples were collected twice (spring and summer 2007) at one-half of the sites. Environmental data including water and streambed-sediment chemistry data (primarily nutrients, fecal-indicator bacteria, and organic wastewater compounds), land use, streamflow, and habitat data were used in statistical analyses to evaluate relations between biological conditions and variables that may affect them. This report includes an evaluation of water and streambed-sediment chemistry, assessment of habitat conditions, comparison of biological community attributes (such as composition, diversity, and abundance) among sampling sites, placement of sampling sites into impairment categories, evaluation of biological data relative to environmental variables, and evaluation of changes in biological communities and effects of urbanization. This evaluation is useful for understanding factors that affect stream quality, for improving water-quality management programs, and for documenting changing conditions over time. The information will become increasingly important for protecting streams in the future as urbanization continues. Results of this study indicate that the biological quality at nearly all biological sampling sites in Johnson County has some level of impairment. Periphyton taxa generally were indicative of somewhat degraded conditions with small to moderate amounts of organic enrichment. Camp Branch in the Blue River watershed was the only site that met State criteria for full support of aquatic life in 2007. Since 2003

  5. Bayesian Population Physiologically-Based Pharmacokinetic (PBPK Approach for a Physiologically Realistic Characterization of Interindividual Variability in Clinically Relevant Populations.

    Directory of Open Access Journals (Sweden)

    Markus Krauss

    Full Text Available Interindividual variability in anatomical and physiological properties results in significant differences in drug pharmacokinetics. The consideration of such pharmacokinetic variability supports optimal drug efficacy and safety for each single individual, e.g. by identification of individual-specific dosings. One clear objective in clinical drug development is therefore a thorough characterization of the physiological sources of interindividual variability. In this work, we present a Bayesian population physiologically-based pharmacokinetic (PBPK approach for the mechanistically and physiologically realistic identification of interindividual variability. The consideration of a generic and highly detailed mechanistic PBPK model structure enables the integration of large amounts of prior physiological knowledge, which is then updated with new experimental data in a Bayesian framework. A covariate model integrates known relationships of physiological parameters to age, gender and body height. We further provide a framework for estimation of the a posteriori parameter dependency structure at the population level. The approach is demonstrated considering a cohort of healthy individuals and theophylline as an application example. The variability and co-variability of physiological parameters are specified within the population; respectively. Significant correlations are identified between population parameters and are applied for individual- and population-specific visual predictive checks of the pharmacokinetic behavior, which leads to improved results compared to present population approaches. In the future, the integration of a generic PBPK model into an hierarchical approach allows for extrapolations to other populations or drugs, while the Bayesian paradigm allows for an iterative application of the approach and thereby a continuous updating of physiological knowledge with new data. This will facilitate decision making e.g. from preclinical to

  6. IMPACT OF AGRICULTURAL POLICY ON RELATIVE PRICE VARIABILITY OF FOOD CROPS AND INFLATION IN NIGERIA

    Directory of Open Access Journals (Sweden)

    Ifeoluwa Akin Babalola

    2016-08-01

    Full Text Available Prices of food crops in Nigeria tend to exhibit similar trend with inflation. The study therefore established quantitatively relationships among agricultural policy, relative price variability (RPV of food crops and inflation in Nigeria. Data for the study includes annual producer prices (nominal and output of food crops and annual inflation rate obtained from the publications of the Central Bank of Nigeria, Nigerian Bureau of Statistics, Food and Agricultural Organisation and Nigerian Institute of Social and Economic Research covering the period of 1970-2009. Analytical tools used were RPV index and Error Correction Method (ECM. The results showed that the variables are stationary at their levels. As inflation increases, RPV of food crops also increases both in short run (0.0002 and the long run (0.0310. Civilian Post-Structural Adjustment Period Policies (CPSAP caused a significant reduction in inflation and consequently reduced the   RPV of food crops in the long run. There is a need for policies that will buffer the food crop sub-sector from the effects of inflation. Policies that reduce the rate of inflation and minimise RPV among food crops are needed. Effective management of inefficiencies and misallocation of resources in the sub-sector should be explored.

  7. Genetic Variability in DNA Repair Proteins in Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Janusz Blasiak

    2012-10-01

    Full Text Available The pathogenesis of age-related macular degeneration (AMD is complex and involves interactions between environmental and genetic factors, with oxidative stress playing an important role inducing damage in biomolecules, including DNA. Therefore, genetic variability in the components of DNA repair systems may influence the ability of the cell to cope with oxidative stress and in this way contribute to the pathogenesis of AMD. However, few reports have been published on this subject so far. We demonstrated that the c.977C>G polymorphism (rs1052133 in the hOGG1 gene and the c.972G>C polymorphism (rs3219489 in the MUTYH gene, the products of which play important roles in the repair of oxidatively damaged DNA, might be associated with the risk of AMD. Oxidative stress may promote misincorporation of uracil into DNA, where it is targeted by several DNA glycosylases. We observed that the g.4235T>C (rs2337395 and c.−32A>G (rs3087404 polymorphisms in two genes encoding such glycosylases, UNG and SMUG1, respectively, could be associated with the occurrence of AMD. Polymorphisms in some other DNA repair genes, including XPD (ERCC2, XRCC1 and ERCC6 (CSB have also been reported to be associated with AMD. These data confirm the importance of the cellular reaction to DNA damage, and this may be influenced by variability in DNA repair genes, in AMD pathogenesis.

  8. Effects of an Emotional Intelligence program in variables related to the prevention of violence

    Directory of Open Access Journals (Sweden)

    Maite eGaraigordobil

    2015-06-01

    Full Text Available In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest-posttest measures and control groups. To measure the variables, 4 assessment instruments were administered before and after the program, as well as in the follow-up phase (one year after the conclusion of the intervention. The program consisted of 20 one-hour sessions. The pretest-posttest ANCOVAs showed that the program significantly increased: (1 emotional intelligence (attention, clarity, emotional repair; (2 assertive cognitive social interaction strategies; (3 internal control of anger; and (4 the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed.

  9. Effects of an emotional intelligence program in variables related to the prevention of violence.

    Science.gov (United States)

    Garaigordobil, Maite; Peña-Sarrionandia, Ainize

    2015-01-01

    In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (EI) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest-posttest measures and control groups. To measure the variables, four assessment instruments were administered before and after the program, as well as in the follow-up phase (1 year after the conclusion of the intervention). The program consisted of 20 one-hour sessions. The pretest-posttest ANCOVAs showed that the program significantly increased: (1) EI (attention, clarity, emotional repair); (2) assertive cognitive social interaction strategies; (3) internal control of anger; and (4) the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed.

  10. An exploratory clinical study to determine the utility of heart rate variability analysis in the assessment of dosha imbalance

    Directory of Open Access Journals (Sweden)

    P. Ram Manohar

    2018-04-01

    Full Text Available The present study is a comparison of the data of spectral analysis of heart rate variability with clinical evaluation of pathological state of doshas. The calculated cardiointervalography values are combined into three integral indexes, which according to the authors' opinion reflect the influence on heart rhythm of vata, pitta and kapha, the regulation systems of the body known as doshas in Ayurveda. Seven gross dosha imbalances were assessed to test the agreement between the two methods in this study. Heart Rate Variability (HRV spectral data was collected from 42 participants to make the comparison with the clinical assessment of dosha imbalance. Clinical method of dosha assessment and method of calculating integral indexes by cardiointervalography data showed substantial agreement by Kappa coefficient statistic (k = 0.78 in assessment of gross dosha imbalance. The results of the data generated from this pilot study warrant further studies to rigorously validate the algorithms of HRV analysis in understanding dosha imbalance in Ayurvedic clinical practice and research settings. Keywords: Heart rate variability, Ayurveda, Spectral analysis

  11. What Can We Learn about GRB from the Variability Timescale Related Correlations?

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Wei; Lei, Wei-Hua; Wang, Ding-Xiong, E-mail: leiwh@hust.edu.cn [School of Physics, Huazhong University of Science and Technology, Wuhan 430074 (China)

    2017-04-01

    Recently, two empirical correlations related to the minimum variability timescale (MTS) of the light curves are discovered in gamma-ray bursts (GRBs). One is the anti-correlation between MTS and Lorentz factor Γ, and the other is the anti-correlation between the MTS and gamma-ray luminosity L {sub γ}. Both of the two correlations might be used to explore the activity of the central engine of GRBs. In this paper, we try to understand these empirical correlations by combining two popular black hole central engine models (namely, the Blandford and Znajek mechanism (BZ) and the neutrino-dominated accretion flow (NDAF)). By taking the MTS as the timescale of viscous instability of the NDAF, we find that these correlations favor the scenario in which the jet is driven by the BZ mechanism.

  12. Cortisol Variability and Self-reports in the Measurement of Work-related Stress

    DEFF Research Database (Denmark)

    Karlson, Björn; Eek, Frida; Hansen, Åse Marie

    2011-01-01

    We examined whether a high cortisol awakening response (CAR) and low cortisol decline over the day (CDD) are related to self-reported work stress and well-being, and whether there are gender differences in these relationships. Three hundred eighty-three working men and women responded to a survey...... measuring job stress factors, mastery at work, symptoms and well-being. Salivary cortisol was sampled at awakening, after 45 min and at 21:00, from which the variables CAR and CDD were defi ned. A high CAR was associated with lower perceived job control and work mastery, and poorer well-being. Low CDD...... men, a similar comparison showed those with low CDD to have poorer scores on job stress factors and symptom load. We conclude that individuals displaying high CAR or low CDD differ from those not displaying these cortisol profi les in self-report of work stress and well-being, and that gender...

  13. [Metabolic control in the critically ill patient an update: hyperglycemia, glucose variability hypoglycemia and relative hypoglycemia].

    Science.gov (United States)

    Pérez-Calatayud, Ángel Augusto; Guillén-Vidaña, Ariadna; Fraire-Félix, Irving Santiago; Anica-Malagón, Eduardo Daniel; Briones Garduño, Jesús Carlos; Carrillo-Esper, Raúl

    Metabolic changes of glucose in critically ill patients increase morbidity and mortality. The appropriate level of blood glucose has not been established so far and should be adjusted for different populations. However concepts such as glucose variability and relative hypoglycemia of critically ill patients are concepts that are changing management methods and achieving closer monitoring. The purpose of this review is to present new data about the management and metabolic control of patients in critical areas. Currently glucose can no longer be regarded as an innocent element in critical patients; both hyperglycemia and hypoglycemia increase morbidity and mortality of patients. Protocols and better instruments for continuous measurement are necessary to achieve the metabolic control of our patients. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  14. What Can We Learn about GRB from the Variability Timescale Related Correlations?

    International Nuclear Information System (INIS)

    Xie, Wei; Lei, Wei-Hua; Wang, Ding-Xiong

    2017-01-01

    Recently, two empirical correlations related to the minimum variability timescale (MTS) of the light curves are discovered in gamma-ray bursts (GRBs). One is the anti-correlation between MTS and Lorentz factor Γ, and the other is the anti-correlation between the MTS and gamma-ray luminosity L γ . Both of the two correlations might be used to explore the activity of the central engine of GRBs. In this paper, we try to understand these empirical correlations by combining two popular black hole central engine models (namely, the Blandford and Znajek mechanism (BZ) and the neutrino-dominated accretion flow (NDAF)). By taking the MTS as the timescale of viscous instability of the NDAF, we find that these correlations favor the scenario in which the jet is driven by the BZ mechanism.

  15. Quality of life after surgical treatment of coarctation in long-term follow-up (CoAFU): Predictive value of clinical variables.

    Science.gov (United States)

    Bambul Heck, Pinar; Pabst von Ohain, Jelena; Kaemmerer, Harald; Ewert, Peter; Hager, Alfred

    2018-01-01

    We sought to analyze the quality of life and the predictive value of clinical variables from previous follow-up study in patients late after surgical treatment of aortic coarctation on the quality of life. All patients, who have participated in the prospective cross-sectional COALA Study in 2000 with a structural clinical investigation including blood pressure measurement and symptom-limited exercise test were contacted for the health-related quality of life questionnaire SF-36 from January 2013 through December 2014. From 273 eligible patients, we received data from 135 patients, 9 of them died during the follow-up time at the median age of 46years (range 30-64years). Seventy-four patients did not participate in the study, other 64 patients moved to remote or unknown areas and could not be contacted. Quality of life was good in the fields of physical role and pain. However, patients reported a significant impairment in general health and in health transition, depending on the age. Arterial hypertension and variables from echocardiography or exercise testing from the COALA study were not predictive on functional health status. Quality of life in patients late after aortic coarctation repair is fairly good compared with healthy controls. Impairments in general health and health transition depend mainly on age, can be explained due to numerous comorbidities and reinterventions in long-term. The predictive value of the commonly assessed clinical variables on quality of life is limited. Copyright © 2017. Published by Elsevier B.V.

  16. Spatio-temporal variability of the North Sea cod recruitment in relation to temperature and zooplankton.

    Directory of Open Access Journals (Sweden)

    Delphine Nicolas

    Full Text Available The North Sea cod (Gadus morhua, L. stock has continuously declined over the past four decades linked with overfishing and climate change. Changes in stock structure due to overfishing have made the stock largely dependent on its recruitment success, which greatly relies on environmental conditions. Here we focus on the spatio-temporal variability of cod recruitment in an effort to detect changes during the critical early life stages. Using International Bottom Trawl Survey (IBTS data from 1974 to 2011, a major spatio-temporal change in the distribution of cod recruits was identified in the late 1990s, characterized by a pronounced decrease in the central and southeastern North Sea stock. Other minor spatial changes were also recorded in the mid-1980s and early 1990s. We tested whether the observed changes in recruits distribution could be related with direct (i.e. temperature and/or indirect (i.e. changes in the quantity and quality of zooplankton prey effects of climate variability. The analyses were based on spatially-resolved time series, i.e. sea surface temperature (SST from the Hadley Center and zooplankton records from the Continuous Plankton Recorder Survey. We showed that spring SST increase was the main driver for the most recent decrease in cod recruitment. The late 1990s were also characterized by relatively low total zooplankton biomass, particularly of energy-rich zooplankton such as the copepod Calanus finmarchicus, which have further contributed to the decline of North Sea cod recruitment. Long-term spatially-resolved observations were used to produce regional distribution models that could further be used to predict the abundance of North Sea cod recruits based on temperature and zooplankton food availability.

  17. Similar star formation rate and metallicity variability time-scales drive the fundamental metallicity relation

    Science.gov (United States)

    Torrey, Paul; Vogelsberger, Mark; Hernquist, Lars; McKinnon, Ryan; Marinacci, Federico; Simcoe, Robert A.; Springel, Volker; Pillepich, Annalisa; Naiman, Jill; Pakmor, Rüdiger; Weinberger, Rainer; Nelson, Dylan; Genel, Shy

    2018-06-01

    The fundamental metallicity relation (FMR) is a postulated correlation between galaxy stellar mass, star formation rate (SFR), and gas-phase metallicity. At its core, this relation posits that offsets from the mass-metallicity relation (MZR) at a fixed stellar mass are correlated with galactic SFR. In this Letter, we use hydrodynamical simulations to quantify the time-scales over which populations of galaxies oscillate about the average SFR and metallicity values at fixed stellar mass. We find that Illustris and IllustrisTNG predict that galaxy offsets from the star formation main sequence and MZR oscillate over similar time-scales, are often anticorrelated in their evolution, evolve with the halo dynamical time, and produce a pronounced FMR. Our models indicate that galaxies oscillate about equilibrium SFR and metallicity values - set by the galaxy's stellar mass - and that SFR and metallicity offsets evolve in an anticorrelated fashion. This anticorrelated variability of the metallicity and SFR offsets drives the existence of the FMR in our models. In contrast to Illustris and IllustrisTNG, we speculate that the SFR and metallicity evolution tracks may become decoupled in galaxy formation models dominated by feedback-driven globally bursty SFR histories, which could weaken the FMR residual correlation strength. This opens the possibility of discriminating between bursty and non-bursty feedback models based on the strength and persistence of the FMR - especially at high redshift.

  18. Kidney adysplasia and variable hydronephrosis, a new mutation affecting the odd-skipped related 1 gene in the mouse, causes variable defects in kidney development and hydronephrosis.

    Science.gov (United States)

    Davisson, Muriel T; Cook, Susan A; Akeson, Ellen C; Liu, Don; Heffner, Caleb; Gudis, Polyxeni; Fairfield, Heather; Murray, Stephen A

    2015-06-15

    Many genes, including odd-skipped related 1 (Osr1), are involved in regulation of mammalian kidney development. We describe here a new recessive mutation (kidney adysplasia and variable hydronephrosis, kavh) in the mouse that leads to downregulation of Osr1 transcript, causing several kidney defects: agenesis, hypoplasia, and hydronephrosis with variable age of onset. The mutation is closely associated with a reciprocal translocation, T(12;17)4Rk, whose Chromosome 12 breakpoint is upstream from Osr1. The kavh/kavh mutant provides a model to study kidney development and test therapies for hydronephrosis. Copyright © 2015 the American Physiological Society.

  19. Relative efficiency and sample size for cluster randomized trials with variable cluster sizes.

    Science.gov (United States)

    You, Zhiying; Williams, O Dale; Aban, Inmaculada; Kabagambe, Edmond Kato; Tiwari, Hemant K; Cutter, Gary

    2011-02-01

    The statistical power of cluster randomized trials depends on two sample size components, the number of clusters per group and the numbers of individuals within clusters (cluster size). Variable cluster sizes are common and this variation alone may have significant impact on study power. Previous approaches have taken this into account by either adjusting total sample size using a designated design effect or adjusting the number of clusters according to an assessment of the relative efficiency of unequal versus equal cluster sizes. This article defines a relative efficiency of unequal versus equal cluster sizes using noncentrality parameters, investigates properties of this measure, and proposes an approach for adjusting the required sample size accordingly. We focus on comparing two groups with normally distributed outcomes using t-test, and use the noncentrality parameter to define the relative efficiency of unequal versus equal cluster sizes and show that statistical power depends only on this parameter for a given number of clusters. We calculate the sample size required for an unequal cluster sizes trial to have the same power as one with equal cluster sizes. Relative efficiency based on the noncentrality parameter is straightforward to calculate and easy to interpret. It connects the required mean cluster size directly to the required sample size with equal cluster sizes. Consequently, our approach first determines the sample size requirements with equal cluster sizes for a pre-specified study power and then calculates the required mean cluster size while keeping the number of clusters unchanged. Our approach allows adjustment in mean cluster size alone or simultaneous adjustment in mean cluster size and number of clusters, and is a flexible alternative to and a useful complement to existing methods. Comparison indicated that we have defined a relative efficiency that is greater than the relative efficiency in the literature under some conditions. Our measure

  20. Analysis of the relation between socioeconomic variables and truck trips in the metropolitan region of Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Beatriz Lagnier Gil Ferreira

    2016-04-01

    Full Text Available The goal of this paper is to analyze the relation between socioeconomic variables and freight trip generation, regarding the Metropolitan Region of Rio de Janeiro, through the use of linear regression models. A systematic literature review is conducted in order to identify which independent variables could be used in the models. The variables found are mostly related to the establishment, such as number of employees, floor area, number of stores among others; and socioeconomic variables, such as population, households and jobs in the region. The relation between the latter and number of truck trips is verified with linear regression models, and the results show that the models are valid and the variables are able to explain the freight flow in the region studied, contributing to  the region’s transport planning and  to the strategic planning  of companies that operate in the region.

  1. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: Determination of interobserver variability and correlation to clinical outcome after 2 years

    International Nuclear Information System (INIS)

    Marlovits, Stefan; Singer, Philipp; Zeller, Philip; Mandl, Irena; Haller, Joerg; Trattnig, Siegfried

    2006-01-01

    In an observational study, the validity and reliability of magnetic resonance imaging (MRI) for the assessment of autologous chondrocyte transplantation (ACT) in the knee joint was determined. Two years after implantation, high-resolution MRI was used to analyze the repair tissue with nine pertinent variables. A complete filling of the defect was found in 61.5%, and a complete integration of the border zone to the adjacent cartilage in 76.9%. An intact subchondral lamina was present in 84.6% and an intact subchondral bone was present in 61.5%. Isointense signal intensities of the repair tissue compared to the adjacent native cartilage were seen in 92.3%. To evaluate interobserver variability, a reliability analysis with the determination of the intraclass correlation coefficient (ICC) was calculated. An 'almost perfect' agreement, with an ICC value >0.81, was calculated in 8 of 9 variables. The clinical outcome after 2 years showed the visual analog score (VAS) at 2.62 (S.D. ±0.65). The values for the knee injury and osteoarthritis outcome score (KOOS) subgroups were 68.29 (±23.90) for pain, 62.09 (±14.62) for symptoms, 75.45 (±21.91) for ADL function, 52.69 (±28.77) for sport and 70.19 (±22.41) for knee-related quality of life. The clinical scores were correlated with the MRI variables. A statistically significant correlation was found for the variables 'filling of the defect,' 'structure of the repair tissue,' 'changes in the subchondral bone,' and 'signal intensities of the repair issue'. High resolution MRI and well-defined MRI variables are a reliable, reproducible and accurate tool for assessing cartilage repair tissue

  2. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: Determination of interobserver variability and correlation to clinical outcome after 2 years

    Energy Technology Data Exchange (ETDEWEB)

    Marlovits, Stefan [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: stefan.marlovits@meduniwien.ac.at; Singer, Philipp [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Zeller, Philip [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Mandl, Irena [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich-Collin-Strasse, A-1140 Vienna (Austria); Trattnig, Siegfried [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2006-01-15

    In an observational study, the validity and reliability of magnetic resonance imaging (MRI) for the assessment of autologous chondrocyte transplantation (ACT) in the knee joint was determined. Two years after implantation, high-resolution MRI was used to analyze the repair tissue with nine pertinent variables. A complete filling of the defect was found in 61.5%, and a complete integration of the border zone to the adjacent cartilage in 76.9%. An intact subchondral lamina was present in 84.6% and an intact subchondral bone was present in 61.5%. Isointense signal intensities of the repair tissue compared to the adjacent native cartilage were seen in 92.3%. To evaluate interobserver variability, a reliability analysis with the determination of the intraclass correlation coefficient (ICC) was calculated. An 'almost perfect' agreement, with an ICC value >0.81, was calculated in 8 of 9 variables. The clinical outcome after 2 years showed the visual analog score (VAS) at 2.62 (S.D. {+-}0.65). The values for the knee injury and osteoarthritis outcome score (KOOS) subgroups were 68.29 ({+-}23.90) for pain, 62.09 ({+-}14.62) for symptoms, 75.45 ({+-}21.91) for ADL function, 52.69 ({+-}28.77) for sport and 70.19 ({+-}22.41) for knee-related quality of life. The clinical scores were correlated with the MRI variables. A statistically significant correlation was found for the variables 'filling of the defect,' 'structure of the repair tissue,' 'changes in the subchondral bone,' and 'signal intensities of the repair issue'. High resolution MRI and well-defined MRI variables are a reliable, reproducible and accurate tool for assessing cartilage repair tissue.

  3. Variable RBE in proton therapy: comparison of different model predictions and their influence on clinical-like scenarios

    International Nuclear Information System (INIS)

    Giovannini, Giulia; Böhlen, Till; Cabal, Gonzalo; Bauer, Julia; Tessonnier, Thomas; Frey, Kathrin; Debus, Jürgen; Mairani, Andrea; Parodi, Katia

    2016-01-01

    In proton radiation therapy a constant relative biological effectiveness (RBE) of 1.1 is usually assumed. However, biological experiments have evidenced RBE dependencies on dose level, proton linear energy transfer (LET) and tissue type. This work compares the predictions of three of the main radio-biological models proposed in the literature by Carabe-Fernandez, Wedenberg, Scholz and coworkers. Using the chosen models, a spread-out Bragg peak (SOBP) as well as two exemplary clinical cases (single field and two fields) for cranial proton irradiation, all delivered with state-of-the-art pencil-beam scanning, have been analyzed in terms of absorbed dose, dose-averaged LET (LET D ), RBE-weighted dose (D RBE ) and biological range shift distributions. In the systematic comparison of RBE predictions by the three models we could show different levels of agreement depending on (α/β) x and LET values. The SOBP study emphasizes the variation of LET D and RBE not only as a function of depth but also of lateral distance from the central beam axis. Application to clinical-like scenario shows consistent discrepancies from the values obtained for a constant RBE of 1.1, when using a variable RBE scheme for proton irradiation in tissues with low (α/β) x , regardless of the model. Biological range shifts of 0.6– 2.4 mm (for high (α/β) x ) and 3.0 – 5.4 mm (for low (α/β) x ) were found from the fall-off analysis of individual profiles of RBE-weighted fraction dose along the beam penetration depth. Although more experimental evidence is needed to validate the accuracy of the investigated models and their input parameters, their consistent trend suggests that their main RBE dependencies (dose, LET and (α/β) x ) should be included in treatment planning systems. In particular, our results suggest that simpler models based on the linear-quadratic formalism and LET D might already be sufficient to reproduce important RBE dependencies for re-evaluation of plans optimized with

  4. Calibration of multivariate scatter plots for exploratory analysis of relations within and between sets of variables in genomic research

    NARCIS (Netherlands)

    Graffelman, J.; Eeuwijk, van F.A.

    2005-01-01

    The scatter plot is a well known and easily applicable graphical tool to explore relationships between two quantitative variables. For the exploration of relations between multiple variables, generalisations of the scatter plot are useful. We present an overview of multivariate scatter plots

  5. Transition Achievement among Young Adults with Deafness: What Variables Relate to Success?

    Science.gov (United States)

    Bullis, Michael; And Others

    1995-01-01

    Examines the transition achievement of deaf persons 3 or 4 years out of high school (n=308). Ten independent variables were used to predict 2 dichotomous dependent variables: engagement with community (56%), and residential status (52% living independently). Results are presented for each dependent variable. (JPS)

  6. A Virtual Clinical Trial of FDG-PET Imaging of Breast Cancer: Effect of Variability on Response Assessment1

    OpenAIRE

    Harrison, Robert L; Elston, Brian F; Doot, Robert K; Lewellen, Thomas K; Mankoff, David A; Kinahan, Paul E

    2014-01-01

    INTRODUCTION: There is growing interest in using positron emission tomography (PET) standardized uptake values (SUVs) to assess tumor response to therapy. However, many error sources compromise the ability to detect SUV changes. We explore relationships between these errors and overall SUV variability. METHODS: We used simulations in a virtual clinical trial framework to study impacts of error sources from scanning and analysis effects on assessment of SUV changes. We varied tumor diameter, s...

  7. Planning performance in schizophrenia patients: a meta-analysis of the influence of task difficulty and clinical and sociodemographic variables.

    Science.gov (United States)

    Knapp, F; Viechtbauer, W; Leonhart, R; Nitschke, K; Kaller, C P

    2017-08-01

    Despite a large body of research on planning performance in adult schizophrenia patients, results of individual studies are equivocal, suggesting either no, moderate or severe planning deficits. This meta-analysis therefore aimed to quantify planning deficits in schizophrenia and to examine potential sources of the heterogeneity seen in the literature. The meta-analysis comprised outcomes of planning accuracy of 1377 schizophrenia patients and 1477 healthy controls from 31 different studies which assessed planning performance using tower tasks such as the Tower of London, the Tower of Hanoi and the Stockings of Cambridge. A meta-regression analysis was applied to assess the influence of potential moderator variables (i.e. sociodemographic and clinical variables as well as task difficulty). The findings indeed demonstrated a planning deficit in schizophrenia patients (mean effect size: ; 95% confidence interval 0.56-0.78) that was moderated by task difficulty in terms of the minimum number of moves required for a solution. The results did not reveal any significant relationship between the extent of planning deficits and sociodemographic or clinical variables. The current results provide first meta-analytic evidence for the commonly assumed impairments of planning performance in schizophrenia. Deficits are more likely to become manifest in problem items with higher demands on planning ahead, which may at least partly explain the heterogeneity of previous findings. As only a small fraction of studies reported coherent information on sample characteristics, future meta-analyses would benefit from more systematic reports on those variables.

  8. Effects of ultrasound-related variables on sonochemically synthesized SAPO-34 nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Askari, Sima, E-mail: sima.askari@aut.ac.ir [Faculty of Chemical Engineering, Amirkabir University of Technology (Tehran Polytechnic), P.O. Box 15875-4413, Hafez Ave., Tehran (Iran, Islamic Republic of); Halladj, Rouein, E-mail: halladj@aut.ac.ir [Faculty of Chemical Engineering, Amirkabir University of Technology (Tehran Polytechnic), P.O. Box 15875-4413, Hafez Ave., Tehran (Iran, Islamic Republic of)

    2013-05-01

    The sonochemical method was developed to synthesize uniform SAPO-34 (silicoaluminophosphate molecular sieve) nanoparticles with high crystallinity using TEAOH as a structure-directing agent (SDA). The physicochemical characteristics of SAPO-34 products, i.e. crystallinity, particle size and shape can be controlled by varying the ultrasonic-related variable such as ultrasound power intensity, ultrasonic irradiation time, sonication temperature and geometrical characteristics of the ultrasonic device (e.g., sonotrode size). The products were characterized by XRD, SEM, TEM and BET. It is found that each of the parameters can play a significant role in acoustic cavitation, number of nuclei and the crystal growth. The experimental data establish that the crystallinity is related to ultrasonic intensity and diameter of the sonotrode, as well as sonication temperature. By increasing the ultrasonic power, duration and the sonication temperature, the mean sizes of particles decrease and the morphology of the products efficiently alters from spherical aggregates of cube type SAPO-34 particles to uniform spherical nanoparticles. - Graphical abstract: Increasing US power by increasing either US power intensity or the sonotrode diameter leads to smaller particle size and the morphology changes from spherical aggregates of cubic particles to uniform nanospheres. Highlights: • Effects of ultrasonic parameters on sonochemical synthesis of SAPO-34 nanoparticles. • The higher crystallinity by increasing ultrasonic power, duration and sonication temperature. • The morphology changes from spherical aggregates of cubic particles to uniform nanospheres. • Decreasing the particle size by increasing ultrasonic power, duration and sonication temperature.

  9. Meta-analysis of clinical studies supports the pharmacokinetic variability hypothesis for acquired drug resistance and failure of antituberculosis therapy.

    Science.gov (United States)

    Pasipanodya, Jotam G; Srivastava, Shashikant; Gumbo, Tawanda

    2012-07-01

    Using hollow-fiber tuberculosis studies, we recently demonstrated that nonadherence is not a significant factor for ADR and that therapy failure only occurs after a large proportion of doses are missed. Computer-aided clinical trial simulations have suggested that isoniazid and rifampin pharmacokinetic variability best explained poor outcomes. We were interested in determining whether isoniazid pharmacokinetic variability was associated with either microbiological failure or ADR in the clinic. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Prospective, randomized, controlled clinical trials that reported isoniazid acetylation status and microbiological outcomes were selected. The main effects examined were microbiological sputum conversion, ADR, and relapse. Effect size was expressed as pooled risk ratios (RRs) comparing rapid with slow acetylators. Thirteen randomized studies with 1631 rapid acetylators and 1751 slow acetylators met inclusion and exclusion criteria. Rapid acetylators were more likely than slow acetylators to have microbiological failure (RR, 2.0; 95% confidence interval [CI], 1.5-2.7), ADR (RR, 2.0; CI, 1.1-3.4), and relapse (RR, 1.3; CI, .9-2.0). Higher failure rates were encountered even in drug regimens comprising >3 antibiotics. No publication bias or small-study effects were observed for the outcomes evaluated. Pharmacokinetic variability to a single drug in the regimen is significantly associated with failure of therapy and ADR in patients. This suggests that individualized dosing for tuberculosis may be more effective than standardized dosing, which is prescribed in directly observed therapy programs.

  10. Cognitive development, clinical knowledge, and clinical experience related to diagnostic ability.

    Science.gov (United States)

    Aquilino, M L

    1997-01-01

    To examine the relationship among cognitive development, clinical knowledge, and clinical experience in nursing students. A survey of junior and senior baccalaureate nursing students from three Midwestern colleges (N = 55). Students' diagnostic ability increased as they gained clinical experience and clinical knowledge. However, students failed to identify many nursing diagnoses and demonstrated only moderate levels of cognitive development. Nurse educators and nursing students need to change their approaches to teaching and learning to enhance students' diagnostic ability and cognitive development.

  11. Assessment of intrafamilial clinical variability of poikiloderma with neutropenia by a 10-year follow-up of three affected siblings.

    Science.gov (United States)

    Concolino, Daniela; Sestito, Simona; Falvo, Francesca; Romano, Giusy; Ceravolo, Miriam; Anastasio, Elisa; Pensabene, Licia; Colombo, Elisa A; Larizza, Lidia

    2018-05-23

    Clericuzio-type poikiloderma with neutropenia is a well-defined nosological entity, but despite a remarkable number of clinical reports, no long term follow-up data has been presented to date regarding patients with this rare condition. Here we describe the results of clinical follow-up of three siblings, one male (Patient 1) and two females (Patients 2 and 3), subsequent to their first clinical and then molecular diagnosis of Clericuzio-type poikiloderma with neutropenia syndrome due to mutation of USB1gene. Patient 1 always expressed the most severe phenotype, while patients 2 and 3 showed an intermediate and mild phenotype, respectively, as observed since their first clinical evaluation. None of the patients developed skin cancer and/or myelodysplastic disorders considering the peripheral haematological findings. Lens opacity, never reported before, was found in two of the three patients. The long term follow-up observations confirm the stability over time of the pronounced intra-familial heterogeneity of clinical manifestations observed prior to and upon molecular diagnosis. We conclude that prolonged follow-up is an adjunct tool to monitor intra-familial variability of PN clinical spectrum which may favour surveillance of more serious complications of the disease among siblings, when a patient-specific clinical expressivity is present. Copyright © 2018. Published by Elsevier Masson SAS.

  12. Clinical study on influences of enteric coated aspirin on blood pressure and blood pressure variability.

    Science.gov (United States)

    Ji, A-L; Chen, W-W; Huang, W-J

    2016-12-01

    We investigated the effects of oral administration of enteric coated aspirin (ASA) on blood pressure and blood pressure variability of hypertension patients before sleep. We observed 150 hypertension cases, classified as Grade 1-2, from September 2006 to March 2008. They are divided into a control group with 30 cases, ASA I group with 60 cases and ASA II group with 60 cases randomly. Subjects in the control group had proper diets, were losing weight, exercising and maintaining a healthy mentality and were taking 30 mg Adalat orally once a day. Based on the treatment of control group, patients in ASA I group were administered 0.1 g Bayaspirin (produced by Bayer Company) at drought in the morning. Also, based on the treatment of control group, patients in ASA II group were administered 0.1 g Bayaspirin at draught before sleep. The course of treatment is 3 months and then after the treatment, decreasing blood pressure and blood pressure variability conditions in three groups will be compared. Through the comparison of ASA II group with the control group, they have differences in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), decreasing range of blood pressure and blood pressure variability (p sleep has synergistic effects on decreasing blood pressure of hypertension patients and improving blood pressure variability.

  13. Variables explaining health-related quality of life in community-dwelling older adults.

    Science.gov (United States)

    Sartor-Glittenberg, Cecelia; Lehmann, Sara; Okada, Mari; Rosen, Danielle; Brewer, Kathryn; Bay, R Curtis

    2014-01-01

    Although health-related quality of life (HRQL) has been linked to numerous factors in older adults, limited or conflicting studies have investigated variables explaining HRQL in healthy, community-dwelling older adults. The purpose of this study was to determine whether physical activity, gait speed, balance, strength, endurance, and flexibility were associated with HRQL in healthy, community-dwelling older adults. Participants of this cross-sectional, correlational research design study included residents of a senior living community, aged 60 years and older who were independent in at least unlimited household ambulation. These residents participated in tests of physical activity, gait speed, balance, strength, endurance, flexibility, and HRQL (Medical Outcomes Study Short-Form Health Survey, SF-36). The physical (PCS) and mental (MCS) component summary scores of the SF-36 were calculated. Data were collected on 84 participants (mean [SD] age = 78.6 (5.9) years, 54.8% women). Significant correlations were found between the PCS and fast gait speed (FGS) (r = 0.43; p Fullerton Advanced Balance Scale (r = 0.44; p balance, and lower body strength were associated with the PCS of the SF-36; however, FGS was the only variable that uniquely contributed to the variance in the PCS. Body mass index was associated with the MCS; however, only balance uniquely contributed to the variance in the MCS. Physical activity was not associated with the PCS or MCS. The results of this study support the assessment of FGS in community-dwelling older adults to gain insight into physical health status. Interventions directed toward FGS, balance, and BMI may contribute to optimum HRQL in this population.

  14. Vertical Motion Changes Related to North-East Brazil Rainfall Variability: a GCM Simulation

    Science.gov (United States)

    Roucou, Pascal; Oribe Rocha de Aragão, José; Harzallah, Ali; Fontaine, Bernard; Janicot, Serge

    1996-08-01

    The atmospheric structure over north-east Brazil during anomalous rainfall years is studied in the 11 levels of the outputs of the Laboratoire de Météorologie Dynamique atmospheric general circulation model (LMD AGCM). Seven 19-year simulations were performed using observed sea-surface temperature (SST) corresponding to the period 1970- 1988. The ensemble mean is calculated for each month of the period, leading to an ensemble-averaged simulation. The simulated March-April rainfall is in good agreement with observations. Correlations of simulated rainfall and three SST indices relative to the equatorial Pacific and northern and southern parts of the Atlantic Ocean exhibit stronger relationships in the simulation than in the observations. This is particularly true with the SST gradient in the Atlantic (Atlantic dipole). Analyses on 200 ;hPa velocity potential, vertical velocity, and vertical integral of the zonal component of mass flux are performed for years of abnormal rainfall and positive/negative SST anomalies in the Pacific and Atlantic oceans in March-April during the rainy season over the Nordeste region. The results at 200 hPa show a convergence anomaly over Nordeste and a divergence anomaly over the Pacific concomitant with dry seasons associated with warm SST anomalies in the Pacific and warm (cold) waters in the North (South) Atlantic. During drought years convection inside the ITCZ indicated by the vertical velocity exhibits a displacement of the convection zone corresponding to a northward migration of the ITCZ. The east-west circulation depicted by the zonal divergent mass flux shows subsiding motion over Nordeste and ascending motion over the Pacific in drought years, accompanied by warm waters in the eastern Pacific and warm/cold waters in northern/southern Atlantic. Rainfall variability of the Nordeste rainfall is linked mainly to vertical motion and SST variability through the migration of the ITCZ and the east-west circulation.

  15. Estimating the Relative Sociolinguistic Salience of Segmental Variables in a Dialect Boundary Zone

    Science.gov (United States)

    Llamas, Carmen; Watt, Dominic; MacFarlane, Andrew E.

    2016-01-01

    One way of evaluating the salience of a linguistic feature is by assessing the extent to which listeners associate the feature with a social category such as a particular socioeconomic class, gender, or nationality. Such ‘top–down’ associations will inevitably differ somewhat from listener to listener, as a linguistic feature – the pronunciation of a vowel or consonant, for instance – can evoke multiple social category associations, depending upon the dialect in which the feature is embedded and the context in which it is heard. In a given speech community it is reasonable to expect, as a consequence of the salience of the linguistic form in question, a certain level of intersubjective agreement on social category associations. Two metrics we can use to quantify the salience of a linguistic feature are (a) the speed with which the association is made, and (b) the degree to which members of a speech community appear to share the association. Through the use of a new technique, designed as an adaptation of the Implicit Association Test, this paper examines levels of agreement among 40 informants from the Scottish/English border region with respect to the associations they make between four key phonetic variables and the social categories of ‘Scotland’ and ‘England.’ Our findings reveal that the participants exhibit differential agreement patterns across the set of phonetic variables, and that listeners’ responses vary in line with whether participants are members of the Scottish or the English listener groups. These results demonstrate the importance of community-level agreement with respect to the associations that listeners make between social categories and linguistic forms, and as a means of ranking the forms’ relative salience. PMID:27574511

  16. Clinical Malaria Transmission Trends and Its Association with Climatic Variables in Tubu Village, Botswana: A Retrospective Analysis.

    Science.gov (United States)

    Chirebvu, Elijah; Chimbari, Moses John; Ngwenya, Barbara Ntombi; Sartorius, Benn

    2016-01-01

    Good knowledge on the interactions between climatic variables and malaria can be very useful for predicting outbreaks and preparedness interventions. We investigated clinical malaria transmission patterns and its temporal relationship with climatic variables in Tubu village, Botswana. A 5-year retrospective time series data analysis was conducted to determine the transmission patterns of clinical malaria cases at Tubu Health Post and its relationship with rainfall, flood discharge, flood extent, mean minimum, maximum and average temperatures. Data was obtained from clinical records and respective institutions for the period July 2005 to June 2010, presented graphically and analysed using the Univariate ANOVA and Pearson cross-correlation coefficient tests. Peak malaria season occurred between October and May with the highest cumulative incidence of clinical malaria cases being recorded in February. Most of the cases were individuals aged >5 years. Associations between the incidence of clinical malaria cases and several factors were strong at lag periods of 1 month; rainfall (r = 0.417), mean minimum temperature (r = 0.537), mean average temperature (r = 0.493); and at lag period of 6 months for flood extent (r = 0.467) and zero month for flood discharge (r = 0.497). The effect of mean maximum temperature was strongest at 2-month lag period (r = 0.328). Although malaria transmission patterns varied from year to year the trends were similar to those observed in sub-Saharan Africa. Age group >5 years experienced the greatest burden of clinical malaria probably due to the effects of the national malaria elimination programme. Rainfall, flood discharge and extent, mean minimum and mean average temperatures showed some correlation with the incidence of clinical malaria cases.

  17. Glenoid version by CT scan: an analysis of clinical measurement error and introduction of a protocol to reduce variability

    Energy Technology Data Exchange (ETDEWEB)

    Bunt, Fabian van de [VU University Medical Center, Amsterdam (Netherlands); Pearl, Michael L.; Lee, Eric K.; Peng, Lauren; Didomenico, Paul [Kaiser Permanente, Los Angeles, CA (United States)

    2015-11-15

    Recent studies have challenged the accuracy of conventional measurements of glenoid version. Variability in the orientation of the scapula from individual anatomical differences and patient positioning, combined with differences in observer measurement practices, have been identified as sources of variability. The purpose of this study was to explore the utility and reliability of clinically available software that allows manipulation of three-dimensional images in order to bridge the variance between clinical and anatomic version in a clinical setting. Twenty CT scans of normal glenoids of patients who had proximal humerus fractures were measured for version. Four reviewers first measured version in a conventional manner (clinical version), measurements were made again (anatomic version) after employing a protocol for reformatting the CT data to align the coronal and sagittal planes with the superior-inferior axis of the glenoid, and the scapular body, respectively. The average value of clinical retroversion for all reviewers and all subjects was -1.4 (range, -16 to 21 ), as compared to -3.2 (range, -21 to 6 ) when measured from reformatted images. The mean difference between anatomical and clinical version was 1.9 ± 5.6 but ranged on individual measurements from -13 to 26 . In no instance did all four observers choose the same image slice from the sequence of images. This study confirmed the variation in glenoid version dependent on scapular orientation previously identified in other studies using scapular models, and presents a clinically accessible protocol to correct for scapular orientation from the patient's CT data. (orig.)

  18. Glenoid version by CT scan: an analysis of clinical measurement error and introduction of a protocol to reduce variability

    International Nuclear Information System (INIS)

    Bunt, Fabian van de; Pearl, Michael L.; Lee, Eric K.; Peng, Lauren; Didomenico, Paul

    2015-01-01

    Recent studies have challenged the accuracy of conventional measurements of glenoid version. Variability in the orientation of the scapula from individual anatomical differences and patient positioning, combined with differences in observer measurement practices, have been identified as sources of variability. The purpose of this study was to explore the utility and reliability of clinically available software that allows manipulation of three-dimensional images in order to bridge the variance between clinical and anatomic version in a clinical setting. Twenty CT scans of normal glenoids of patients who had proximal humerus fractures were measured for version. Four reviewers first measured version in a conventional manner (clinical version), measurements were made again (anatomic version) after employing a protocol for reformatting the CT data to align the coronal and sagittal planes with the superior-inferior axis of the glenoid, and the scapular body, respectively. The average value of clinical retroversion for all reviewers and all subjects was -1.4 (range, -16 to 21 ), as compared to -3.2 (range, -21 to 6 ) when measured from reformatted images. The mean difference between anatomical and clinical version was 1.9 ± 5.6 but ranged on individual measurements from -13 to 26 . In no instance did all four observers choose the same image slice from the sequence of images. This study confirmed the variation in glenoid version dependent on scapular orientation previously identified in other studies using scapular models, and presents a clinically accessible protocol to correct for scapular orientation from the patient's CT data. (orig.)

  19. Health-Related Variables and Academic Performance among First-Year College Students: Implications for Sleep and Other Behaviors.

    Science.gov (United States)

    Trockel, Mickey T.; Barnes, Michael D.; Egget, Dennis L.

    2000-01-01

    Analyzed the effect of several health behaviors and health-related variables on college freshmen's grade point averages (GPAs). Survey data indicated that sleep habits, particularly wake-up time, accounted for the most variance in GPAs. Higher GPAs related to strength training and study of spiritually oriented material. Lower GPAs related to…

  20. FDG-PET imaging in HIV-infected subjects: relation with therapy and immunovirological variables

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, Giovanni; Orunesu, Eva [Neurological Institute Milan, Laboratory of Cellular Neurophysiology, IRCCS Foundation, Milan (Italy); Cesari, Miriam [Univ. of Milan (Italy). Dept. of Clinical Science; Marzo, Katia; Chiti, Arturo [IRCCS Humanitas, Milan (Italy). Dept. of Nuclear Medicine; Pacei, Michela [Milan Univ. (Italy). Lab. of Immunology; Bechi, Giulia [IRCCS Foundation, Milan (Italy). Lab. of Cellular Neurophysiology; Gori, Andrea [Univ. of Milan Biococca, Monza (Italy). Inst. of Infectious Disseases; Gaito, Sabrina [Milan Univ. (Italy). Dept. of Computer Science; Clerici, Mario [Milan Univ. (Italy). Dept. of Biomedical Sciences and Technologies

    2009-04-15

    To characterise tissue sites of immune activation and HIV replication we performed FDG-PET in ART-treated and ART-naive HIV-infected individuals. Specific aims were to establish whether HIV-infected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to ART, and whether these FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients were divided into five groups as follows: subgroup A1 (full responders, n=8): current ART treatment, CD4+ T lymphocytes >500/mL, viral load <50 copies/mL; subgroup A2 (full responders, n=5): same criteria as A-1, but with a previous history of AIDS; subgroup A3 (immunological non responders, n=5): current ART treatment, viral load <50 copies/mL, low CD4+ T lymphocytes (<200/mL); group B (virological non responders, n = 2): current ART treatment, CD4+ T lymphocytes around 500/mL, viral load >50,000 copies/mL; group C (ART-naive, n=5): no current or previous ART treatment, increased viral load. PET images revealed different patterns of FDG uptake. All ART-treated patients with either suppressed (<50 copies/mL; Group A) or high viremia (group B) showed a normal pattern of FDG uptake. On the contrary, the ART-naive subjects with high viraemia (group C) displayed multiple foci of increased glucose metabolism in the lymph nodes. In the ART-naive subjects, FDG uptake, apparently related to viraemia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viraemia below 100,000 copies/mL; in those with viraemia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal lymph nodes. The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that

  1. Concurrent relations among cigarette smoking status, resting heart rate variability, and erectile response.

    Science.gov (United States)

    Harte, Christopher B

    2014-05-01

    Heart rate variability (HRV) is a marker of sympathovagal balance; it has been implicated in erectile function and is also altered by tobacco use. Furthermore, smoking and erectile health are strongly related, given that smokers are at increased risk for erectile dysfunction. Few studies have explored the interrelationships between smoking, HRV, and erectile function concurrently. The aim of this study was to examine potential mechanisms underlying tobacco's effects on penile hemodynamics by exploring the mediating role of HRV. The sample comprised 119 men (smokers = 64; nonsmokers = 55) (mean age 28.90 years; standard deviation (SD) 11.68; range 18-58) selected from the control conditions of three previously published experiments. Participants were free from a history of cardiovascular disease, myocardial infarct, and/or cardiac/cardiovascular medication use. During a laboratory visit, self-report, anthropometric, cardiovascular, and electrocardiographic data were assessed, as well as sexual arousal responses elicited from viewing an erotic film. Objective sexual arousal indices (circumferential change via penile plethysmography), self-reported erectile function (per the erectile function domain score of the International Index of Erectile Function [IIEF-EF]), and time- (SD of beat-to-beat intervals) and frequency-domain parameters of HRV (ratio of low-frequency [LF] power to high-frequency [HF] power [LF/HF ratio]) were assessed. Being a current long-term cigarette smoker was associated with dysregulated sympathovagal balance (higher LF/HF ratios, indicative of sympathetic nervous system dominance), which in turn showed inverse relations with magnitude of erectile tumescence. HRV did not mediate relations between tobacco use and either IIEF-EF scores or resting penile circumference. Findings suggest that dysfunctional cardiac autonomic tone may be an underlying mechanism by which tobacco exerts its deleterious effects on erectile health. Further research

  2. Brucella Genetic Variability in Wildlife Marine Mammals Populations Relates to Host Preference and Ocean Distribution.

    Science.gov (United States)

    Suárez-Esquivel, Marcela; Baker, Kate S; Ruiz-Villalobos, Nazareth; Hernández-Mora, Gabriela; Barquero-Calvo, Elías; González-Barrientos, Rocío; Castillo-Zeledón, Amanda; Jiménez-Rojas, César; Chacón-Díaz, Carlos; Cloeckaert, Axel; Chaves-Olarte, Esteban; Thomson, Nicholas R; Moreno, Edgardo; Guzmán-Verri, Caterina

    2017-07-01

    Intracellular bacterial pathogens probably arose when their ancestor adapted from a free-living environment to an intracellular one, leading to clonal bacteria with smaller genomes and less sources of genetic plasticity. Still, this plasticity is needed to respond to the challenges posed by the host. Members of the Brucella genus are facultative-extracellular intracellular bacteria responsible for causing brucellosis in a variety of mammals. The various species keep different host preferences, virulence, and zoonotic potential despite having 97-99% similarity at genome level. Here, we describe elements of genetic variation in Brucella ceti isolated from wildlife dolphins inhabiting the Pacific Ocean and the Mediterranean Sea. Comparison with isolates obtained from marine mammals from the Atlantic Ocean and the broader Brucella genus showed distinctive traits according to oceanic distribution and preferred host. Marine mammal isolates display genetic variability, represented by an important number of IS711 elements as well as specific IS711 and SNPs genomic distribution clustering patterns. Extensive pseudogenization was found among isolates from marine mammals as compared with terrestrial ones, causing degradation in pathways related to energy, transport of metabolites, and regulation/transcription. Brucella ceti isolates infecting particularly dolphin hosts, showed further degradation of metabolite transport pathways as well as pathways related to cell wall/membrane/envelope biogenesis and motility. Thus, gene loss through pseudogenization is a source of genetic variation in Brucella, which in turn, relates to adaptation to different hosts. This is relevant to understand the natural history of bacterial diseases, their zoonotic potential, and the impact of human interventions such as domestication. © The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  3. On the spatial diffusion of fertility decline: the distance-to-clinic variable in a Chilean community.

    Science.gov (United States)

    Fuller, G

    1974-10-01

    Survey data collected in San Gregorio, Chile during 1967 were selected for an investigation of the importance of residence distance-from-clinic in the pattern of contraceptive acceptance. Data were obtained through interviews conducted with women of fertile age who resided in every 4th house in the community. 1163 household reports could be employed. This number included a total of 1612 women in their fertile years. The 1612 women could be divided into users of some means of contraception and non-users. Once the basic binary classification procedure has been applied, each available socioeconomic variable for users and non-users may then be compared to determine if a significant difference exists among the distribution of the variables for each group. The variables of abortions, recent births, and aspiration level were the most potent discriminators between users and non-users of birth control. The more conventional socioeconomic variables showed little discriminatory power. Distance was found to be a fairly powerful discriminator between the group of users and non-users. Several variables other than distance are correlated with birth control practice, but once the influence of the spatial variation of these correlates has been extracted, distance emerges as the single most powerful discriminator between users and non-users of contraceptive techniques. There thus appears to be a need to emphasize the distribution of contraceptive supply in order to reduce the distance which women must travel to obtain birth control information or devices.

  4. [Possible relation between clinical guidelines and legal standard of medicine].

    Science.gov (United States)

    Furukawa, Toshiharu; Kitagawa, Yuko

    2010-10-01

    Legal standard of medicine is not equal across the all kinds of medical institutions. Each medical institution is required its respective standard of medicine in which its doctors are expected to have studied medical informations, which have been spread among medical institutions with similar characteristics. Therefore, in principle, clinical guidelines for the treatment of a disease formed by public committees do not directly become the medical standards of respective disease treatment. However, doctors would be legally required to practice medicine with reference to the clinical guidelines because medical informations, mediated by internet or many kinds of media, have been spread very fast to all medical institutions these days. Moreover, doctors would be required to inform their patients of non-standardized new treatments, even if such treatments are not listed in clinical guidelines in case patients have special concern about new treat-

  5. VARIABILITY IN THEIR RELATIVE DORMANCY OF Lithraea molleoides (Vell. Eng. DIASPORES

    Directory of Open Access Journals (Sweden)

    Ana Paula de Aguiar Berger

    2014-06-01

    Full Text Available http://dx.doi.org/10.5902/1980509814570The large diversity of Anacardiaceae diaspores morphology has a notable repercussion in the processes of germination and emergence besides generating a differentiated behavior among the species. In this family, there are some species that present physical dormancy, some others present mechanical dormancy, others present no dormancy at all and some of them have no information detailed in the available literature. Lithraea molleoides (Vell. Eng. is one of the species which little is known regarding to dormancy. Therefore, the objective was to evaluate the germination and the emergence processes of seedlings from diaspores of this species collected in Araguari river valley, in the state of Minas Gerais, as well as to quantify the variability of dormancy intensity present among different individuals of the population. The diaspores were collected in October and November of 2004 and 2005, from six matrixes. Two experiments were set up. The germination experiment was conducted under controlled conditions and the emergence experiment was conducted in a semi-open greenhouse. Data was collected every 24 hours, up serving the protrusion of the embryo in the experiment setup in the laboratory, and the emergence of the hypocotyl of the seedling above the substrate in the experiment kept in the greenhouse. In both experiments, the diaspores originated from plant number two were more notable to some extent, having superior physiological quality compared to the others (average time between 4 and 22 days; average speeds between 0.042 and 0.0217 days-1; uncertainty between 1.62 and 3.5 bits and synchrony between 0.04 and 0.381. The high uncertainty values and the low synchrony values indicate that the germination and emergence processes of the Lithraea molleoides seedlings are spread in time, which allows us to characterize them as bearers of relative dormancy, although its intensity is variable among individuals of the

  6. Solving the Omitted Variables Problem of Regression Analysis Using the Relative Vertical Position of Observations

    Directory of Open Access Journals (Sweden)

    Jonathan E. Leightner

    2012-01-01

    Full Text Available The omitted variables problem is one of regression analysis’ most serious problems. The standard approach to the omitted variables problem is to find instruments, or proxies, for the omitted variables, but this approach makes strong assumptions that are rarely met in practice. This paper introduces best projection reiterative truncated projected least squares (BP-RTPLS, the third generation of a technique that solves the omitted variables problem without using proxies or instruments. This paper presents a theoretical argument that BP-RTPLS produces unbiased reduced form estimates when there are omitted variables. This paper also provides simulation evidence that shows OLS produces between 250% and 2450% more errors than BP-RTPLS when there are omitted variables and when measurement and round-off error is 1 percent or less. In an example, the government spending multiplier, , is estimated using annual data for the USA between 1929 and 2010.

  7. Variable Origin of the Superior Laryngeal Artery and Its Clinical Significance

    OpenAIRE

    Soubhagya R. Nayak1*, Ashwin Krishnamurthy2, Latha V. Prabhu2, Bhagath Kumar Potu3, Ishwar B. Bagoji4, Jiji PJ2 and Ganesh Kumar Chettiar2

    2011-01-01

    The superior laryngeal artery (SLA) is the dominant arterial supply of the laryngeal muscles, mucosa and glands. The purpose of the present study was to document the variable origin of the SLA in the carotid triangle. Although the variation in the SLA origin and morphology is important during the partial laryngectomy and reconstruction surgery of the larynx, the description of the SLA in modern literature is vague. The anatomy of SLA was studied in 37 adult South Indian preserved cadavers age...

  8. Intra-Gene DNA Methylation Variability Is a Clinically Independent Prognostic Marker in Women’s Cancers

    Science.gov (United States)

    Bartlett, Thomas E.; Jones, Allison; Goode, Ellen L.; Fridley, Brooke L.; Cunningham, Julie M.; Berns, Els M. J. J.; Wik, Elisabeth; Salvesen, Helga B.; Davidson, Ben; Trope, Claes G.; Lambrechts, Sandrina; Vergote, Ignace; Widschwendter, Martin

    2015-01-01

    We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV) based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221), which validates in two independent data sets from Mayo Clinic (n = 198) and TCGA (n = 358), with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF) binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes. PMID:26629914

  9. Is the algorithm used to process heart rate variability data clinically relevant? Analysis in male adolescents.

    Science.gov (United States)

    Soares, Antonio Henrique Germano; Farah, Breno Quintella; Cucato, Gabriel Grizzo; Bastos-Filho, Carmelo José Albanez; Christofaro, Diego Giulliano Destro; Vanderlei, Luiz Carlos Marques; Lima, Aluísio Henrique Rodrigues de Andrade; Ritti-Dias, Raphael Mendes

    2016-01-01

    To analyze whether the algorithm used for the heart rate variability assessment (fast Fourier transform versus autoregressive methods) influenced its association with cardiovascular risk factors in male adolescents. This cross-sectional study included 1,152 male adolescents (aged 14 to 19 years). The low frequency, high frequency components (absolute numbers and normalized units), low frequency/high frequency ratio, and total power of heart rate variability parameters were obtained using the fast Fourier transform and autoregressive methods, while the adolescents were resting in a supine position. All heart rate variability parameters calculated from both methods were different (padolescentes do gênero masculino. Estudo transversal, que incluiu 1.152 adolescentes do gênero masculino (14 a 19 anos). Componentes de baixa e alta frequência (absolutos e unidades normalizadas), razão componente de baixa frequência/componente de alta frequência e poder total da variabilidade da frequência cardíaca foram obtidos em repouso, na posição supina, usando os métodos transformada rápida de Fourier e autorregressivo. Todos os parâmetros da variabilidade da frequência cardíaca para ambos os métodos foram diferentes (padolescentes masculinos, mas essas diferenças não foram clinicamente significativas.

  10. Search for relation between flares and photometric variability outside of flares in EV Lac

    International Nuclear Information System (INIS)

    Rojzman, G.Sh.

    1984-01-01

    The observations of the flare star EV Lac in July-September 1981 have confirmed the existence of photometric variability outside the flares during the night. It was found that, as a rule, a slow increase of brightness in U and B bands during 1-2 hours preceded the flares. It is suggested that the variability outside the flares is the result of the variability of chpomospheric emission lines and continuum that are emitted by the chromospheric preflare formations

  11. Predicting Calcium Values for Gastrointestinal Bleeding Patients in Intensive Care Unit Using Clinical Variables and Fuzzy Modeling

    Directory of Open Access Journals (Sweden)

    G Khalili-Zadeh-Mahani

    2016-07-01

    Full Text Available Introduction: Reducing unnecessary laboratory tests is an essential issue in the Intensive Care Unit. One solution for this issue is to predict the value of a laboratory test to specify the necessity of ordering the tests. The aim of this paper was to propose a clinical decision support system for predicting laboratory tests values. Calcium laboratory tests of three categories of patients, including upper and lower gastrointestinal bleeding, and unspecified hemorrhage of gastrointestinal tract, have been selected as the case studies for this research. Method: In this research, the data have been collected from MIMIC-II database. For predicting calcium laboratory values, a Fuzzy Takagi-Sugeno model is used and the input variables of the model are heart rate and previous value of calcium laboratory test. Results: The results showed that the values of calcium laboratory test for the understudy patients were predictable with an acceptable accuracy. In average, the mean absolute errors of the system for the three categories of the patients are 0.27, 0.29, and 0.28, respectively. Conclusion: In this research, using fuzzy modeling and two variables of heart rate and previous calcium laboratory values, a clinical decision support system was proposed for predicting laboratory values of three categories of patients with gastrointestinal bleeding. Using these two clinical values as input variables, the obtained results were acceptable and showed the capability of the proposed system in predicting calcium laboratory values. For achieving better results, the impact of more input variables should be studied. Since, the proposed system predicts the laboratory values instead of just predicting the necessity of the laboratory tests; it was more generalized than previous studies. So, the proposed method let the specialists make the decision depending on the condition of each patient.

  12. Leadership Is Positively Related to Athletic Training Students' Clinical Behaviors

    Science.gov (United States)

    Kutz, Matthew R.

    2012-01-01

    Context: Leadership development by health professionals positively affects patient outcomes. Objective: To 1) determine if there is any relationship between demonstrated leadership behaviors and clinical behaviors among entry-level AT students (ATS); 2) to explore if the level of leadership behavior changes between ATS level; and 3) to determine…

  13. Variability of carotid artery measurements on 3-Tesla MRI and its impact on sample size calculation for clinical research.

    Science.gov (United States)

    Syed, Mushabbar A; Oshinski, John N; Kitchen, Charles; Ali, Arshad; Charnigo, Richard J; Quyyumi, Arshed A

    2009-08-01

    Carotid MRI measurements are increasingly being employed in research studies for atherosclerosis imaging. The majority of carotid imaging studies use 1.5 T MRI. Our objective was to investigate intra-observer and inter-observer variability in carotid measurements using high resolution 3 T MRI. We performed 3 T carotid MRI on 10 patients (age 56 +/- 8 years, 7 male) with atherosclerosis risk factors and ultrasound intima-media thickness > or =0.6 mm. A total of 20 transverse images of both right and left carotid arteries were acquired using T2 weighted black-blood sequence. The lumen and outer wall of the common carotid and internal carotid arteries were manually traced; vessel wall area, vessel wall volume, and average wall thickness measurements were then assessed for intra-observer and inter-observer variability. Pearson and intraclass correlations were used in these assessments, along with Bland-Altman plots. For inter-observer variability, Pearson correlations ranged from 0.936 to 0.996 and intraclass correlations from 0.927 to 0.991. For intra-observer variability, Pearson correlations ranged from 0.934 to 0.954 and intraclass correlations from 0.831 to 0.948. Calculations showed that inter-observer variability and other sources of error would inflate sample size requirements for a clinical trial by no more than 7.9%, indicating that 3 T MRI is nearly optimal in this respect. In patients with subclinical atherosclerosis, 3 T carotid MRI measurements are highly reproducible and have important implications for clinical trial design.

  14. Interobserver variability of clinical target volume delineation in supra-diaphragmatic Hodgkin's disease. A multi-institutional experience

    International Nuclear Information System (INIS)

    Genovesi, Domenico; Cefaro, Giampiero Ausili; Vinciguerra, Annamaria

    2011-01-01

    To determine interobserver variability in clinical target volume (CTV) of supra-diaphragmatic Hodgkin's lymphoma. At the 2008 AIRO (Italian Society of Radiation Oncology) Meeting, the Radiation Oncology Department of Chieti proposed a multi-institutional contouring dummy-run of two cases of early stage supra-diaphragmatic Hodgkin's lymphoma after chemotherapy. Clinical history, diagnostics, and planning CT imaging were available on Chieti's radiotherapy website (www.radioterapia.unich.it). Participating centers were requested to delineate the CTV and submit it to the coordinating center. To quantify interobserver variability of CTV delineations, the total volume, craniocaudal, laterolateral, and anteroposterior diameters were calculated. A total of 18 institutions for case A and 15 institutions for case B submitted the targets. Case A presented significant variability in total volume (range: 74.1-1,157.1 cc), craniocaudal (range: 6.5-22.5 cm; median: 16.25 cm), anteroposterior (range: 5.04-14.82 cm; median: 10.28 cm), and laterolateral diameters (range: 8.23-22.88 cm; median: 15.5 cm). Mean CTV was 464.8 cc (standard deviation: 280.5 cc). Case B presented significant variability in total volume (range: 341.8-1,662 cc), cranio-caudal (range: 8.0-28.5 cm; median: 23 cm), anteroposterior (range: 7.9-1.8 cm; median: 11.1 cm), and laterolateral diameters (range: 12.9-24.0 cm; median: 18.8 cm). Mean CTV was 926.0 cc (standard deviation: 445.7 cc). This significant variability confirms the need to apply specific guidelines to improve contouring uniformity in Hodgkin's lymphoma. (orig.)

  15. Temporal and spatial variability in the aviation NOx-related O3 impact

    International Nuclear Information System (INIS)

    Gilmore, Christopher K; Barrett, Steven R H; Koo, Jamin; Wang, Qiqi

    2013-01-01

    Aviation NO x emissions promote tropospheric ozone formation, which is linked to climate warming and adverse health effects. Modeling studies have quantified the relative impact of aviation NO x on O 3 in large geographic regions. As these studies have applied forward modeling techniques, it has not been possible to attribute O 3 formation to individual flights. Here we apply the adjoint of the global chemistry–transport model GEOS-Chem to assess the temporal and spatial variability in O 3 production due to aviation NO x emissions, which is the first application of an adjoint to this problem. We find that total aviation NO x emitted in October causes 40% more O 3 than in April and that Pacific aviation emissions could cause 4–5 times more tropospheric O 3 per unit NO x than European or North American emissions. Using this sensitivity approach, the O 3 burden attributable to 83 000 unique scheduled civil flights is computed individually. We find that the ten highest total O 3 -producing flights have origins or destinations in New Zealand or Australia. The top ranked O 3 -producing flights normalized by fuel burn cause 157 times more normalized O 3 formation than the bottom ranked ones. These results show significant spatial and temporal heterogeneity in environmental impacts of aviation NO x emissions. (letter)

  16. Physiological Study on the Relation of Heart Rate Variability in Ageing and Thyroid Hormone Disorder

    Directory of Open Access Journals (Sweden)

    Elsayed A. M. Shokr

    2016-04-01

    Full Text Available The present study aimed to investigate whether cardiac autonomic dysfunction in aging human might be related to an underlying thyroid disturbance. ageing has been associated with hypothyroidism and cardiac autonomic dysfunction. On the basis of body mass index (BMI, 150 patients were grouped into three groups (n = 50 48 years ± 2, 55 years ± 2 and 63 years ± 2. Electrocardiogram was recorded using PowerLab system and the time and frequency domain measures of heart rate variability (HRV were calculated. Fasting blood samples were drawn for measurement of serum thyroid stimulating hormone (TSH, total thyroxin (T4 and total triiodothyronine (T3 concentrations. The levels of TSH, T4 and T3 were not significantly different between the groups. The frequency domain HRV parameter reflecting parasympathetic tone (high-frequency normalized units, HFnu was significantly reduced in aging third groups group. The parameters which reflect sympathetic activation (Heart rate, low-frequency normalized units; LFnu and the LF/HF ratio were significantly increased in the aging group. HFnu was significantly and negatively correlated with age, whereas LFnu and LF/HF ratio were significantly and positively correlated with the above mentioned parameters. No significant relationships were noted between the HRV parameters and the levels of TSH or thyroid hormones. Cardiac autonomic dysfunction in aging human is not linked with underlying thyroid disturbance.

  17. Regional precipitation variability in East Asia related to climate and environmental factors during 1979-2012

    Science.gov (United States)

    Deng, Yinyin; Gao, Tao; Gao, Huiwang; Yao, Xiaohong; Xie, Lian

    2014-01-01

    This paper studies the inter-annual precipitation variations in different regions of East Asia from oceans to interior areas in China during 1979 – 2012. The results computed by Empirical Orthogonal Functions (EOF) demonstrate that the annual precipitation changes are mainly related to the El Niño-Southern Oscillation, East Asian summer monsoon and aerosols. We also found that the increased Sea surface temperature (SST) could explain the precipitation changes over the Northwest Pacific in the dry season (Oct. – May) and the East China Sea and the South China Sea in the rainy season (Jun. – Sep.). The precipitation changes over the ocean unexplained by SST were likely due to the water vapor transport dominated by dynamic factors. With the increased SST, the moisture transported from oceans to interior land was likely redistributed and caused the complicated regional variability of precipitation. Moreover, the impacts of aerosols on cloud and precipitation varied with different pollution levels and different seasons. PMID:25033387

  18. Winter cloudiness variability over Northern Eurasia related to the Siberian High during 1966–2010

    International Nuclear Information System (INIS)

    Chernokulsky, Alexander; Mokhov, Igor I; Nikitina, Natalia

    2013-01-01

    This letter presents an assessment of winter cloudiness variability over Northern Eurasia regions related to the Siberian High intensity (SHI) variations during 1966–2010. An analysis of cloud fraction and the occurrence of different cloud types was carried out based on visual observations from almost 500 Russian meteorological stations. The moonlight criterion was implemented to reduce the uncertainty of night observations. The SHI was defined based on sea-level pressure fields from different reanalyses. We found a statistically significant negative correlation of cloud cover with the SHI over central and southern Siberia and the southern Urals with regression coefficients around 3% hPa −1 for total cloud fraction (TCF) for particular stations near the Siberian High center. Cross-wavelet analysis of TCF and SHI revealed a long-term relationship between cloudiness and the Siberian High. Generally, the Siberian High intensification by 1 hPa leads to a replacement of one overcast day with one day without clouds, which is associated mainly with a decrease in precipitating and stratiform clouds. These changes point to a positive feedback between cloudiness and the Siberian High. (letter)

  19. Body composition variables and leptin levels in functional hypothalamic amenorrhea and amenorrhea related to eating disorders.

    Science.gov (United States)

    Bruni, Vincenzina; Dei, Metella; Morelli, Chiara; Schettino, M Teresa; Balzi, Daniela; Nuvolone, Daniela

    2011-12-01

    The purpose of the study was to identify diagnostic criteria that can distinguish between subjects with functional hypothalamic amenorrhea largely related to minimal energy deficiency and those in whom failure of adaptive response to stress prevails. We studied 59 young women with secondary amenorrhea related to modest eating disorders and 58 who complained of stressful events in their history. We assessed anthropometric measurements, body composition using dual energy X-ray absorptiometry (DEXA) and bioelectrical impedance analysis (BIA), and basal endocrine profile. Subjects with disordered eating had lower body mass index (BMI), fat mass (FM) measured with both techniques, lumbar mineral density and direct and indirect measures of lean mass. Leptin and free tri-iodothyronine(FT(3)) concentrations also proved lower in the group of subjects with eating disorders, although there was no significant difference in cortisol between the two groups. Leptin levels were positively associated not only with fat mass, but also with body cell mass indexed to height and phase angle, parameters studied with BIA as expression of active lean compartment. A multivariate model confirmed the utility of integrating endocrine data with the study of body composition. The use of bioelectrical impedance analysis proved to be, in clinical use, a valid diagnostic alternative to DEXA, especially considering body cell mass and phase angle. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  20. EVOLUTION OF CATACLYSMIC VARIABLES AND RELATED BINARIES CONTAINING A WHITE DWARF

    Energy Technology Data Exchange (ETDEWEB)

    Kalomeni, B.; Rappaport, S.; Molnar, M. [Department of Physics, and Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Nelson, L. [Department of Physics, Bishop’s University, 2600 College St., Sherbrooke, Quebec, QC J1M 1Z7 (Canada); Quintin, J. [Department of Physics, McGill University, Montréal, QC H3A 2T8 (Canada); Yakut, K., E-mail: kalomeni@mit.edu, E-mail: sar@mit.edu, E-mail: momchil.molnar@gmail.com, E-mail: belinda.kalomeni@ege.edu.tr, E-mail: kadri.yakut@ege.edu.tr, E-mail: lnelson@ubishops.ca, E-mail: jquintin@physics.mcgill.ca [Department of Astronomy and Space Sciences, Ege University, 35100, İzmir (Turkey)

    2016-12-10

    We present a binary evolution study of cataclysmic variables (CVs) and related systems with white dwarf (WD) accretors, including for example, AM CVn systems, classical novae, supersoft X-ray sources (SXSs), and systems with giant donor stars. Our approach intentionally avoids the complications associated with population synthesis algorithms, thereby allowing us to present the first truly comprehensive exploration of all of the subsequent binary evolution pathways that zero-age CVs might follow (assuming fully non-conservative, Roche-lobe overflow onto an accreting WD) using the sophisticated binary stellar evolution code MESA. The grid consists of 56,000 initial models, including 14 WD accretor masses, 43 donor-star masses (0.1–4.7 M {sub ⊙}), and 100 orbital periods. We explore evolution tracks in the orbital period and donor-mass ( P {sub orb}– M {sub don}) plane in terms of evolution dwell times, masses of the WD accretor, accretion rate, and chemical composition of the center and surface of the donor star. We report on the differences among the standard CV tracks, those with giant donor stars, and ultrashort period systems. We show where in parameter space one can expect to find SXSs, present a diagnostic to distinguish among different evolutionary paths to forming AM CVn binaries, quantify how the minimum orbital period in CVs depends on the chemical composition of the donor star, and update the P {sub orb}( M {sub wd}) relation for binaries containing WDs whose progenitors lost their envelopes via stable Roche-lobe overflow. Finally, we indicate where in the P {sub orb}– M {sub don} the accretion disks will tend to be stable against the thermal-viscous instability, and where gravitational radiation signatures may be found with LISA.

  1. EVOLUTION OF CATACLYSMIC VARIABLES AND RELATED BINARIES CONTAINING A WHITE DWARF

    International Nuclear Information System (INIS)

    Kalomeni, B.; Rappaport, S.; Molnar, M.; Nelson, L.; Quintin, J.; Yakut, K.

    2016-01-01

    We present a binary evolution study of cataclysmic variables (CVs) and related systems with white dwarf (WD) accretors, including for example, AM CVn systems, classical novae, supersoft X-ray sources (SXSs), and systems with giant donor stars. Our approach intentionally avoids the complications associated with population synthesis algorithms, thereby allowing us to present the first truly comprehensive exploration of all of the subsequent binary evolution pathways that zero-age CVs might follow (assuming fully non-conservative, Roche-lobe overflow onto an accreting WD) using the sophisticated binary stellar evolution code MESA. The grid consists of 56,000 initial models, including 14 WD accretor masses, 43 donor-star masses (0.1–4.7 M ⊙ ), and 100 orbital periods. We explore evolution tracks in the orbital period and donor-mass ( P orb – M don ) plane in terms of evolution dwell times, masses of the WD accretor, accretion rate, and chemical composition of the center and surface of the donor star. We report on the differences among the standard CV tracks, those with giant donor stars, and ultrashort period systems. We show where in parameter space one can expect to find SXSs, present a diagnostic to distinguish among different evolutionary paths to forming AM CVn binaries, quantify how the minimum orbital period in CVs depends on the chemical composition of the donor star, and update the P orb ( M wd ) relation for binaries containing WDs whose progenitors lost their envelopes via stable Roche-lobe overflow. Finally, we indicate where in the P orb – M don the accretion disks will tend to be stable against the thermal-viscous instability, and where gravitational radiation signatures may be found with LISA.

  2. Effects of ultrasound-related variables on sonochemically synthesized SAPO-34 nanoparticles

    International Nuclear Information System (INIS)

    Askari, Sima; Halladj, Rouein

    2013-01-01

    The sonochemical method was developed to synthesize uniform SAPO-34 (silicoaluminophosphate molecular sieve) nanoparticles with high crystallinity using TEAOH as a structure-directing agent (SDA). The physicochemical characteristics of SAPO-34 products, i.e. crystallinity, particle size and shape can be controlled by varying the ultrasonic-related variable such as ultrasound power intensity, ultrasonic irradiation time, sonication temperature and geometrical characteristics of the ultrasonic device (e.g., sonotrode size). The products were characterized by XRD, SEM, TEM and BET. It is found that each of the parameters can play a significant role in acoustic cavitation, number of nuclei and the crystal growth. The experimental data establish that the crystallinity is related to ultrasonic intensity and diameter of the sonotrode, as well as sonication temperature. By increasing the ultrasonic power, duration and the sonication temperature, the mean sizes of particles decrease and the morphology of the products efficiently alters from spherical aggregates of cube type SAPO-34 particles to uniform spherical nanoparticles. - Graphical abstract: Increasing US power by increasing either US power intensity or the sonotrode diameter leads to smaller particle size and the morphology changes from spherical aggregates of cubic particles to uniform nanospheres. Highlights: ► Effects of ultrasonic parameters on sonochemical synthesis of SAPO-34 nanoparticles. ► The higher crystallinity by increasing ultrasonic power, duration and sonication temperature. ► The morphology changes from spherical aggregates of cubic particles to uniform nanospheres. ► Decreasing the particle size by increasing ultrasonic power, duration and sonication temperature

  3. Marked variability in clinical presentation and outcome of patients with C1q immunodeficiency

    DEFF Research Database (Denmark)

    van Schaarenburg, Rosanne A; Schejbel, Lone; Truedsson, Lennart

    2015-01-01

    OBJECTIVE: Globally approximately 60 cases of C1q deficiency have been described with a high prevalence of Systemic Lupus Erythematosus (SLE). So far treatment has been guided by the clinical presentation rather than the underlying C1q deficiency. Recently, it was shown that C1q production can...

  4. Variability in Clinical Presentation of Neonatal Stroke: Report of Four Cases

    OpenAIRE

    Joseph, Sonia; Angelis, Dimitrios; Bennett, Robert; Kola, Bhargavi; Hughes, Amanda

    2017-01-01

    Neonatal stroke can be a cause of long term neurodevelopmental disability, seizures, and impaired cognitive function. We present four cases of neonatal stroke, associated with different risk factors and clinical presentations. Two of these newborns were born to mothers with no prenatal care.

  5. Relation between knee extensors' strength, postural stability and variability of centre of pressure displacement during gait in adult women

    Directory of Open Access Journals (Sweden)

    Eliza C. de Souza

    2017-03-01

    Full Text Available Background: It has been shown that variability of walking is related to fall risk similarly as postural control and muscle strength. Joint potential of this group of variables for fall risk assessment is promising, however research interested in relations between them is lacking. Objective: The aim of this study was to investigate the relation between knee extensors' strength, centre of pressure (COP velocity during one-leg stance and variability of COP displacement during various phases of gait cycle in middle-age women. Methods: A single group of 40 healthy women (age 56 ± 4.2 years took part in the study. For assessment of knee extensors' strength (peak torque and average work during concentric and eccentric contractions an isokinetic dynamometer was used. Mean velocity of COP during one-leg stance in anterior-posterior (AP and medial-lateral (ML directions was assessed on a force plate on a rigid surface with eyes open (two 30 s trials. Variability of COP displacement was assessed for loading response, midstance, terminal stance and preswing gait cycle phases (determined by vertical ground reaction force in AP and ML directions. It was measured by two force plates positioned in the middle of an 8 m walkway (5 trials at a self-selected speed. For statistical analysis of relationships between variables Pearson correlation was applied. Results: Our results showed significant correlations between eccentric peak torque and COP velocity in AP direction during one-leg stance, eccentric and concentric peak torque and COP variability during loading response in both ML and AP directions and during terminal stance in AP direction. Conclusion: Loading response and terminal stance seems to be more related to knee extensors' strength. Variables derived from postural stability assessment during one-leg stance are independent from variables derived from assessment of COP displacement variability during walking.

  6. Role of demographic and job-related variables in determining work-related quality of life of hospital employees

    Directory of Open Access Journals (Sweden)

    K Shukla

    2017-01-01

    Full Text Available Background: Considering a huge working population in health sector faced with stressful work life, limited autonomy in work and declining work contentment calls for an overemphasis on evaluating and monitoring their satisfaction associated with work-related quality of life (WRQoL. This study evaluates WRQoL of hospital employees and validates the bilingual (English and Marathi version of WRQoL scale. Methods: The study was conducted during March-April′2014 on employees of a corporate hospital of Pune, India after ethical approval and informed consent from employees. The bilingual WRQoL scale has been tested for reliability and validity, and WRQoL scores have been reported. Results: A total of 132 hospital employees (mean age 31 [±8] years, 55% males who participated in the study reported overall moderate WRQoL scores. The scale showed high internal consistency (Cronbach′s alpha = 0.82, P < 0.0001 and moderate to high validity. WRQoL did not significantly vary across marital status, family size, and gender. "Stress at work" score of WRQoL increased with age of employees. Higher work experience, employment at higher positions and those working in clinical and diagnostic departments reported a higher WRQoL. Conclusion: WRQoL scale is a reliable and valid instrument. Better WRQoL in employees placed in higher organizational positions indicates a need for focused measures to enhance WRQoL of employees in lower hierarchical levels, especially in control at work and home life interface domains. WRQoL needs regular monitoring for employees in lower positions and aging employees.

  7. Relations between Behavioral Inhibition, Big Five Personality Factors, and Anxiety Disorder Symptoms in Non-Clinical and Clinically Anxious Children

    Science.gov (United States)

    Vreeke, Leonie J.; Muris, Peter

    2012-01-01

    This study examined the relations between behavioral inhibition, Big Five personality traits, and anxiety disorder symptoms in non-clinical children (n = 147) and clinically anxious children (n = 45) aged 6-13 years. Parents completed the Behavioral Inhibition Questionnaire-Short Form, the Big Five Questionnaire for Children, and the Screen for…

  8. Relations between behavioral inhibition, big five personality factors, and anxiety disorder symptoms in non-clinical and clinically anxious children

    NARCIS (Netherlands)

    L.J. Vreeke (Leonie); P.E.H.M. Muris (Peter)

    2012-01-01

    textabstractThis study examined the relations between behavioral inhibition, Big Five personality traits, and anxiety disorder symptoms in non-clinical children (n = 147) and clinically anxious children (n = 45) aged 6-13 years. Parents completed the Behavioral Inhibition Questionnaire-Short Form,

  9. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    NARCIS (Netherlands)

    Santos, Emilie M. M.; Yoo, Albert J.; Beenen, Ludo F.; Berkhemer, Olvert A.; den Blanken, Mark D.; Wismans, Carrie; Niessen, Wiro J.; Majoie, Charles B.; Marquering, Henk A.; Fransen, Puck S. S.; Beumer, Debbie; van den Berg, Lucie A.; Lingsma, Hester F.; Schonewille, Wouter J.; Vos, Jan Albert; Nederkoorn, Paul J.; Wermer, Marieke J. H.; van Walderveen, Marianne A. A.; Staals, Julie; Hofmeijer, Jeannette; van Oostayen, Jacques A.; Lycklama à Nijeholt, Geert J.; Boiten, Jelis; Brouwer, Patrick A.; Emmer, Bart J.; de Bruijn, Sebastiaan F.; van Dijk, Lukas C.; Kappelle, L. Jaap; Lo, Rob H.; van Dijk, Ewoud J.; de Vries, Joost; de Kort, Paul L. M.; van den Berg, Jan S. P.; A A M van Hasselt, Boudewijn; Aerden, Leo A. M.; Dallinga, René J.; Visser, Marieke C.; Bot, Joseph C. J.; Vroomen, Patrick C.; Eshghi, Omid; Schreuder, Tobien H. C. M. L.; Heijboer, Roel J. J.; Keizer, Koos; Tielbeek, Alexander V.; Hertog, Heleen M. Den; Gerrits, Dick G.; van den Berg-Vos, Renske M.; Karas, Giorgos B.; Steyerberg, Ewout W.; Flach, H. Zwenneke; Sprengers, Marieke E. S.; Jenniskens, Sjoerd F. M.; van den Berg, René; Koudstaal, Peter J.; van Zwam, Wim H.; Roos, Yvo B. W. E. M.; van der Lugt, Aad; van Oostenbrugge, Robert J.; Dippel, Diederik W. J.

    2016-01-01

    Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert

  10. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    NARCIS (Netherlands)

    E.M.M. Santos (Emilie M.); A.J. Yoo (Albert J.); L.F.M. Beenen (Ludo); O.A. Berkhemer (Olvert); M.D. Den Blanken (Mark D.); C. Wismans (Carrie); W.J. Niessen (Wiro); C.B. Majoie (Charles); H. Marquering (Henk)

    2016-01-01

    textabstractIntroduction: Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by

  11. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    NARCIS (Netherlands)

    Santos, E.M.; Yoo, A.J.; Beenen, L.F.; Berkhemer, O.A.; Blanken, M.D. den; Wismans, C.; Niessen, W.J.; Majoie, C.B.; Marquering, H.A.; Dijk, E.J. van; et al.,

    2016-01-01

    INTRODUCTION: Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and

  12. Attitudes toward Money and Demographic Variables as Related to Income and Life Satisfaction: USA Vs. Spain.

    Science.gov (United States)

    Tang, Thomas Li-Ping; Arocas, Roberto Luna; Whiteside, Harold D.

    A study of 207 faculty at a state university in the southeastern United States and 102 faculty members at the University of Valencia (Spain) examined demographic variables and attitudes toward money, income, and life satisfaction. Demographic variables (sex, age, education, marital status, race, current job experience, total work experience, and…

  13. Spontaneous pneumomediastinum on CT : related condition and its clinical significance

    International Nuclear Information System (INIS)

    Kim, Sung Hyun; Im, Jung Gi; Seo, Joon Beom; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

    1998-01-01

    The purpose of this paper is to tabulate underlying disease and to assess the clinical significance of CT-diagnosed spontaneous pneumomediastinum. We retrospectively reviewed CT scans and medical records of 11 consecutive patients with spontaneous pneumomediastinum, and analyzed their clinical history and course, and in five cases, pulmonary function. CT scans of 126 patients with idiopathic pulmonary fibrosis (IPE) collected while the 11 consecutive patients were being treated were analyzed for the prevalence of pneumomediastinum. We analyzed CT findings with respect to the amount and distribution of air in the mediastinum, and the presence of absence of air outside the mediastinum. Spontaneous pneumomediastinum might be associated with idiopathic pulmonary fibrosis and might be a poor prognostic factor in patients with IPE or BOOP. (author). 18 refs., 2 figs

  14. Spontaneous pneumomediastinum on CT : related condition and its clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Hyun; Im, Jung Gi; Seo, Joon Beom; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National Univ. (Korea, Republic of). Coll. of Medicine

    1998-03-01

    The purpose of this paper is to tabulate underlying disease and to assess the clinical significance of CT-diagnosed spontaneous pneumomediastinum. We retrospectively reviewed CT scans and medical records of 11 consecutive patients with spontaneous pneumomediastinum, and analyzed their clinical history and course, and in five cases, pulmonary function. CT scans of 126 patients with idiopathic pulmonary fibrosis (IPE) collected while the 11 consecutive patients were being treated were analyzed for the prevalence of pneumomediastinum. We analyzed CT findings with respect to the amount and distribution of air in the mediastinum, and the presence of absence of air outside the mediastinum. Spontaneous pneumomediastinum might be associated with idiopathic pulmonary fibrosis and might be a poor prognostic factor in patients with IPE or BOOP. (author). 18 refs., 2 figs.

  15. The IL--6 dependent effect of oral warfarin in heart valve replacement patients by measuring interacting clinical and demographic variables

    International Nuclear Information System (INIS)

    Shafiq, H.; Rashid, A.; Majeed, A.; Razah, S.; Asghar, I.

    2016-01-01

    Objective: To examine an inflammatory effect of warfarin and comparing with IL-6 levels along with different demographic and clinical variables. Study Design: Quasi experimental study. Place and Duration of Study: Center of Research in Experimental and Applied Medicine (CREAM), Army Medical College/National University of Sciences and Technology, Islamabad from Oct 2013 to Oct 2015. Material and Methods: The study design was Quasi Experimental study. Samples were collected by Non probability convenience sampling. Total 76 patients were included according to warfarin dose response in warfarin therapy patients, i.e. 32(42 percent) were taking 10mg/day of warfarin dose. Patient's demographic and clinical variables were noted i.e. age, gender, BMI, duration of therapy, INR history, hepatic, gastrointestinal and diabetic complications. Human IL-6 ELISA assay was performed. Results: The statistically significant difference was found between age groups (in years) and different levels of warfarin dose (p=0.046) along with IL-6 production. There is a negative correlation between warfarin dose and age group i.e. as age increases, the dose of warfarin decreases. Among the inter and intra-patient variability age and serum IL-6 levels were found to be statistically significant with warfarin dose response. BMI and warfarin dose were found to be weak positively correlated. Conclusion: A marked immunomodulatory response of warfarin was noted by measuring IL-6 levels. IL-6 levels retained a significant association with warfarin dose. (author)

  16. Exploring correlates of diabetes-related stress among adults with Type 1 diabetes in the T1D exchange clinic registry.

    Science.gov (United States)

    Boden, Matthew Tyler; Gala, Sasha

    2018-04-01

    To explore relations between diabetes-related stress and multiple sociodemographic, diabetes health, other health, and treatment-related variables among a large sample of adults with Type 1 Diabetes (T1D). The sample consisted of 10,821 adults (over 18 years old) enrolled in the T1D Exchange Clinic Registry. The T1D Exchange clinic network consists of 67 diabetes clinical centers throughout the United States selected to broadly represent pediatric and adult patients with T1D. Variables were assessed through participant self-report and extraction of clinic chart data. Univariate and multiple linear regression (with simultaneous entry of all predictors) analyses were conducted. Robustly associated with increased diabetes-related stress across analyses were multiple sociodemographic (female [vs. male], native Hawaiian/other Pacific islander [vs. white/Caucasian], decreased age and diabetes duration), diabetes health (higher HbA1c), other health (lower general health, presence of major life stress and depression, less physical activity), and treatment related variables (use of injections/pen or combination injection/pen/pump [vs. pump], use of CGM, increased frequency of missing insulin doses and BG checking, decreased frequency of BG checking prior to bolus, receipt of mental health treatment). We replicated and extended research demonstrating that diabetes-related stress among people with T1D occurs at higher levels among those with particular sociodemographic characteristics and is associated with a range poorer diabetes health and other health variables, and multiple treatment-related variables. The strong incremental prediction of diabetes-related stress by multiple variables in our study suggests that a multi-variable, personalized approach may increase the effectiveness of treatments for diabetes-related stress. Published by Elsevier B.V.

  17. ABO blood groups and malaria related clinical outcome.

    Science.gov (United States)

    Deepa; Alwar, Vanamala A; Rameshkumar, Karuna; Ross, Cecil

    2011-03-01

    The study was undertaken to correlate the blood groups and clinical presentations in malaria patients and to understand the differential host susceptibility in malaria. From October 2007 to September 2008, malaria positive patients' samples were evaluated in this study. Hemoglobin, total leukocyte count, and platelet count of each patient were done on an automated cell counter. After determining the blood groups, malarial species and the severity of clinical course were correlated. A total of 100 patients were included in the study, of which 63 cases were positive for Plasmodium falciparum and 37 cases were positive for P. vivax infection and 11 patients had mixed infection. The results of the blood groups showed 22 - 'A' group, 42 - 'B' group, 35 - 'O' group and 1 was 'AB' group. When the clinical courses between different groups were compared using the following parameters for severe infection--a parasitic load of >10/1000 RBCs, severe anemia with hemoglobin 101°F and other organ involvement, it was observed that 'O' group had an advantage over other the groups. The difference in rosetting ability between red blood cells of different 'ABO' blood groups with a diminished rosetting potential in blood group 'O' red blood cells was due to the differential host susceptibility. 'O' group had an advantage over the other three blood groups. Based on literature and the results of this study, the diminished rosetting potential in blood group 'O' red blood cells is suggested as the basis for the differential host susceptibility.

  18. Saturated Fat Intake Is Related to Heart Rate Variability in Women with Polycystic Ovary Syndrome.

    Science.gov (United States)

    Graff, Scheila K; Mario, Fernanda M; Magalhães, Jose A; Moraes, Ruy S; Spritzer, Poli Mara

    2017-01-01

    There is a heightened risk for cardiovascular diseases in women with polycystic ovary syndrome (PCOS). Alterations in heart rate variability (HRV) may reflect subclinical cardiovascular disease, with a putative association between HRV and dietary fat. This study evaluated HRV in PCOS and control women based on the dietary intake of saturated fatty acid (SFA). Biochemical/hormonal profile, resting metabolic rate, physical activity, HRV in response to the Stroop test, and dietary intake were assessed in 84 PCOS and 54 control women stratified by median SFA intake in the PCOS group (8.5% of daily energy intake). Body mass index (p = 0.041), blood pressure (p PCOS vs. PCOS women had higher testosterone (p = 0.001), dehydroepiandrosterone sulfate (p = 0.012), and free androgen index (p = 0.001), and lower sex hormone-binding globulin levels than controls (p = 0.001). In both groups, the clinical profile and calorie intake were similar between SFA categories. In PCOS, testosterone was lower when SFA intake PCOS women with SFA PCOS, age and SFA intake were independent predictors of HRV. Lower SFA intake is related to improved cardiovascular autonomic function in PCOS. © 2017 S. Karger AG, Basel.

  19. Visualisation of variable binding pockets on protein surfaces by probabilistic analysis of related structure sets

    Directory of Open Access Journals (Sweden)

    Ashford Paul

    2012-03-01

    conserved occurrence of surface pockets at the active and regulatory sites; ii a simulated ensemble of unliganded Bcl2 structures reveals extensions of a known ligand-binding pocket not apparent in the apo crystal structure; iii visualisations of interleukin-2 and its homologues highlight conserved pockets at the known receptor interfaces and regions whose conformation is known to change on inhibitor binding. Conclusions Through post-processing of the output of a variety of pocket prediction software, Provar provides a flexible approach to the analysis and visualization of the persistence or variability of pockets in sets of related protein structures.

  20. Visualisation of variable binding pockets on protein surfaces by probabilistic analysis of related structure sets.

    Science.gov (United States)

    Ashford, Paul; Moss, David S; Alex, Alexander; Yeap, Siew K; Povia, Alice; Nobeli, Irene; Williams, Mark A

    2012-03-14

    and regulatory sites; ii) a simulated ensemble of unliganded Bcl2 structures reveals extensions of a known ligand-binding pocket not apparent in the apo crystal structure; iii) visualisations of interleukin-2 and its homologues highlight conserved pockets at the known receptor interfaces and regions whose conformation is known to change on inhibitor binding. Through post-processing of the output of a variety of pocket prediction software, Provar provides a flexible approach to the analysis and visualization of the persistence or variability of pockets in sets of related protein structures.

  1. Reduced heart rate variability in pet dogs affected by anxiety-related behaviour problems.

    Science.gov (United States)

    Wormald, Dennis; Lawrence, Andrew J; Carter, Gabrielle; Fisher, Andrew D

    2017-01-01

    We present here the first evidence of correlation between canine anxiety-related behavioural problems and heart rate variability (HRV). HRV is known to be related to a range of mental disorders in humans; however this has not been explored in dogs. Behavioural problems in dogs can result in suffering, property destruction and human injury. Dog behaviour problems were assessed by owner questionnaire and the extreme high and low scoring dogs were recruited into either affected (n=10) or unaffected (n=20) groups. HRV was assessed in dogs at their homes, while being held in lateral recumbency for 5min using manual restraint. Salivary cortisol samples were taken before and after HRV testing. Dogs were assessed as either being reactive to the procedure (barking, growling, struggling or shaking) or unreactive. There was no effect of reactivity or behaviour problems on salivary cortisol levels at baseline or in response to the treatment. There was a significant effect of reactivity on HR (F 1,26 =5.54; P=0.026), and no effect of behaviour problems (F 1,26 =1.07; P=0.311). There was no effect of reactivity on any of the HRV measures. The presence of behaviour problems had a significant effect on a range of measures of HRV, with unaffected dogs having higher standard deviation of RR intervals (F 1,26 =6.39; P=0.018), higher high frequency spectrum (F 1,26 =5.23; P=0.031) and higher low frequency spectrum (F 1,26 =9.25; P=0.005) power. There was no effect of behaviour problems on very low frequency spectrum power (F 1,26 =1.40; P=0.248). Together these results provide evidence for a fundamental physiological difference between dogs affected or unaffected with behaviour problems. This study provides evidence for further investigation into the role of HRV in the pathophysiology of canine anxiety-related behaviour problems. Copyright © 2016. Published by Elsevier Inc.

  2. Evaluation of signalment, clinical, and laboratory variables as prognostic indicators in dogs with acute abdominal syndrome

    OpenAIRE

    SIMEONOVA, Galina; DINEV, Dinko; CHAPRAZOV, Tzvetan; ROYDEV, Rumen

    2013-01-01

    The aim of the study was to identify predictors of mortality and to propose a new severity scoring system in dogs with acute abdominal syndrome. A retrospective study was carried out on 58 dogs presented with acute abdominal syndrome with American Society of Anesthesiologists grades III-IV and treated surgically by exploratory laparotomy. Medical records were reviewed and information regarding dog signalment, history, clinical, and laboratory data; surgical findings; and outcome was collected...

  3. Phenotypic variability of the kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA): clinical, molecular and biochemical delineation

    Science.gov (United States)

    2011-01-01

    Background The kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA) (OMIM 225400) is a rare inheritable connective tissue disorder characterized by a deficiency of collagen lysyl hydroxylase 1 (LH1; EC 1.14.11.4) due to mutations in PLOD1. Biochemically this results in underhydroxylation of collagen lysyl residues and, hence, an abnormal pattern of lysyl pyridinoline (LP) and hydroxylysyl pyridinoline (HP) crosslinks excreted in the urine. Clinically the disorder is characterized by hypotonia and kyphoscoliosis at birth, joint hypermobility, and skin hyperelasticity and fragility. Severe hypotonia usually leads to delay in gross motor development, whereas cognitive development is reported to be normal. Methods We describe the clinical, biochemical and molecular characterisation, as well as electron microscopy findings of skin, in 15 patients newly diagnosed with this rare type of Ehlers-Danlos syndrome. Results Age at diagnosis ranged from 5 months to 27 years, with only 1/3 of the patients been diagnosed correctly in the first year of life. A similar disease frequency was found in females and males, however a broad disease severity spectrum (intra- and interfamilial), independent of molecular background or biochemical phenotype, was observed. Kyphoscoliosis, one of the main clinical features was not present at birth in 4 patients. Importantly we also noted the occurrence of vascular rupture antenatally and postnatally, as well as developmental delay in 5 patients. Conclusion In view of these findings we propose that EDS VIA is a highly variable clinical entity, presenting with a broad clinical spectrum, which may also be associated with cognitive delay and an increased risk for vascular events. Genotype/phenotype association studies and additional molecular investigations in more extended EDS VIA populations will be necessary to further elucidate the cause of the variability of the disease severity. PMID:21699693

  4. Sociodemographic Variables, Clinical Features, and the Role of Preassessment Cross-Sex Hormones in Older Trans People.

    Science.gov (United States)

    Bouman, Walter Pierre; Claes, Laurence; Marshall, Ellen; Pinner, Gill T; Longworth, Julia; Maddox, Victoria; Witcomb, Gemma; Jimenez-Murcia, Susana; Fernandez-Aranda, Fernando; Arcelus, Jon

    2016-04-01

    As referrals to gender identity clinics have increased dramatically over the last few years, no studies focusing on older trans people seeking treatment are available. The aim of this study was to investigate the sociodemographic and clinical characteristics of older trans people attending a national service and to investigate the influence of cross-sex hormones (CHT) on psychopathology. Individuals over the age of 50 years old referred to a national gender identity clinic during a 30-month period were invited to complete a battery of questionnaires to measure psychopathology and clinical characteristics. Individuals on cross-sex hormones prior to the assessment were compared with those not on treatment for different variables measuring psychopathology. Sociodemographic and clinical variables and measures of depression and anxiety (Hospital Anxiety and Depression Scale), self-esteem (Rosenberg Self-Esteem Scale), victimization (Experiences of Transphobia Scale), social support (Multidimensional Scale of Perceived Social Support), interpersonal functioning (Inventory of Interpersonal Problems), and nonsuicidal self-injury (Self-Injury Questionnaire). The sex ratio of trans females aged 50 years and older compared to trans males was 23.7:1. Trans males were removed for the analysis due to their small number (n = 3). Participants included 71 trans females over the age of 50, of whom the vast majority were white, employed or retired, and divorced and had children. Trans females on CHT who came out as trans and transitioned at an earlier age were significantly less anxious, reported higher levels of self-esteem, and presented with fewer socialization problems. When controlling for socialization problems, differences in levels of anxiety but not self-esteem remained. The use of cross-sex hormones prior to seeking treatment is widespread among older trans females and appears to be associated with psychological benefits. Existing barriers to access CHT for older trans

  5. Phenotypic variability of the kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA: clinical, molecular and biochemical delineation

    Directory of Open Access Journals (Sweden)

    Kariminejad Ariana

    2011-06-01

    Full Text Available Abstract Background The kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA (OMIM 225400 is a rare inheritable connective tissue disorder characterized by a deficiency of collagen lysyl hydroxylase 1 (LH1; EC 1.14.11.4 due to mutations in PLOD1. Biochemically this results in underhydroxylation of collagen lysyl residues and, hence, an abnormal pattern of lysyl pyridinoline (LP and hydroxylysyl pyridinoline (HP crosslinks excreted in the urine. Clinically the disorder is characterized by hypotonia and kyphoscoliosis at birth, joint hypermobility, and skin hyperelasticity and fragility. Severe hypotonia usually leads to delay in gross motor development, whereas cognitive development is reported to be normal. Methods We describe the clinical, biochemical and molecular characterisation, as well as electron microscopy findings of skin, in 15 patients newly diagnosed with this rare type of Ehlers-Danlos syndrome. Results Age at diagnosis ranged from 5 months to 27 years, with only 1/3 of the patients been diagnosed correctly in the first year of life. A similar disease frequency was found in females and males, however a broad disease severity spectrum (intra- and interfamilial, independent of molecular background or biochemical phenotype, was observed. Kyphoscoliosis, one of the main clinical features was not present at birth in 4 patients. Importantly we also noted the occurrence of vascular rupture antenatally and postnatally, as well as developmental delay in 5 patients. Conclusion In view of these findings we propose that EDS VIA is a highly variable clinical entity, presenting with a broad clinical spectrum, which may also be associated with cognitive delay and an increased risk for vascular events. Genotype/phenotype association studies and additional molecular investigations in more extended EDS VIA populations will be necessary to further elucidate the cause of the variability of the disease severity.

  6. Logic Learning Machine and standard supervised methods for Hodgkin's lymphoma prognosis using gene expression data and clinical variables.

    Science.gov (United States)

    Parodi, Stefano; Manneschi, Chiara; Verda, Damiano; Ferrari, Enrico; Muselli, Marco

    2018-03-01

    This study evaluates the performance of a set of machine learning techniques in predicting the prognosis of Hodgkin's lymphoma using clinical factors and gene expression data. Analysed samples from 130 Hodgkin's lymphoma patients included a small set of clinical variables and more than 54,000 gene features. Machine learning classifiers included three black-box algorithms ( k-nearest neighbour, Artificial Neural Network, and Support Vector Machine) and two methods based on intelligible rules (Decision Tree and the innovative Logic Learning Machine method). Support Vector Machine clearly outperformed any of the other methods. Among the two rule-based algorithms, Logic Learning Machine performed better and identified a set of simple intelligible rules based on a combination of clinical variables and gene expressions. Decision Tree identified a non-coding gene ( XIST) involved in the early phases of X chromosome inactivation that was overexpressed in females and in non-relapsed patients. XIST expression might be responsible for the better prognosis of female Hodgkin's lymphoma patients.

  7. Incidence of temonera, sulphuhydryl variables and cefotaximase genes associated with β-lactamase producing escherichia coli in clinical isolates

    Science.gov (United States)

    Isaiah, Ibeh Nnana; Nche, Bikwe Thomas; Nwagu, Ibeh Georgina; Nwagu, Ibeh Isaiah

    2011-01-01

    Background: the occurrence of the different types of Extended spectrum beta Lactamase producing Escherichia coli with the, Sulphurhydryl variable, Temonera and the Cefotaximase have been on the rise Aim: The study was to determine the prevalence of extended spectrum beta lactamase gene resistance across the clinical isolates of hospitalized patients. Materials and Method: Three hundred and fifty isolates of Escherichia coli were received from different clinical specimens. The susceptibility profile of the isolates against 10 different antibiotics was examined, the MICs (Minimum Inhibitory Concentration) for ceftazidime were also determined using micro-broth dilution assay. Isolates showing MIC ≥ 6 μg/ml for ceftazidime were screened for ESBL (PCT)phenotypic confirmatory test and subjected to PCR (polymerase chain reaction) to further. Results: By disk diffusion test, there was resistance to ceftazidime and cefotaxime were 180(51.4%) and 120 (34.2%) respectively. However, all strains were susceptible to imipenem. 250 isolates showed MICs≥ 6 μg/ml for ceftazidime of which 180 (72%) were positive for extended spectrum beta lactamase. The prevalence of Sulphurhydryl variable, Temonera and the Cefotaximase among these isolates were 17.1%, 6.6% and 17%, respectively. Conclusion: For the identification of extended spectrum beta lactamase producing isolates it is recommended that clinical laboratories adopt simple test based on Cinical laboratory standard institute recommendation for confirming extended spectrum beta lactamase production in enterobacteriacea species. PMID:22363078

  8. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Rasmussen, Ase Krogh

    2011-01-01

    Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease...... has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated...... TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients....

  9. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Rasmussen, Ase Krogh

    2010-01-01

    Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease...... has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated...... TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients....

  10. An Examination of Some of the Cognitive and Motivation Variables Related to Gender Differences in Lecture Note-Taking

    Science.gov (United States)

    Reddington, Lindsay A.; Peverly, Stephen T.; Block, Caryn J.

    2015-01-01

    The primary purpose of this investigation was to explore if gender is related to note-taking in a large undergraduate sample (divided relatively evenly between males and females), and if it is, to examine the cognitive (handwriting speed, working memory, language comprehension) and motivation variables (conscientiousness and goal orientation) that…

  11. What Predicts Student Success in Introductory Data Management Classes? An Investigation of Demographic, Personality, Computer-Related, and Interaction Variables

    Science.gov (United States)

    Harris, Kenneth J.; Harris, Ranida B.; Lambert, Alysa D.

    2011-01-01

    Introduction to data management classes are often times students' first exposure to advanced material in these areas. Many factors are likely to influence success in these classes, but empirical investigations have focused on relatively few variables. In this study, we extend this research by examining the relative contributions of the previously…

  12. Clinical identification of the simple sleep-related movement disorders.

    Science.gov (United States)

    Walters, Arthur S

    2007-04-01

    Simple sleep-related movement disorders must be distinguished from daytime movement disorders that persist during sleep, sleep-related epilepsy, and parasomnias, which are generally characterized by activity that appears to be simultaneously complex, goal-directed, and purposeful but is outside the conscious awareness of the patient and, therefore, inappropriate. Once it is determined that the patient has a simple sleep-related movement disorder, the part of the body affected by the movement and the age of the patient give clues as to which sleep-related movement disorder is present. In some cases, all-night polysomnography with accompanying video may be necessary to make the diagnosis. Hypnic jerks (ie, sleep starts), bruxism, rhythmic movement disorder (ie, head banging/body rocking), and nocturnal leg cramps are discussed in addition to less well-appreciated disorders such as benign sleep myoclonus of infancy, excessive fragmentary myoclonus, and hypnagogic foot tremor/alternating leg muscle activation.

  13. Calibration of multivariate scatter plots for exploratory analysis of relations within and between sets of variables in genomic research.

    Science.gov (United States)

    Graffelman, Jan; van Eeuwijk, Fred

    2005-12-01

    The scatter plot is a well known and easily applicable graphical tool to explore relationships between two quantitative variables. For the exploration of relations between multiple variables, generalisations of the scatter plot are useful. We present an overview of multivariate scatter plots focussing on the following situations. Firstly, we look at a scatter plot for portraying relations between quantitative variables within one data matrix. Secondly, we discuss a similar plot for the case of qualitative variables. Thirdly, we describe scatter plots for the relationships between two sets of variables where we focus on correlations. Finally, we treat plots of the relationships between multiple response and predictor variables, focussing on the matrix of regression coefficients. We will present both known and new results, where an important original contribution concerns a procedure for the inclusion of scales for the variables in multivariate scatter plots. We provide software for drawing such scales. We illustrate the construction and interpretation of the plots by means of examples on data collected in a genomic research program on taste in tomato.

  14. The Dependence of Cloud Particle Size on Non-Aerosol-Loading Related Variables

    Energy Technology Data Exchange (ETDEWEB)

    Shao, H.; Liu, G.

    2005-03-18

    An enhanced concentration of aerosol may increase the number of cloud drops by providing more cloud condensation nuclei (CCN), which in turn results in a higher cloud albedo at a constant cloud liquid water path. This process is often referred to as the aerosol indirect effect (AIE). Many in situ and remote sensing observations support this hypothesis (Ramanathan et al. 2001). However, satellite observed relations between aerosol concentration and cloud drop size are not always in agreement with the AIE. Based on global analysis of cloud effective radius (r{sub e}) and aerosol number concentration (N{sub a}) derived from satellite data, Sekiguchi et al. (2003) found that the correlations between the two variables can be either negative, or positive, or none, depending on the location of the clouds. They discovered that significantly negative r{sub e} - N{sub a} correlation can only be identified along coastal regions of the continents where abundant continental aerosols inflow from land, whereas Feingold et al. (2001) found that the response of r{sub e} to aerosol loading is the greatest in the region where aerosol optical depth ({tau}{sub a}) is the smallest. The reason for the discrepancy is likely due to the variations in cloud macroscopic properties such as geometrical thickness (Brenguier et al. 2003). Since r{sub e} is modified not only by aerosol but also by cloud geometrical thickness (H), the correlation between re and {tau}{sub a} actually reflects both the aerosol indirect effect and dependence of H. Therefore, discussing AIE based on the r{sub e}-{tau}{sub a} correlation without taking into account variations in cloud geometrical thickness may be misleading. This paper is motivated to extract aerosols' effect from overall effects using the independent measurements of cloud geometrical thickness, {tau}{sub a} and r{sub e}.

  15. Microscale profiling of photosynthesis-related variables in a highly productive biofilm photobioreactor.

    Science.gov (United States)

    Li, Tong; Piltz, Bastian; Podola, Björn; Dron, Anthony; de Beer, Dirk; Melkonian, Michael

    2016-05-01

    In the present study depth profiles of light, oxygen, pH and photosynthetic performance in an artificial biofilm of the green alga Halochlorella rubescens in a porous substrate photobioreactor (PSBR) were recorded with microsensors. Biofilms were exposed to different light intensities (50-1,000 μmol photons m(-2) s(-1) ) and CO2 levels (0.04-5% v/v in air). The distribution of photosynthetically active radiation showed almost identical trends for different surface irradiances, namely: a relatively fast drop to a depth of about 250 µm, (to 5% of the incident), followed by a slower decrease. Light penetrated into the biofilm deeper than the Lambert-Beer Law predicted, which may be attributed to forward scattering of light, thus improving the overall light availability. Oxygen concentration profiles showed maxima at a depth between 50 and 150 μm, depending on the incident light intensity. A very fast gas exchange was observed at the biofilm surface. The highest oxygen concentration of 3.2 mM was measured with 1,000 μmol photons m(-2) s(-1) and 5% supplementary CO2. Photosynthetic productivity increased with light intensity and/or CO2 concentration and was always highest at the biofilm surface; the stimulating effect of elevated CO2 concentration in the gas phase on photosynthesis was enhanced by higher light intensities. The dissolved inorganic carbon concentration profiles suggest that the availability of the dissolved free CO2 has the strongest impact on photosynthetic productivity. The results suggest that dark respiration could explain previously observed decrease in growth rate over cultivation time in this type of PSBR. Our results represent a basis for understanding the complex dynamics of environmental variables and metabolic processes in artificial phototrophic biofilms exposed to a gas phase and can be used to improve the design and operational parameters of PSBRs. © 2015 Wiley Periodicals, Inc.

  16. The Nature of Global Large-scale Sea Level Variability in Relation to Atmospheric Forcing: A Modeling Study

    Science.gov (United States)

    Fukumori, I.; Raghunath, R.; Fu, L. L.

    1996-01-01

    The relation between large-scale sea level variability and ocean circulation is studied using a numerical model. A global primitive equaiton model of the ocean is forced by daily winds and climatological heat fluxes corresponding to the period from January 1992 to February 1996. The physical nature of the temporal variability from periods of days to a year, are examined based on spectral analyses of model results and comparisons with satellite altimetry and tide gauge measurements.

  17. A period-luminosity relation for Mira variables in globular clusters and its impact on the distance scale

    International Nuclear Information System (INIS)

    Menzies, J.W.; Whitelock, P.A.

    1985-01-01

    JHKL photometry is presented for 31 red variables in 15 galactic globular clusters. The photometry of the Mira variables is used to find absolute bolometric magnitudes and an Msub(bol)-log P relation which differs from the one found for LMC Miras. This can be understood only if there is some systematic error in the globular cluster and/or LMC distance scales or if there is some fundamental difference between the cluster Miras and those in the LMC. (author)

  18. Clinical Implications of Residual Urine in Korean Benign Prostatic Hyperplasia (BPH) Patients: A Prognostic Factor for BPH-Related Clinical Events.

    Science.gov (United States)

    Ko, Young Hwii; Chae, Ji Yun; Jeong, Seung Min; Kang, Jae Il; Ahn, Hong Jae; Kim, Hyung Woo; Kang, Sung Gu; Jang, Hoon Ah; Cheon, Jun; Kim, Je Jong; Lee, Jeong Gu

    2010-12-01

    Although post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI). From January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266). Group 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11. These data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.

  19. Undergraduate nursing students' experience related to their clinical learning environment and factors affecting to their clinical learning process.

    Science.gov (United States)

    Arkan, Burcu; Ordin, Yaprak; Yılmaz, Dilek

    2018-03-01

    Clinical education is an essential part of nursing education. The purpose of this study was to explore nurse students' experiences related to cinical learning environments, factors effecting to clinical learning process. Descriptive qualitative design was used in this study, and data were collected from 2nd class nursing student (n = 14). The study took the form of in-depth interviews between August-October 2015. The qualitative interviews were analyzed by using simple content analysis. Data were analyzed manually. Experiences nurse students are described five themes. The themes of the study are (1) effecting persons to clinical learning, (2) educational atmosphere, (3) students' personal charactering, (4) the impact of education in school, and (5) students' perceptions related to clinical learning. Participants stated that they experienced many difficulties during clinical learning process. All students importantly stated that nurse teacher is very effecting to clinical learning. This study contributes to the literature by providing data on beginner nursing student' experiences about clinical learning process. The data of this present study show to Turkish nursing student is affecting mostly from persons in clinical learning. The data of this present study will guide nurse teacher when they plan to interventions to be performed to support student during clinical learning process. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Clinical, molecular, and pharmacological aspects of FMR1 related disorders.

    Science.gov (United States)

    Pugin, A; Faundes, V; Santa María, L; Curotto, B; Aliaga, S; Salas, I; Soto, P; Bravo, P; Peña, M I; Alliende, M A

    2017-05-01

    Fragile X syndrome, the most common inherited cause of intellectual disability, is associated with a broad spectrum of disorders across different generations of a single family. This study reviews the clinical manifestations of fragile X-associated disorders as well as the spectrum of mutations of the fragile X mental retardation 1 gene (FMR1) and the neurobiology of the fragile X mental retardation protein (FMRP), and also provides an overview of the potential therapeutic targets and genetic counselling. This disorder is caused by expansion of the CGG repeat (>200 repeats) in the 5 prime untranslated region of FMR1, resulting in a deficit or absence of FMRP. FMRP is an RNA-binding protein that regulates the translation of several genes that are important in synaptic plasticity and dendritic maturation. It is believed that CGG repeat expansions in the premutation range (55 to 200 repeats) elicit an increase in mRNA levels of FMR1, which may cause neuronal toxicity. These changes manifest clinically as developmental problems such as autism and learning disabilities as well as neurodegenerative diseases including fragile X-associated tremor/ataxia syndrome (FXTAS). Advances in identifying the molecular basis of fragile X syndrome may help us understand the causes of neuropsychiatric disorders, and they will probably contribute to development of new and specific treatments. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Urban-Related Environmental Variables and Their Relation with Patterns in Biological Community Structure in the Fountain Creek Basin, Colorado, 2003-2005

    Science.gov (United States)

    Zuellig, Robert E.; Bruce, James F.; Evans, Erin E.; Stogner, Sr., Robert W.

    2007-01-01

    In 2003, the U.S. Geological Survey, in cooperation with Colorado Springs City Engineering, began a study to evaluate the influence of urbanization on stream ecosystems. To accomplish this task, invertebrate, fish, stream discharge, habitat, water-chemistry, and land-use data were collected from 13 sites in the Fountain Creek basin from 2003 to 2005. The Hydrologic Index Tool was used to calculate hydrologic indices known to be related to urbanization. Response of stream hydrology to urbanization was evident among hydrologic variables that described stormflow. These indices included one measurement of high-flow magnitude, two measurements of high-flow frequency, and one measurement of stream flashiness. Habitat and selected nonstormflow water chemistry were characterized at each site. Land-use data were converted to estimates of impervious surface cover and used as the measure of urbanization annually. Correlation analysis (Spearman?s rho) was used to identify a suite of nonredundant streamflow, habitat, and water-chemistry variables that were strongly associated (rho > 0.6) with impervious surface cover but not strongly related to elevation (rho analysis (BIO-ENV, PRIMER ver 6.1, Plymouth, UK) was used to create subsets of eight urban-related environmental variables that described patterns in biological community structure. The strongest and most parsimonious subset of variables describing patterns in invertebrate community structure included high flood pulse count, lower bank capacity, and nutrients. Several other combinations of environmental variables resulted in competing subsets, but these subsets always included the three variables found in the most parsimonious list. This study found that patterns in invertebrate community structure from 2003 to 2005 in the Fountain Creek basin were associated with a variety of environmental characteristics influenced by urbanization. These patterns were explained by a combination of hydrologic, habitat, and water

  2. Time variability of C-reactive protein: implications for clinical risk stratification.

    Directory of Open Access Journals (Sweden)

    Peter Bogaty

    Full Text Available C-reactive protein (CRP is proposed as a screening test for predicting risk and guiding preventive approaches in coronary artery disease (CAD. However, the stability of repeated CRP measurements over time in subjects with and without CAD is not well defined. We sought to determine the stability of serial CRP measurements in stable subjects with distinct CAD manifestations and a group without CAD while carefully controlling for known confounders.We prospectively studied 4 groups of 25 stable subjects each 1 a history of recurrent acute coronary events; 2 a single myocardial infarction ≥7 years ago; 3 longstanding CAD (≥7 years that had never been unstable; 4 no CAD. Fifteen measurements of CRP were obtained to cover 21 time-points: 3 times during one day; 5 consecutive days; 4 consecutive weeks; 4 consecutive months; and every 3 months over the year. CRP risk threshold was set at 2.0 mg/L. We estimated variance across time-points using standard descriptive statistics and Bayesian hierarchical models.Median CRP values of the 4 groups and their pattern of variability did not differ substantially so all subjects were analyzed together. The median individual standard deviation (SD CRP values within-day, within-week, between-weeks and between-months were 0.07, 0.19, 0.36 and 0.63 mg/L, respectively. Forty-six percent of subjects changed CRP risk category at least once and 21% had ≥4 weekly and monthly CRP values in both low and high-risk categories.Considering its large intra-individual variability, it may be problematic to rely on CRP values for CAD risk prediction and therapeutic decision-making in individual subjects.

  3. Variability of disease activity in patients treated with ranibizumab for neovascular age-related macular degeneration.

    Science.gov (United States)

    Enders, P; Scholz, P; Muether, P S; Fauser, S

    2016-08-01

    PurposeTo analyze choroidal neovasularization (CNV) activity and recurrence patterns in patients with neovascular age-related macular degeneration (nAMD) treated with ranibizumab, and the correlation with individual intraocular vascular endothelial growth factor (VEGF) suppression time (VST).MethodsPost-hoc analysis of data from a prospective, non-randomized clinical study. Patients with nAMD treated with ranibizumab on a pro re nata regimen. Disease activity was analyzed monthly by spectral-domain optical coherence tomography and correlated with VSTs.ResultsOverall, 73 eyes of 73 patients were included in the study with a mean follow-up of 717 days (range: 412-1239 days). Overall, the mean CNV-activity-free interval was 76.5 days (range: 0-829 days). The individual range of the length of dry intervals was high. A total of 42% of patients had a range of more than 90 days. Overall, 16% of patients showed persistent activity. And 12% stayed dry after the initial ranibizumab treatment. No significant correlation was found between the CNV-recurrence pattern and VST (P=0.12).ConclusionsCNV activity in nAMD is irregular, which is reflected in the range of the duration of dry intervals and late recurrences. The biomarker VST solely seems not to be sufficient to explain recurrence pattern of CNV in all AMD patients.

  4. Lower heart rate variability is associated with cancer-related fatigue in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Alexandra Dupont

    2012-09-01

    Full Text Available Background : Fatigue is the most common and distressing symptom reported by breast cancer survivors and yet the pathophysiology of cancer-related fatigue remains largely unknown. Fatigue is associated with lower parasympathetic and higher sympathetic nervous system activity in non-cancer samples, but only one study has demonstrated this same relationship in breast cancer survivors. This study evaluates the relationship between fatigue and basal autonomic nervous system activity as measured by heart rate variability (HRV in a sample of breast cancer survivors. Methods : Women who had been diagnosed with early stage breast cancer before the age of 50 were recruited from the UCLA tumor registry and completed psychological questionnaires, including measures of fatigue. A subset of these women (n=30 participated in a follow-up study in which they completed measures of fatigue, energy and mood four times per day for 5 days using electronic diaries, provided 3 days of saliva samples for cortisol assessment and underwent physiological assessment including electrocardiogram (ECG. HRV was assessed via ECG R-R wave spectral and time sequence analysis. Results : Questionnaire measures of fatigue were negatively associated with indices of parasympathetic nervous system activity, B= − 3.85, p = 0.04 for RMSSD (root of the mean squared difference of successive normal to normal waves and B= − 76.97, p = 0.04 for LF power % (low-frequency wave power percentage. Daily fatigue was also associated with lower basal HRV, B= − 15.1, p = 0.04 for RMSSD. However, fatigue indices were not associated with sympathetic nervous system activity as measured by low- to high-frequency wave ratio. Of note, fatigue was not associated with average daily cortisol output (AUC. Conclusions : Lower HRV has been associated with increased chronic inflammation, which is elevated in cancer survivors reporting persistent fatigue, thus providing insight into

  5. Tramadol effects on clinical variables and the mechanical nociceptive threshold in horses

    OpenAIRE

    Franco,Leandro Guimarães; Moreno,Juan Carlos Duque; Teixeira Neto,Antônio Raphael; Souza,Moisés Caetano e; Silva,Luiz Antônio Franco da

    2014-01-01

    This study assessed the clinical effects and the mechanical antinociceptive potential of intravenous (IV) tramadol in horses.A blinded and randomized study was designed with 7 horses treated with 1 (Tr1), 2 (Tr2) or 3 (Tr3) mg kg-1 of tramadol IV. The heart rate, respiratory rate (fR), arterial pressure, degree of sedation, gastrointestinal motility (GI), behavior changes and the mechanical nociceptive threshold (MNT) were evaluated. The MNT was determined with von Frey device method.Tr3 had ...

  6. Malignant otitis externa: Variability of clinical course and difficulties of diagnostics

    Directory of Open Access Journals (Sweden)

    Janićijević Miloš

    2014-01-01

    Full Text Available This paper shows the case of a 70-year-old diabetic patient who was admitted to the ORL and MFS clinic as an emergency case with the right ear otalgia, in the right mastoid extension, facialis paralysis and the right ear suppuration all of which lasted for a month before the hospitalization. On admission, the initial diagnostics stated canal skin edema of the external hearing canal which made the eardrum impossible to visualize. Granulations at the bottom of the canal were visible. During the admission, the patient was submitted to conservative and surgical treatments which confirmed that it was the case of malignant otitis externa.

  7. The Impact of Clinical and Cognitive Variables on Social Functioning in Parkinson's Disease: Patient versus Examiner Estimates

    Directory of Open Access Journals (Sweden)

    Patrick McNamara

    2010-01-01

    Results. Patients' estimates of their own social functioning were not significantly different from examiners' estimates. The impact of clinical variables on social functioning in PD revealed depression to be the strongest association of social functioning in PD on both the patient and the examiner version of the Social Adaptation Self-Evaluation Scale. Conclusions. PD patients appear to be well aware of their social strengths and weaknesses. Depression and motor symptom severity are significant predictors of both self- and examiner reported social functioning in patients with PD. Assessment and treatment of depression in patients with PD may improve social functioning and overall quality of life.

  8. Assessing Factors Related to Waist Circumference and Obesity: Application of a Latent Variable Model

    OpenAIRE

    Dalvand, Sahar; Koohpayehzadeh, Jalil; Karimlou, Masoud; Asgari, Fereshteh; Rafei, Ali; Seifi, Behjat; Niksima, Seyed Hassan; Bakhshi, Enayatollah

    2015-01-01

    Background. Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults. Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variabl...

  9. Relations estimate between investment in digital media and financial variables of companies: a Colombian overview

    OpenAIRE

    Amalia Novoa Hoyos; Mauricio Sabogal Salamanca; Camilo Vargas Walteros

    2016-01-01

    This article shows a first estimate about the relationship between investment in digital media and some financial variables in Colombia. First, a literature review is made about the impact of marketing and digital marketing in Company performance. Then, an analysis of the sectorial variables such as liquidity, profitability, indebtedness and concentration in sectors like food, personal grooming, automotive, drinking and tobacco, construction, entertainment, furniture, services, telecommunicat...

  10. Clinical Signs, Staphylococcus and Atopic Eczema-Related Seromarkers

    Directory of Open Access Journals (Sweden)

    Kam Lun Hon

    2017-02-01

    Full Text Available Childhood eczema or atopic dermatitis (AD is a distressing disease associated with pruritus, sleep disturbance, impaired quality of life and Staphylococcus aureus isolation. The pathophysiology of AD is complex and various seromarkers of immunity are involved. We investigated if anti-staphylococcal enterotoxin IgE (anti-SE, selected seromarkers of T regulatory (Treg, T helper (Th and antigen-presenting cells (APC are associated with clinical signs of disease severity and quality of life. Disease severity was assessed with the Scoring Atopic Dermatitis (SCORAD index, and quality of life with the Children’s Dermatology Life Quality Index (CDLQI in AD patients ≤18 years old. Concentrations of anti-staphylococcus enterotoxin A and B immunoglobulin E (anti-SEA and anti-SEB, selected Treg/Th/APC chemokines, skin hydration and transepidermal water loss (TEWL were measured in these patients. Forty patients with AD [median (interquartile range age of 13.1 (7.9 years were recruited. Backward stepwise linear regression (controlling for age, personal allergic rhinitis and asthma, and other blood markers showed the serum anti-SEB level was positively associated with S. aureus and S. epidermidis isolations, objective SCORAD, clinical signs and CDLQI. TNF-α (a Th1 cytokine was positively associated with objective SCORAD (B = 4.935, p = 0.010, TGF-β (a Treg cytokine negatively with disease extent (B = −0.015, p = 0.001, IL-18 (an APC cytokine positively with disease extent (B = 0.438, p = 0.001 and with TEWL (B = 0.040, p = 0.010, and IL-23 (an APC cytokine negatively with disease extent (B = −2.812, p = 0.006 and positively with pruritus (B = 0.387, p = 0.007. Conclusions: Blood levels of anti-SEB, Th1, Treg and APC cytokines are correlated with various clinical signs of AD. AD is a systemic immunologic disease involving Staphylococcus aureus, cellular, humoral, cytokine and chemokine pathophysiology.

  11. Exploratory factor analysis for differentiating sensory and mechanical variables related to muscle-tendon unit elongation

    Directory of Open Access Journals (Sweden)

    Mauro H. Chagas

    2016-01-01

    Full Text Available ABSTRACT Background Stretching exercises are able to promote adaptations in the muscle-tendon unit (MTU, which can be tested through physiological and biomechanical variables. Identifying the key variables in MTU adaptations is crucial to improvements in training. Objective To perform an exploratory factor analysis (EFA involving the variables often used to evaluate the response of the MTU to stretching exercises. Method Maximum joint range of motion (ROMMAX, ROM at first sensation of stretching (FSTROM, peak torque (torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy were investigated in 36 participants during passive knee extension on an isokinetic dynamometer. Stiffness and energy values were normalized by the muscle cross-sectional area and their passive mode assured by monitoring the EMG activity. Results EFA revealed two major factors that explained 89.68% of the total variance: 53.13% was explained by the variables torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy, whereas the remaining 36.55% was explained by the variables ROMMAX and FSTROM. Conclusion This result supports the literature wherein two main hypotheses (mechanical and sensory theories have been suggested to describe the adaptations of the MTU to stretching exercises. Contrary to some studies, in the present investigation torqueMAX was significantly correlated with the variables of the mechanical theory rather than those of the sensory theory. Therefore, a new approach was proposed to explain the behavior of the torqueMAX during stretching exercises.

  12. Tramadol effects on clinical variables and the mechanical nociceptive threshold in horses

    Directory of Open Access Journals (Sweden)

    Leandro Guimarães Franco

    2014-03-01

    Full Text Available This study assessed the clinical effects and the mechanical antinociceptive potential of intravenous (IV tramadol in horses.A blinded and randomized study was designed with 7 horses treated with 1 (Tr1, 2 (Tr2 or 3 (Tr3 mg kg-1 of tramadol IV. The heart rate, respiratory rate (fR, arterial pressure, degree of sedation, gastrointestinal motility (GI, behavior changes and the mechanical nociceptive threshold (MNT were evaluated. The MNT was determined with von Frey device method.Tr3 had a significant increase in their fR and more pronounced behavioral changes than other treatments.The Tr1 showed a significant increase in arterial pressure. The GI reduced significantly, mainly in Tr2. The tramadol did not change the MNT of the horses.The clinical alterations observed with the different treatments were considered mild and transitory, being most evident in Tr2. However the tramadol did not have any analgesic effect with any of the doses evaluated.

  13. Description, evaluation and clinical decision making according to various fetal heart rate patterns. Inter-observer and regional variability

    DEFF Research Database (Denmark)

    Lidegaard, O; Bøttcher, L M; Weber, Tom

    1992-01-01

    departments, especially between departments far apart. It is concluded that we still need a scientific clarification of which specific heart rate changes are the best predictors of fetal stress. Artificial intelligence programs for interpreting fetal cardiotocograms and ECG signals constitute one promising......At 10 Danish obstetrical departments, 116 residents (42 senior and 74 junior) participated in a study to assess inter-observer and regional variability in the description and evaluation of and clinical decision regarding 11 fetal heart rate patterns. The 11 traces included normal as well...... as pathological patterns, and normal as well as clinically asphyxiated babies. Five antepartum and six intrapartum patterns were included. A total of 1,276 descriptions and evaluations were obtained. The degree of agreement in description of fetal heart rate changes was high regarding the baseline...

  14. How to ascertain drug related deaths during clinical trials ?

    Science.gov (United States)

    Lele, R D

    2013-10-01

    Recent guidelines by the Drug Controller General of India require extra care by Investigators & Sponsors of Clinical Trials in India. The author, an eminent member & Chairman of various Independent Ethics Committees in Mumbai, proposes various concrete solutions for adherence to these guidelines. Insurance cover to the subjects, use of Internet databanks for drug interactions, active involvement by the pharmacologists in Ethics Committee, review of data from animal studies, being amongst them. In case of death due to trial, autopsies, or at least verbal autopsies, are essential in the interest of Science and Law. More importantly Anticipation and prevention of ADEs can be done by exclusion of subjects from trials by using newer technologies like cDNA in microarrays to determine several polygenic quantitative trait loci (QTLs) and tests for Single Nucleotide Polymorphisms (SNPs). Drug manufacturers must provide prototypes of Affymetrix chips to clinicians and bear the cost in their own enlightened self-interest.

  15. [Forensic psychiatry. Its relations to clinical psychiatry and criminology].

    Science.gov (United States)

    Kröber, H-L

    2005-11-01

    A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.

  16. Perceived family-related stressors and clinical manifestations of ...

    African Journals Online (AJOL)

    These symptoms vary in individuals, usually multiple and affect different body parts. Studies have shown that stress relating to health, work and financial ... but association with pattern and extent of PSM has not been widely studied in Nigeria. ... disorder- patient health questionnaire somatoform, anxiety and depression ...

  17. Cerebral venous thrombosis in Saudi Arabia. Clinical variables, response to treatment, and outcome

    International Nuclear Information System (INIS)

    Kajtazi, Naim I; Arulneyam, Jayanthi C; AlSenani, Fahmi M; Zimmerman, Valerie A; AlShami, Sadiq Y

    2009-01-01

    To investigate cerebral venous thrombosis (CVTR) clinical presentations, risk factors, and response to treatment in Saudi Arabia. Retrospective analysis of the King Farad Medical City, Riyadh, acute stroke database from April 2005 through February 2008 revealed 22 patients with CVTR. Hyper coagulable work-up and neuroimaging were performed. Sixteen patients were female (72.7%), and the median age was 35 years. Clinical presentations included: headache (77.3%), seizures (54.5%), focal neurological signs (54.5%), and decreased level of consciousness (50%). Over two-thirds (n=11; 69%) of female patients had a history of oral contraceptive use, which was the most common risk factor. Protein S deficiency (n=3), anti phospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n=1), rhinocerebral mucormycosis (n=1), leukemia (n=1), non-Hodgkin's lymphoma (n=1), sepsis (n=1), and unknown (n=6) were causes. Affected areas included superior sagittal (n=13), transverse (n=16), sigmoid (n=14), straight (n=6), and cavernous sinus (n=1); internal cerebral vein (n=2); vein of Galen (n=3); cortical veins (n=10); and internal jugular vein (n=12). Two patients had quadriparesis, and 2 patients died. The remainder (n=18, 81.8%) improved. Bilateral hemorrhagic presentation or venous infarction, deep venous system thrombosis, and underlying malignancy had less favorable results. Presentations in our series were similar to those in other reports, although altered consciousness and seizures were more common. Cortical vein involvement was also higher than commonly reported. Oral contraceptive use was a primary risk factor in female patients. Outcomes were favorable in 81.8% of patients. (author)

  18. Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables

    Directory of Open Access Journals (Sweden)

    Laura MUNTEAN

    2009-12-01

    Full Text Available Objective: To evaluate bone mineral density (BMD in patients with ankylosing spondylitis (AS and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA. Using the modified Schober’s test we assessed spine mobility. We examined the sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

  19. Clinical Variability in Cardiovascular Disease Risk Factor Screening and Management in Adolescent and Young Adult Women with Polycystic Ovary Syndrome.

    Science.gov (United States)

    Baer, Tamara E; Milliren, Carly E; Walls, Courtney; DiVasta, Amy D

    2015-10-01

    To review the clinical presentation, evaluation, and management of normal-weight (NW), overweight (OW), and obese (OB) adolescent and young adult women with polycystic ovary syndrome (PCOS) during a 2-year follow-up. Retrospective chart review. One hundred seventy-three adolescent and young adult women, aged 12-22 years, diagnosed with PCOS. Demographic, health data, and laboratory measures were abstracted from 3 clinic visits: baseline and 1- and 2-year follow-up. Subjects were classified as NW, OW, or OB. Longitudinal data were analyzed using repeated-measures analysis of variance. Body mass index, self-reported concerns, and lifestyle changes. Most patients (73%) were OW or OB. Family history of type 2 diabetes was greater in OW (38%) and OB (53%) patients compared with NW (22%) patients (P = .002). Acanthosis nigricans was identified in OW (62%) and OB (21%) patients but not in NW patients (0%; P insulin (P PCOS were OW or OB. Substantial clinical variability existed in cardiovascular disease (CVD) screening; among those screened, OW and OB patients had greater CVD risk factors. Despite self-reported concerns about weight and diabetes risk among OW and OB patients, no clinically significant change in body mass index percentile occurred. Evidence-based interventions and recommendations for screening tests are needed to address CVD risk in adolescents and young adults with PCOS. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  20. [Cross-sectional study of the variability of work-related stress among post-graduate medical residents at the main University Polyclinic of Sicily].

    Science.gov (United States)

    Costantino, Claudio; Albeggiani, Valentina; Bonfante, Maria Stefania; Monte, Caterina; Lo Cascio, Nunzio; Mazzucco, Walter

    2015-02-10

    Among health care workers (HCWs), work-related stress is one of the main topics in risk assessment and prevention at the workplace. Post-graduate medical residents (MRs) are a group of HCWs comparable to medical doctors in terms of occupational exposure and occurrence of work-related stress syndromes. Risk assessment of work-related stress among MRs attending the major University Hospital of Sicily. A cross-sectional survey via an anonymous and self-administered questionnaire. 45% of clinical MRs and 37% of surgical MRs had access to compensatory rest days against 92% of MRs of the services area (p<0.001). A work attendance recording system for MRs was available in 80% of the postgraduate medical schools of the services area, in 60% of the clinical postgraduate schools and in 50% of the surgical postgraduate schools (p<0.001). MRs of the postgraduate surgical schools reported having access to work breaks (41%) with less frequency compared to clinical (60%) and services MRs (74%) (p<0.001). Both clinical (47%) and surgical MRs (47%) were more exposed to work-related stress than MRs of the services area (27%) (p<0.001). The survey demonstrated excess exposure to work-related stress for all the considered variables in MRs of the surgical area, compared with MRs of clinical and services areas. It is strongly recommended to provide specific training programmes aimed at managing the MRs' risk of exposure to work-related stress, focusing both on the workers and the work environment.

  1. Cytogenetic, clinical, and cytologic characteristics of radiotherapy-related leukemias

    International Nuclear Information System (INIS)

    Philip, P.; Pedersen-Bjergaard, J.

    1988-01-01

    From 1978 to 1985, we observed eight cases of acute nonlymphocytic leukemia or preleukemia, three cases of acute lymphoblastic leukemia, and three cases of chronic myeloid leukemia in patients previously treated exclusively with radiotherapy for other tumor types. The latent period from administration of radiotherapy to development of leukemia varied between 12 and 243 months. Clonal chromosome aberrations reported previously as characteristic of acute nonlymphocytic leukemia following therapy with alkylating agents were observed in three of the eight patients with acute nonlymphocytic leukemia (5q- and -7) and in two of the three patients with acute lymphoblastic leukemia (-7 and 12p-). All three patients with radiotherapy-related chronic myeloid leukemia presented a t(9;22)(q34;q11). The results suggest that cytogenetic characteristics may reflect the etiology in radiation-induced acute leukemias, whereas radiation-related chronic myeloid leukemia does not seem to differ chromosomally from de novo cases of the disease

  2. IgG4-RELATED DISEASE. CLINICAL NOTES

    Directory of Open Access Journals (Sweden)

    Vladimir Ivanovich Vasilyev

    2013-01-01

    Full Text Available IgG4-related diseases are a new nosological entity that encompasses a few previously known diseases. IgG4-related systemic disease is diagnosed if two or more affected organs are detected. This group of diseases has two similar signs: serological (elevated serum IgG4 subclass concentrations and histological (organ and tissue infiltration from plasmo-cytes secreting IgG4, and eosinophils, and the development of fibrosclerosis and phlebitis obliterans. The paper describes two cases. In one case, a multisystemic disease was observed virtually at its onset whereas in the other this lesion was diagnosed several years after the natural course of the disease.

  3. Reporting and evaluation of HIV-related clinical endpoints in two multicenter international clinical trials

    DEFF Research Database (Denmark)

    Lifson, A; Rhame, F; Bellosa, W

    2006-01-01

    adjudication between reviewers before diagnostic certainty was assigned. CONCLUSION: Important requirements for HIV trials using clinical endpoints include objective definitions of "confirmed" and "probable," a formal reporting process with adequate information and supporting source documentation, evaluation......PURPOSE: The processes for reporting and review of progression of HIV disease clinical endpoints are described for two large phase III international clinical trials. METHOD: SILCAAT and ESPRIT are multicenter randomized HIV trials evaluating the impact of interleukin-2 on disease progression...... and death in HIV-infected patients receiving antiretroviral therapy. We report definitions used for HIV progression of disease endpoints, procedures for site reporting of such events, processes for independent review of reported events by an Endpoint Review Committee (ERC), and the procedure...

  4. Variable effects of climate on forest growth in relation to climate extremes, disturbance, and forest dynamics

    Science.gov (United States)

    Itter, Malcolm S.; Finley, Andrew O.; D'Amato, Anthony W.; Foster, Jane R.; Bradford, John B.

    2017-01-01

    Changes in the frequency, duration, and severity of climate extremes are forecast to occur under global climate change. The impacts of climate extremes on forest productivity and health remain difficult to predict due to potential interactions with disturbance events and forest dynamics—changes in forest stand composition, density, size and age structure over time. Such interactions may lead to non-linear forest growth responses to climate involving thresholds and lag effects. Understanding how forest dynamics influence growth responses to climate is particularly important given stand structure and composition can be modified through management to increase forest resistance and resilience to climate change. To inform such adaptive management, we develop a hierarchical Bayesian state space model in which climate effects on tree growth are allowed to vary over time and in relation to past climate extremes, disturbance events, and forest dynamics. The model is an important step toward integrating disturbance and forest dynamics into predictions of forest growth responses to climate extremes. We apply the model to a dendrochronology data set from forest stands of varying composition, structure, and development stage in northeastern Minnesota that have experienced extreme climate years and forest tent caterpillar defoliation events. Mean forest growth was most sensitive to water balance variables representing climatic water deficit. Forest growth responses to water deficit were partitioned into responses driven by climatic threshold exceedances and interactions with insect defoliation. Forest growth was both resistant and resilient to climate extremes with the majority of forest growth responses occurring after multiple climatic threshold exceedances across seasons and years. Interactions between climate and disturbance were observed in a subset of years with insect defoliation increasing forest growth sensitivity to water availability. Forest growth was particularly

  5. Variable effects of climate on forest growth in relation to climate extremes, disturbance, and forest dynamics.

    Science.gov (United States)

    Itter, Malcolm S; Finley, Andrew O; D'Amato, Anthony W; Foster, Jane R; Bradford, John B

    2017-06-01

    Changes in the frequency, duration, and severity of climate extremes are forecast to occur under global climate change. The impacts of climate extremes on forest productivity and health remain difficult to predict due to potential interactions with disturbance events and forest dynamics-changes in forest stand composition, density, size and age structure over time. Such interactions may lead to non-linear forest growth responses to climate involving thresholds and lag effects. Understanding how forest dynamics influence growth responses to climate is particularly important given stand structure and composition can be modified through management to increase forest resistance and resilience to climate change. To inform such adaptive management, we develop a hierarchical Bayesian state space model in which climate effects on tree growth are allowed to vary over time and in relation to past climate extremes, disturbance events, and forest dynamics. The model is an important step toward integrating disturbance and forest dynamics into predictions of forest growth responses to climate extremes. We apply the model to a dendrochronology data set from forest stands of varying composition, structure, and development stage in northeastern Minnesota that have experienced extreme climate years and forest tent caterpillar defoliation events. Mean forest growth was most sensitive to water balance variables representing climatic water deficit. Forest growth responses to water deficit were partitioned into responses driven by climatic threshold exceedances and interactions with insect defoliation. Forest growth was both resistant and resilient to climate extremes with the majority of forest growth responses occurring after multiple climatic threshold exceedances across seasons and years. Interactions between climate and disturbance were observed in a subset of years with insect defoliation increasing forest growth sensitivity to water availability. Forest growth was particularly

  6. Development of a relational database to capture and merge clinical history with the quantitative results of radionuclide renography.

    Science.gov (United States)

    Folks, Russell D; Savir-Baruch, Bital; Garcia, Ernest V; Verdes, Liudmila; Taylor, Andrew T

    2012-12-01

    Our objective was to design and implement a clinical history database capable of linking to our database of quantitative results from (99m)Tc-mercaptoacetyltriglycine (MAG3) renal scans and export a data summary for physicians or our software decision support system. For database development, we used a commercial program. Additional software was developed in Interactive Data Language. MAG3 studies were processed using an in-house enhancement of a commercial program. The relational database has 3 parts: a list of all renal scans (the RENAL database), a set of patients with quantitative processing results (the Q2 database), and a subset of patients from Q2 containing clinical data manually transcribed from the hospital information system (the CLINICAL database). To test interobserver variability, a second physician transcriber reviewed 50 randomly selected patients in the hospital information system and tabulated 2 clinical data items: hydronephrosis and presence of a current stent. The CLINICAL database was developed in stages and contains 342 fields comprising demographic information, clinical history, and findings from up to 11 radiologic procedures. A scripted algorithm is used to reliably match records present in both Q2 and CLINICAL. An Interactive Data Language program then combines data from the 2 databases into an XML (extensible markup language) file for use by the decision support system. A text file is constructed and saved for review by physicians. RENAL contains 2,222 records, Q2 contains 456 records, and CLINICAL contains 152 records. The interobserver variability testing found a 95% match between the 2 observers for presence or absence of ureteral stent (κ = 0.52), a 75% match for hydronephrosis based on narrative summaries of hospitalizations and clinical visits (κ = 0.41), and a 92% match for hydronephrosis based on the imaging report (κ = 0.84). We have developed a relational database system to integrate the quantitative results of MAG3 image

  7. Impact of environmental chemicals, sociodemographic variables, depression, and clinical indicators of health and nutrition on self-reported health status

    Science.gov (United States)

    Public health researchers ideally integrate social, environmental, and clinical measures to identify predictors of poor health. Chemicals measured in human tissues are often evaluated in relation to intangible or rare health outcomes, or are studied one chemical at a time. Using ...

  8. Clinical and molecular characterization of duplications encompassing the human SHOX gene reveal a variable effect on stature.

    Science.gov (United States)

    Thomas, N Simon; Harvey, John F; Bunyan, David J; Rankin, Julia; Grigelioniene, Giedre; Bruno, Damien L; Tan, Tiong Y; Tomkins, Susan; Hastings, Robert

    2009-07-01

    Deletions of the SHOX gene are well documented and cause disproportionate short stature and variable skeletal abnormalities. In contrast interstitial SHOX duplications limited to PAR1 appear to be very rare and the clinical significance of the only case report in the literature is unclear. Mapping of this duplication has now shown that it includes the entire SHOX gene but little flanking sequence and so will not encompass any of the long-range enhancers required for SHOX transcription. We now describe the clinical and molecular characterization of three additional cases. The duplications all included the SHOX coding sequence but varied in the amount of flanking sequence involved. The probands were ascertained for a variety of reasons: hypotonia and features of Asperger syndrome, Leri-Weill dyschondrosteosis (LWD), and a family history of cleft palate. However, the presence of a duplication did not correlate with any of these features or with evidence of skeletal abnormality. Remarkably, the proband with LWD had inherited both a SHOX deletion and a duplication. The effect of the duplications on stature was variable: height appeared to be elevated in some carriers, particularly in those with the largest duplications, but was still within the normal range. SHOX duplications are likely to be under ascertained and more cases need to be identified and characterized in detail in order to accurately determine their phenotypic consequences.

  9. Agreement between clinical estimation and a new quantitative analysis by Photoshop software in fundus and angiographic image variables.

    Science.gov (United States)

    Ramezani, Alireza; Ahmadieh, Hamid; Azarmina, Mohsen; Soheilian, Masoud; Dehghan, Mohammad H; Mohebbi, Mohammad R

    2009-12-01

    To evaluate the validity of a new method for the quantitative analysis of fundus or angiographic images using Photoshop 7.0 (Adobe, USA) software by comparing with clinical evaluation. Four hundred and eighteen fundus and angiographic images of diabetic patients were evaluated by three retina specialists and then by computing using Photoshop 7.0 software. Four variables were selected for comparison: amount of hard exudates (HE) on color pictures, amount of HE on red-free pictures, severity of leakage, and the size of the foveal avascular zone (FAZ). The coefficient of agreement (Kappa) between the two methods in the amount of HE on color and red-free photographs were 85% (0.69) and 79% (0.59), respectively. The agreement for severity of leakage was 72% (0.46). In the two methods for the evaluation of the FAZ size using the magic and lasso software tools, the agreement was 54% (0.09) and 89% (0.77), respectively. Agreement in the estimation of the FAZ size by the lasso magnetic tool was excellent and was almost as good in the quantification of HE on color and on red-free images. Considering the agreement of this new technique for the measurement of variables in fundus images using Photoshop software with the clinical evaluation, this method seems to have sufficient validity to be used for the quantitative analysis of HE, leakage, and FAZ size on the angiograms of diabetic patients.

  10. THE RELATIVE IMPORTANCE OF FINANCIAL RATIOS AND NONFINANCIAL VARIABLES IN PREDICTING OF INSOLVENCY

    Directory of Open Access Journals (Sweden)

    Ivica Pervan

    2013-02-01

    Full Text Available One of the most important decisions in every bank is approving loans to firms, which is based on evaluated credit risk and collateral. Namely, it is necessary to evaluate the risk that client will be unable to repay the obligations according to the contract. After Beaver's (1967 and Altman's (1968 seminal papers many authors extended the initial research by changing the methodology, samples, countries, etc. But majority of business failure papers as predictors use financial ratios, while in the real life banks combine financial and nonfinancial variables. In order to test predictive power of nonfinancial variables authors in the paper compare two insolvency prediction models. The first model that used financial rations resulted with classification accuracy of 82.8%, while the combined model with financial and nonfinancial variables resulted with classification accuracy of 88.1%.

  11. CDKL5-Related Disorders: From Clinical Description to Molecular Genetics.

    Science.gov (United States)

    Bahi-Buisson, N; Bienvenu, T

    2012-04-01

    Mutations in the cyclin-dependent kinase-like 5 gene (CDKL5) have been described in girls with Rett-like features and early-onset epileptic encephalopathy including infantile spasms. To date, with more than 80 reported cases, the phenotype of CDKL5-related encephalopathy is better defined. The main features consist of early-onset seizures starting before 5 months of age, severe mental retardation with absent speech and Rett-like features such as hand stereotypies and deceleration of head growth. On the other hand, neuro-vegetative signs and developmental regression are rare in CDKL5 mutation patients. The CDKL5 gene encodes a serine threonine kinase protein which is characterized by a catalytic domain and a long C-terminal extension involved in the regulation of the catalytic activity of CDKL5 and in the sub-nuclear localization of the protein. To our knowledge, more than 70 different point mutations have been described including missense mutations within the catalytic domain, nonsense mutations causing the premature termination of the protein distributed in the entire open reading frame, splice variants, and frameshift mutations. Additionally, CDKL5 mutations have recently been described in 7 males with a more severe epileptic encephalopathy and a worse outcome compared to female patients. Finally, about 23 male and female patients have been identified with gross rearrangements encompassing all or part of the CDKL5 gene, with a phenotype reminiscent of CDKL5-related encephalopathy combined with dysmorphic features. Even if recent data clearly indicate that CDKL5 plays an important role in brain function, the protein remains largely uncharacterized. Phenotype-genotype correlation is additionally hampered by the relatively small number of patients described.

  12. WEATHE- RELATED VARIABILITY OF CALORIMETERY PERFORMANCE IN A POORLY-CONTROLLED ENVIRONMENT

    International Nuclear Information System (INIS)

    CAMERON, M.A.

    2007-01-01

    Four Antech airbath calorimeters at the Hanford site were studied for three summers and two winters in a location not well-shielded from outside temperature changes. All calorimeters showed significant increases in variability of standard measurements during hot weather. The increased variability is postulated to be due to a low setting of the Peltier cold face temperature, which doesn't allow the instrument to drain heat fast enough in a hot environment. A higher setting of the Peltier cold face might lead to better performance in environments subjected to a broad range of temperatures

  13. Relations estimate between investment in digital media and financial variables of companies: a Colombian overview

    Directory of Open Access Journals (Sweden)

    Amalia Novoa Hoyos

    2016-06-01

    Full Text Available This article shows a first estimate about the relationship between investment in digital media and some financial variables in Colombia. First, a literature review is made about the impact of marketing and digital marketing in Company performance. Then, an analysis of the sectorial variables such as liquidity, profitability, indebtedness and concentration in sectors like food, personal grooming, automotive, drinking and tobacco, construction, entertainment, furniture, services, telecommunication, tourism and clothing using the technique of ordinary squared minimums (OSM in the years 2011, 2012, 2013 and 2014. For this study, investment in digital media in the above- mentioned years is also taken into account.

  14. [Common variable immunodeficiency: Clinical and immunological characterization of patients and homogeneous subgroup definition by means of B lymphocyte subpopulation typing].

    Science.gov (United States)

    Vélez, Alejandra Catalina; Castaño, Diana María; Gómez, Rubén Darío; Orrego, Julio César; Moncada, Marcela; Franco, José Luis

    2015-01-01

    Common variable immunodeficiency is a heterogeneous syndrome characterized by recurrent infections, hypogammaglobulinemia and defective production of specific antibodies. Abnormalities in peripheral blood lymphocyte subpopulations, in particular of B lymphocytes, allow the classification of patients into homogeneous groups. To perform a clinical and immunological characterization and to evaluate lymphocyte subpopulations of twelve Colombian patients with common variable immunodeficiency in order to define homogeneous groups. We reviewed medical records and evaluated serum immunoglobulins (Ig), lymphoproliferation, delayed hypersensitivity and used flow cytometry to quantify peripheral blood total lymphocyte and B cell populations. All patients had recurrent respiratory and/or gastrointestinal infections, while some also had infections affecting other systems. All patients had abnormally low serum IgG levels, while IgA and IgM levels were reduced in nine and ten patients, respectively. Lymphoproliferation to mitogen was lower in patients than in healthy controls but lymphoproliferation to specific antigen was normal in all. Flow cytometry revealed high numbers of T cells in three patients, while seven had a low CD4+/CD8+ ratio and four had reduced NK cells . Eleven patients had normal B cell counts, and eight of them also showed decreased memory B lymphocytes, and four had increased transitional or CD21 low B lymphocytes. Lymphocyte typing allowed assigning all but one patient to homogeneous groups according to international classification schemes, indicating the necessity of including more criteria until an ideal classification is achieved. This study will lead to a better medical monitoring of common variable immunodeficiency patients in groups at high risk of developing clinical complications.

  15. Variability of intraductal papillomas of the mammary gland: Clinical, roentgenologic and morphologic investigations

    International Nuclear Information System (INIS)

    Rummel, W.

    1974-01-01

    The radiodiagnostical method of choice is the galactographic technique. However, a specific X-ray image of the papilloma does not exist. The galactographic technique has to be adapted to the surgical and histologic one. Only by combining these three techniques good results can be achieved. It is not possible to draw conclusions from the colour of the pathologic discharge about the type and character of the pathologic process. Contrary to the findings documented in the literature, we were able to diagnose with our technique not only small tumours, but also tumours situated in the periphery of the lactiferous duct. Because of our investigations it is no longer possible to maintain and keep the strict division of the proliferative changes occurring at the lactiferous duct walls. In this study, the most significant morphologic results are described in detail. In all patients with pathologic discharge of the mammary gland, the so-called papillo-carcinoma was found only in one case. As clinical consequence it has therefore to be demanded that in all women with the symptom of pathologic mamillary discharge first of all the origin of this discharge has to be localised by means of galactography. Only the individual morphologic picture of a proliferative change of the lactiferous duct provides some prognostic value. The prerequisites for such an individual assessment are differentiated roentgenologic, surgical and histological techniques. (orig./MG) [de

  16. Experimental Cowpox Virus (CPXV) Infections of Bank Voles: Exceptional Clinical Resistance and Variable Reservoir Competence.

    Science.gov (United States)

    Franke, Annika; Ulrich, Rainer G; Weber, Saskia; Osterrieder, Nikolaus; Keller, Markus; Hoffmann, Donata; Beer, Martin

    2017-12-19

    Cowpox virus (CPXV) is a zoonotic virus and endemic in wild rodent populations in Eurasia. Serological surveys in Europe have reported high prevalence in different vole and mouse species. Here, we report on experimental CPXV infections of bank voles ( Myodes glareolus ) from different evolutionary lineages with a spectrum of CPXV strains. All bank voles, independently of lineage, sex and age, were resistant to clinical signs following CPXV inoculation, and no virus shedding was detected in nasal or buccal swabs. In-contact control animals became only rarely infected. However, depending on the CPXV strain used, inoculated animals seroconverted and viral DNA could be detected preferentially in the upper respiratory tract. The highest antibody titers and virus DNA loads in the lungs were detected after inoculation with two strains from Britain and Finland. We conclude from our experiments that the role of bank voles as an efficient and exclusive CPXV reservoir seems questionable, and that CPXV may be maintained in most regions by other hosts, including other vole species. Further investigations are needed to identify factors that allow and modulate CPXV maintenance in bank voles and other potential reservoirs, which may also influence spill-over infections to accidental hosts.

  17. Genital tuberculosis in postmenopausal women with variable clinical presentations: A report of 3 cases

    Directory of Open Access Journals (Sweden)

    Ashima Arora

    2018-04-01

    Full Text Available Genital tuberculosis is usually diagnosed in young women being assessed for infertility. After menopause it usually presents with symptoms resembling endometrial malignancy, such as postmenopausal bleeding, persistent vaginal discharge and pyometra. The diagnosis is made by detection of acid-fast bacilli on microscopy or bacteriological culture and/or presence of epithelioid granuloma on biopsy. Anti-tubercular therapy involves the use of rifampicin, isoniazid, pyrazinamide and ethambutol. Surgery is indicated if a pelvic mass and recurrence of pain or bleeding persist after 9 months of treatment. Three cases of genital tuberculosis in postmenopausal women with different clinical presentations are reported. The first woman presented with ascites and weight loss. The second had postmenopausal bleeding with a pipelle biopsy suggestive of endometrial intraepithelial neoplasia. The third presented with weight loss and a palpable abdominal mass. Pelvic malignancy was initially suspected but a diagnosis of tuberculosis was made following pre-operative endometrial biopsy, bacteriological culture and intra-operative frozen section. All three women responded to anti-tubercular therapy. Keywords: Genital tuberculosis, Postmenopausal, Endometrial intraepithelial neoplasia, Anti-tubercular therapy, Endometrial biopsy

  18. Clinical and Individual Variables in Children's Dental Fear: A School-Based Investigation.

    Science.gov (United States)

    Silveira, Ethieli Rodrigues da; Goettems, Marília Leão; Demarco, Flávio Fernando; Azevedo, Marina Sousa

    2017-01-01

    This cross-sectional study evaluated the prevalence of dental fear and associated factors in schoolchildren aged 8 to 12 years old, in Pelotas, southern Brazil. Schoolchildren enrolled in 20 public and private schools were selected using a multi-stage sample design. Sociodemographic characteristics, children's dental visit and oral hygiene habits were assessed by questionnaires. The Dental Anxiety Question was used to measure dental fear prevalence. Children's clinical examination evaluated presence of dental caries (DMFT/dmft index) and gingival bleeding. Data were analyzed using Poisson regression with robust variance (prevalence ratio; 95% confidence interval). One thousand two hundred and two children were included. Dental fear prevalence was 24.6%. After the adjustment, girls [PR=1.71 (CI 95%: 1.31-2.22)], children from poorer families [PR=1.96 (CI 95%: 1.36-2.83)], those who had decayed teeth (D/d index>0)[PR=1.32 (CI 95%: 1.01-1.72), and who had never been at the dentist [PR=1.85 (CI 95%: 1.42-2.41) remained significantly associated with dental fear. The prevalence of dental fear indicates that it is a common problem among schoolchildren. Early dental care and dental caries prevention are important factors to prevent dental fear.

  19. Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

    NARCIS (Netherlands)

    Zaal, R.J.; Jansen, M.; Duisenberg-van Essenberg, M.; C.C., Tijssen; Roukema, J.A.; van den Bemt, P.M.

    2013-01-01

    Background Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective study.

  20. Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

    NARCIS (Netherlands)

    R.J. Zaal (Rianne); M.M.P.M. Jansen (Mark M. P.); M. Duisenberg-Van Essenberg (Marjolijn); C.C. Tijssen (Cees); J.A. Roukema; P.M.L.A. van den Bemt (Patricia)

    2013-01-01

    textabstractBackground Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective

  1. Correlates of adolescent sleep time and variability in sleep time: the role of individual and health related characteristics.

    Science.gov (United States)

    Moore, Melisa; Kirchner, H Lester; Drotar, Dennis; Johnson, Nathan; Rosen, Carol; Redline, Susan

    2011-03-01

    Adolescents are predisposed to short sleep duration and irregular sleep patterns due to certain host characteristics (e.g., age, pubertal status, gender, ethnicity, socioeconomic class, and neighborhood distress) and health-related variables (e.g., ADHD, asthma, birth weight, and BMI). The aim of the current study was to investigate the relationship between such variables and actigraphic measures of sleep duration and variability. Cross-sectional study of 247 adolescents (48.5% female, 54.3% ethnic minority, mean age of 13.7years) involved in a larger community-based cohort study. Significant univariate predictors of sleep duration included gender, minority ethnicity, neighborhood distress, parent income, and BMI. In multivariate models, gender, minority status, and BMI were significantly associated with sleep duration (all pminority adolescents, and those of a lower BMI obtaining more sleep. Univariate models demonstrated that age, minority ethnicity, neighborhood distress, parent education, parent income, pubertal status, and BMI were significantly related to variability in total sleep time. In the multivariate model, age, minority status, and BMI were significantly related to variability in total sleep time (all pminority adolescents, and those of a lower BMI obtaining more regular sleep. These data show differences in sleep patterns in population sub-groups of adolescents which may be important in understanding pediatric health risk profiles. Sub-groups that may particularly benefit from interventions aimed at improving sleep patterns include boys, overweight, and minority adolescents. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Family functioning in bipolar disorder: Characteristics, congruity between patients and relatives, and clinical correlates.

    Science.gov (United States)

    Reinares, María; Bonnín, C Mar; Hidalgo-Mazzei, Diego; Colom, Francesc; Solé, Brisa; Jiménez, Esther; Torrent, Carla; Comes, Mercè; Martínez-Arán, Anabel; Sánchez-Moreno, José; Vieta, Eduard

    2016-11-30

    Functional improvement has become one of the aims of the treatment of bipolar disorder. However, scant attention has been given to family functioning, even though it has a role in the illness outcome and is affected by the disorder. The aims of this study were to compare family functioning reported by euthymic patients with bipolar disorder and healthy controls; explore the level of congruence in the perception of family environment between patients with bipolar disorder and their relatives; and analyse the relationship between clinical variables and family functioning. The sample comprised 82 adult euthymic subjects with bipolar disorder, 82 family caregivers of these patients and 47 healthy controls. Participants completed the Family Environment Scale. Results showed moderate correlations and a mean pattern almost identical between relatives' and patients' reported scores in family functioning subscales. There were significant differences between patients and controls, favourable for the latter, in the subscales cohesion (pbipolar disorder and highlight the importance of family work. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Estimating relations between temperature, relative humidity as independed variables and selected water quality parameters in Lake Manzala, Egypt

    Directory of Open Access Journals (Sweden)

    Gehan A.H. Sallam

    2018-03-01

    Full Text Available In Egypt, Lake Manzala is the largest and the most productive lake of northern coastal lakes. In this study, the continuous measurements data of the Real Time Water Quality Monitoring stations in Lake Manzala were statistically analyzed to measure the regional and seasonal variations of the selected water quality parameters in relation to the change of air temperature and relative humidity. Simple formulas are elaborated using the DataFit software to predict the selected water quality parameters of the Lake including pH, Dissolved Oxygen (DO, Electrical Conductivity (EC, Total Dissolved Solids (TDS, Turbidity, and Chlorophyll as a function of air temperature, relative humidity and quantities and qualities of the drainage water that discharge into the lake. An empirical positive relation was found between air temperature and the relative humidity and pH, EC and TDS and negative relation with DO. There is no significant effect on the other two parameters of turbidity and chlorophyll.

  4. Variability of bio-clinical parameters in Chinese-origin Rhesus macaques infected with simian immunodeficiency virus: a nonhuman primate AIDS model.

    Directory of Open Access Journals (Sweden)

    Song Chen

    Full Text Available BACKGROUND: Although Chinese-origin Rhesus macaques (Ch RhMs infected with simian immunodeficiency virus (SIV have been used for many years to evaluate the efficacy of AIDS vaccines and therapeutics, the bio-clinical variability of such a nonhuman primate AIDS model was so far not established. METHODOLOGY/PRINCIPAL FINDINGS: By randomizing 150 (78 male and 72 female Ch RhMs with diverse MHC class I alleles into 3 groups (50 animals per group challenged with intrarectal (i.r. SIVmac239, intravenous (i.v. SIVmac239, or i.v. SIVmac251, we evaluated variability in bio-clinical endpoints for 118 weeks. All SIV-challenged Ch RhMs became seropositive for SIV during 1-2 weeks. Plasma viral load (VL peaked at weeks 1-2 and then declined to set-point levels as from week 5. The set-point VL was 30 fold higher in SIVmac239 (i.r. or i.v.-infected than in SIVmac251 (i.v.-infected animals. This difference in plasma VL increased overtime (>100 fold as from week 68. The rates of progression to AIDS or death were more rapid in SIVmac239 (i.r. or i.v.-infected than in SIVmac251 (i.v.-infected animals. No significant difference in bio-clinical endpoints was observed in animals challenged with i.r. or i.v. SIVmac239. The variability (standard deviation in peak/set-point VL was nearly one-half lower in animals infected with SIVmac239 (i.r. or i.v. than in those infected with SIVmac251 (i.v., allowing that the same treatment-related difference can be detected with one-half fewer animals using SIVmac239 than using SIVmac251. CONCLUSION/SIGNIFICANCE: These results provide solid estimates of variability in bio-clinical endpoints needed when designing studies using the Ch RhM SIV model and contribute to the improving quality and standardization of preclinical studies.

  5. Removable denture-related oral mucosal lesions: descriptive clinical study

    Directory of Open Access Journals (Sweden)

    Gökçen Akçiçek

    2017-05-01

    Full Text Available Objective: The aim of this study was to investigate whether there was a relationship between removable denture-related oral mucosal lesions and denture type, and demographic characteristics. Materials and Method: The age, sex, denture type, systemic condition and medication use, presence of denture-related oral mucosal lesions (DROML, their locations and patients’ awareness of above mentioned lesions were recorded for 199 patients. Pearson chi-square test was used to analyse the relationship between the DROML and denture type, and demographic characteristics of the patients. Results: Among the patients included to the study, 122 (61.3% were female and 77 (38.7% were male. Ninety-six patients (48.2% exhibited DROML, whereas 103 patients (51.8% had no DROML. No relationship was detected between DROML and age, and sex (p>0.05. The most commonly detected DROML was denture stomatitis (34.7%. Denture stomatitis was significantly more frequently seen in partial denture wearers (p<0.05, while epulis fissuratum and flabby ridge were statistically more frequent in complete denture wearers (p<0.001. Traumatic ulcer was more frequently found in mandibular complete denture wearers (p<0.05, while epulis fissuratum and flabby ridge were significantly more common in maxillary complete denture wearers (p<0.001. Among the patients with DROML, 57.3% stated that they were unaware of these lesions. Conclusion: In this study sample, the rate of DROML was high in patients wearing removable dentures (48.2%, and more than half of the patients with DROML were not aware of these lesions. Upon these findings, it is considered that removable denture wearers should follow the denture usage instructions and should be informed about the importance of periodic controls.

  6. The Correlation between Clinical Variables and Sleep Onset Rapid Eye Movement Period Frequencies in Narcoleptic Patients

    Directory of Open Access Journals (Sweden)

    Jin Hwa Jeong

    2010-11-01

    Full Text Available Background and Objective A diagnosis of narcolepsy is defined by less than 8 minutes of mean sleep latency, and two or more sleep onset rapid eye movement periods on the Multiple Sleep Latency Test. This study examined the relationship between the sleep onset rapid eye movement period frequencies during Multiple Sleep Latency Test and narcoleptic symptom severity. Methods From March 2004 to August 2009, 126 patients suffering from excessive daytime sleepiness who visited the Sleep Disorders Clinic of St. Vincent’s Hospital at the Catholic University of Korea were tested by polysomnography and Multiple Sleep Latency Test. Subjects were divided into three groups according to the number of sleep onset rapid eye movement periods that appeared on the Multiple Sleep Latency Test. Symptom severity instruments included the Epworth Sleepiness Scale and the Stanford Center for Narcolepsy Sleep Inventory, and various sleep parameters. In addition, we performed human leukocyte antigen genotyping for human leukocyte antigen-DQB1*0602 on all patients. Results Among the three groups classified by the number of sleep onset rapid eye movement periods during Multiple Sleep Latency Test, we found no significant differences in demographic features, Epworth Sleepiness Scale, and most polysomnographic findings. However, we observed cataplexy, hypnagogic hallucination, sleep paralysis, and human leukocyte antigen-DQB1*0602 positivity more frequently in groups with higher sleep onset rapid eye movement period frequencies. In addition, the proportions of stage II sleep, REM sleep latency from polysomnography, and mean sleep latency and mean REM sleep latency from the Multiple Sleep Latency Test significantly decreased with increasing sleep onset rapid eye movement period frequency. Conclusions In this study, we demonstrated that sleep onset rapid eye movement period frequency during Multiple Sleep Latency Test correlated with sleep architecture, daytime symptom

  7. Risk adjustment models for interhospital comparison of CS rates using Robson's ten group classification system and other socio-demographic and clinical variables.

    Science.gov (United States)

    Colais, Paola; Fantini, Maria P; Fusco, Danilo; Carretta, Elisa; Stivanello, Elisa; Lenzi, Jacopo; Pieri, Giulia; Perucci, Carlo A

    2012-06-21

    Caesarean section (CS) rate is a quality of health care indicator frequently used at national and international level. The aim of this study was to assess whether adjustment for Robson's Ten Group Classification System (TGCS), and clinical and socio-demographic variables of the mother and the fetus is necessary for inter-hospital comparisons of CS rates. The study population includes 64,423 deliveries in Emilia-Romagna between January 1, 2003 and December 31, 2004, classified according to theTGCS. Poisson regression was used to estimate crude and adjusted hospital relative risks of CS compared to a reference category. Analyses were carried out in the overall population and separately according to the Robson groups (groups I, II, III, IV and V-X combined). Adjusted relative risks (RR) of CS were estimated using two risk-adjustment models; the first (M1) including the TGCS group as the only adjustment factor; the second (M2) including in addition demographic and clinical confounders identified using a stepwise selection procedure. Percentage variations between crude and adjusted RRs by hospital were calculated to evaluate the confounding effect of covariates. The percentage variations from crude to adjusted RR proved to be similar in M1 and M2 model. However, stratified analyses by Robson's classification groups showed that residual confounding for clinical and demographic variables was present in groups I (nulliparous, single, cephalic, ≥37 weeks, spontaneous labour) and III (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, spontaneous labour) and IV (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, induced or CS before labour) and to a minor extent in groups II (nulliparous, single, cephalic, ≥37 weeks, induced or CS before labour) and IV (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, induced or CS before labour). The TGCS classification is useful for inter-hospital comparison of CS section rates, but

  8. Ankle torque steadiness is related to muscle activation variability and coactivation in children with cerebral palsy

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Rose, Martin Høyer; Sløk, Rikke

    2009-01-01

    The aims of this study were to: (1) investigate the significance of muscle activation variability and coactivation for the ability to perform steady submaximal ankle torque (torque steadiness) in healthy children and those with cerebral palsy (CP), and (2) assess ankle function during isometric...

  9. Intraindividual variability is related to cognitive change in older adults: evidence for within-person coupling.

    Science.gov (United States)

    Bielak, Allison A M; Hultsch, David F; Strauss, Esther; MacDonald, Stuart W S; Hunter, Michael A

    2010-09-01

    In this study, the authors addressed the longitudinal nature of intraindividual variability over 3 years. A sample of 304 community-dwelling older adults, initially between the ages of 64 and 92 years, completed 4 waves of annual testing on a battery of accuracy- and latency-based tests covering a wide range of cognitive complexity. Increases in response-time inconsistency on moderately and highly complex tasks were associated with increasing age, but there were significant individual differences in change across the entire sample. The time-varying covariation between cognition and inconsistency was significant across the 1-year intervals and remained stable across both time and age. On occasions when intraindividual variability was high, participants' cognitive performance was correspondingly low. The strength of the coupling relationship was greater for more fluid cognitive domains such as memory, reasoning, and processing speed than for more crystallized domains such as verbal ability. Variability based on moderately and highly complex tasks provided the strongest prediction. These results suggest that intraindividual variability is highly sensitive to even subtle changes in cognitive ability. (c) 2010 APA, all rights reserved.

  10. Varieties of attention-deficit/hyperactivity disorder-related intra-individual variability

    NARCIS (Netherlands)

    Castellanos, F.X.; Sonuga-Barke, E.J.S.; Scheres, A.P.J.; Martino, A. Di; Hyde, C.; Walters, J.R.

    2005-01-01

    Intra-individual variability in behavior and functioning is ubiquitous among children with attention-deficit/hyperactivity disorder (ADHD), but it has not been systematically examined or integrated within causal models. This article seeks to provide a conceptual, methodologic, and analytic framework

  11. Confidence Intervals for a Semiparametric Approach to Modeling Nonlinear Relations among Latent Variables

    Science.gov (United States)

    Pek, Jolynn; Losardo, Diane; Bauer, Daniel J.

    2011-01-01

    Compared to parametric models, nonparametric and semiparametric approaches to modeling nonlinearity between latent variables have the advantage of recovering global relationships of unknown functional form. Bauer (2005) proposed an indirect application of finite mixtures of structural equation models where latent components are estimated in the…

  12. Net primary productivity of subalpine meadows in Yosemite National Park in relation to climate variability

    Science.gov (United States)

    Peggy E. Moore; Jan W. van Wagtendonk; Julie L. Yee; Mitchel P. McClaran; David N. Cole; Neil K. McDougald; Matthew L. Brooks

    2013-01-01

    Subalpine meadows are some of the most ecologically important components of mountain landscapes, and primary productivity is important to the maintenance of meadow functions. Understanding how changes in primary productivity are associated with variability in moisture and temperature will become increasingly important with current and anticipated changes in climate....

  13. A class of constitutive relations with internal variable derivatives. Derivation from homogenization and initial value problem

    International Nuclear Information System (INIS)

    Andrieux, S.; Joussemet, M.; Lorentz, E.

    1996-01-01

    A general framework for deriving and using a class of constitutive laws incorporating spatial gradients of internal variables is presented. It uses two basic ingredients: a derivation of such models by homogenization techniques and a reformulation of the evolution equation at the scale of the whole structure. (orig.)

  14. Conventional clinical and prognostic variables in 150 oral squamous cell carcinoma cases from the indigenous population of Karachi.

    Science.gov (United States)

    Alamgir, Muhammad Mohiuddin; Jamal, Qamar; Mirza, Talat

    2016-01-01

    To analyze clinical and prognostic variables of Oral Squamous Cell Carcinoma (OSCC) cases from the indigenous population of Karachi and to correlate with the common risk factor of tobacco habit. The study was conducted at Ziauddin University, Karachi. One hundred fifty OSCC cases were collected from the Oncology Department of Ziauddin University Hospital, North Nazimabad, Karachi and Otolaryngology ward of Civil Hospital, Karachi, during 2011 and 2015. The reporting included demographic details and variables like intra-oral subsites, clinical stage and histological grade. Recurrence of tumor after initial resection was also documented. The patient's population comprised of 98 males and 52 females. The mean age was 47.1± 12.22 (range:20-78 years). Maximum numbers were seen in the 41-50 years age group. Urdu-speaking community was the most affected ethnic group (n=75). Clinico-pathological analysis revealed that majority of cases were moderately differentiated (59%) and were either clinical stage II (35%) or IV (29%) tumors. The most common intra-oral subsite came out to be buccal mucosa of cheeks (56%) followed by lateral borders of tongue (21%), lips (13%), alveolar (6%), palate (2.6%) floor of mouth (1.3%), etc. Recurrence was observed in 08 out of 150 cases. All patients underwent primary resection±neck dissection and reconstruction where possible. Overall experience with oral squamous cell carcinoma shows that it has a high tendency for local invasion as well as dissemination to regional lymph nodes, i.e. cervical lymph nodes, both are associated with a poor prognosis. Preventable risk factor of tobacco chewing has been observed in majority of these cases.

  15. Accuracy, calibration and clinical performance of the EuroSCORE: can we reduce the number of variables?

    Science.gov (United States)

    Ranucci, Marco; Castelvecchio, Serenella; Menicanti, Lorenzo; Frigiola, Alessandro; Pelissero, Gabriele

    2010-03-01

    The European system for cardiac operative risk evaluation (EuroSCORE) is currently used in many institutions and is considered a reference tool in many countries. We hypothesised that too many variables were included in the EuroSCORE using limited patient series. We tested different models using a limited number of variables. A total of 11150 adult patients undergoing cardiac operations at our institution (2001-2007) were retrospectively analysed. The 17 risk factors composing the EuroSCORE were separately analysed and ranked for accuracy of prediction of hospital mortality. Seventeen models were created by progressively including one factor at a time. The models were compared for accuracy with a receiver operating characteristics (ROC) analysis and area under the curve (AUC) evaluation. Calibration was tested with Hosmer-Lemeshow statistics. Clinical performance was assessed by comparing the predicted with the observed mortality rates. The best accuracy (AUC 0.76) was obtained using a model including only age, left ventricular ejection fraction, serum creatinine, emergency operation and non-isolated coronary operation. The EuroSCORE AUC (0.75) was not significantly different. Calibration and clinical performance were better in the five-factor model than in the EuroSCORE. Only in high-risk patients were 12 factors needed to achieve a good performance. Including many factors in multivariable logistic models increases the risk for overfitting, multicollinearity and human error. A five-factor model offers the same level of accuracy but demonstrated better calibration and clinical performance. Models with a limited number of factors may work better than complex models when applied to a limited number of patients. Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  16. Relationship between perceived social support and clinical variables in infertile couples

    Directory of Open Access Journals (Sweden)

    Nurdan Eren BODUR

    2013-04-01

    Full Text Available In this study it was aimed to assess and evaluate the impact of the levels of perceived social support in infertile couples on stress related with infertility and marital adjustment. The study included 104 couples with primary or secondary infertility and 44 healthy couples with children for the control group. Control group was given the Hospital Anxiety Depression Scale (HADS, Dyadic Adjustment Scale (DAS and Multidimensional Scale of Perceived Social Support (MSPSS. Infertile group was given HADS, DAS, MSPSS and also Fertility Problem Inventory. Women in infertile couples reported greater psychological symptoms and more decreased marital adjustment than men in infertile couples; but the couples did not show any significant difference with those in control groups regarding these parameters. It was determined that, in general, while marital adjustment in infertile couples increases, depression and anxiety levels decrease. It was also observed that perceieved social support from the family has a positive effect on the marital adjustment. The perceived social support level in men in infertil couples is lower than women in the same group, and this outcome is also related with the increasing anxiety in men. These results showed that psychosocial problems in infertile couples should be evaluated with specific scales. Psychosocial support which will be given to infertile couples and motivating social support systems while providing this service would have positive effects especially on men. [Cukurova Med J 2013; 38(2.000: 214-223

  17. Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

    Science.gov (United States)

    Stucchi, Giulia; Battevi, Natale; Pandolfi, Monica; Galinotti, Luca; Iodice, Simona; Favero, Chiara

    2018-02-01

    Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.

  18. Clinical variability of Waardenburg-Shah syndrome in patients with proximal 13q deletion syndrome including the endothelin-B receptor locus.

    Science.gov (United States)

    Tüysüz, Beyhan; Collin, Anna; Arapoğlu, Müjde; Suyugül, Nezir

    2009-10-01

    Waardenburg-Shah syndrome (Waardenburg syndrome type IV-WS4) is an auditory-pigmentary disorder that combines clinical features of pigmentary abnormalities of the skin, hair and irides, sensorineural hearing loss, and Hirschsprung disease (HSCR). Mutations in the endothelin-B receptor (EDNRB) gene on 13q22 have been found to cause this syndrome. Mutations in both alleles cause the full phenotype, while heterozygous mutations cause isolated HSCR or HSCR with minor pigmentary anomalies and/or sensorineural deafness. We investigated the status of the EDNRB gene, by FISH analysis, in three patients with de novo proximal 13q deletions detected at cytogenetic analysis and examined the clinical variability of WS4 among these patients. Chromosome 13q was screened with locus specific FISH probes and breakpoints were determined at 13q22.1q31.3 in Patients 1 and 3, and at 13q21.1q31.3 in Patient 2. An EDNRB specific FISH probe was deleted in all three patients. All patients had common facial features seen in proximal 13q deletion syndrome and mild mental retardation. However, findings related to WS4 were variable; Patient 1 had hypopigmentation of the irides and HSCR, Patient 2 had prominent bicolored irides and mild bilateral hearing loss, and Patient 3 had only mild unilateral hearing loss. These data contribute new insights into the pathogenesis of WS4.

  19. Variability in clinical prevalence of PaV1 in Caribbean spiny lobsters occupying commercial casitas over a large bay in Mexico.

    Science.gov (United States)

    Candia-Zulbarán, Rebeca I; Briones-Fourzán, Patricia; Negrete-Soto, Fernando; Barradas-Ortiz, Cecilia; Lozano-Álvarez, Enrique

    2012-08-27

    In Bahía de la Ascensión, Mexico, the fishery for spiny lobsters Panulirus argus is based on the extensive use of casitas, large artificial shelters that can harbor the full size range of these highly gregari